ECG

Question 1

How many lead needed for V4R

Answer 1

11

Question 2

Main ions in cardiac myocyte

Answer 2

Potassium
Sodium
Calcium

Question 3

Ions intracellular

Answer 3

High K
Low Na
Low Ca

Question 4

Ions extracellular

Answer 4

Low K
High Na
High Ca

Question 5

Stage 0
Cardiac Action Potential

Answer 5

Rapid depolarization caused by influx of sodium

Question 6

Stage 1

Answer 6

Initial repolarization

Question 7

Phase 2

Answer 7

Plateau phase due to slow Ca influx

Question 8

Phase 3

Answer 8

Restores the resting potential
Repolarisation due to delayed rectifier K channels

Question 9

Phase 4

Answer 9

Stable period - resting potential

Question 10

P wave

Answer 10

Atrial contraction
Initiated from SA node
Proceeds inferiorly to AV node
First bit of P wave is R atrium, 2nd bit is Left atrium

Question 11

PR

Answer 11

Signal down through bundles of His to ventricles

Question 12

QRS Complex

Answer 12

Ventricular contraction
<120ms (3sq)

Question 13

T wave

Answer 13

Ventricular repolarisation
T wave inversion V1-V3 until about 10 years ‘Juvenile T wave pattern’

Question 14

U wave

Answer 14

Hypocalcaemia
Hypokalaemia
more visible in bradycardia

Question 15

Tall P waves

Answer 15

P Pulmonale
Right atrial enlargement
<3sq normal

Question 16

Wide P waves

Answer 16

Left Atrial enlargement
<90ms normal

Question 17

Bifid P wave

Answer 17

Asynchrony between R + L atriums

Question 18

Short PR

Answer 18

WPW - delta wave. Risk of VF
Glycogen storage disease

Question 19

Long PR Interval

Answer 19

AV block (first degree)
e.g. in Ebsteins (half R ventricle functions as R atrium)
- ASD

Question 20

Variable PR interval

Answer 20

Mobitz type 1 - type wone - widens (second degree heart block)

Question 21

Wolf Parkinson White

Answer 21

Short PR
Associated with SVT (80%)
Verapamil and Digoxin contraindicated
Delta waves common (50%)

Question 22

Lateral

Answer 22

I, aVL, V5, V6

Question 23

Inferior

Answer 23

II, III, aVF

Question 24

Anterior

Answer 24

V1,V2,V3, V4

Question 25

Septal

Answer 25

V1, V2

Question 26

Remember Lead views

Answer 26

Big LII Little LI ASS ALL

Question 27

Pathological Q waves

Answer 27

Lateral Leads - e.g. aVL = ALCAPA V1, V2, V3 - TGA

Question 28

Upright T wave in V1 before 10 years old is?

Answer 28

RV hypertrophy

Question 29

Flat T waves

Answer 29

Hypokalaemia Hypothyroidism Pericarditis Myocarditis MI Raised ICP

Question 30

Prolonged QT

Answer 30

<440 Long QT syndrome Hypothermia Hypocalcaemia Hypokalaemia

Question 31

Mobitz type 1

Answer 31

Widening benign

Question 32

Mobitz type 2

Answer 32

Can progress to complete heart block, may require pacing

Question 33

Adenosine action in WPW

Answer 33

Blocks conduction through AV node

Question 34

Atrial Flutter

Answer 34

Saw tooth baseline Narrow complex tachycardia Type of SVT

Question 35

Superior axis -30 to -60

Answer 35

S>R in aVF AVSD Ebsteins Tricuspid atresia (anything interfering with endocardial cushion)