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1 Rotations > EKG/ ACLS > Flashcards

EKG/ ACLS Flashcards

1
Q

If lead I and aVF are both (+) what does this tell you about the QRS axis?

A

Normal

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2
Q

If lead I is (+) and aVF is (-) what does this tell you about the QRS axis?

A

LAD

next check lead II

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3
Q

If LAD based on I and aVF and QRS is predominately (+) in lead II, what does this tell you about the QRS axis?

A

Normal axis

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4
Q

If LAD based on I and aVF and QRS is predominately (-) in lead II, what does this tell you about the QRS axis?

A

LAD

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5
Q

If lead I is (-) and aVF is (+) what does this tell you about the QRS axis?

A

RAD

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6
Q

An m-shaped P wave in lead II indicates?

A

LAE

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7
Q

A tall P wave in lead II (≥ 3mm) indicates?

A

RAE

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8
Q

If QRS is narrow, you should skip looking for what?

A

BBB

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9
Q

Wide QRS, broad/ slurred R in V5/V6, deep S wave in V1, and ST elevations in V1-V3 indicates?

A

Left BBB

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10
Q

Wide QRS, RsR’ in V1/V2, and wide S wave in V6 indicates?

A

Right BBB

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11
Q

Q waves/ ST elevations in V1-V4 indicates an infarction where and involves what artery?

A

Anterior wall

Left anterior descending (LAD)

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12
Q

Q waves/ ST elevations in V1-V2 indicates an infarction where and involves what artery?

A

Anterior wall/ septal

Proximal LAD

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13
Q

Q waves/ ST elevations in I, aVL, V5-V6 indicates an infarction where and involves what artery?

A

Lateral wall

Circumflex (CFX)

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14
Q

Q waves/ ST elevations in I, aVL, V4-V6 indicates an infarction where and involves what artery?

A

Anterolateral

Mid LAD +/- CFX

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15
Q

Q waves/ ST elevations in II, III, aVF indicates an infarction where and involves what artery?

A

Inferior

Right coronary artery (RCA)

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16
Q

Q waves/ ST depressions in V1-V2 indicates an infarction where and involves what artery?

A

Posterior wall

RCA/ CFX

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17
Q

Vectors move towards __ and away from __?

A

Vectors move towards hypertrophy and away from infarction

summation of all the vectors = general direction of the impulses through the heart = (QRS) axis

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18
Q

If lead I is (-) and aVF is (-) what does this tell you about the QRS axis?

A

ERAD

extreme RAD

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19
Q

What are the only 2 shockable rhythms using defibrillation (unsynchronized cardioversion)?

A

V-fib and pulseless V-tach

20
Q

A sinus arrhythmia will increase with __ and decrease with __?

A

A sinus arrhythmia will increase with inspiration and decrease with expiration

21
Q

In a sinus rhythm, P waves are positive/ upright in leads __ and negative in __?

A

In a sinus rhythm, P waves are positive/ upright in leads I, II, aVF and negative in aVR

22
Q

What is the tx for sinus tachycardia?

A

Treat underlying cause then BBs if persistent

23
Q

What is the tx for sinus bradycardia if symptomatic or unstable?

A

Atropine

24
Q

What is the tx for sinus bradycardia if asymptomatic/ physiologic?

A

No tx needed

25
Q

What is the tx for sick sinus syndrome if stable?

alternating episodes of tachy/ brady

A

None- sxs transient

26
Q

What is the tx for sick sinus syndrome if hemodynamically unstable?
(alternating episodes of tachy/ brady)

A

Atropine

+/- dopamine/ epinephrine/ transcutaneous pacing

27
Q

What is the tx for long-term sick sinus syndrome?

alternating episodes of tachy/ brady

A

Pacemaker

28
Q

Prolonged PR interval with all P waves followed by QRS complexes indicates?

A

1st degree AV block

29
Q

Progressive PR internal lengthening followed by a dropped QRS indicates?

A

2nd degree type I AV block

30
Q

Constant prolonged PR interval followed followed by a dropped QRS indicates?

A

2nd degree type II AV block

31
Q

Sawtooth pattern with no discernible P waves on EKG indicates?

A

Atrial flutter (250-350 bpm)

32
Q

Irregularly irregular rhythm with fibrillary waves (no discrete P waves) on EKG indicates?

A

Atrial fibrillation

33
Q

What is used for anticoagulation risk stratification in nonvalvular atrial fibrillation?
≥2 = moderate to high risk = chronic oral anticoagulation

A 
CHA2DS2-VAS 
congestive HF- 1
hypertension- 1
age ≥ 75- 2
dm- 1
stroke/ TIA/ thrombus- 2
vascular disease- 1
age 65-74- 1
sex (female)- 1
34
Q

Regular, narrow-complex tachycardia with no discernible P waves on EKG indicates?

A

Paroxysmal SVT

“If you can’t tell if the bump is a P or a T, then it must be SVT”

35
Q

How do you differentiate between wandering atrial pacemaker and multifocal atrial tachycardia?

A

Both ≥ 3 P wave morphologies but WAP HR < 100 and MAT HT > 100

36
Q

Delta waves (slurred QRS upstroke) on EKG indicates?

A

WPW, bundle of kent

Wave (delta), PR interval (short), Wide QRS

37
Q

P waves inverted or not seen with narrow QRS indicates?

A

AV junctional dysrhythmias

38
Q

Junctional rhythm HR = __ bpm
Accelerated junctional rhythm HR = __ bpm
Junctional tachycardia HR = __ bpm

A

Junctional rhythm HR = 40-60 bpm
Accelerated junctional rhythm HR = 60-100 bpm
Junctional tachycardia HR > 100 bpm

39
Q

Wide, bizarre QRS occurring earlier than expected with the T wave in the opposite direction of the QRS indicates?

A

Premature ventricular complex (PVC)

40
Q

Waxing and waning QRS amplitude indicates?

A

Torsades de pointes- tx with IV magnesium

41
Q

What is the most common etiology of ventricular tachycardia?

A

Underlying heart disease (ischemic most common)

42
Q

Torsades de pointes is a variant of v-tach or v-fib?

A

V-tach

43
Q

Clinical manifestations of __ include unresponsive, pulseless, or syncope

A

Clinical manifestations of v-fib include unresponsive, pulseless, or syncope
(erratic pattern of electrical impulses/ no P waves on EKG)

44
Q

What are the classes of anti-arrhythmic agents?

A 
I- Na channel blockers
II- beta blockers
III- K channel blockers
IV- Ca channel blockers
V- other (Digoxin) 
Nets play BK for the Championship
45
Q

What classes of anti-arrhythmic agents are primarily used for rhythm control?

A

I (Na channel blockers) and III (K channel blockers)

46
Q

What classes of anti-arrhythmic agents are primarily used for rate control?

A

II (beta blockers) and IV (Ca channel blockers)

1 Rotations (7 decks)

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