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63 Cards in this Set
- Front
- Back
duration: P wave
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0.08-0.11 s
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duration: PR interval
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0.12-0.2 s
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duration: QRS interval
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0.06-0.11 s
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max normal depression of PR
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0.8 mm
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range for atrial rhythm
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60-80
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range for junctional rhythm
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40-60
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range for ventricular rhythm
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20-40
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P wave is + in which leads?
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I, II, V4, V5, V6
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P wave is - in which leads?
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aVR
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P-mitrale criteria and dx
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>= 0.12s in I, II; >= 0.04 between humps; LAE
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P-pulmonale criteria and dx
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> 2.5 mm high in limb leads; RAE
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biphasic criteria for LAE
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height x width of 2nd wave is >= 0.3 s (or 2nd wave is wider and deeper than 1 small block)
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biphasic criteria for RAE
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height of 1st wave in V1 > that in V6
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causes of short PR intervals (5)
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origin near AV node, tachycardia, retrograde junctional wave, LGL, WPW
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cause of LGL
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impulse travels through James fibers which bypass the normal physiologic block at the AV node
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criteria for LGL
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short PR, normal QRS, possible tachycardia
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cause of WPW
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impulse travels through Kent bundle which bypasses normal atrial-ventricular conduction at AV node
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criteria for WPW
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short PR, prolonged QRS, delta wave, ST-T changes, tachycardia
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causes of prolonged PR interval (7)
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cell-to-cell transmission, hyperK, 1st deg block, Mobitz 1 and 2, 3rd deg block
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criteria for 1st deg block
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prolonged PR interval
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criteria for Mobitz 1
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PR prolongs until a beat is dropped
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criteria for Mobitz 2
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PR interval remains the same (but prolonged) then a beat is dropped
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criteria for 3rd deg block
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no association between P and QRS
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causes of PR depression (2)
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pericarditis, atrial infarct (rare)
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criteria for pericarditis
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PR depression, tachycardia, ST elevation, notch at end of QRS
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criteria for short QRS
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< 5 mm in limb, < 10 mm in precordial
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criteria for LVH
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S of V1/2 + R v5/6 >= 35 mm; precordial >= 45mm; R in aVL >= 11mm; R in I >= 12mm; R in aVF >= 20 mm
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criteria for RVH
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R:S > 1 in V1/2
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Ddx for R:S > 1 in V1/2 (4)
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RVH, RBBB, WPW-A, PWMI
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Ddx for prolonged QRS (8)
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hyperK, V tach, idioventricular rhythms, drugs, WPW, BBB, PVC, aberrantly conducted complexes
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criteria for significant Q wave
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>= 0.03 s and > 1/3 height of QRS
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criteria for benign Q wave
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occurs in I or aVL (septal), QS in V1
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benign ST segment elevation is associated with what?
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QRS notching
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what is an Osborn (J) wave?
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large deflection at end of QRS caused by hypothermia
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with what is Osborn (J) wave associated?
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ST depression, flipped T waves, bradycardia, prolonged QT, arrhythmias
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Ddx for RAD (5)
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child, RVH, LPH, dextrocardia, ectopic ventricular beats/rhythms
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Ddx for LAD (2)
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LAH, ectopic ventricular beats/rhythms
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criteria for RBBB (5)
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prolonged QRS, slurred S in I and V6, rSR in V1, R:S > 1 in V1/2, disconcordant T
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criteria for LBBB (5)
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prolonged QRS, monomorphic complexes, ST depression/elevation, wave in direction of left and posterior, disconcordant T
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criteria for localized IVCD
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normal QRS with lots of peaks
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criteria for LAH (4)
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normal QRS, LAD (-30 to -90), qR or R in I, rS in III
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criteria for LPH (4)
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RAD, s in I, q in III, exclude RAE and RVH
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T wave is + in which leads
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I, II, V3/4/5/6
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T wave is - in which leads?
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aVR
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Ddx for symmetric T wave
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ischemia, electrolyte abn
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DDx: tall narrow T wave
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hyperK
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Ddx: broad T wave
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CNS event
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criteria for abn T wave height
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> 2/3 height of R wave
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DDx: diffuse J point
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early repolarization, LVH with strain, pericarditis
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DDx: ST segment depression and opposite T wave
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ischemia
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DDx: ST elevation
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MI
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DDx: ST concave up
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early repol, pericarditis
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DDx: ST concave down
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strain
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DDx: tombstone
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infarction, ventricular aneurysm
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criteria for ischemia
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ST elevation/depression, ST flat or slopping down, sym T wave or biphasic starting negative
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criteria for RVH with strain
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S1Q3T3, R:S > 1 in V1/2, concave down ST that is depressed, flipped asym T or biphasic with 1st negative
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criteria for LVH with strain
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LVH criteria, ST depressed and concave down in V4-6, ST elevation and concave up in V1-3
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DDx: ST depression in V1/2
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RVH, RBBB, WPW-A, PWMI
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reciprocal leads for inferior wall
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I, aVL
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reciprocal leads for septum
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V7-9
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criteria for hyperK with K levels
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tall peaked T (>5.5), IVCD (>6.5), decreased amp of P (>7), missing P (>8.8)
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DDx: U wave
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hypoK, bradycardia, LVH, CNS events, drug use (dig, class I antiarrhythmics, phenothiazine)
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criteria for hyperCa
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shortened ST and QTc
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