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(OMS2) CPR II Exam 1 > EKG Tutorial Part 1 & 2 > Flashcards

EKG Tutorial Part 1 & 2 Flashcards

1
Q

What is the Tx for sinus tachycardia?

A

Treat underlying cause

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2
Q

What is the pacemaker of the heart?

A

SA node

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3
Q

What effect does acute inferior MI have on the heart rate?

A

Bradycardia

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4
Q

What is the tx for sinus bradycardia if it is symptomatic?

A

Atropine

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5
Q

What is automaticity?

A

Cardiac cell depolarizes spontaneously during phase 4 of action potential which leads to generation of an impulse

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6
Q

What is seen in a absence of significant heart disease; associated with stress, alcohol, tobacco, coffee, COPD, and CAD?

A

Premature Atrial Contraction

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7
Q

What does a non-conducted premature atrial contraction look like on ecg?

A

No QRS following a premature P wave

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8
Q

What is the Tx of premature atrial contractions?

A

1) Stop the underlying cause

2) Beta blocker such as metoprolol

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9
Q

What is paroxysmal atrial tachycardia?

A

Sudden onset heart rate greater than 100

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10
Q

When is seen on ecg with paroxysmal atrial tachycardia with AV block?

What is the most likely cause?

A

1) Spiked P waves and a 2:1 ration of P:QRS

2) Digitalis toxicity

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11
Q

What is multifocal atrial tachycardia characterized by?

What intervals vary?

What is the rhythm?

What is the rate?

A

1) 3 or more different P waves
2) P-R interval varies
3) Irregular ventricular rhythm
4) HR > 100

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12
Q

Multifocal Atrial Tachycardia is associated with?

What is the axis in this situation?

A

1) Lung disease

2) Right axis

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13
Q

What should you avoid when treating multifocal atrial tachycardia due to the pulmonary problems?

A

Beta blockers

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14
Q

What is the Tx for multifocal atrial tachycardia?

A

Calcium channel blockers such as diltiazem and verapamil

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15
Q

What is the atrial rate for atrial fibrillation?

What does it look like on ecg?

What interval is irregular?

What is the ventricular rhythm described?

A

1) >350-600/min
2) Undulating baseline (not flat) and no P waves
3) RR interval
4) Irregularly irregular

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16
Q

What characteristic appearance does atrial flutter have?

What leads is it best seen in?

A

1) Saw tooth

2) Leads II, III, AVF, V

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17
Q

What does Paroxysmal junctional tachycardia look like on ecg?

A

P waves can be lost in QRS complex, inverted before QRS or after QRS

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18
Q

Paroxysmal supraventricular tachycardia includes?

A

Paroxysmal atrial tachycardia and paroxysmal junctional tachycardia

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19
Q

What does premature ventricular contractions look like on ecg?

A

1) Premature wide QRS
2) No preceding P wave
3) ST-T wave moves in opposite direction of QRS

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20
Q

When should you use metoprolol to treat premature ventricular contractions?

When should you use amiodarone, lidocaine, or procainamide?

A

1) Stable PVC but still symptomatic

2) Unstable PVC

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21
Q

Ventricular Tachycardia is defined by?

What is the ventricular rate?

What happens to the P wave?

How long does it last?

What type of beat is it associated with?

A

1) 3 or more consecutive wide QRS complexes
2) 120-200
3) Lost
4) Longer than 30 seconds
5) Fusion beats (Dressler)

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22
Q

What does Torsades de Pointes look like on ECG?

A

QRS swings from positive to negative direction

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23
Q

If Torsades de Pointes is inherited it is associated with?

A

Long QT

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24
Q

How is Torsades de Pointes treated?

A

MgSO4

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25
Q

What is characterized by disorganized depolarization and ineffective pumping of blood?

A

Ventricular fibrillation

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26
Q

A block that causes a disruption of atrial-to-ventricular electrical conduction is known as?

A

AV block

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27
Q

What indicates 1st degree AV block?

A

PR interval more than 0.2 seconds

28
Q

What are some causes of 1st degree AV block?

A

1) Atherosclerosis
2) Hypertension
3) Diabetes
4) Fibrosis

29
Q

What are the two types of 2nd degree AV block?

A

1) Mobitz I (Wenckebach)

2) Mobitz II

30
Q

What indicates Mobitz I (Wenckebach) 2nd degree AV block?

What indicates Mobitz II?

A

1) PR interval prolongation prior to dropped QRS

2) PR interval uniform and dropped QRS

31
Q

Mobitz I (Wenckebach) 2nd degree AV block can be seen with?

What can Mobitz II be seen with?

A

1) Inferior MI

2) Anterior MI

32
Q

Which 2nd degree AV block has a worse prognosis?

A

Mobitz II

33
Q

Where is the site of block for Mobitz II?

A

Lower than AV node such as Bundle of His

34
Q

What indicates 3rd degree heart block aka complete heart block?

A

P waves that beat independently from QRS complexes

35
Q

When is a 3rd degree block characterized as a junctional rhythm?

What does this result in?

A

1) Block is above AV node

2) Narrow QRS

36
Q

When is a 3rd degree block characterized as a ventricular pacemaker?

What does this result in?

A

1) Block is below AV node

2) Wide QRS

37
Q

What are common features of bundle branch block (BBB)?

A

1) Wide QRS complex

2) ST segment – T waves slope off in opposite direction to QRS

38
Q

How do you differentiate between left and right BBB?

A

1) In LBBB the QRS complex is downwardly deflected in lead V1
2) In RBBB the QRS complex is upwardly deflected in lead V1

39
Q

What are hemiblocks?

A

Term for blockage of one of two main division of left bundle branch

40
Q

Which hemiblock is more common, left anterior hemiblock or left posterior hemiblock?

A

Left anterior hemiblock

41
Q

What is the criteria for left anterior hemiblock?

A

1) Left axis deviation
2) Small Q in leads I and AVL
3) Small R in leads II, III and AVF

42
Q

What is the criteria for left posterior hemiblock?

A

1) Right axis deviation
2) Small R in leads I and AVL
3) Small Q in leads II, III, AVF

43
Q

What are some ways that cause atrial enlargement?

A

1) Increase in volume of blood in the chamber

2) Increase in resistance to blood flow out of chamber

44
Q

What leads is atrial enlargement best seen in?

A

I, II, III, V1

45
Q

Which atrium is activated first in atrial enlargment?

A

RA

46
Q

What does right atrial enlargement look like on ecg?

A

Tall, pointed p wave

47
Q

What is right atrial enlargement is associated with what condition?

A

Pulmonary HTN

48
Q

What does left atrial enlargement look like on ecg?

A

M shaped P wave called P-mitrale

49
Q

What is right atrial enlargement is caused by?

A

Mitral stenosis or regurgitation

50
Q

What is the most common cause of left ventricular hypertrophy?

A

HTN

51
Q

What does left ventricular hypertrophy look like on ecg?

A

1) Deep S waves and tall R waves in limb leads
2) Deep S waves in V1, V2, or V3
3) Tall R waves in V5, V6

52
Q

What is the most common cause of right ventricular hypertrophy?

A

COPD

53
Q

What does right ventricular hypertrophy look like on ecg?

A

1) Right axis
2) Tall R waves in V1
3) Deep S waves in V6
4) R/S ratio in V1 > 1
5) S/R ratio in V6 > 1

54
Q

What effect does acidosis have on the heart?

A

Increased risk for Vfib

55
Q

What does hypokalemia look like on ecg?

A

1) Prominent U waves
2) Long QT
3) Flat or inverted T wave

56
Q

What is a common cause of hypokalemia?

A

Diuretics

57
Q

What is a common cause of hyperkalemia?

A

Renal failure

58
Q

What does hyperkalemia look like on ecg?

A

1) Peaked T wave
2) Wide QRS
3) Long PR interval
4) No P wave

59
Q

What are common causes of hypercalcemia?

A

1) Hyperparathyroidism

2) Malignancy

60
Q

What does hypercalcemia look like on ecg?

A

1) Short QT interval

2) Short ST segment

61
Q

What does hypocalcemia look like on ecg?

A

1) Long QT interval

2) Long ST segment

62
Q

What is hypothermia defined as?

What happens to HR?

What is the characteristic finding on ecg?

A

1) Less than 35◦ C (95◦ F)
2) Bradycardia
3) J wave or Osborne wave (notch after QRS complex)

63
Q

What effect does a pulmonary embolus have on HR?

A

Tachycardia

64
Q

What does a PE look like on ecg?

A

1) Large S wave in lead I
2) ST depression in II
3) Large Q wave in III
4) T wave inversion in V1-V4
5) RBBB

65
Q

What does Wolff-Parkinson – White Syndrome look like on ecg?

A

1) Short PR interval

2) Slurred upstroke (delta wave) of QRS complex

66
Q

What conduction pathway is involved with Wolff-Parkinson – White Syndrome?

A

Bundle of Kent

67
Q

What does acute pericarditis look like on ecg?

A

1) Concave ST segment elevation in leads I, II, aVL, aVF, and V2-6
2) ST segment depression in lead aVR

(OMS2) CPR II Exam 1 (23 decks)

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