Clincal Exam - Ekg 2

Front 1

duration: P wave

Back 1

0.08-0.11 s

Front 2

duration: PR interval

Back 2

0.12-0.2 s

Front 3

duration: QRS interval

Back 3

0.06-0.11 s

Front 4

max normal depression of PR

Back 4

0.8 mm

Front 5

range for atrial rhythm

Back 5

60-80

Front 6

range for junctional rhythm

Back 6

40-60

Front 7

range for ventricular rhythm

Back 7

20-40

Front 8

P wave is + in which leads?

Back 8

I, II, V4, V5, V6

Front 9

P wave is - in which leads?

Back 9

aVR

Front 10

P-mitrale criteria and dx

Back 10

>= 0.12s in I, II; >= 0.04 between humps; LAE

Front 11

P-pulmonale criteria and dx

Back 11

> 2.5 mm high in limb leads; RAE

Front 12

biphasic criteria for LAE

Back 12

height x width of 2nd wave is >= 0.3 s (or 2nd wave is wider and deeper than 1 small block)

Front 13

biphasic criteria for RAE

Back 13

height of 1st wave in V1 > that in V6

Front 14

causes of short PR intervals (5)

Back 14

origin near AV node, tachycardia, retrograde junctional wave, LGL, WPW

Front 15

cause of LGL

Back 15

impulse travels through James fibers which bypass the normal physiologic block at the AV node

Front 16

criteria for LGL

Back 16

short PR, normal QRS, possible tachycardia

Front 17

cause of WPW

Back 17

impulse travels through Kent bundle which bypasses normal atrial-ventricular conduction at AV node

Front 18

criteria for WPW

Back 18

short PR, prolonged QRS, delta wave, ST-T changes, tachycardia

Front 19

causes of prolonged PR interval (7)

Back 19

cell-to-cell transmission, hyperK, 1st deg block, Mobitz 1 and 2, 3rd deg block

Front 20

criteria for 1st deg block

Back 20

prolonged PR interval

Front 21

criteria for Mobitz 1

Back 21

PR prolongs until a beat is dropped

Front 22

criteria for Mobitz 2

Back 22

PR interval remains the same (but prolonged) then a beat is dropped

Front 23

criteria for 3rd deg block

Back 23

no association between P and QRS

Front 24

causes of PR depression (2)

Back 24

pericarditis, atrial infarct (rare)

Front 25

criteria for pericarditis

Back 25

PR depression, tachycardia, ST elevation, notch at end of QRS

Front 26

criteria for short QRS

Back 26

< 5 mm in limb, < 10 mm in precordial

Front 27

criteria for LVH

Back 27

S of V1/2 + R v5/6 >= 35 mm; precordial >= 45mm; R in aVL >= 11mm; R in I >= 12mm; R in aVF >= 20 mm

Front 28

criteria for RVH

Back 28

R:S > 1 in V1/2

Front 29

Ddx for R:S > 1 in V1/2 (4)

Back 29

RVH, RBBB, WPW-A, PWMI

Front 30

Ddx for prolonged QRS (8)

Back 30

hyperK, V tach, idioventricular rhythms, drugs, WPW, BBB, PVC, aberrantly conducted complexes

Front 31

criteria for significant Q wave

Back 31

>= 0.03 s and > 1/3 height of QRS

Front 32

criteria for benign Q wave

Back 32

occurs in I or aVL (septal), QS in V1

Front 33

benign ST segment elevation is associated with what?

Back 33

QRS notching

Front 34

what is an Osborn (J) wave?

Back 34

large deflection at end of QRS caused by hypothermia

Front 35

with what is Osborn (J) wave associated?

Back 35

ST depression, flipped T waves, bradycardia, prolonged QT, arrhythmias

Front 36

Ddx for RAD (5)

Back 36

child, RVH, LPH, dextrocardia, ectopic ventricular beats/rhythms

Front 37

Ddx for LAD (2)

Back 37

LAH, ectopic ventricular beats/rhythms

Front 38

criteria for RBBB (5)

Back 38

prolonged QRS, slurred S in I and V6, rSR in V1, R:S > 1 in V1/2, disconcordant T

Front 39

criteria for LBBB (5)

Back 39

prolonged QRS, monomorphic complexes, ST depression/elevation, wave in direction of left and posterior, disconcordant T

Front 40

criteria for localized IVCD

Back 40

normal QRS with lots of peaks

Front 41

criteria for LAH (4)

Back 41

normal QRS, LAD (-30 to -90), qR or R in I, rS in III

Front 42

criteria for LPH (4)

Back 42

RAD, s in I, q in III, exclude RAE and RVH

Front 43

T wave is + in which leads

Back 43

I, II, V3/4/5/6

Front 44

T wave is - in which leads?

Back 44

aVR

Front 45

Ddx for symmetric T wave

Back 45

ischemia, electrolyte abn

Front 46

DDx: tall narrow T wave

Back 46

hyperK

Front 47

Ddx: broad T wave

Back 47

CNS event

Front 48

criteria for abn T wave height

Back 48

> 2/3 height of R wave

Front 49

DDx: diffuse J point

Back 49

early repolarization, LVH with strain, pericarditis

Front 50

DDx: ST segment depression and opposite T wave

Back 50

ischemia

Front 51

DDx: ST elevation

Back 51

MI

Front 52

DDx: ST concave up

Back 52

early repol, pericarditis

Front 53

DDx: ST concave down

Back 53

strain

Front 54

DDx: tombstone

Back 54

infarction, ventricular aneurysm

Front 55

criteria for ischemia

Back 55

ST elevation/depression, ST flat or slopping down, sym T wave or biphasic starting negative

Front 56

criteria for RVH with strain

Back 56

S1Q3T3, R:S > 1 in V1/2, concave down ST that is depressed, flipped asym T or biphasic with 1st negative

Front 57

criteria for LVH with strain

Back 57

LVH criteria, ST depressed and concave down in V4-6, ST elevation and concave up in V1-3

Front 58

DDx: ST depression in V1/2

Back 58

RVH, RBBB, WPW-A, PWMI

Front 59

reciprocal leads for inferior wall

Back 59

I, aVL

Front 60

reciprocal leads for septum

Back 60

V7-9

Front 61

criteria for hyperK with K levels

Back 61

tall peaked T (>5.5), IVCD (>6.5), decreased amp of P (>7), missing P (>8.8)

Front 62

DDx: U wave

Back 62

hypoK, bradycardia, LVH, CNS events, drug use (dig, class I antiarrhythmics, phenothiazine)

Front 63

criteria for hyperCa

Back 63

shortened ST and QTc