EKG V and VI

Question 1

What do you look at on an EKG to determing AV block

Answer 1

The PR interval is the key to differentiating AV blocks

Question 2

What are the four types of AV blocks

Answer 2

1. First degree 2. Second degree Mobitz 1 (wenckebach) 3. Second degree Mobitz 2 4. Third degree (complete Heart Blcok)

Question 3

Characterisics of first degree AV block

Answer 3

If its just an AV block the rest of the EKG will be normal except the PR interval will be prolonged >0.2 in all beats and will be consistent

Question 4

Weneckbach Characteristics

Answer 4

The PR interval gets longer and longer until a missing beat weeeeerrrrrrrnnnnnnnneeeeeeckkkkkk BACH

Question 5

Second degree AVB Mobitz type II Characteristics

Answer 5

-This is when some impulses to the ventricles are completely blocked so missing ventricular beat - The PR interval remains CONSTANT but then a beat is dropped, PR can be prolonged

Question 6

What can a second degree Mobitz type II block turn into

Answer 6

a Third degree complete heart block

Question 7

Third Degree Heart BLock what will be regular what will be irregular

Answer 7

the P-P the R-R There wont be a 1:1 to ratio (1 P wave for every QRS)

Question 8

Will ventricles in a third degree AV block be narrow or wide?

Answer 8

They will be Wide because they are pacing themselves

Question 9

Which leads do you look at for bundle branch blocks

Answer 9

Diagnosed by RR’ in V1 and V6

Question 10

What is a bundle branch block, where does the block occur

Answer 10

This is a delay or interruption in the transmission of electrical impulse that occurs below the bifurcation of the bundle of his Can be complete or incomplete

Question 11

Which is worse RBBB or LBBB

Answer 11

LBBB- this does not occur in a healthy heart, espically alarming if its a new diagnoses RBBB- Can occur in a healthy heart

Question 12

What can cause a RBBB

Answer 12

CAD HTN Acute pulmonary embolism Chronic electrical degeneration

Question 13

What can cause a LBBB

Answer 13

HTN Cardiomyopathy Acute MI Aortic Stenosis Extensive CAD Diseased electrical system

Question 14

Man Characteristic of LBBB

Answer 14

Rabbit ears on lead V6

Question 15

Which is more concerning discordance or concordance

Answer 15

Concordance

Question 16

What is discordance

Answer 16

In a BBB if the QRS wave is up the T-wave should be down or if the QRS is down the T-wave should be up

Question 17

what is Concordance

Answer 17

This is alarming and is when a BBB has both T-wave upright and QRS upright and can be suggestive of Ischemia or MI

Question 18

what is the difference btw ischemia and infarction

Answer 18

with ischemia the heart muscle is still savable whereas with infarction it is dead

Question 19

A clot in the RCA would cause which kind of heart attack

A. Inferior

B. Anterior

C. Posterior

D. Septal

Answer 19

A. Inferior seen in leads I,II, III

Question 20

A clot in the top portion of the LMA would have what effects on the heart?

A. An anterior MI and Lateral MI

B. Septal MI

C. Anterior MI

D. Posterior MI and Septal MI

Answer 20

Best answer is A

A block in the LMA will show st elevation in the anterior and lateral leads

Question 21

What two types of MIs can bee seen with a block to the LAD?

A. Posterior and inferior

B. Septal and anterior

C. Septal and lateral

D. Anterior and lateral

Answer 21

B. Septal and anterior

Question 22

You see ST elevation in leads I, avL, V5 and V6. What kind of MI is the pt having and which artery is being occluded?

Answer 22

Latreral MI with the circumflex artery occluded

Question 23

If suspecting a Posterior MI what could you do to make sure your suspicion is right?

Answer 23

Place leads 7 - 9 on the back of the pt

Question 24

With a posterior MI are you going to see elevated ST segments or Depressed ST segements? Also in which leads would you see these findings?

Answer 24

It would be ST depression and in the septal and anterior perocardial leads V1-V4

Question 25

Later leads refer to which?

A. II, III, AVf

B. I, avL, V5, V6

C. V1, V2

D. V2, V3, V4

Answer 25

B. I, avL, V5, V6

Question 26

Septal Leads refer to which?

A. V1, V2

B. V4, V5, V6

C. I, II, III

D. V2, V3, V4

Answer 26

A. V1, V2

Question 27

which of the following are inferior leads?

A. I, II, III

B. I, II, avF

c. II, III, avF

D. avF, avL, avR

Answer 27

C. II, III, avF

Question 28

Which of the following are anterior leads

A. V1, V2, V4

B. V2, V3, V4

C. V5, V6

D. V1, V2,V3

Answer 28

B. V2, V3, V4

Question 29

If you see ST elevation is only one lead can you call it myocardial ischemia?

Answer 29

No there needs to be two points of ST depression or T-wave inversion

Question 30

What leads do you look at when considering myocardial ischemia with st depression

Answer 30

Leads V5 or V6

and III or avF

Question 31

How large must the ST depression be in leads V5 and V6 and also III and avF for it to be considered myocardial ischemia

Question 32

Which leads is it normal to see T-wave inversion

Answer 32

Leads avL and V1