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Emergency Medicine > EKG Review > Flashcards

EKG Review Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Osborne waves or notched j oints

A

hypothermia

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2
Q

order of electrical pathway

A

SA to AV to bundle HIS to purkinje fibers to ventricles

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3
Q

easy way to count rate

A

300 150 100 75 60 50 43 37

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4
Q

how to count rythym on 3 sec strip

A

number of QRS complexes in 30 boxes times 10

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5
Q

what are 4 possible irregular rythyms

A

sinus arrhythmia
wandering pacemaker
multifocal atrial tachycardia
atrial fibrillation

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6
Q

sinus arrhythmia description

A

considered normal yet irregular rhythm that varies with respiration

P waves should look identical

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7
Q

wandering pacemaker description

A

p waves shape varies as location varies
rate is under 100 bpm
considered irregular ventricular rhythm

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8
Q

what pts are at risk for Wandering pacemaker

A

COPD pts

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9
Q

multifocal atrial tachycardia

A

p waves shape varies
rate is over 100 bpm
irregular rhythm
COPD pt

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10
Q

atrial fib description

A

continuous chaotic atrial spikes
no p waves
irregular ventricular rhythm

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11
Q

sinus arrest with 60-80 bpm is called

A

atrial escape rhythm

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12
Q

sinus arrest with beats 40-60 per min called

A

junctional escape rhythm

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13
Q

ventricular escape rhythm description

A

idioventricular rhythm 20-40 min

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14
Q

what leads to an atrial escape beat

A

a sinus block - get atrial escape beat then SA node resumes pacing

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15
Q

3 types of premature beats

A

PAC, PVC and PJB (premature junctional beat)

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16
Q

7 tachyarrythmias

A 
paroxysmal atrial tachycardia 
paroxysmal junctional tachycardia 
paroxysmal ventricular tachycardia 
atrial flutter 
ventricular flutter 
atrial fibrillation 
ventricular fibrillation
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17
Q

AV block first degree has ____ PR interval

A

prolonged, more than .2 seconds

18
Q

2nd degree type I mobitz aka wenckebach

A

pr lengthens .. going going gone dropped QRS

19
Q

2nd degree av block mobitz II

A

some P waves don’t produce a QRS

20
Q

3rd degree AV block aka ____

A

complete heart block
no relationship between P and QRS
treat with pacemaker

21
Q

RBBB criteria

A

R prime in V1

and S wave in v 6

22
Q

LBBB criteria

A

R prime in v 5 or v6

plus rS in V1

23
Q

what leads are your thumbs when trying to figure out axis

A

left hand thumb is lead one
right hand thumb is aVF

If both up = normal axis
+ deflection in one only = left axis
+ deflection in aVF only = right axis
both - deflection = ..??

24
Q

right atrial enlargement findings

A

large diphasic P wave in lead II (tall initial peak)

25
Q

LAE findings

A

large diphasic P with wide terminal component (camel humps)
in lead II
while horizantle s wave in V1

26
Q

RVH findings

A

V1: large r wave gets smaller from v2-v4

27
Q

LVH findings

A

large s wave in V1 leads to large R wave in V5 over 35 mm

28
Q

t wave inversion signals

A

ischemic injury

always compare to old ekg

29
Q

ST segment elevation means

A

acute injury
(depressions also signal this)
MONA (oxygen first, asa, nitro then morphine)

30
Q

don’t give ___ if RV is involved in infarction

A

nitroglycerin

why? worry about preload - can induce cardiogenic shock

31
Q

changes in leads II, III and aVF signal what type of mi and artery

A

inferior wall MI and RCA involved

32
Q

changes V1-V4 __ MI

A

anterior or anteroseptal

artery: LAD

33
Q

changes v5-v6, I, aVL

A

lateral MI

artery: LCA involved

34
Q

ST depression in V1, V2 signals

A

posterior MI

LCA or RCA

35
Q

how to treat SVT

A

vagal maneuver
carotid massage (push fast and flush)
adenosine 6 mg

36
Q

if rate is over 160 you know its not __

A

SVT

37
Q

tx a flutter

A

CCB - diltiazem

38
Q

tx afib

A

coumadin

39
Q

what is bigeminay PVC concern for?

A

irregular rhythm development

40
Q

pulseless vtach shock __-

A

at 200 j biphasic

41
Q

v tach with pulse and unstable

A

synchronized 100J cardiovert

42
Q

vtach with pulse and stable

A

amiodarone

Emergency Medicine (19 decks)

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