EKG

Question 1

what leads do we look at for LAE and RAE and what changes?

Answer 1

• look at P waves in II and V1
• in II, RAE increases P wave height while LAE increases P wave duration
• in V1, RAE increases height of hump, LAE increases depth of dip

Question 2

criteria for LAE in V1

Answer 2

dip is at least 1mm deep AND 1mm wide

Question 3

BBB or His block indicated by…

Answer 3

QRS longer than .12

Question 4

look for RBBB in what lead?

Answer 4

V1, bunny ears, terminal vector positive, >.12

Question 5

look for LBBB in what lead?

Answer 5

V6, terminal vector positive, >.12

Question 6

what diagnoses can not be made in the presence of LBBB?

Answer 6

LVH, anterior MI, inferior MI, because of mimicry

Question 7

left anterior hemi block sign

Answer 7

marked LAD

Question 8

left posterior hemi block sign

Answer 8

marked RAD

Question 9

LVH look for what signs?

Answer 9

• LAD

- add S in V1 and R in V5, >35?

Question 10

RVH look for what signs?

Answer 10

• RAD

- tall R in V1

Question 11

anterior MI signs

Answer 11

pathological Q waves in V1-V4

Question 12

inferior MI signs

Answer 12

pathological Q waves in II, III, aVF

Question 13

lateral MI signs

Answer 13

Q waves in I, aVL, V5, V6

Question 14

sub-endocardial ischemia signs

Answer 14

• ST depression in anterior leads I and II, and lateral leads V4-V6
• late ischemia will have downslope

Question 15

transmural ischemia signs

Answer 15

• ST elevation in leads corresponding to LAD artery V1-5
• early is concave upward
• late is concave downward

Question 16

in which lead are P waves supposed to be negative or biphasic?

Answer 16

V1

Question 17

sick sinus syndrome?

Answer 17

• well conditioned athletes, just a slow sinus rhythm or…

- delayed conduction after end of fit of a-fib, causing syncope

Question 18

mobitz I also known as

Answer 18

wenckebach

Question 19

mobitz I and II are examples of what degree of AV block?

Answer 19

2nd degree

Question 20

what is the main problem in first degree AV block?

Answer 20

delay in conduction - there is a Q for every P

Question 21

what is the main problem in second degree of AV block?

Answer 21

intermittent failure in conduction - there are some Ps with no Qs

Question 22

big difference between mobitz I and II on EKG?

Answer 22

mobitz I has the wenckebach phenomenon with increasing length of PR segment.

Question 23

what does third degree heart block look like?

Answer 23

• ventricular escape rhythm with non-conducting P waves dispersed in unrelated manner

Question 24

what does the backward depolarization in WPW look like on an EKG?

Answer 24

inverted P wave in lead II

Question 25

heart rate in WPW?

Answer 25

150-250

Question 26

three conditions for re-entry

Answer 26

• two pathways
• pathways have different refractory periods
• pathways have different rates of conduction

Question 27

two types of SVTs

Answer 27

• re-entrant (WPW)

- AV nodal re-entrant

Question 28

compare WPW EKG to AV nodal reentry EKG

Answer 28

• WPW - inverted P waves in lead II, delta waves during normal sinus rhythm
• AV nodal has P waves buried in QRS complex, QRS is normal

Question 29

what is a left ventricular strain pattern?

Answer 29

ST depression in leads V5-V6

Question 30

what is a right ventricular strain pattern?

Answer 30

ST depression in leads V1-V4