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EKG 5 > EKG 5 quiz > Flashcards

EKG 5 quiz Flashcards

1
Q

In BBB, the QRS increases in duration to what?

A

> .12 seconds

3 small squares

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2
Q

In LBBB, which ventricle depolarizes first? second?

A

Right is on time

left is delayed

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3
Q

In RBBB, which ventricle depolarizes first? second?

A

Left is on time

right is delayed

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4
Q

Which chest leads shows R, R’ that means LBBB is present?

A

V5 or V6

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5
Q

Which chest leads show R, R’ that means RBBB is present?

A

V1, V2

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6
Q

Which BBB dips below the baseline before the R’?

A

Right BBB

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7
Q

What is an R, R’ with a QRS of normal duration (<.12 sec) called?

A

“incomplete” BBB

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8
Q

Which leads are the best source for atrial enlargement?

A

V1, II

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9
Q

What shape of P wave do we see with atrial enlargement?

A

diphasic

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10
Q

If the initial component of the diphasic P wave is larger and often peaked, which atria is enlarged?

A

Right

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11
Q

If the terminal component of the diphasic P wave is large and wide, which atria is enlarged?

A

Left

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12
Q

Which part of the EKG do we expect to show us if there is ventricular hypertrophy present?

A

QRS complex

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13
Q

In which lead is the QRS mostly negative (R is downwardly deflected)?

A

V1

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14
Q

What if we see a large R wave in V1 and Right Axis Deviation?

A

Right ventricular hypertrophy

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15
Q

In RVH, as we move from V1 –> V3 what do we notice about the R wave?

A

It gets progressively smaller

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16
Q

Is which two leads are most helpful in noticing LVH?

A

V1 (Deeper S), and V5,V6 (large R)

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17
Q

If the depth of the S in V1 and the depth of the R in V5 or V6 have to add up to be greater than what to signify LVH?

A

35 mm

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18
Q

What other part of the EKG can show LVH, besides QRS?

A

Inverted T wave

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19
Q

An inverted T wave in which leads are most significant for LVH?

A

V5 and V6

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20
Q

What is ventricular strain?

A

depression of ST segment in corresponding leads to right and left

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21
Q

What EKG findings are characteristic of a pulmonary embolus?

A

Large S wave in lead I, Q wave and inverted T wave in lead III (S1, Q3T3), and ST depression in II

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22
Q

PE might cause what kind of BBB?

A

Right

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23
Q

What is the most striking and classic feature of elevated potassium (hyperkalemia) on EKG?

A

Peaked T wave

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24
Q

What happens to the T wave in hypokalemia?

A

It will flatten out and as the concentration gets lower and lower then it will invert.

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25
Q

What other wave appears in response to low K?

A

U wave

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26
Q

How do Calcium levels effect the QT interval?

A 
Hypercalcemia = shorter
Hypocalcemia = prolonged
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27
Q

What effect does Digitalis have on an EKG?

A

gradual downward curve/slope of the ST segment (lowest part is below the baseline)

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28
Q

What are two effects seen on EKG with pericarditis?

A

DIFFUSE ST elevation, and elevates T off baseline

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29
Q

What is Brugada Syndrome characterized by?

A

RBBB pattern + ST elevation with “peaked” down-sloping

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30
Q

What are patients with Brugada Syndrome susceptible to?

A

arrhythmias that can lead to sudden death in young, healthy people

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31
Q

What can’t you diagnose if there is LBBB present?

A

MI, axis, or hypertrophy!

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32
Q

What’s a common cause of Left Atria Enlargement?

A

Mitral Stenosis

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33
Q

Which ions are associated with fast? Slow?

A 
Fast = Na
Slow = Ca
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34
Q

What are the intrinsic rates of the different automaticity sites of the heart?

A

SA - 60-100
AV - 40-60
Ventricular - 30-45

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35
Q

Which leads are considered “frontal”?

A

I, II, III, aVF, aVL, aVR

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36
Q

Which leads are considered “horizontal”?

A

V1-V6

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37
Q

The p wave in which lead is always INVERTED?

A

aVR

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38
Q

What part of the EKG can show you the ABSOLUTE refractory period?

A

QRS –> peak of T wave

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39
Q

What part of the EKG can show you the RELATIVE refractory period?

A

QRS –> after T wave

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40
Q

What are the dimensions of a big box on the EKG strip?

A

5 mm (height) x .2sec (width)

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41
Q

Where do you expect to find “segments”?

A

horizontally on the baseline

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42
Q

What does the P wave signify?

A

atrial depolarization

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43
Q

What does the T wave signify?

A

Ventricular repolarization

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44
Q

What does the PR segment signify?

A

delay through the AV node

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45
Q

What does the PR interval signify?

A

Atrial contraction and AV delay

46
Q

What are the normal range of length of PR interval?

A

.12-.2 seconds

47
Q

What is the normal width of the QRS complex?

A

<.12 seconds

48
Q

What is the normal range of the QT interval?

A

.3 - .44 seconds

less then 1/2 of R-R

49
Q

What is the paper speed of the EKG machine?

A

25 mm

50
Q

What value is bradycardic?

A

< 60 bpm

51
Q

What value is tachycardic?

A

> 100 bpm

52
Q

What kind of rhythm does sinus arrhythmia have?

A

regularly irregular

53
Q

In sinus arrhythmia when do we see the rate INcrease?

A

INspiration!

54
Q

If we were calculating rate by memorizing the sequential dark lines, what is the order?

A

300-150-100-75-60-50

55
Q

If calculating rate mathematically, what math equation do we use if we know how many big boxes are between an R-R? small boxes?

A

300/BIG

1500/SMALL

56
Q

If have a 6 second strip of an irregular rhythm, we can calculate rate by multiplying R-R by what value?

A

10

57
Q

Which leads is the P wave best seen in?

A

V1, II

same as for atrial enlargement

58
Q

What is a premature atrial contraction?

A

Early beat with different looking p wave

59
Q

What is a premature junctional contraction?

A

early beat with NO P WAVE (or inverted) and wider QRS than normal

60
Q

What is a premature ventricular contraction?

A

Very wide QRS, No p wave

61
Q

I have 2 PVCs in a row?

A

couplet

62
Q

If have every other beat is a PVC?

A

bigeminy

63
Q

What is an escape atrial beat?

A

LONG PAUSE, then different p wave

64
Q

What is an escape junctional beat?

A

LONG PAUSE, then no p (or inverted) and wider QRS

65
Q

How would we tell we have a WANDERING PACEMAKER?

A

3 different p wave morphologies

66
Q

What is MAT?

A

wandering pacemaker at a rate of 100-200 bpm

67
Q

Which is considered “saw-tooth” at a rate of 240-360 bpm?

A

Atrial FLUTTER

68
Q

See an occasional QRS with an “IRREGULARLY IRREGULAR” rhythm, and a rate of 400-800.

A

Atrial FIBRILLATION

69
Q

What is characteristic of WPW?

A

DELTA wave

Bundle of Kent

70
Q

How would you know you have mutlifocal PVCs?

A

they look different but still have wide QRS

71
Q

What does an IDIOVENTRICULAR rhythm look like?

A

WIDE QRS, rate of 20-40 (intrinsic)

72
Q

What makes an Idioventricular rhythm “accelerated”?

A

Rate of 50-100

73
Q

How many PVCs in a row qualify for V Tach?

A

3+

74
Q

T/F. V tach can be pulseless?

A

TRUE

75
Q

T/F. Regular p waves are seen in V tach.

A

FALSE

76
Q

Which rhythm is dubbed “irregularly irregular with WIDE, CHAOTIC, fast, “bag of worms”?

A

V FIBRILLATION

77
Q

What is diagnostic for Torsades?

A

R on T phenomenon

prolonged QT

78
Q

What is the major cause of PULSELESS ELECTRICAL ACTIVITY?

A

HYPOvolemia

79
Q

A PR interval of > .2 seconds signifies what?

A

AV block

80
Q

If PR is >.2 but FIXED =

A

First-degree

81
Q

if PR is >.2 and INCREASING + LONE P WAVE =

A

Second-degree Type I (Wenchebach)

82
Q

If PR is >.2 but CONSISTENT + LONE P WAVE =

A

Second-degree Type II

83
Q

Atria and ventricles are independent and see mayhem

A

Third-degree

84
Q

What is the different between a FIXED and DEMAND pacemaker?

A

fixed does it all, all the time

Demand only when it needs it (can be suppressed)

85
Q

Where do you see an Atrial Pacemaker fire?

A

Before p wave

86
Q

Where do you see a Ventricular Pacemaker fire?

A

Before QRS

87
Q

T/F. 2 pacemakers will be seen in a DUAL chamber pacemaker?

A

TRUE. both before p wave and before QRS

88
Q

If body habitus is skinny where does the axis point?

A

Vertical

89
Q

IF body habitus is Obese where does the axis point?

A

horizontal

90
Q

In ventricular hypertrophy, the axis will deviate towards which side?

A

TOWARDS affected side

91
Q

In MI, vector will point?

A

AWAY from affected side

92
Q

In which leads do we check for axis deviation?

A

I & aVF

93
Q

If both leads I and aVF are pointed downward, what kind of axis deviation is it?

A

EXTREME right Axis

94
Q

If see upward deflecting R wave in V1, what does this signify?

A

Early transition

95
Q

How do you tell if an MI was ACUTE?

A

Q wave + ST elevation

96
Q

How do you tell if an MI is AGE-INDETERMINATE?

A

Q wave + ST @ baseline, T inverted

97
Q

How do you tell if an MI is OLD?

A

Q wave + ST @ baseline, T upright

98
Q

Which coronary artery is the worst to have an infarct in?

A

RCA - because supplies nodes and bundles

99
Q

What do we see on EKG with ISCHEMIA?

A

T wave inversion

100
Q

What do we see on EKG with INJURY?

A

ST elevation (remember, this also means ACUTE)

101
Q

What is foreboding about a TOMBSTONE ST elevation?

A

On it’s way to Q waves (infarct)

102
Q

What is a SIGNIFICANT Q wave?

A

sign of infarct. Needs to be > 1mm in height or 1/3 of QRS height

103
Q

What shows STRAIN?

A

ST depression

104
Q

T/F. Significant Q waves in aVR are positive for infarct.

A

FALSE - NEVER in AVR!

105
Q

Which leads are INFERIOR?

A

II, III, aVF

106
Q

Which leads are LATERAL?

A

I, aVL, V5, V6

107
Q

Which leads are ANTERIOR?

A

V1-V4

108
Q

What artery is associated with the POSTERIOR leads and is damaged in Infarct?

A

Right Coronary (RCA)

109
Q

Which artery is associated with infarcts in Lateral leads?

A

Left circumflex

110
Q

Which artery is associated with infarcts in Anterior leads?

A

LAD

111
Q

Which artery is associated with infarcts in Inferior leads?

A

RCA

EKG 5 (1 decks)

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