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Oral Boards > PGY1 EKGs > Flashcards

PGY1 EKGs Flashcards

1
Q

EKG Block Measurements

mm, sec, msec

A

Small Box = 1mm = 0.04 sec = 40 msec

x 5 =

Large Box = 5mm = 0.2 sec = 200msec

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2
Q

Axis Determination

A
  • Normal = I Pos, aVF Pos
  • LAD = I Pos, avF neg
  • RAD = 1 Neg, aVF pos
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3
Q

PR Interval

A

120-200 msec (2-5 small boxes)

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4
Q

QRS Duration

A

80-120 msec (2-3 small boxes)

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5
Q

QT interval

A

400-430 msec

Or half the length of space between beats

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6
Q

STEMI Criteria

A

ST Elevation in 2 contiguous Leads:

  • 1mm in all leads except for V2/V3
  • V2/V3
    • Men < 40 = 2.5 mm
    • Men > 40 = 2 mm
    • Women: 1.5 mm
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7
Q

Pathological Q Waves

A
  1. > 40 msec (1 block) wide
  2. > 2mm deep
  3. >25% depth of QRS
  4. Seen in Leads V1-3

May be normal in III and aVR

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8
Q

See EKG

A

LBBB

QRS > 120

If the QRS looks like W in V1 and M in V6 it is LBBB. (Wi_LL_iaM)

Or look at V1 - LBBB if main effect is down

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9
Q

See EKG

A

RBBB

QRS > 120

If the QRS looks like M in V1 and W in V6 it is RBBB. (MoRRoW)

Or look at V1 - RBBB if main effect of QRS is up

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10
Q

Lateral Infarct

  • Leads
  • Vessel
  • Reciprocal
A
  • I
  • AVL
  • V5-V6

LCX or Diagonal of LAD

V1

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11
Q

Anterior Infarct

  • Leads
  • Vessel
  • Reciprocal
A

V1-V4

LAD

II, III, aVF

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12
Q

Inferior Infarct

  • Leads
  • Vessel
  • Reciprocal
A

II, III, aVF

RCA usually, sometimes LCx

I, aVL

-40% with RV infarct - get right-sided EKG

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13
Q

Post Infarct

  • Leads
  • Vessel
  • Reciprocal
A
  • Suspect with Lateral or Inferior MI
  • No STE on regular EKG
    • Seen in Inferior and Lateral Ischemia -
    • Horizontal STD in V1-V3
    • V2 with R/S > 1
  • Get posterior
  • V1-V2
  • Posterior Descending Branch of RCA
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14
Q

Septal Infarct

  • Leads
  • Vessel
  • Reciprocal
A

Loss of R Wave in V1-V3

None

LAD or RCA

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15
Q

See EKG

A

1st Degree AV Block

Long PR - No Dropped Beat

(Long PR > 200msec)

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16
Q

See EKG

A

Second Degree Type I Block

Progressive PR lengthening until drop (looks like groups)

17
Q
A

Second Degree Type II

Regular PR with nml P-R interval with occasional dropped beats

18
Q
A

Third Degree Block

Complete Dissociation

19
Q
A

Early Repol

20
Q
A

Mod Hyper K (6.5-8.0)

Widening QRS

Loss of P-waves

ST-segment changes

Chronological ECG changes of hyperkalemia include:

  1. Peaked T waves
  2. Prolongation of PR interval
  3. Widening QRS Complex
  4. Loss of P wave
  5. “Sine Wave”
  6. Asystole
21
Q
A

Early Hyper K (>5.5)

Peaked T waves

Long PR

Chronological ECG changes of hyperkalemia include:

  1. Peaked T waves
  2. Prolongation of PR interval
  3. Widening QRS Complex
  4. Loss of P wave
  5. “Sine Wave”
  6. Asystole
22
Q
A

Severe Hyper K (6.5-8.0)

Sine Wave

Chronological ECG changes of hyperkalemia include:

  1. Peaked T waves
  2. Prolongation of PR interval
  3. Widening QRS Complex
  4. Loss of P wave
  5. “Sine Wave”
  6. Asystole
23
Q
A

SVT

24
Q
A

Pericarditis

25
Q
A

Hypokalemia

26
Q

EKG Rate

A
  • Multiple Number of QRSs by 6
  • # Boxes B/t QRS:
  • 300, 150, 100, 75, 60
27
Q

Right Sided Infarct

  • Leads
  • Vessel
  • Reciprocal
A
  • Seen in 30-50% of Inferior Infarcts
  • Suggested if EKG
    • STE in V1 + ST Depression in V2 (Highly Specific)
    • STE in III > II
  • Get Rt Sided EKG - V3R-V6R
  • Avoid Nitro
  • Give fluids
28
Q

Inferior Infarct

  • Leads
  • Vessel
  • Reciprocal
A
  • Leads II, III, AvF
  • RCA (80%), LCx (18%)
  • I, aVL, Septal Leads
29
Q
A

Rt Infarct

STE in III > II

STE in V1

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