EKG

Question 1

atrial vs ventricular vs myocardial conducting cells

Answer 1

SA node to Bachmann’s bundle vs L/RB vs EC coupling; Troponin = MI marker

Question 2

PR seg depression vs PR short interval (<0.12s) indicate?

Answer 2

pericarditis vs WPW (+ delta waves, bundle of Kent)

Question 3

limb vs augmented vs V leads. bi vs unipolar leads

Answer 3

I-III vs AVF/L/R vs V1-6. I-III vs AVR/L/F, V1-6

Question 4

dextrocardia degrees vs Kartagener

Answer 4

120 vs 1° ciliary dyskinesia, situs inversus totalis, sterile

Question 5

Equiphasic approach

Answer 5

equiphasic QRS in lead –> find the other lead 90° away –> pos -> 0° axis, neg -> 150° axis

Question 6

firing rate of SA vs AV vs Purk

Answer 6

60-100 vs 40-60 vs <40bpm

Question 7

causes of sinus brady vs tachy

Answer 7

beta blockers, Ca2+ channel blockers, digoxin; hypoxia, hypothyroid, hypothermia; RCA syndrome -> MI; high vagal/parasymph tone vs fever, resp distress; hypovol, hyperthyroid; cocaine, meth, bronchodil, pseudoephedrine

Question 8

when to do Transcutaneous pacing? what’s electrical vs mechanical capture? how to use it?

Answer 8

for sx brady, HoTN, AMS, shock, ischemic chest discomfort, acute heart fail. electrical activity present, consistent complexes, pacer spike vs electrical activity + pulse, improving CO (inc bp, consciousness, perfusion). sedate w/ IV Versed & Fentanyl -> inc mA till pulse on mechanical & add 10% on electrical capture

Question 9

when to do AICD? internal pacemakers?

Answer 9

primary prevention for pts w/ inc risk of life threatening VT/VF; secondary prevention for pts w/ prior sustained hemodynamically unstable vtach & can’t find reversible cause. 3rd AV block, sx AVB block or brady, recurrent tachy, MI

Question 10

supraventricular tachy = caused by which types of reentrant circuits vs inc automaticity?

Answer 10

AV/NRT, aflutter vs sinus tachy, afib, multifocal atrial tachy (3 diff forms of p waves, COPD)

Question 11

how to distinguish multifocal atrial arrhythmia from afib? wandering atrial pacemaker?

Answer 11

irreg; >3 diff looking p waves present; 100-200bpm. MAT but <100bpm

Question 12

how to tx afib? what rhythms do we defib?

Answer 12

1. ctrl ventricular response
2. convert rhythm back to sinus. pulseless VT/F, afib w/ WPW + pulse