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L&D > EKG > Flashcards

EKG Flashcards

1
Q

look at what to determine rhythm?

A

P wave before every QRS? P’ waves? wide QRS? PR interval, QT interval

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2
Q

look at which leads for axis?

A

lead 1 and AVF

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3
Q

look at which leads to determine hypertrophy?

A

atrial: V1-V2, then lead 2
vent: V1, then V5/V6

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4
Q

what 3 things signifjy infarction?

A

inverted T waves, ST elevation or depression, big Q waves

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5
Q

normal PR interval

A

0.12-0.2 sec (3-5 little squares)

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6
Q

normal QRS interval

A
  • QRS = 0.08-0.10 sec (2-2.5 squares)
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7
Q

normal P wave height and length

A

o Height = <0.25mV (2.5 little squares)

o Length = <0.12 sec (3 small squares)

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8
Q

axis points toward what and away from what?

A

toward hypertrophy, away fro infarction

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9
Q

which leads have largest sinus P waves?

A

lead 2, V1

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10
Q

in which lead is everything inverted?

A

AVR

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11
Q

look in which leads for RBBB?

A

V1, V2

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12
Q

suspect what for very large R wave in V1

A

posterior MI or R vent hypertrophy

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13
Q

which lead has the deepest S wave?

A

V2

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14
Q

which lead has tallest R wave?

A

V5

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15
Q

3 PVCs in a row

A

VT

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16
Q

PVCs for >30 sec

A

sustained VT

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17
Q

delta wave and decreased PR segment length, slightly widened QRS. due to going through bundle of Kent

A

o Wolff Parkinson White

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18
Q

no delta wave, very short PR segment, normal QRS. due to James bundle

A

o Lown ganong levine

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19
Q

o No P or QRS for 1 cycle

o Then resumes normal

A

sinus block

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20
Q

 Multiple epidsodes of sinus block

 No escape foci

A

sick sinus syndrome

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21
Q

 Intermittent episodes of SVT, atrial flutter, or afib

 Mingled w/ sinus bradycardia

A

o Bradycardia – tachycardia syndrome (SSS variant)

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22
Q

what is present if there is at least 1 long PR interval?

A

AV block

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23
Q

 Consistently lengthened PR interval by the same amount in every cycle
 No dropped Ps or QRSes (normal P QRS T in every cycle)

A

1st degree AV block

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24
Q
  • PR interval gradually lengthens
  • Then lone P wave missing a QRS
  • Set ratio of 3:2, 4:3, et
A

2nd degree AV block type 1

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25
Q
  • Multiple P waves, then 1 P-QRS-T in a set ratio (3:1, 4:1, etc)
  • Consistent and normal PR interval length.
A

2nd degree AV block type 2

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26
Q

Mobitz after vagal maneuver?

A

becomes 1:1 or no change

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27
Q

 Independent atrial and ventricular rates. SA node or atrial foci continue firing. Junctional or ventricular foci fire independent rhythm
 P waves look the same
 Each QRS will look the same unless containing P wave
 T wave in same direction as R

A

3rd degree heart block

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28
Q

o No P waves
o Wide and tall QRS
regular rhythm

A

downward displacement of pacemaker

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29
Q

o R wave has 2 peaks in V1 and V2

o QRS is >0.12 sec (3 small squares)

30
Q

 in V1 or V2, Peaked P wave > 1.5mm in width

 Initial portion of V1 biphasic P wave is larger and peaked

A

right atrial hypertrophy

31
Q

 Height of P wave in any limb lead exceeds 2.5mm (esp 2, 3, AVF)

A

right atrial hypertrophy

32
Q

 V1 has biphasic P wave whose end component is taller or longer than initial (can be subtle). >40ms (1 square) in width and >1mm deep
 Lead 2 has a broad bifid P wave >40ms (1 square). Total P wave duration >110ms (3 squares+)

A

L atrial H

33
Q
  • In V1, R wave is larger than S wave (>7mm tall or R/S ratio >1)
  • Right axis deviation in frontal plane of +110 degrees or more
  • In V5 or V6, S wave is bigger than R wave (>7mm tall or R/S ratio <1)
  • QRS duration <0.12 s
34
Q

V1 S wave depth + V5 or V6 R wave height >35mm) (voltage)

• In V5 and V6, there is often an asymmetric and inverted T wave

35
Q

o ST segment depression and T wave inversion in left sided leads

36
Q

 Charaterised by ST segment depression with upward bump in the middle
• Esp in V1

A

ventricular strain (R if V1)

37
Q

 Inferior leads ST elevation
 Hypotension, rhythm disturbance (bracycardic)
 No pulmonary edema

A

R vent infarct

38
Q

how do you confirm R vent infarct?

A

put V4 on R side and see ST elevation

39
Q

 Big R wave in V1-V4 esp V1-V3

 ST depression in V1-V4 esp V1-V3

A

posterior infarct

40
Q

what confirms posterior infarct?

A

 ST elevations in V7-V9

41
Q

classic sign of ischemia?

A

inverted T wave (symmetric)

42
Q

transient T wave inversion and ST depression

43
Q

persistent ST elevation that never reetruns to baselein

A

ventricular aneurysm

44
Q

ST elevation in V1-V4 without Q wave

A

anterior left vent active transmural MI

45
Q

ST depression in V1 or V2 With large R waves

A

acute transmural MI in posterior wall

46
Q

large Q wave >0.04 sec or 1/3 of entire QRS amplitude

47
Q

 Q wave in lead 1 and deep S wave in 3 (Q1, S3) confirms diagnosis

A

anterior hemiblock

48
Q

 In inf leads (2,3, AVF), small R waves, then deep S waves
 In high lateral leads (1, AVL), small Q waves, then tall R waves
 In AVL, increased R wave peak time

A

anterior hemiblock

49
Q

 S1Q3 (deep/wide S wave in lead 1, Q in 3)
 In high lateral leads (1, AVL), small R waves, deep S waves
 In inferior leads (2,3, AVF), small Q waves, tall R waves
 In AVF, increase R wave peak time

A

posterior hemilblock

50
Q

 RBBB (RR’ and QRS>0.12) with ST elevation in V1, V2, V3

 Susceptible to deadly arrhythmias

A

o Brugada syndrome (genetic)

51
Q

 Caused by stenosed LAD

 Marked T wave inversion in V2, V3

A

wellens syndrome

52
Q

 QT interval >1/2 cardiac cycle (R to R interval) in any lead (use the one that is easiest to calculate)

A

long QT syndrome

53
Q

most common abnormality seen w/ PE

A

sinus tachycardia

54
Q

 S1Q3T3 in 20% of pts (large S wave in lead 1, Q wave in 3, inverted T wave in 3)

55
Q

tall peaked T waves

A

hyperkalemia

56
Q

flat T wave, prominent U wave

A

hypokalemia

57
Q

short QT interval

A

hypercalcemia

58
Q

hypocalcemia

A

prolonged QT interval

59
Q

 PABs are often earliest warning sign
 Gradual downward curve of ST segment
 Best observed in leads with no S waves (L chest or limb leads)
 R wave

60
Q

super narrow vertical spikes

A

artifical pacemakers

61
Q

ST elevattion in all leads

A

pericarditis

62
Q

anterior infarct vessels

A

L coronary a, LAD

63
Q

lateral infarct vessels

A

circumflex

64
Q

septal infarct vessels

65
Q

inf infarct vessel

66
Q

R vent infarct

A

branch of RCA

67
Q

post infarct vessels

A

RCA, circumflex

68
Q

afib, a flutter, tachydysrhythmais, PVCs, 2nd degree AV block can indicate infarct where?

69
Q

PVCs can indicate infarct where?

A

ant, lateral, inf, or R vent (everywhere except post)

70
Q

sinus bradycardia seen w/ infarct where? which vessel?

A

inferior. RCA

71
Q

AV nod blocks can be ASW infarct in any area except?

72
Q

Infarct in which area presents as only 2nd or 3rd degree heart block?

A

septal (V1-V2)

L&D (6 decks)

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