Ecg

Question 1

Normal QRS axis between

Answer 1

-30 and +100

Question 2

Upright in I and aVF?

Answer 2

Axis is between 0 and +90 so the axis is in the normal range

Question 3

Upright in I and II?

Answer 3

Axis is between -30 and +60 so the axis is in the normal range

Question 4

QRS complex normally predominantly negative in ____ and positive in _____

Answer 4

Negative in V1 and positive V6

Question 5

Isoeletric transition point usually

Answer 5

V3 or V4

Question 6

Normal PR interval

Answer 6

120-200 ms (3 to 5 small boxes)

Question 7

Normal interval for QRS

Answer 7

Less than 80 ms (2 small boxes or less)

Question 8

QT normal interval

Answer 8

~400 ms

Question 9

Q waves are large than one small box wide or deep except for aVR

Answer 9

False; except for aVR it is smaller

Question 10

Left ventricular hypertrophy shows an ___________:

1. Amplitude of S- wave in _____ plus R wave in _______ > 35mm (7 big boxes)

Or

2. Amplitude of R wave in ______ >11mm

Or

3. Amplitude of R-wave in _____ > 15mm

Answer 10

Increased QRS amplitude:

1. Amplitude os S wave in V1 plus R wave in V5 or V6 > 35 mm
2. Amplitude of R-wave in aVL > 11 mm
3. Amplitude of R wave in I > 15 mm

Question 11

Left ventricular hypertrophy is caused by

Answer 11

1. Systemic HTN
2. Aortic valve stenosis
3. Hypetrophic cardiomyopathy (an enlargement of LV not explained by blood pressure or aortic valve disease)

Question 12

The ______ is the reference for ST analysis

Answer 12

Isoelectric line

Question 13

ST segment below the isoelectric line

Answer 13

ST depression maybe due to a MI, left ventricular hypertrophy

Question 14

ST segment above the isoelectric line

Answer 14

ST elevation

Question 15

ST elevation

1. Dynamic
2. Stable

Answer 15

1. Dynamic: evolving over hours to days due to acute MI or pericarditis
2. Stable: not changing over months to years— LV aneurysms, LBBB

Question 16

QR interval is usually

Answer 16

Less than half the R-R interval

Question 17

T wave inversions in leads expected to have an

Answer 17

Upright T- waves

• can indicate a recent bout of MI or NSTEMI

Question 18

Sinus pause or sinus arrest

Answer 18

If >3 sec of no P, QRS and T wave present

• consider pacemaker

Question 19

First degree AV block

Answer 19

Where a PR interval >200ms

There is a one:one relationship with p:QRS

Question 20

Second degree Mobitz I AV block

Answer 20

Progressive increase PR then non-conducted

• non-conducted p wave

Question 21

Second degree Mobitz II AV block

Answer 21

Fixed PR interval than non-conducted

• non-conducted P wave

Question 22

Third degree AV block narrow complex

Answer 22

Complete heart block with narrow QRS complex high AV node escape rhythm

Question 23

Third degree AV block with wide QRS

Answer 23

Complete heart block with escape rhythm from ventricle

Question 24

Bradycardia

Answer 24

Sinus pauses

Question 25

sinus bradycardia is HR less than

Answer 25

60

Question 26

sinus tachycardia is HR more than

Answer 26

100

Question 27

atrial bigeminy

Answer 27

alternating axis of the p waves always before a narrow QRS

Question 28

ventricular bigeminy

Answer 28

alternating narrow QRS and wide QRS complex

Question 29

PAC

Answer 29

atrial premature beat where there is narrow QRS complex reseting the SA node - preceded by a P wave

Question 30

PVC

Answer 30

ventricular premature beat showing a wide QRS complex that has no effect on SA node - no p wave

Question 31

what are the treatments used in supraventricular tachyarrhythmies

Answer 31

therapies that slow conduction through the AV node

Question 32

reentrant atrial arrhythmia created by wave circumnavigating a physical structure such as tricuspid valve annulus

Answer 32

atrial flutter

Question 33

reentrant arrhythmia contained within the AV node

Answer 33

AVNRT

Question 34

treatments for AVNRT

Answer 34

transient block of AV node using either vagal maneuvers or adenosine

Question 35

produces SVT caused by a macro-reentrant arrhythmia with conduction down AV node and up bypass tract

Answer 35

WPW

Question 36

wide complex tachycardia with similar QRS morphology and axis - reentry arrhytmia from one area of ventricle: often prior MI scar

Answer 36

monomorphic VT

Question 37

wide complex tachycardia with variable QRS morphology - caused by acute ischemia, medications that prolong QT interval

Answer 37

polymorphic VT -sometimes called torsades de pointes

Question 38

difference between monomorphic VT vs SVT with aberrancy

Answer 38

monomorphic VT: AV dissociation while SVT with Aberrancy has an no AV association

Question 39

chaotic arrhythmia caused by simultaneous ventricular waves; complete loss of effective mechanical heart function

Answer 39

VT: hemodynamically stable VF: always hemodynamically unstable

Question 40

sinus rhythm

Answer 40

activation of the heart by sinus node - shows a P, QRS, T complex

Question 41

Bardyarrhythmias

Answer 41

1. SA dysfunction | 2. AV blocks (I, II and III)

Question 42

tachyarrhythmias

Answer 42

1. afib 2. aflutter 3. AVNRT 4. ANRT 5. VT 6. Vfib

Question 43

palpitations a sign of a

Answer 43

tachyarrhythmia