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Cardio > EKG - Exam 2 > Flashcards

EKG - Exam 2 Flashcards

1
Q

What anatomic site does first degree AV block occur?

A

in the AV node of His bundle

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2
Q

AV dissociation occurs most often with what kind of block?

A

3rd degree AV

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3
Q

What will an incomplete right BBB look like on EKG? What leads should you look at?

A

RSR’ pattern but the QRS will NOT be wide like it is in a normal RBBB

leads V1 and V2

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4
Q

What arrhythmia are commonly seen with increased frequency in WPW?

A

atrial fib AND paroxysmal SVT (both wide and narrow complext)

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5
Q

What arrhythmia are commonly seen with increased frequency in LGL?

A

atrial fib AND paroxysmal SVT (both wide and narrow complext)

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6
Q

What is the delta wave of WPW syndrome a result of?

A

premature ventricular depolarization

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7
Q

What are some characteristics of the atrial fib that is associated with WPW?

A

It can induce ventricular fibrillation

Ventricular rates can rise as high as 300 bpm

It can cause syncope or sudden death

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8
Q

______ is likely to be present in torsades before the patient starts to have s/s?

A

long QT interval due to a prolonged ventricular repolarization

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9
Q

What are some EKG characteristics of a patient with hypothermia?

A

Prolongation of the PR interval
Prolongation of the QT interval
sinus bradycardia
prolongation of the QRS complex

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10
Q

What is the unusually shaped QRS complexes shown reveal what abormality? What lead should you look at?

A

the osborne wave of hypothermia?

can see rsr’ in V5

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11
Q

EKG changes associated with therapeutic levels of digitalis include?

A

ST segment depression

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12
Q

T/F: The length of the QT interval varies with the heart rate?

A

True

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13
Q

What are 4 things Brugada syndrome is characterized by?

A

Inherited as an autosomal dominant trait
A pattern resembling right bundle branch block
ST segment elevation in leads V1, V2, and V3
It is a cause of sudden cardiac death in persons with seemingly normal hearts.

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14
Q

a pt taking a TCA, what abnormality may present on an EKG?

A

prolonged QT interval

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15
Q

What are the 4 questions you need to ask yourself at the start?

A

normal P waves?
QRS narrow/wide?
what is the relationship between P and QRS complex?
is the rhythm regular or irregular?

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16
Q

What are reentrant rhythms due to?

A

due to accessory pathways, reenter the cycle of condition

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17
Q

What is recentrant impulse formation?

A

new impluses are formed elsewhere other than the sinus node

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18
Q

What is reentrant impulse transmission?

A

reentrant reentry

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19
Q

What is the reentrant reentry loop?

A

electric impulse that spins in a loop and send out wave of depolarization in all directions (can over ride sinus mechanism)

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20
Q

What rate is sinus tachycardia? what does a deep breath do to your heart rate? How many boxes?

A

101-149

deep breath in= increases HR

less than 3 big boxes

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21
Q

What rate is considered sinus bradycardia? What happens when you exhale? By how many boxes?

A

less than 60

exhale out = decrease HR

greater than 5 big boxes

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22
Q

What is the MC escape node?

A

junctional escape (AV node)

23
Q

what rate is associated with atrial pacemaker?

A

60-75 bpm

24
Q

What rate is associated with a junctional pacemaker?

A

40-60 bpm

25
Q

What rate is associated with ventricular pacemaker?

A

30-45 bpm

26
Q

What is the rate associated with mulitfocal atrial rhythm?

A

100-200 bpm and need at least 3 different P waves

27
Q

What is the rate associated with atrial flutter?

A

250-350 bpm

28
Q

What are PAC characterized by?

A

abnormal P wave followed by narrow QRS, some P wave can be embedded in the T wave

29
Q

What is the difference between junctional escape and premature junctional?

A

junctional escape occurs late following a pause and premature happens early

30
Q

What is accelerated idioventricular rhythm characterized by?

A

sustained VT but slower between 50-100 bpm

less than 50, loss the accelerated

31
Q

T/F: Any rhythm can become regularly irregular`

A

TRUE

32
Q

What is the normal length of PR interval?

A

0.12- 0.2

33
Q

If you have a RBBB, what leads should QRS be positive?

A

V1, V2, aVR, III

34
Q

If you have a LBBB, what leads should have positive QRS?

A

V5, V6, I, aVF

35
Q

What is a bifascular block?

A

RBBB with combo of either left anterior or left posterior hemiblock

36
Q

What is the criteria for nonspecific intraventricular conduction delay?

A

QRS wider than 0.1 but no other criteria are met

37
Q

What is the criteria for incomplete RBBB?

A

rsr’ pattern but normal width QRS

38
Q

What is the accessory pathway for WPW? LGL?

A

bundle of kent - WPW

james fibers = LGL

39
Q

How wide is QRS in WPW? in LGL?

A

WPW= QRS is wider than 2.5 boxes (greater than 0.1 seconds)

LGL= QRS is normal

40
Q

What is an orthodromic tachycardia? What will the QRS look like?

A

a rapid, NARROW complex tachycardia that occurs when electrical signal loop through the AV node and accessory pathway

41
Q

What is antidromic tachycardia? What will the QRS look like?

A

activates ventricles through accessory pathways

will have WIDE QRS

42
Q

What is characteristic EKG finding for a pt with hypothermia?

A

everything slows down!! sinus brady!!

can see rsr’ in V5 on EKG

abrupt rise at J point and then sudden depression back = J wave/Osborn wave

ST elevation with J point elevation

43
Q

What is characteristic to find for digoxin effect on EKG?

A

ST segment depression with flattening/inverted T waves DIFFUSE across all leads

44
Q

What can the digoxin effect lead to? What is it commonly seen with?

A

can result in bradyarrythmias/tacharrythmias

commonly seen with AV blocks

45
Q

How many boxes is 1 second?

A

5 big boxes = 1 second

46
Q

What leads are digitalis effect more prominent in? What AV blocks are they associated iwth?

A

leads with tall R waves

Digitalis slows conduction through the AV node and can therefore cause first-, second-, and even third-degree AV block.

47
Q

What is the most characteristic rhythm disturbances of digitalis intoxication?

A

PAT with second-degree AV block

48
Q

What are causes of a prolonged QTc interval?

A
49
Q

What does Brugada syndrome resember? MC in men or women? What is the underlying cause?

A

long QT syndromes

men

genetic
mutation affecting voltage-dependent sodium channels during repolarization.

50
Q

How do you identify the Brugada pattern?

A

(1) a pattern resembling right bundle branch block with a slow,
prolonged downslope of the R′ component of the QRS complex

(2) T-wave
inversion in leads V1 and/or V2

(3) ST-segment elevation in leads V1,
V2, and V3.

51
Q

in Brugada pattern, describe the ST-segment elevation pattern?

A

The ST-segment elevation is often concave and descends into an inverted T wave, a pattern referred to as coving.

52
Q

What is this?

A

brugada pattern in lead V1

53
Q
A

Cardio (20 decks)

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