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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
What other wave appears in response to low K?
U wave
26
How do Calcium levels effect the QT interval?
``` Hypercalcemia = shorter Hypocalcemia = prolonged ```
27
What effect does Digitalis have on an EKG?
gradual downward curve/slope of the ST segment (lowest part is below the baseline)
28
What are two effects seen on EKG with pericarditis?
DIFFUSE ST elevation, and elevates T off baseline
29
What is Brugada Syndrome characterized by?
RBBB pattern + ST elevation with “peaked” down-sloping
30
What are patients with Brugada Syndrome susceptible to?
arrhythmias that can lead to sudden death in young, healthy people
31
What can’t you diagnose if there is LBBB present?
MI, axis, or hypertrophy!
32
What’s a common cause of Left Atria Enlargement?
Mitral Stenosis
33
Which ions are associated with fast? Slow?
``` Fast = Na Slow = Ca ```
34
What are the intrinsic rates of the different automaticity sites of the heart?
SA - 60-100 AV - 40-60 Ventricular - 30-45
35
Which leads are considered “frontal”?
I, II, III, aVF, aVL, aVR
36
Which leads are considered “horizontal”?
V1-V6
37
The p wave in which lead is always INVERTED?
aVR
38
What part of the EKG can show you the ABSOLUTE refractory period?
QRS --> peak of T wave
39
What part of the EKG can show you the RELATIVE refractory period?
QRS --> after T wave
40
What are the dimensions of a big box on the EKG strip?
5 mm (height) x .2sec (width)
41
Where do you expect to find “segments”?
horizontally on the baseline
42
What does the P wave signify?
atrial depolarization
43
What does the T wave signify?
Ventricular repolarization
44
What does the PR segment signify?
delay through the AV node
45
What does the PR interval signify?
Atrial contraction and AV delay
46
What are the normal range of length of PR interval?
.12-.2 seconds
47
What is the normal width of the QRS complex?
<.12 seconds
48
What is the normal range of the QT interval?
.3 - .44 seconds | less then 1/2 of R-R
49
What is the paper speed of the EKG machine?
25 mm
50
What value is bradycardic?
< 60 bpm
51
What value is tachycardic?
> 100 bpm
52
What kind of rhythm does sinus arrhythmia have?
regularly irregular
53
In sinus arrhythmia when do we see the rate INcrease?
INspiration!
54
If we were calculating rate by memorizing the sequential dark lines, what is the order?
300-150-100-75-60-50
55
If calculating rate mathematically, what math equation do we use if we know how many big boxes are between an R-R? small boxes?
300/BIG | 1500/SMALL
56
If have a 6 second strip of an irregular rhythm, we can calculate rate by multiplying R-R by what value?
10
57
Which leads is the P wave best seen in?
V1, II | same as for atrial enlargement
58
What is a premature atrial contraction?
Early beat with different looking p wave
59
What is a premature junctional contraction?
early beat with NO P WAVE (or inverted) and wider QRS than normal
60
What is a premature ventricular contraction?
Very wide QRS, No p wave
61
I have 2 PVCs in a row?
couplet
62
If have every other beat is a PVC?
bigeminy
63
What is an escape atrial beat?
LONG PAUSE, then different p wave
64
What is an escape junctional beat?
LONG PAUSE, then no p (or inverted) and wider QRS
65
How would we tell we have a WANDERING PACEMAKER?
3 different p wave morphologies
66
What is MAT?
wandering pacemaker at a rate of 100-200 bpm
67
Which is considered “saw-tooth” at a rate of 240-360 bpm?
Atrial FLUTTER
68
See an occasional QRS with an “IRREGULARLY IRREGULAR” rhythm, and a rate of 400-800.
Atrial FIBRILLATION
69
What is characteristic of WPW?
DELTA wave | Bundle of Kent
70
How would you know you have mutlifocal PVCs?
they look different but still have wide QRS
71
What does an IDIOVENTRICULAR rhythm look like?
WIDE QRS, rate of 20-40 (intrinsic)
72
What makes an Idioventricular rhythm “accelerated"?
Rate of 50-100
73
How many PVCs in a row qualify for V Tach?
3+
74
T/F. V tach can be pulseless?
TRUE
75
T/F. Regular p waves are seen in V tach.
FALSE
76
Which rhythm is dubbed “irregularly irregular with WIDE, CHAOTIC, fast, “bag of worms”?
V FIBRILLATION
77
What is diagnostic for Torsades?
R on T phenomenon | prolonged QT
78
What is the major cause of PULSELESS ELECTRICAL ACTIVITY?
HYPOvolemia
79
A PR interval of > .2 seconds signifies what?
AV block
80
If PR is >.2 but FIXED =
First-degree
81
if PR is >.2 and INCREASING + LONE P WAVE =
Second-degree Type I (Wenchebach)
82
If PR is >.2 but CONSISTENT + LONE P WAVE =
Second-degree Type II
83
Atria and ventricles are independent and see mayhem
Third-degree
84
What is the different between a FIXED and DEMAND pacemaker?
fixed does it all, all the time | Demand only when it needs it (can be suppressed)
85
Where do you see an Atrial Pacemaker fire?
Before p wave
86
Where do you see a Ventricular Pacemaker fire?
Before QRS
87
T/F. 2 pacemakers will be seen in a DUAL chamber pacemaker?
TRUE. both before p wave and before QRS
88
If body habitus is skinny where does the axis point?
Vertical
89
IF body habitus is Obese where does the axis point?
horizontal
90
In ventricular hypertrophy, the axis will deviate towards which side?
TOWARDS affected side
91
In MI, vector will point?
AWAY from affected side
92
In which leads do we check for axis deviation?
I & aVF
93
If both leads I and aVF are pointed downward, what kind of axis deviation is it?
EXTREME right Axis
94
If see upward deflecting R wave in V1, what does this signify?
Early transition
95
How do you tell if an MI was ACUTE?
Q wave + ST elevation
96
How do you tell if an MI is AGE-INDETERMINATE?
Q wave + ST @ baseline, T inverted
97
How do you tell if an MI is OLD?
Q wave + ST @ baseline, T upright
98
Which coronary artery is the worst to have an infarct in?
RCA - because supplies nodes and bundles
99
What do we see on EKG with ISCHEMIA?
T wave inversion
100
What do we see on EKG with INJURY?
ST elevation (remember, this also means ACUTE)
101
What is foreboding about a TOMBSTONE ST elevation?
On it’s way to Q waves (infarct)
102
What is a SIGNIFICANT Q wave?
sign of infarct. Needs to be > 1mm in height or 1/3 of QRS height
103
What shows STRAIN?
ST depression
104
T/F. Significant Q waves in aVR are positive for infarct.
FALSE - NEVER in AVR!
105
Which leads are INFERIOR?
II, III, aVF
106
Which leads are LATERAL?
I, aVL, V5, V6
107
Which leads are ANTERIOR?
V1-V4
108
What artery is associated with the POSTERIOR leads and is damaged in Infarct?
Right Coronary (RCA)
109
Which artery is associated with infarcts in Lateral leads?
Left circumflex
110
Which artery is associated with infarcts in Anterior leads?
LAD
111
Which artery is associated with infarcts in Inferior leads?
RCA

EKG 5 (1 decks)

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