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Diagnostics > TEST 3 > Flashcards

TEST 3 Flashcards

1
Q

Chest leads have what type of polarity

A

V1-V6 = unipolar

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2
Q

Limb leads have what type of polarity

A

I, II, III, aVR, aVL, aVF = bipolar

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3
Q

Right arm always have what type of charge

A

NEGATIVE - -

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4
Q

Left arm always has what type of charge

A

Positive or negative +/-

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5
Q

Left leg always has what type of charge

A

POSITIVE ++

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6
Q

Electrical impulse always moves towards which pole?

A

to the positive pole. This causes and upward deflection in the EKG strip

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7
Q

aVR has what type of deflection?

A

negative

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8
Q

aVL and aVF have what type of deflection?

A

Positive

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9
Q

Leads I, II, III should have what type of deflection

A

POSITIVE

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10
Q

V1 AND V2 PLACEMENT

A

4TH ICS

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11
Q

V4 AND V5 PLACEMENT

A

5TH ICS

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12
Q

V1-V3 deflection

A

Going away from so negative with increasing positivity

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13
Q

V4-V6 deflection

A

Coming toward that lead so positive

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14
Q

What does SAL represent

A

Septal V1 and V2
Anterior V3 and V4
Lateral V5 and V6

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15
Q

I and aVL represent which area of the heart

A

high lateral

-V5 and V6 are lateral as well

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16
Q

II, III, and aVF represent which area of the heart

A

inferior

“boot”, boot them to the Cath lab

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17
Q

V1 - V4 represent which area of the heart

A

anterior septal

18
Q

ST depression on EKG is representative of what

A

Ischemia

19
Q

inverted T waves represents what

A

previous damage or previous MI

20
Q

Q waves represent what

A

never go away - represent an MI in the past

defined as duration >0.04 or >25% R wave amplitude

21
Q

Axis Deviation trick

A

whichever finger is pointing up is the deviation

if positive deflection, finger up
if negative deflection, finger down

use lead I (lateral) and lead aVF (interior)

both down? no mans land = bundle branch block

22
Q

Which leads do you look at to determine a BBB

A

I, V1, V6

23
Q

RBBB

A

always a wide QRS

Two QRS out of phase. R and R in right

24
Q

LBBB

A

always a wide QRS

Double elevated R wave

25
Q

Steering wheel method

A

to determine BBB

always look at V1

if terminal force is up, flip blinker up, turning RIGHT=RBBB

if terminal force is down, flip blinker down, turning LEFT = LBBB

26
Q

Holter Monitor

A

ambulatory ekg monitor with continuous EKG for 24-48 hours

27
Q

Ambulatory Event Monitor

A

longer than holter

patient triggered or automatic recording with abnormalities

loop recorders can be implanted for up to 2 years

28
Q

troponin

A

levels rise within 2-3 hours

only one elevated troponin is needed to dx MI

if no EKG changes are present, NSTEMI

29
Q

creatinine kinase

A

CPK2 or CKMB are specific enzymes for the heart, they take longer to rise (2-4hrs) and peak at 24 hours

when ordered usually wanting to determine if it is a cardiac problem

30
Q

what does a stress test determine

A

areas of the heart that have decreased oxygenation with increased contractility and oxygen demand

31
Q

contraindications to stress test

A 
CHF
uncontrolled arrhythmias
angina
MI
PE
aortic dissection

patient must be NPO for 4 hours and have IV access

32
Q

Left side cardiac cath

A

Looks at vessels, valves, and ejection fraction. Diagnoses cardiovascular disease

interventions can be made- stents, balloons, etcs

33
Q

Right side cardiac cath

A

Looks at pressures in the heart, blood flow problems, valve issues, pulmonary hypertension

more diagnostic then interventional

34
Q

Echocardiogram

A

looks at the inside of the heart - valves, walls, pericardium, cardiac function, regurgitation, insuffiency

does not diagnose arthroscleoritc heart disease

recommended for long standing hypertension

35
Q

TEE

A

Looks at the back of the heart and can see better

can see vegetation

36
Q

Bubble study

A

confirms a atrial-septal defect

37
Q

normal ef

A

50-80%

38
Q

new murmur noticed?

A

order an echo. Best way to see valves and diagnose insufficiency verses regurgitation

39
Q

Stenosis

A

valves don’t open properly… back flow is occurring

40
Q

Aortic Stenosis

A

causes back flow in to the LV and then lungs

syncope, dyspnea, narrow pulse pressure, arythmias and sudden cardiac death, LV hypertrophy

41
Q

If can’t do a cardiac cath, options?

A

CTA - can see calcium plaque on vessels
PET scan
MRA

Diagnostics (4 decks)

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