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49 Cards in this Set
- Front
- Back
In a RBBB, what are you looking for?
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RSR’ in V1; Slurred S in Lead I and V6
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What is a floppy eared bunny?
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qRR’ MI + BBB
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In a LBBB, what are you looking for?
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V1 has a broad monomorphic S; I and V6 have broad monomorphic R
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What is the structural different between the LAF and the LPF?
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LAF is a single cord of fibers; LPF is a fan like structure
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LAH has what diagnostic criteria?
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Left axis deviation; Lead I: qR or large R; Lead III: rS complex
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Diagnostic criteria of a LPH?
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Right Axis deviation; Large S in lead I; Small q in lead III
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What is P-mitrale?
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Severe left atrial enlargement
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Diagnostic criteria of P-mitrale?
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P wave greater than .12 seconds in Leads I and II and notched (M shaped)
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Diagnostic criteria of RAE?
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Peaked P wave >2.5 mm
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Biphasic P waves are evidence of?
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Intraatrial conduction delay
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What biphasic P wave is associated with LAE?
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Larger second half
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What biphasic P wave is associated with RAE?
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First half of V1 is taller than the second half of V6
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What are the 5 criteria for LVH?
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S of V1 or 2 + R of V5 or 6 >35 mm; Any precordial lead >45; The R of aVL is >11; The R of Lead I is >12; The R of lead aVF is >20
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What is the main criteria for RVH?
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R>S in V1 and V2
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Diagnostic criteria of LVH with strain?
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V1-3: ST elevation, upward concavity, T wave is upright and asymmetric; V4-6: ST depression, concave down, T wave is inverted and asymmetric
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Where is the strain pattern greatest?
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In the lead with the tallest and deepest QRS
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What is the main difference seen in ischemia and not in strain?
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ST is flat and T wave is symmetrical
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Diagnostic criteria for RVH with strain?
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Increased R:S ratio; Concave down; ST depression; Inverted T wave
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What is the tissue charge in ischemia? Causing what ST?
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Negative, ST depression
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What is the shape of the wedge in ischemia? Why?
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Larger in the epicardium, due to collateral supply in the endocardium
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What is the tissue charge in injury? Causing what ST?
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Positive, ST elevation
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What is the T wave in ischemia, injury, and ischemia?
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Inverted T wave in all
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What is the tissue charge in Infarction?
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Neutral
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What is the shape of the wedge in infarction?
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Wider in the endocardium
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What is the Q wave?
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Caused by the dead tissue (neutral) with all the electrical forces headed away
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What are the 2 classifications of infarcts?
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Q wave and Non-Q wave
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What type of infarct has a higher long-term mortality if aggressive treatment isn’t taken?
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Non-Q wave
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What are the 3 implications in Q wave infarcts?
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Higher acute mortality, increased tissue damage and development of CHF
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In progression of an infarct, what is always the first ECG change?
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T wave inversion
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In a chronic infarct, what is the only ECG sign?
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Q wave
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Anterior wall infarcts are shown in what leads?
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V3 and V4
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Inferior wall infarcts are shown in what leads?
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II, III, and aVF
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Reciprocal changes of inferior wall infarcts are shown in what leads?
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I and aVL
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Lateral wall infarcts are shown in what leads?
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I, aVL, V5 and V6
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Reciprocal changes of lateral wall infarcts are shown in what leads?
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II, III, and aVF
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Septal wall infarcts are shown in what leads?
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V1 and V2
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Reciprocal changes of septal wall infarcts are shown in what leads?
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V7-9 (posterior leads)
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Blood supply obstruction in an inferior MI?
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RCA, LCx
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Blood supply obstruction in an inferior-RV MI?
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Proximal RCA
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Blood supply obstruction in an inferoposterior MI?
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RCA, LCx
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Blood supply obstruction in an isolated RV MI?
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LCx
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Blood supply obstruction in an isolated posterior MI?
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RCA, LCx
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Blood supply obstruction in an anterior MI?
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LAD
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Blood supply obstruction in an anteroseptal MI?
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LAD
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Blood supply obstruction in an anteroseptal-lateral MI?
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Proximal LAD
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Blood supply obstruction in an anterolateral, inferolateral, or posterolateral MI?
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LCx
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What is the change of having an arrhythmia leading to sudden cardiac death in an AMI?
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40%
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What infarct area does not show reciprocal change?
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Anterior
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What is one of the first signs of an inferior infarct?
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Downward sloping ST
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