EKG Meds and Metabolic Derangements

Question 1

What does digitalis/digoxin do to an EKG?

Answer 1

causes a scooped ST depression in therapeutic doses

Question 2

What are symptoms of digoxin toxicity?

Answer 2

GI: Nausea, vomiting, anorexia, diarrhea. Visual: Blurred vision, yellow/green discoloration, haloes. CVS: Palpitations, syncope, dyspnea. CNS: Confusion, dizziness, delirium, fatigue

Question 3

What is the classic dysrrhythmia caused by digoxin toxicity?

Answer 3

combination of asupraventricular tachycardia (due to increased automaticity) with aslow ventricular response (due to decreased AV conduction),e.g. ’atrial tachycardia with block’

Question 4

What EKG changes are associated with hyperkalemia?

Answer 4

peaked T waves, P wave can also flatten and widen, QRS complex can widen

Question 5

What EKG changes are associated with hypokalemia?

Answer 5

Classic changes are the presence of U waves. T waves can flatten out and possibly invert. Causes irritation of ventricular foci which can lead to Torsades, VT, VF

Question 6

What EKG changes are associated with hypercalcemia?

Answer 6

Short QT interval

Question 7

What EKG changes are associated with hypocalcemia?

Answer 7

Prolonged QT interval

Question 8

What EKG changes are associated with hypomagnesemia?

Answer 8

Prolonged QT, Torsades, Frequent PVCs, PACs, Ventricular and supraventricular tachyarrhythmias

Question 9

What is the Osborn wave?

Answer 9

a positive deflection at the J point (negative in aVR and V1). is usually most prominent in the precordial leads. associate with hypothermia

Question 10

What EKG changes are associated with pulmonary embolus?

Answer 10

Most common finding is sinus tachycardia. Ekg changes may include S in lead 1 and Q wave with inverted T in lead 3. Right axis deviation. Transient RBBB. T wave inversions in V1-V4