EKG continued

Question 1

What are the different types of ST depression

Answer 1

downsloping
upsloping
horizontal

Question 2

If an upscoping ST depression with peaked T wave in V1-V3 is seen on an ECG, what is the likely diagnosis

Answer 2

Proximal LAD occlusion

Question 3

What type of ST depression is most concerning for ischemia

Answer 3

horizontal depression

Question 4

What is a J wave

Answer 4

Short deflection following a downscoping R wave (fishhook appearance)

Question 5

What are J waves useful for

Answer 5

to differentiate between benign early repolarization vs. STEMI

Question 6

When are J waves seen on an ECG

Answer 6

Benign early repolarization
hypothermia
hypercalcemia
brugada syndrome

Question 7

Which leads is it normal to see T wave inversion in

Answer 7

V1, V2, lead 3

Question 8

If there is a T wave inversion in aVL only, what are you concerned for

Answer 8

inferior MI

Question 9

How big does a T wave inversion have to be, to be concerning

Answer 9

> 1mm

Question 10

What are the ddx for t wave inversion

Answer 10

LVH strain
Increased ICP
PE
BBB
Ischemia

Question 11

What is a hyper acute T wave

Answer 11

Tall broad base with asymmetric peak
**Can fit QRS in hyperacute T wave

Question 12

When are hyper acute T waves seen

Answer 12

vasospasm
early STEMI

Question 13

What is a biphasic T wave

Answer 13

Initial positive deflection followed by a downward deflection (could also go in reverse order)

Question 14

When are biphasic T waves seen

Answer 14

ischemia
hyperkalemia

Question 15

When are flat T waves seen

Answer 15

Ischemia
hypokalemia

Question 16

What are peaked T waves

Answer 16

Tall, narrow base, relatively symmetrical peak

> 10mm in height

Question 17

What are the ddx for peaked T waves

Answer 17

hyperkalemia
hypermagnesemia
Ischemia

Question 18

Which leads should you NEVER see a T wave

Answer 18

V1-V3

Question 19

What are the criteria for a pathologic T wave

Answer 19

> .04 sec
2mm depth
or
25% QRS

Question 20

What are some causes of pathologic Q waves

Answer 20

MI (old or new)
PE
LBBB
LVH

Question 21

What is the criteria for low voltage QRS

Answer 21

Voltage of leads I, 2, 3 = <15mm
OR
V1+V2+V3 = <30mm

Question 22

What are some ddx of low voltage qrs

Answer 22

pericardial effusion
obesity
COPD
HF

Question 23

What are some causes of shortened QT-I

Answer 23

Hyperkalemia
hypermagnesemia
digoxin toxicity

Question 24

Which leads do you right and left atrial enlargement in

Answer 24

2 and V1

Question 25

If the P wave in lead 2 is >2.5mm, what is the likely dx

Answer 25

RAE

Question 26

If there is a positive deflection that is > than the negative deflection p wave seen on ECG, what is the common cause

Answer 26

RAE

Question 27

If a bifid Pwave in lead 2 that is >.04 seconds, what is it indicative of

Answer 27

LAE

Question 28

If the negative deflection of the P wave is greater than the positive in V1, what is the Dx

Answer 28

LAE

Question 29

What are the ddx for RAE

Answer 29

tricuspid stenosis
pulmonary HTN
Pulm. valve stenosis

Question 30

What are the DDX for LAE

Answer 30

mitral valve stenos
HTN
aortic valve stenosis

Question 31

What are you concerned about when there is a short PR-I on an ECG

Answer 31

PAC
or
WPW

Question 32

What is prinzmetal angina

Answer 32

vasospasm

Question 33

What is the criteria for ST elevation

Answer 33

> 1mm elevation in 2 contiguous leads
**except V2-V3 where 2mm elevation is required

Question 34

What are examples of narrow and regular rhythms

Answer 34

Sinus tachy
2:1 aflutter
SVT

Question 35

What are examples of narrow and irregular rhythms

Answer 35

afib
variable aflutter
MAT

Question 36

What are examples of wide regular rhythms

Answer 36

vtach
SVT with BBB
Sinus tachy with BBB
WPW

Question 37

What is the funny current

Answer 37

slow, constant flow of Na+ until transmembrane potential is -60mV