Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophys > EKG & Rhythms > Flashcards

EKG & Rhythms Flashcards

1
Q

Steps in Rhythm Analysis

A
  1. Is the patient sick?
  2. What is the heart rate?
  3. Is the rhythm regular?
  4. Are there normal-looking QRS complexes?
  5. Are there normal-looking P waves?
  6. What is the relationship between the P waves and the QRS complexes?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
A

Wandering Atrial Pacemaker

-HR <100
-Irregularly irregular
-Different P wave morphology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
A

Sinus Dysrhythmia

-Heart rate speeds up, then slows slows down all on its own
-Often benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
A

Sinus Block = Pause equal to or less than 2 P-P intervals

Sinus Arrest = Pause more than 2 P-P intervals

TX:
Treat if PT is symptomatic bradycardic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
A

Junctional Rhythm

-HR 40-60
-Narrow QRS
-Inverted/absent P waves

TX:
-Atropine
-Pace
-Epi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
A

Accelerated Junctional Rhythm

-HR 60-100
-Narrow QRS
-Absent P waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
A

Junctional Tachycardia

-HR >100
-Narrow QRS
-Absent P waves

TX:
-Diltiazem
-Adenosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
A

Idioventricular (IVR)

-HR 20-40
-Wide QRS
-Absent P waves

TX:
-Pace
-TX for shock
(Epi, Fluids, O2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
A

Accelerated Idioventricular (AIVR)

-HR 40-100
-Wide QRS
-Absent P waves

TX:
-Same as IVR if indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
A

A fib w/ RVR

-HR no >150

TX:
-Diltiazem
-Sync Cardiovert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
A

Premature Atrial Complex

-Different P wave morphology

TX:
-TX for Bradycardia if indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
A

Premature Junctional Complex (Rare)

-Inverted/absent P wave

TX:
-TX for Bradycardia if indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
A

Premature Ventricular Complex
(Benign)

3 or more consecutive is considered VT

TX:
Bradycardic = Pace if Symptomatic

Vtach = Amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

1st Degree HB PR interval

A

5 small boxes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

1st & 2nd Degree type I MI’s

A

Inferior

TX:
-Atropine
-Pace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

2nd Degree type II & 3rd Degree Block MI’s

A

Anterior

TX:
-Pace (unstable)
-Epi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
A

2nd Degree Type 2 “Mobitz 2”

Intermittent block below AV node
Occasional “dropped” beats
Regular P, irregular R
Requires close monitoring

TX:
Pace
Epi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
A

Complete Heart Block (3rd Degree)

TX:
-Pace
-Epi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

SVT rates in Peds

A

Infants: 220

Children: 190

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Polarity of Leads I,II,III

A

Bipolar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Polarity of Leads aVr, aVL, aVf

A

Unipolar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Polarity of Leads V1 - V6

A

Unipolar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

1 small box (1mm) time

A

0.04 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

5 small boxes (1 big box) time

A

0.2 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

5 big boxes time

A

1 second

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Normal P wave duration

A

0.12 - 0.20 seconds

3-5 small boxes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Normal QRS complex duration

A

0.08 - 0.10 seconds

2-2.5 small boxes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Tall peaked P waves (Lead 2)

A

Right atrial enlargement, usually due to pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Peaked T waves

A

Acute myocardial ischemia onset

Hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

ST Depression

A

Ischemia
*Horizontal/downsloping in 2 continuos leads

Hypokalemia
*Downsloping w/ T-wave flattening/inversion, prominent U waves and a prolonged QU interval

Digoxin
*Downsloping ST depression with a “sagging” morphology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

ST elevation

A

Injury (prolonged ischemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Pathological Q waves (25% or more bigger than R wave, 2 continuos leads minimum)

A

Myocardial Infarction

33
Q

Most common Pathological Q wave location

A

V 1-3

34
Q

Inverted T waves (deep/symmetrical)

A

Ischemia

35
Q

V1-3 Inverted T waves in Peds-Juveniles

A

Normal Finding

36
Q

Calling a STEMI

A

2 consecutive leads or

2 or more leads

1 anterior lead (V3 or V4)

37
Q

ST elevation criteria

A

1mm in any Lead except V2 & V3

38
Q

If seen in LBBB..

A

Concordant ST elevation ≥ 1 mm in ≥ 1 lead

Coronary Occlusion MI
(STEMI equivalent)

Criteria A Modified Sgarbossa

39
Q

If seen in LBBB..

A

Concordant ST depression ≥ 1 mm in ≥ 1 lead of V1-V3

Coronary Occlusion MI
(STEMI equivalent)

Criteria B Modified Sgarbossa

40
Q

If seen in LBBB..

A

Any lead discordant where the STE is ≥ 25% than the depth of the R point

Coronary Occlusion MI
(STEMI equivalent)

Criteria C Modified Sgarbossa

41
Q

Inferior STEMI

A

Inverted T waves

Reciprocality (ST depression) in:
-aVL
-(maybe lead I)

42
Q

Lateral or anterolateral STEMI

A

Inverted T waves:
Lateral = I, aVL, V5-6
Anterior = V2-6

Reciprocality (ST depression) in:
-Lead III
-aVF
-(maybe lead II)

43
Q

Horizontal ST depression in V1-3 (or 4) with upright T waves and tall R waves

A

Posterior MI

44
Q
A

Wellen’s A

Up Down Biphasic T wave due to ischemia

45
Q

ST depression w/ variable morphology in leads V4-6 + I,II, & aVL

A

Subendocardial ischemia

46
Q
A

De winter T wave

*Anterior STEMI equivalent seen in 2% of acute LAD occlusions

47
Q

Widespread ST depression with ST elevation in aVR

A

Left main coronary artery occlusion

Severe triple vessel disease

48
Q
A

Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

-May cause VT & sudden death in young, apparently healthy individuals

49
Q
A

Sodium Channel Blockade

-Amitriptyline, imipramine, or insecticide induced

-Deadly

50
Q
A

Bruguda syndrome

Deadly

Cause:
-Heart defects
-Anti Depressants/Psychotics
-Stimulants (Drugs)
-Electrolyte disbalance

S/S:
-Blackouts or Syncope
-VT

51
Q

Electrical Alternants (alternating QRS amplitude)

A

Pericardial Effusion

Cardiac Tamponade

52
Q
A

Intracranial Hemorrhage/Increased ICP

-Widespread T wave inversion
-QT prolongation

53
Q
A

Hypertrophic Cardiomyopathy

-High precordial voltage
-T wave inversion on all precordial leads, Inferior & Lateral leads

54
Q
A

Down Up Biphasic T wave due to Hyperkalemia

55
Q
A

Hyperkalemia

56
Q

T-wave inversions in the right precordial (V1-3) and inferior (II, III, aVF) leads

A

PE

57
Q

S wave in lead I, Q wave in lead III, T-wave inversion in lead III

A

PE

S1 Q3 T3

58
Q
A

PE

S1 Q3 T3

S wave in lead I, Q wave in lead III, T-wave inversion in lead III

59
Q

Bunny ears?

A

Go to V1

UP = RBBB
DOWN = LBBB

60
Q

RBBB causes

A

Right ventricular hypertrophy
Pulmonary embolus
Ischemic heart disease
Rheumatic heart disease
Congenital heart disease
Myocarditis
Cardiomyopathy
Lenègre-Lev disease: primary degenerative disease (fibrosis) of the conducting system
Heart disease due to high blood pressure in the lungs (pulmonary hypertension)
COPD

61
Q

RBBB discordance

A

ST depression and T wave inversion in V1-3

62
Q

LBBB causes

A

Anterior MI

Dilated cardiomyopathy

Lenègre-Lev disease: primary
degenerative disease (fibrosis) of the conducting system

Hyperkalemia

Digoxin toxicity

63
Q

Axis Deviation?

A

Lead I & aVF

64
Q

Right Axis deviation causes

A

Left posterior fascicular block
Lateral myocardial infarction
Right ventricular hypertrophy
Acute lung disease (e.g. Pulmonary Embolus)
Chronic lung disease (e.g. COPD)
Ventricular ectopy
Hyperkalemia
Sodium-channel blocker toxicity
WPW syndrome
Normal in children or thin adults with a horizontally positioned heart

65
Q

Left Axis deviation causes

A

Left anterior fascicular block

Left bundle branch block

Left ventricular hypertrophy

Inferior MI

Ventricular ectopy

Paced rhythm

Wolff-Parkinson White syndrome

66
Q
A

HYPOKALEMIA

Slightly peaked P wave

Prolonged PR interval

Widespread ST depression & T wave flattening/inversion

Prominent U waves (best seen in V2-V3)

Long QU interval

67
Q
A

Hypokalemia

Could Lead to:
-Frequent Supraventricular & Ventricular ectopics
-AF, A flutter, AT
-VT, VF, Torsades

68
Q
A

Hypokalemia

69
Q
A

Hyperkalemia

70
Q
A

Progression of Hyperkalemia

Could Lead to:
-Bradyarrythmias
-Sine Wave
-Asystole
-VF
-PEA (bizarre wide complex rhythm)

71
Q
A

Hyperkalemia

72
Q
A

Hyperkalemia

73
Q

Long QT intervals

A

Hypocalcemia

Hypomagnesemia

74
Q

Short QT interval
J wave

A

Hypercalcemia

75
Q

-Early Prolonged PR interval (early sign)
-Sinus bradycardia
-1st degree, 2nd degree and 3rd degree AV block
-Junctional bradycardia
-Ventricular bradycardia

A

Beta Blocker & Calcium Channel Blocker OD

76
Q
A

BB or CCB OD

77
Q
A

BB or CCB OD

78
Q

Sinus tachycardia, widened QRS, dominant terminal R wave in aVR

A

TCA OD (has Sodium Blockage effect)

79
Q
A

TCA OD

Pathophys (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions