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Semester 5 PMCP Exam 1 > Other ECG > Flashcards

Other ECG Flashcards

1
Q

Junctional premature complex (3)

A

P wave usually inverted, absent, or retrograde
PR interval short
QRS rate less than .12 for premature beat (usually 60-100 bpm)

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2
Q

Junctional premature complex - P wave inverted in what leads

A

II, III, aVF

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3
Q

Common etiology for junctional premature complex

A 
normal finding 
stress, caffeine, alcohol
Heart failure, MI, pericarditis 
Valvular heart disease
Chronic lung disease, hyperthyroidism
Electrolyte abnormalities 
Excessive vagal tone
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4
Q

Clinical signs and symptoms - junctional premature complex

A

seldom produces any
maybe irregular pulse
serious if frequent
might be warning for serious junctional dysrhythmias

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5
Q

Tx for junctional premature complex

A

no specific tx indicated

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6
Q

junctional rhythm (3)

A

P wave for every QRS (inverted, absent, retrograde)
PR interval short
QRS rate - between 40-60, QRS narrow

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7
Q

Junctional rhythm common etiology

A 
IWMI
Heart failure
Valvular heart disease
Cardiomyopathy 
Sick sinus syndrome
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8
Q

Clinical signs and symptoms - junctional rhythm

A

slow irregular pulse

often temporary dysrhythmia

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9
Q

Treatment for junctional rhythm

A

determine underlying cause
withhold digoxin
may need to accelerate heart rate if low
pacemaker

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10
Q

3 possible places to find P wave in junctional rhythm

A

Retrograde
Absent (buried in QRS)
Inverted

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11
Q

Where in cardiac cycle does PJC occur

A

PR interval

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12
Q

What is digoxin

A

Glucoside
Slows HR, improves flow of Ca in and out
At toxic levels, increases HR

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13
Q

Sinus block (3)

A

P wave is normal and upright
PR interval .12 to .20 sec
QRS rate - less than .12

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14
Q

Etiology of sinus block

A 
inc vagal tone
IWMI
Excess digoxin
Hyperkalemia
Myocarditis
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15
Q

Clinical signs and sx of sinus block

A

pt usually unaware

may sense skipped beat

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16
Q

First degree AV block (3)

A

P wave before each WRS
PR interval .21 or more
QRS rate - regular

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17
Q

Where is the block with first degree AV block

A

at the top of the AV node

Long PR interval - telling us AV node

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18
Q

Common etiology of first degree AV block

A 
Insult to AV node
Hypoxemia
MI
Digitalis toxicity 
Ischemic disease
Right coronary artery disease
Rheumatic heart disease
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19
Q

Clinical signs and sx of first degree AV block

A

None - unless HR is too low

May progress into 2nd or 3rd degree block

20
Q

First degree AV block treatment

A

usually not indicated since asymptomatic

21
Q

Second degree AV block - Type 1 (3)

A

P wave before every QRS
PR interval - progressively lengthens
QRS rate - often slow, regular with dropped beat

22
Q

Common etiology of second degree AV block

A 
Parasympathetic excess
Drugs that mimic or induce 
Right coronary artery disease
Digoxin toxicity 
Might be transient with severe ischemia
23
Q

Second Degree AV block Type 1 - treatment

A

patients usually are asymptomatic
if drug toxicity is cause - hold drugs
Pacemaker if rate too low

24
Q

Second degree AV block Type 2 (3)

A

P wave before each QRS
PR interval wide and fixed
QRS - dropped QRS every 2nd, 3rd, or 4th P wave

25
Q

Second degree AV block Type 2 - common etiology

A

Insult to AV node
Common with IWMI
Hypoxemia
Inc vagal tone on AV ndoe

26
Q

Second degree AV block type 2 - signs and sx

A

Usually none

If HR dec then dec CO too

27
Q

Second degree AV block type 2 - treatment

A

pacemaker
withhold causative drugs
atrophine to accelerate underlying rate
Can progress to be more lethal

28
Q

Third AV block (3)

A

P wave - regular
PR - variable
QRS - usually below 60

29
Q

Third degree heart block - common etiologfy

A

Insult to AV
Cardiac drugs
Acute MI
Ischemic disease of conduction system

30
Q

Third degree AV block - clinical signs and sx

A 
Extremely dangerous
Rate is slow
Drop in CO
Can progress to ventricular asystole
Ventrcular escape or irritability may ocur
Can cause Stokes Adams attack
31
Q

Third degree AV block tx

A

Administer atropine
Epinephrine
Withhold drug
Pacemaker

32
Q

Prolonged PR interval makes you think -

A

First degree AV block

Second degree AV block type 1 and 2

33
Q

ECK with missing QRS makes you think

A

Second degree AV block type 1 or 2

34
Q

Right bundle branch block

A

P wave and PR int depend on underlying rhythm
QRS - 0.12 s or higher
Wide QRS and pos in lead V1

35
Q

Common etiology with R bundle branch block

A 
R vent hypertrophy
R vent strain
CAD
Myocarditis
Cardiac contusion
Idiopathic
Wolff Parkinson white syndrome
PE
COPD
36
Q

Right bundle branch block - signs and sx

A

Usually none

If all three bundle branches blocked - can lead to complete heart block or ventricular standstill

37
Q

Right bundle branch block - tx

A

None unless associated with MI or syncope

38
Q

Left bundle branch block (3)

A

P wve and PR int depend on underlying rhythm

QRS - .12 or higher, QRS wide and negative in V1

39
Q

What does the deep S wave signify in left bundle branch block

A

delayed activation of left ventricle

40
Q

Common etiology of left bundle branch block

A 
L vent hypertrophy
Cardiomyopathy 
Hypertension
CAD
Myocarditis
WPW syndrome
Aortic valve disease
41
Q

Clinical signs and sx for left bundle branch block

A

usually none unless with syncope or MI

42
Q

Tx for left bundle branch block

A

usually unnecessary

43
Q

Dx of bundle branch block is based on what

A

widened QRS

44
Q

Myocardial ischemia produces

A

inverted and symmetrical T wave OR ST depression

45
Q

Myocardial injury produces

A

ST elevation

46
Q

Myocardial infarction produces

A

Widened and deepened Q wave OR ST elevation OR depression in V1 and V2

47
Q

Subendocardial only effects

A

the subendocardium so significant Q wave will not appear on ECG

Semester 5 PMCP Exam 1 (6 decks)

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