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Year 3 - OSCE Cardio - Imperial > ECGs > Flashcards

ECGs Flashcards

1
Q

What does the P wave represent and how long should it normally be?

A

Atrial depolarisation
Should be around max 12 ms (3 squares)

https://lms.rn.com/courses/2076/page13595.html see for ecg tests

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2
Q

In which lead is the p wave negative or inverted?

A

AVR

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3
Q

Peaks in the p wave suggest what and why might this arise?

A

Atrial hypertrophy due to:

Valvular disease
COPD
Pulmonary embolism
Heart failure

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4
Q

What might an inverted p wave suggest?

A

Reverse conduction from Av junction to atria

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5
Q

What do absent p waves suggest?

A

Conduction bypasses the SAN node, so could be atrial fibrillation or junctional rhythm

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6
Q

What is junctional rhythm?

A

When the impulse starts in the bundle of His/AV node

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7
Q

What would junctional rhythm look like on an ECG?

A

Absent p waves
Inverted p waves followed by QRS complex (this may be obscured by the T wave or QRS complex)

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8
Q

What is the PR interval and where is it drawn from?

A

The time it takes for the impulse to go from the atria to the AV node
Start of P wave to start of R wave

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9
Q

Normal duration of a PR interval?

A

120-200ms (3-5 small squares)

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10
Q

What would a short PR interval of less than 120ms suggest?

A

That the impulse generated from someone other than the SAN. Could be a junctional arrhythmia or pre-excitation syndrome.

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11
Q

What would a long PR interval of more than 200ms suggest?

A

Conduction block due to:
-digoxin toxicity
-heart block

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12
Q

What is the normal duration of the QRS complex?

A

Half the time of the PR interval, so 60-100ms (0.06-0.10s)

about 2 small squares

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13
Q

The QRS should be negative in which leads?

A

Leads V1-3 and aVR

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14
Q

An inferior wall infarct would be due to which artery?

A

Right coronary artery

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15
Q

Which leads would be affected in inferior wall infarct?

A

Leads 2, 3, aVF

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16
Q

Which artery would cause anterior wall defect?

A

LAD

17
Q

Which leads would be affected if the left anterior descending artery was affected?

A

Leads V1-V4

18
Q

Which artery would cause lateral wall infarction?

A

Left circumflex

19
Q

Which leads would be affected if the left circumflex artery was affected?

A

Leads 1, aVL, v5 and v6

20
Q

What would cause posterior wall defect?

A

Posterior descending artery

21
Q

Which leads would be affected in posterior wall problem? What would be seen on an ECG?

A

Tall R wave and ST elevation in leads V1-3

22
Q

Which leads are related to the lateral part of the heart?

A

Lead 1
AVL
V5-v6

23
Q

Which leads are related to the inferior part of the heart?

A

Lead 2, 3
AVF

24
Q

Which leads are the anterior or septal leads?

A

V1-V4

25
Q

Axis deviation

A

lead 1 and 2

if lead 1 is up and lead 2 is down, it’s left axis deviation
if lead 1 is down but lead 2 is up, it’s right axis deviation

26
Q

What is the p was really high?

A

P pulmonale, due to cor pulmonale

27
Q

If the third heart block was above the bundle of his, what does the QRS complex like?

A

Narrow complex

28
Q

If the third heart block was below the bundle of his, what does the QRS complex like?

A

Wide complex

29
Q

Differentiate between LBBB and RBBB

A

LEFT = WiLLiaM
RIGHT = MaRRoW

Look at V1 and V6
If the QRS complex is under the isoelectric line and looks like a W in V1, and then is above the isoelectric line and looks like an M in V6, it’s LEFT bundle branch block

If the opposite, it’s RBBB

30
Q

What would wide, big Q waves suggest?

A

Previous MI - pathological Q waves

31
Q

What would be seen in HYPERkalemia?

A

Tented T waves
Flat P waves
Broad QRS and bradycardia

32
Q

Treatment for hyperkalemia?

A

10ml, 10% calcium gluconate
10U insulin (causes cells to take up potassium)
50mL, 50% dextrose ( stop them from having a hypo from the insulin)

33
Q

Hypokalemia ECG changes

A

U waves
ST depression
Prolonged QT interval

34
Q

QR interval in males and females?

A

Men <0.44s
Women <0.46s

35
Q

QT interval calculation

A

T wave shouldn’t be half way through the two R waves

36
Q

Causes of prolonged QT?

A

Acquired:
Hypomagnsia
hypokalemia
COngenital
??????

37
Q

What could cause tall tented T waves?

A

Hyperkalemia
Hyperacute MI

38
Q

What do you call a sloping QRS complex and what does it suggest?

A

Delta wave
Wolf Parkinson White syndrome

Year 3 - OSCE Cardio - Imperial (12 decks)

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