EKG

Question 1

Inferior MI leads

Answer 1

II, III, aVF

Question 2

Lateral MI leads

Answer 2

I, aVL, V5, V6

Question 3

Posterior MI leads

Answer 3

AVR

Question 4

Septal MI leads

Answer 4

V1, V2

Question 5

Anterior MI leads

Answer 5

V3, V4

Question 6

Time of a small box

Answer 6

0.04

Question 7

Time of a big box

Answer 7

0.2

Question 8

Number of Boxes and Rate

Answer 8

1 box-300 bpm
2 boxes- 150 bpm
3 boxes- 100 bpm
4 boxes- 75 bpm

Question 9

Best place to look for p waves

Answer 9

Inferior limb leads

Question 10

Define first degree AV block

Answer 10

Delayed conduction through AV node

Longer PR interval >200ms

Question 11

2nd degree AV block
Aka Mobitz 1
Aka Wenckebach

Answer 11

Progressively longer PR interval with a non conducted (dropped) beat

Question 12

2nd degree AV block Mobitz II

Answer 12

PR interval is constant with intermittent dropped beat

Question 13

3rd degree heart block

Answer 13

No association between QRS and P waves, often more p waves than QRS- higher atrial rate

Question 14

Inverted p waves indicate:

Answer 14

Lower atrial or junctional rhythms with retrograde conduction…

Question 15

Know the axis

Answer 15

Question 16

Method for determining QRS axis

Answer 16

1. Find isoelectric lead- direction of vector is perpendicular to this lead
2. Choose lead that is 90 degrees away
3. If QRS is +, this is the axis
4. If QRS is -, axis is 180 degrees from this lead

Question 17

Causes of right axis deviation

Answer 17

RV strain (PE)

COPD (pulmonary hypertension)

Lateral STEMI

Question 18

Causes of Left axis deviation

Answer 18

LBBB

Inferior MI

Question 19

Wave characteristics in left atrial enlargement

Answer 19

Lead II Bifid P wave- (two connected waves)

Lead V1- biphasic

Question 20

Right atrial enlargement

Answer 20

Peaked p wave (p pulmonale) >2.5mm leads II, III

Question 21

Sokolow- Lyon index

Answer 21

EKG criteria for ventricular hypertrophy

S in V1 + R in V5 >35mm….

Question 22

Pattern of strain in EKG

Answer 22

Downsloping ST depression with rapid UPSLOPE

Question 23

Pathological Q waves

Answer 23

> 2mm deep
25% of QRS complex
ST/T abnormalities with Qs suggest true infarct

Small Qs are normal

Question 24

ISCHEMIA in ST depression

Answer 24

> 1mm of horizontal or downsloping ST depression 60-80 msec after J point

Question 25

Indications of acute posterior STEMI on EKG

Answer 25

Depression in V1-3 anterior ST elevation in V7-9 posterior…

Question 26

J point elevation

Answer 26

Can be benign Osborn waves with hypothermia (notch?) Widespread across ekg <2mm No reciprocal st depression

Question 27

Pericarditis

Answer 27

Widespread concave ST elevation PR depression Reciprocal ST depression aVR and V1

Question 28

Bundle branch blocks osmosis

Answer 28

Question 29

Kaylie’s MI regions

Answer 29

Question 30

Small box mm size

Answer 30

1 mm

Question 31

Large box size mm

Answer 31

5mm

Question 32

First sign of transmural injury

Answer 32

Broad peaked T waves Will progress to ST elevation

Question 33

First sign of transmural injury

Answer 33

Broad peaked T waves Will progress to ST elevation

Question 34

PE EKG pattern

Answer 34

However, the “S1Q3T3” pattern of acute cor pulmonale is classic; this is termed the McGinn-White Sign. A large S wave in lead I, a Q wave in lead III and an inverted T wave in lead III together indicate acute right heart strain.

Question 35

J wave

Answer 35

J wave- widespread (like pericarditis) makes sense in the setting of hypothermia, no reciprocal changes, less than 2mm, notching present in inferior leads

Question 36

J wave

Answer 36

J wave- widespread (like pericarditis) makes sense in the setting of hypothermia, no reciprocal changes, less than 2mm, notching present in inferior leads

Question 37

Which leads show reciprocal ST depression in pericarditis

Answer 37

aVR and V1

Question 38

Acls h’s

Answer 38

Hypovolemia Hypoxia Hydrogen ion acidosis Hypo/hyperkalemia Hypothermia