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EKG > Exam 1 > Flashcards

Exam 1 Flashcards

0
Q

Treatments for Vfib?

A

Defibrillation, implantible cardioverter defibrillator, precordial thump, anti arrhythmic drugs - amiodarone, lidocaine

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1
Q

Is Vfib a shockable rhythm?

A

Yes

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2
Q

Common causes for torsades de pointes

A

Hypomagnesia, hypokalemia, malnourished and chronic alcoholics, MI

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3
Q

torsades de pointes characteristics

A

Prolonged qt interval (prolonged vent repolarization). Looks like VT except QRS do “streamer” effect around baseline

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4
Q

Most general way of determining ventricular vs supraventrular arrhythmias?

A

Supra - narrow qrs

Vent - wide qrs

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5
Q

Difference between vt and Psvt?

A 
•VT
–No response to carotid massage
–Cannon A waves may be present
–Fusion beats may be seen
•PSVT
–May terminate with carotid massage
–Cannon A waves are not seen
–Fusion beats are not seen
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6
Q

Difference between PAC and PVC?

A

PVC has compensatory pause, PAC has a more normal-looking QRS

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7
Q

Characteristics of PVC?

A
  • Wide and irregular QRS complex
  • Retrograde or no P wave
  • Presence of ‘compensatory pause’
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8
Q

Names of PVC/normal qrs ratios?

A 
–1:1 = bigeminy
–1:2 = trigeminy
–1:3 = quadrageminy
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9
Q

What if PVCs have different shapes?

A

They are coming from different areas (irritable foci of the ventricles)

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10
Q

How are PVCs and Vtac related?

A

Vtac is 3+ PVCs in a row

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11
Q

VTac is how many BPM?

A

120-200

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12
Q

Treatment for PVC’s?

A

1mg/kg lidocaine

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13
Q

Treatment for VTac?

A

Defibrillation and ACLS

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14
Q

Main difference between hypertrophy and enlargement?

A

Enlargement - Refers to dilatation of a chamber

Hypertrophy - Refers to an increase in muscle mass

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15
Q

Enlargement and Hypertrophy changes

A

Increase in wave duration
Chamber takes longer to depolarize
Increase in wave amplitude
Chamber can generate more current at a time
Shift of electrical axis
Larger percentage of total electrical current can move through the expanded chamber

16
Q

Which plane is the axis?

A

Frontal

17
Q

Correspond each lead with AVF etc

A

AVF - 1, AVL - 2, AVR - 3

18
Q

Match Leads 1-3, AVF etc with corresponding numerical values

A

1 = 0, 2 = 60, 3=120, AVF =90, AVL=-30, AVR=-150

19
Q

Best leads to see atrial enlargement

A

2 and v1

20
Q

Duration, length of normal P wave

A

< 4 blocks long, <2.5 blocks high

21
Q

Hypertrophy generally refers to ______ and enlargement generally refers to ________

A

Hypertrophy of ventricles, enlargement of atria

22
Q

Causes of arrhythmias?

A
  1. Hypoxia 2. Ischemia and irritability 3. sympathetic stimulation 4. Drugs 5. Electrolyte disturbances 6. Bradycardia 7. Stretch
23
Q

What is the mnemonic for arrhythmias and what does it stand for?

A

HISDEBS, treatable factors leading to arrhythmias. Hypoxia, Ischemia/Irritability, Sympathetic Stimulation, Drugs, Electrolyte disturbance, Bradycardia, Stretch (enlargement/hypertrophy)

24
Q

What is HR when R-R interval is a. 3 large squares b. 4 c. 5 d. 6

A

a. 100bpm b. 75 c. 60 d. 50

25
Q

What are 4 basic questions to ask when assessing an EKG?

A
  1. Are normal P waves present?
  2. Are the QRS complexes narrow or wide?
  3. What is the relationship between the P waves and the QRS complexes?
  4. Is the rhythm regular or irregular?
26
Q

Describe PSVT

A

Normal rhythm but rate is 150-250bpm. May have retrograde R wave in lead 2 or pseudo-R in V1. Usually not indication of underlying cardiac disease, may just be excitement, caffeine or alcohol.

27
Q

Describe the carotid massage vagal response

A

Massage of carotid artery stimulates baroreceptors to send reflex response from brain along vagus nerve to the heart to decrease rate at which sinus node fires.

28
Q

Carotid massage can break what arrhythmia?

A

PSVT

29
Q

Describe how to do carotid massage

A

Pt lying flat w/ neck extended and head to left. Palpate RIGHT artery and apply pressure 10-15s (try left side if right fails).

EKG (9 decks)

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