EKG FINAL

Question 1

which are bipolar vs unipolar leads? which are frontal vs transverse leads? which leads NOT to use to dx ant MI?

Answer 1

I/II/III vs avR/L/F & chest leads. limb/aug vs chest leads. frontal leads

Question 2

how to dx post MI?

Answer 2

R>s w/ st dep V1-3

Question 3

hyperkal vs hypokal

Answer 3

no p waves, sine, peaked T waves; RAD; can lead to vfib. tx: ca gluconate, 1 amp insulin, 1 amp carb, patiromer oral vs prolonged QT/R on T -> Torsades, U waves. etio: alkalosis, diuretics, insulin, intractable vomit

Question 4

how to dx RAE vs LAE? etio of RAE vs LAE

Answer 4

tall p waves >2.5mm in II, >1.5mm in V1 vs notched p waves in II, neg or diphasic p waves in V1. pulm HTN/stenosis/embol, COPD vs LVH, HTN, mitral sten

Question 5

etio vs tx of afib/flutter

Answer 5

hyperthyroid -> tachy, stroke, heart fail vs rate w/ BB/CCB, rhythm w/ cardiovert, IV amio/ibu/procainamide; cardiovert if unstable; anticoag, TEE

Question 6

PVC etio vs tx

Answer 6

CAD/MI, digoxin tox, alkalosis, hypox/kal/mag, caff/alc, decongest, stimulants, drugs vs tx underlying

Question 7

SVT sx vs tx

Answer 7

CP, dyspnea, lighthead, syncope, palpitations vs vagal, carotid massage, adenosine IV rapid push

Question 8

which ions move in AV node vs His/Purk vs T wave/vent repol?

Answer 8

slow moving Na+ vs fast moving Ca2+ vs K+

Question 9

Marfan’s can cause what EKG variation?

Answer 9

RAD

Question 10

small vs big PR interval? QRs 0.10-0.12 vs >0.12? QT >0.44s & cause?

Answer 10

high catechol, WPW vs AV nodal blocks. incomplete BBB vs BBB, PVC, ventricular rhythm. prolonged QT & hypomag, type I antiarrhythmics, macrolide abx

Question 11

nml box size for PR interval vs QRS vs QT

Answer 11

<1 big box vs <1/2 big box vs <2 big boxes, <1/2 RR intervals

Question 12

criteria for RVH vs LVH

Answer 12

Tall R wave in V1 that decreases thru V6, neg T wave in lead I vs Tall R wave in V6, Deep S wave in V1 >35mm, >12mm in avL, applies to >35yo

Question 13

how to tx mono vs polymorphic vtach?

Answer 13

amiodarone 150mg IV over 10min; IV sed/pain, cardiovert vs Mg2+/overdrive pace if stable; electricity if unstable

Question 14

how to tx sinus tach w/ WPW?

Answer 14

defib. IV fluids, O2 nasal cannula, Tylenol, abx

Question 15

which rhythms do you defib?

Answer 15

vfib, pulseless mono vtach, any poly vtach, afib w/ abberant

Question 16

Bachmann’s bundle. if you see a neg deflection after PR interval but before R wave, what does it mean?

Answer 16

communicates b/w R&LA. septal depol

Question 17

pos deflection means?

Answer 17

depol towards pos electrode

Question 18

which EKG features represent acute vs chronic STEMI? acute NSTEMI?

Answer 18

ST elev vs patho Q waves. ST dep