Where are the possible locations of first-degree AV blocks?
____
Answer
at the AV node or His bundle
Card 2
The diagnosis of ____-degree AV block requires only that the PR interval be longer than 0.2 seconds
Answer
first
Card 3
The diagnosis of first-degree AV block requires only that the ____ interval be longer than 0.2 seconds
Answer
PR
Card 4
The diagnosis of first-degree AV block requires only that the PR interval be longer than ____ seconds
Answer
0.2
Card 5
In first-degree AV block, ____ (all/some/none) of the beats are conducted through to the ventricles
Answer
all
Card 6
In second-degree AV block, ____ (all/some/none) of the beats are conducted through to the ventricles
Answer
some
Card 7
In third-degree AV block, ____ (all/some/none) of the beats are conducted through to the ventricles
Answer
none
Card 8
Wenckebach block is almost always due to a block ____ (below/within) the AV node
Answer
within
vs Mobitz type II which is below the AV node
Card 9
____ AV block is also called Wenckebach block
Answer
Mobitz type I second-degree
Card 10
Mobitz type I second-degree AV block is also called ____ block
Answer
Wenckebach
Card 11
____ block is a progressive lengthening of the PR interval with each beat and then a dropped beat
Answer
Wenckebach
Card 12
Wenckebach block is a ____ of the PR interval with each beat and then a dropped beat
Answer
progressive lengthening
Card 13
Wenckebach block is a progressive lengthening of the PR interval with each beat and then ____
Answer
a dropped beat
Card 14
Mobitz type II block is usually due to a block ____ (below/within) the AV node in the His bundle
Answer
below
vs Mobitz type I which is within the AV node
Card 15
Progressive lengthening of the PR interval ____ (does/doesn't) occur in Mobitz type II
Answer
doesn't
vs Mobitz type I
Card 16
The diagnosis of ____ block requires the presence of a dropped beat without progressive lengthening of the PR interval
Answer
Mobitz type II
vs Mobitz type I
Card 17
What type of block is this?
____
Answer
Wenckebach
Card 18
What type of block is this?
____
Answer
Mobitz type II
Card 19
Is Mobitz type I or II more serious?
____
Answer
type II
Card 20
Where are the possible locations of third-degree AV blocks?
____
Answer
either at the AV node or lower
Card 21
The EKG in ____-degree heart block shows P waves that appear at their usual rate with the QRS complexes that appear at a much slower escape rate
Answer
third
Card 22
The EKG in third-degree heart block shows P waves that appear at ____ rate with the QRS complexes that appear at a much slower escape rate
Answer
their usual
Card 23
The EKG in third-degree heart block shows P waves that appear at their usual rate with the QRS complexes that appear at ____ rate
Answer
a much slower escape
Card 24
In ____-degree heart block the QRS complexes appear wide and bizarre
Answer
third
arise from the ventricles
Card 25
In third-degree heart block the QRS complexes appear ____
Answer
wide and bizarre
arise from the ventricles
Card 26
What conduction block is this?
____
Answer
Third-degree AV block
The P waves appear at regular intervals, as do the QRS complexes, but they have nothing to do with one another. The QRS complexes are wide, implying a ventricular origin
Card 27
Is this a PVC or ventrivular escape?
____
Answer
PVC
Card 28
Is this a PVC or ventrivular escape?
____
Answer
ventricular escape
Card 29
The diagnosis of ____-degree heart block requires the presence of AV dissociation in which the ventricular rate is slower than the sinus or atrial rate
Answer
third
Card 30
The diagnosis of third-degree heart block requires the presence of AV dissociation in which the ventricular rate is ____ than the sinus or atrial rate
Answer
slower
Card 31
One of the more common causes of reversible complete heart block is ____
Answer
Lyme disease
Card 32
Bundle branch blocks have ____ QRS complexes
Answer
wide
Card 33
In ____ bundle branch block, the QRS complex in V1 and V2 will assume a "rabbit ears" appearance
Answer
right
The whole complex is called RSR′ (“R–S–R prime”)
Card 34
In right bundle branch block, the QRS complex in ____ and ____ will assume a "rabbit ears" appearance
Answer
V1
V2
The whole complex is called RSR′ (“R–S–R prime”)
Card 35
In right bundle branch block, the QRS complex in V1 and V2 will assume a "____" appearance
Answer
rabbit ears
The whole complex is called RSR′ (“R–S–R prime”)
Card 36
In ____ bundle branch block, the left lateral leads will show late deep S waves
Answer
right
I, aVL, V5, V6
Card 37
In right bundle branch block, the ____ leads will show late deep S waves
Answer
left lateral
I, aVL, V5, V6
Card 38
In right bundle branch block, the left lateral leads will show ____
Answer
late deep S waves
I, aVL, V5, V6
Card 39
Is this a L or R bundle branch block?
____
Answer
right
You will not always see a beautiful pair of rabbit ears with right bundle branch block. Sometimes, as in the tracing below, you will only see tall R waves, but the QRS complexes will certainly be wide
Card 40
In ____ bundle branch block, the QRS complexes in the leads over the left ventricle will show broad or notched R waves with prolonged upstroke
Answer
left
leads I, aVL, V5, V6
Card 41
In left bundle branch block, the QRS complexes in the leads over the left ventricle will show ____
Answer
broad or notched R waves with prolonged upstroke
leads I, aVL, V5, V6
Card 42
In ____ bundle branch block, the leads over the right ventricle will show reciprocal, broad, deep S waves
Answer
left
leads I, aVL, V5, V6
Card 43
In left bundle branch block, the leads over the right ventricle will show ____
Answer
reciprocal, broad, deep S waves
leads I, aVL, V5, V6
Card 44
In left bundle branch block, ____ axis deviation may be present
Answer
left
however this is variable
Card 45
In ____ bundle branch block, the right precordial leads will show ST-segment depression and T-wave inversion
Answer
right
Card 46
In right bundle branch block, the right precordial leads will show ____-segment depression and ____-wave inversion
Answer
ST
T
Card 47
In right bundle branch block, the right precordial leads will show ST-segment ____ and T-wave ____
Answer
depression
inversion
Card 48
In ____ bundle branch block, the left lateral leads will show ST-segment depression and T-wave inversion
Answer
left
Card 49
In left bundle branch block, the left lateral leads will show ____-segment depression and ____-wave inversion
Answer
ST
T
Card 50
In left bundle branch block, the left lateral leads will show ST-segment ____ and T-wave ____
Answer
depression
inversion
Card 51
____ (Left/Right) bundle branch block is common in normal hearts
In some individuals, bundle branch block only appears when a particular heart rate, called the ____
Answer
critical rate
Card 54
The development of a rate-related bundle branch block is directly related to ____
Answer
the time it takes a particular bundle branch to repolarize
Card 55
The term ____ refers to a conduction block of just one of the fascicles
Answer
hemiblock
Card 56
The major effect that hemiblocks have on the EKG is ____
Answer
axis deviation
Card 57
You can only diagnose ____ when no other cause of left axis deviation is present
Answer
left anterior hemiblock
Card 58
You can only diagnose ____ when no other cause of right axis deviation is present
Answer
left posterior hemiblock
Card 59
The QRS complex in hemiblock is ____
Answer
normal
Card 60
The T waves in hemiblock are ____
Answer
normal
Card 61
The ST segments in hemiblock are ____
Answer
normal
Card 62
Left ____ (anterior/posterior) hemiblock is far more common than left ____ (anterior/posterior) hemiblock
Answer
anterior
posterior
Card 63
Left anterior hemiblock is far ____ (more/less) common than left posterior hemiblock
Answer
more
Card 64
Left ____ (anterior/posterior) hemiblock can be seen in both normal and diseased hearts
Answer
anterior
Card 65
Left ____ (anterior/posterior) hemiblock is virtually the exclusive province of sick hearts
Answer
posterior
Card 66
What type of hemiblock is this?
____
Answer
left anterior hemiblock
Card 67
The term ____ refers to the combination of right bundle branch block with either left anterior or left posterior hemiblock
Answer
bifascicular block
Card 68
The EKG of right bundle branch block with left anterior hemiblock will show:
1. ____
2. ____
3. ____
Answer
widened QRS
RSR' in V1 and V2
L axis deviation
Card 69
The EKG of right bundle branch block with left posterior hemiblock will show:
1. ____
2. ____
3. ____
Answer
widened QRS
RSR' in V1 and V2
R axis deviation
Card 70
What type of block is shown?
____
Answer
R bundle branch block with left anterior hemiblock
Card 71
A ____ occurs when there is QRS widening greater than 0.10 seconds without the other criteria for either bundle branch block or bifascicular block
Answer
nonspecific intraventricular conduction delay
Card 72
An ____ occurs when the EKG tracing shows a left or right bundle branch appearance but the QRS duration is between 0.10 and 0.12 seconds
Answer
incomplete bundle branch block
Card 73
What kind of block does this show?
____
Answer
Incomplete right bundle branch block
Card 74
An orderly approach for determining combination blocks is:
1. ____
2. ____
3. ____
Answer
Is there an AV block?
Is there a bundle branch block?
Is there a hemiblock?
Card 75
This EKG shows:
1. ____
2. ____
3. ____
Answer
first-degree AV block (the PR interval exceeds 0.20 seconds)
right bundle branch block (there are wide QRS complexes with rabbit ears in leads V1 through V4)
left anterior hemiblock (left axis deviation is present)
Card 76
When a ventricular pacemaker fires, the ensuing QRS complex will be ____
Answer
wide and bizarre
Card 77
When a ventricular pacemaker fires, the ____ (right/left) ventricle will contract first
Answer
right
Card 78
When a ____ pacemaker fires, a left bundle branch block pattern is seen and a retrograde P wave may or may not be present
Answer
ventricular
Card 79
When a ventricular pacemaker fires, a ____ block pattern is seen and a retrograde P wave may or may not be present
Answer
left bundle branch
Card 80
When a ventricular pacemaker fires, a left bundle branch block pattern is seen and a ____ P wave may or may not be present
Answer
retrograde
Card 81
EKG from a patient with a(n) ____ pacemaker
Answer
ventricular
Card 82
EKG from a patient with a(n) ____ pacemaker
Answer
atrial
Card 83
A(n) ____ pacemaker will generate a spike followed by a P wave, a normal PR interval, and a normal QRS complex
Answer
atrial
Card 84
A(n) atrial pacemaker will generate a spike followed by a P wave, a ____ PR interval, and a normal QRS complex
Answer
normal
Card 85
A(n) atrial pacemaker will generate a spike followed by a P wave, a normal PR interval, and a ____ QRS complex
Answer
normal
Card 86
With a ____ pacemaker, two spikes will be seen, one preceding a P wave and one preceding a wide, bizarre QRS complex
Answer
sequential
Card 87
With a sequential pacemaker, two spikes will be seen, one preceding a ____ and one preceding a ____
Answer
P wave
wide, bizarre QRS complex
Card 88
EKG from a patient with a(n) ____ pacemaker
Answer
AV sequential
With a sequential pacemaker, two spikes will be seen, one preceding a P wave and one preceding a wide, bizarre QRS complex.
Card 89
What does this rhythm strip show?
____
Answer
tachycardia
first-degree AV block
R bundle branch block
Card 90
What does this rhythm strip show?
Lead V1
____
Answer
pacemaker failing to capture the heart
Card 91
What does this rhythm strip show?
____
Answer
normal PR interval with R bundle branch block
Card 92
What does this rhythm strip show?
____
Answer
increased PR interval (first-degree AV block) with R bundle branch block
Card 93
The criteria for Wolff-Parkinson-White are:
1. ____
2. ____
3. ____
Answer
PR interval less than .12 seconds
Wide QRS complexes
Delta waves in some leads
Card 94
The specific criterion for diagnosis of Wolff-Parkinson-White is a ____ interval less than 0.12 seconds.
Answer
PR
Card 95
The specific criterion for diagnosis of Wolff-Parkinson-White is a PR interval less than ____ seconds.
Answer
0.12
Card 96
Wolff-Parkinson-White has ____ QRS complexes
Answer
widened
Card 97
A short PR interval, with wide QRS complexes, and delta waves is suggestive of ____
Answer
Wolff-Parkinson-White
Card 98
This shows ____ and ____ which is suggestive of ____
Answer
short PR intervals
delta waves
Wolff-Parkinson-White
Card 99
This shows ____ and ____ which is suggestive of ____
Answer
short PR intervals
no delta waves
a nonspecific preexcitation syndrome
Card 100
The two tachyarrhythmias most often seen in WPW are ____ and ____
Answer
supraventricular tachycardia
atrial fibrillation
Card 101
In WPW, because the reentrant loop reciprocates between the atria and ventricles, the arrhythmia is termed ____
Answer
AV reciprocating tachycardia (AVRT)
Card 102
In WPW, when the tachycardia activates the ventricles in an antegrade manner through the AV node, generating a narrow QRS complex, the arrhythmia is further subcategorized as an ____ tachycardia
Answer
orthodromic
Card 103
In WPW, reciprocating tachycardias that activate the ventricles through the accessory pathway, generating a wide QRS complex, are subcategorized as ____ tachycardia
Answer
antidromic
Card 104
Atrial fibrillation can induce ____ in WPW patients
Answer
ventricular fibrillation
Card 105
Patients with a short PR interval without delta waves and who have had at least one tachyarrhythmia are said to have ____ syndrome
Answer
Lown-Ganong-Levine
Card 106
Always look for ____ and ____ on the EKG of any patient who presents with a history suggestive of a tachyarrhythmia, for example, palpitations or syncope
Answer
a short PR interval
a delta wave
Card 107
What are the first set of changes to take place in the EKG of an acute STEMI?
____
Answer
T wave peaking and inversion
Card 108
What are the second set of changes to take place in the EKG of an acute STEMI?
____
Answer
ST-segment elevation
Card 109
What are the third set of changes to take place in the EKG of an acute STEMI?
____
Answer
The appearance of new Q waves
Card 110
Is T-wave inversion specific or nonspecific for myocardial infarction?
____
Answer
NONspecific
Card 111
Is A or B indicative of ischemia?
____
Answer
A
Card 112
In patients whose T waves are already inverted, ischemia may cause them to ____, a phenomenon called pseudonormalization
Answer
revert to normal
Card 113
In patients whose T waves are already inverted, ischemia may cause them to revert to normal, a phenomenon called ____
Answer
pseudonormalization
Card 114
It is normal to see inverted T waves in leads ____, ____, and ____ in children and young adults
Answer
V1
V2
V3
Card 115
It is normal to see inverted T waves in leads V1, V2, and V3 in ____ and ____
Answer
children
young adults
Card 116
Besides leads V1, V2, and V3, an inverted T wave is also common in lead ____
Answer
III
Card 117
____ T waves are to be expected in lead aVR
Answer
Inverted
Card 118
The ST-segment is compared to the ____ segment to determine if elevation has occured
Answer
TP
Card 119
ST segments usually return to baseline within a few hours, but persistent ST-segment elevation often indicates the formation of ____
Answer
a ventricular aneurysm
Card 120
STEMI or J point elevation?
____
Answer
STEMI
Card 121
STEMI or J point elevation?
____
Answer
STEMI
Card 122
STEMI or J point elevation?
____
Answer
J point elevation
Card 123
STEMI or J point elevation?
____
Answer
J point elevation
Card 124
J point elevation is often seen in young, healthy individuals, particularly in leads ____, ____ and ____
Answer
V1
V2
V3
Card 125
Sometimes, along with an elevated J point, you will see a ____ in the downslope of the R wave, and this combination of findings is referred to as early repolarization
Answer
small notch or slur
Card 126
Sometimes, along with an elevated J point, you will see a small notch or slur in the downslope of the ____ wave, and this combination of findings is referred to as early repolarization
Answer
R
Card 127
Sometimes, along with an elevated J point, you will see a small notch or slur in the downslope of the R wave, and this combination of findings is referred to as ____
Answer
early repolarization
Card 128
What does this strip show?
____
Answer
Early repolarization
Card 129
How can the ST-segment elevation be distinguished from that of J point elevation?
____
Answer
With myocardial injury, the elevated ST segment has a distinctive configuration. It is bowed upward (convex downward) and tends to merge imperceptibly with the T wave.
In J point elevation, the T wave maintains its independent waveform
Card 130
The criteria for diagnosing a STEMI in men < 40 are:
1. > ____ mm of ST elevation in leads V2 or V3
2. > 1 mm of ST elevation in all other leads
Answer
2.5
Card 131
The criteria for diagnosing a STEMI in men > 40 are:
1. > ____ mm of ST elevation in leads V2 or V3
2. > 1 mm of ST elevation in all other leads
Answer
2.0
Card 132
The criteria for diagnosing a STEMI in women are:
1. > ____ mm of ST elevation in leads V2 or V3
2. > 1 mm of ST elevation in all other leads
Answer
1.5
Card 133
Two simple steps you can use when you are unsure if the ST-segment elevation on a patient’s EKG is concerning:
1. ____
2. ____
Answer
compare to an old EKG
get serial EKGs
Card 134
The criteria for significant Q waves are:
1. ____
2. ____
Answer
> 0.04 seconds in duration
depth of the Q wave must be at least 25% the height of the R wave in the same QRS complex
Because lead aVR occupies a unique position on the frontal plane, it normally has a very deep Q wave. Lead aVR should not be considered when using Q waves to look for possible infarction
Card 135
Lead ____ should not be considered when using Q waves to look for possible infarction
Answer
aVR
Because lead aVR occupies a unique position on the frontal plane, it normally has a very deep Q wave. Lead aVR should not be considered when using Q waves to look for possible infarction
Card 136
Isolated deep Q waves in lead ____ are a particularly common normal variant that almost never signifies a myocardial infarction
Answer
III
Card 137
Which of the following Q waves are significant?
____
Answer
I and aVF
Card 138
Inferior infarctions are often caused by occlusions of the ____ artery
Answer
right coronary
Card 139
Lateral infarctions are often caused by occlusions of the ____ artery
Answer
left circumflex
Card 140
Anterior infarctions are often caused by occlusions of the ____ artery
Answer
left anterior descending
Card 141
Posterior infarctions are often caused by occlusions of the ____ artery
Answer
right coronary
Card 142
____ infarctions will show changes in leads II, III, and aVF
Answer
Inferior
Card 143
Inferior infarctions will show changes in leads ____, ____, and ____
Answer
II
III
aVF
Card 144
____ infarctions will show changes in leads I, aVL, V5, and V6
Answer
Lateral
Card 145
Lateral infarctions will show changes in leads ____, ____, ____, and ____
Answer
I
aVL
V5
V6
Card 146
____ infarctions will show changes in leads V1-V6
Answer
Anterior
Card 147
Anterior infarctions will show changes in leads ____-____
Answer
V1
V6
Card 148
Posterior infarctions will show reciprocal changes in leads ____-____
Answer
V1
V3
Card 149
____ infarctions will show changes in the precordial leads plus leads I and aVL
Answer
Anterolateral
Card 150
Anterolateral infarctions will show changes in the ____ leads plus leads ____ and ____
Answer
precordial
I
aVL
Card 151
Anterolateral infarctions are often caused by occlusions of the ____ artery
Answer
left main
Card 152
Where is the infarct?
____
Answer
inferior
Card 153
Where is the current infarct?
____
Answer
lateral wall
bonus: there is an old inferior infarct (deep Q waves in V3-V6
Card 154
Poor R wave progression may be a sign of an ____ infarcation
Answer
anterior
Card 155
What does this strip show?
____
Answer
deWinter's T waves
Card 156
What does this strip show?
____
Answer
Wellen's T waves
Card 157
In the appropriate clinical setting, the presence of ____ in lead V1 is highly suggestive of a posterior infarction
Answer
an R wave of greater amplitude than the corresponding S wave
Card 158
In the appropriate clinical setting, the presence of an R wave of greater amplitude than the corresponding S wave in lead ____ is highly suggestive of a posterior infarction
Answer
V1
Card 159
In the appropriate clinical setting, the presence of an R wave of greater amplitude than the corresponding S wave in lead V1 is highly suggestive of a ____ infarction
Answer
posterior
Card 160
How can you tell posterior infarctions from right ventricular hypertrophy?
____
Answer
right axis deviation will be present in right ventricular hypertrophy
Card 161
Right ventricle infarctions often accompany ____ infarctions
Answer
inferior
Card 162
What will right ventricle infarctions often show on EKG?
____
Answer
the expected changes of an inferior infarction (i.e., ST elevation and so forth in leads II, III and aVF) plus T-wave changes and ST-segment elevation in the most rightward anterior lead, V1
Card 163
What does this strip show?
____
Answer
inferior STEMI with right ventricle STEMI
Card 164
Where is the infarct?
____
Answer
This is an example of an anterior infarction. There is ST-segment elevation in leads V2 and V3 as well as poor R-wave progression.
Card 165
Where is the infarct? Is it acute?
____
Answer
acute posterior and inferior infarction
Card 166
The only EKG changes seen with non-STEMIs are ____ and ____
Answer
T-wave inversion
ST-segment depression
Card 167
What does this show?
____
Answer
non-STEMI
Card 168
The cause of takotsubo cardiomyopathy is usually ____
Answer
psychological or emotional stress
another name for this syndrome is broken heart syndrome
Card 169
What EKG criteria distinguish takotsubo cardiomyopathy from a STEMI?
____
Answer
none :)
Card 170
Takotsubo cardiomyopathy is a condition that can closely mimic ____ on the EKG
Answer
an acute STEMI
complete with T-wave inversions and ST-segment elevations
Card 171
EKG of a patient with unstable angina may show ____ and often ____
Answer
T-wave inversion
ST-segment depression
Card 172
EKG of a patient with stable angina may show ____ and often ____
Answer
T-wave inversion
ST-segment depression
Card 173
____ is a type of angina that is associated with ST-segment elevation
Answer
Prinzmetal angina
Card 174
Prinzmetal angina is a type of angina that is associated with ____-segment elevation
Answer
ST
Card 175
Prinzmetal angina is a type of angina that is associated with ST-segment ____
Answer
elevation
Card 176
What are the criteria to assess if there is infarction in a patient with left bundle branch block?
____
Answer
1. Presence of ST-segment elevation of at least 1 mm in any lead with a predominant R wave
OR
2. ST-segment depression of at least 1 mm in leads V1–V3 if deep S waves are present
Card 177
The appearance of a new left bundle branch block may signify ____
Answer
infarction
should be treated with the same urgent attention as a STEMI
Card 178
What does this EKG show?
____
Answer
ST-segment elevation in leads V2 through V5. There are no Q waves. An acute anterior STEMI
Card 179
What does this EKG show?
____
Answer
normal sinus rhythm is being interrupted by a run of three consecutive premature ventricular contractions (PVCs)
Card 180
What does this EKG show?
____
Answer
ST elevations in lateral leads with Q waves in anterior leads
Card 181
What does this EKG show?
____
Answer
3rd degree AV block
Card 182
What does this EKG show?
____
Answer
Q wave in V2
normal for reference:
Card 183
Hyperkalemia produces a progressive evolution of changes in the EKG that can culminate in the rhythm ____
Answer
ventricular fibrillation
Card 184
As the potassium rises, the ____ waves across the entire 12-lead EKG begin to peak
Answer
T
Card 185
As the potassium rises, the T waves across the entire 12-lead EKG begin to ____
Answer
peak
Card 186
What electrolyte disturbance may cause this?
____
Answer
hyperkalemia
Card 187
With a further increase in the serum potassium, the ____ interval becomes prolonged, and the P wave gradually flattens and then disappears
Answer
PR
Card 188
With a further increase in the serum potassium, the PR interval becomes ____, and the P wave gradually flattens and then disappears
Answer
prolonged
Card 189
With a further increase in the serum potassium, the PR interval becomes prolonged, and the ____ wave gradually flattens and then disappears
Answer
P
Card 190
With a further increase in the serum potassium, the PR interval becomes prolonged, and the P wave gradually ____
Answer
flattens and then disappears
Card 191
What electrolyte disturbance may cause this?
____
Answer
hyperkalemia
Card 192
The presence of ____ may be an important clue that the wide QRS complexes are the result of hyperkalemia
Answer
a rightward axis
remember R axis = a negative QRS complex in lead I, a positive QRS in aVF
Card 193
What electrolyte disturbance may cause this?
____
Answer
hyperkalemia
remember R axis = a negative QRS complex in lead I, a positive QRS in aVF
Card 194
What electrolyte disturbance may cause this?
____
Answer
hyperkalemia
Card 195
What changes may be seen in the EKG due to hypokalemia?
1. ____
2. ____
3. ____
Answer
ST-segment depression
Flattening of the T wave with prolongation of the QT interval
Appearance of a U wave
Card 196
What electrolyte disturbance may cause this?
____
Answer
hypokalemia
Card 197
Hypokalemia may cause ____-segment depression
Answer
ST
Card 198
Hypokalemia may cause ST-segment ____
Answer
depression
Card 199
____ may cause flattening of the T wave with prolongation of the QT interval
Answer
Hypokalemia
Card 200
Hypokalemia may cause ____ of the T wave with prolongation of the QT interval
Answer
flattening
Card 201
Hypokalemia may cause flattening of the ____ wave with prolongation of the QT interval
Answer
T
Card 202
Hypokalemia may cause flattening of the T wave with prolongation of the ____ interval
Answer
QT
Card 203
____-kalemia may cause the appearance of a U wave
Answer
Hypo
Other conditions can produce prominent U waves (e.g., central nervous system disease and certain antiarrhythmic drugs)
Card 204
Hypo-kalemia may cause the appearance of a ____ wave
Answer
U
Other conditions can produce prominent U waves (e.g., central nervous system disease and certain antiarrhythmic drugs)
Card 205
Rarely, severe ____-kalemia can cause ST-segment elevation
Answer
hypo
“Whenever you see ST-segment elevation or depression on an EKG, your first instinct should always be to suspect some form of cardiac ischemia, but always keep hypokalemia in your differential diagnosis.
Card 206
Alterations in the serum calcium primarily affect the ____ interval
Answer
QT
Card 207
____-calcemia prolongs the QT interval
Answer
Hypo
Hypocalcemia prolongs it; hypercalcemia shortens it
Card 208
Hypo-calcemia ____ the QT interval
Answer
prolongs
Hypocalcemia prolongs it; hypercalcemia shortens it
Card 209
____-calcemia shortens the QT interval
Answer
Hyper
Hypocalcemia prolongs it; hypercalcemia shortens it
Card 210
Hyper-calcemia ____ the QT interval
Answer
shortens
Hypocalcemia prolongs it; hypercalcemia shortens it
Card 211
____-calcemia can lead to torsades
Answer
Hypo
Hypocalcemia prolongs the QT interval
Card 212
What electrolyte disturbance may cause this?
____
Answer
hypocalcemia
Hypocalcemia prolongs the QT interval
Card 213
Which electrolyte disturbances can prolong the QT interval?
1. ____
2. ____
3. ____
Answer
hypocalcemia
hypokalemia
hypomagnesemia
Hypocalcemia prolongs the QT interval
Card 214
____ (bradycardia/tachycardia) is common in hypothermia
Answer
Bradycardia
Card 215
Hypothermia causes of prolongation of ____
Answer
all the segments and intervals
Card 216
What does this show?
____
Answer
Osborn waves
Card 217
A ____ may mimic atrial flutter in patients who are hypothermic
Answer
muscle tremor artifact
also seen in Parkinson's
Card 218
A muscle tremor artifact may mimic ____ in patients who are hypothermic
Answer
atrial flutter
also seen in Parkinson's
Card 219
Therapeutic levels of digitalis produce characteristic ____-segment depression with flattening or inversion of the T wave
Answer
ST
has a distinct gradual downslope
Card 220
Therapeutic levels of digitalis produce characteristic ST-segment ____ with flattening or inversion of the T wave
Answer
depression
has a distinct gradual downslope
Card 221
Therapeutic levels of digitalis produce characteristic ST-segment depression with ____ or ____ of the T wave
Answer
flattening
inversion
has a distinct gradual downslope
Card 222
Therapeutic levels of digitalis produce characteristic ST-segment depression with flattening or inversion of the ____ wave
Answer
T
has a distinct gradual downslope
Card 223
What drug could cause this?
____
Answer
therapeutic levels of digitalis
Card 224
Toxic levels of digitalis can ____ the sinus node
Answer
suppress
Card 225
Digitalis ____ conduction through the AV node
Answer
slows
Card 226
What drug could cause this?
____
Answer
toxic levels of digitalis
Card 227
____ and ____ are the most common tachyarrhythmias seen in digitalis toxicity
Answer
Paroxysmal atrial tachycardia (PAT)
PVCs
Card 228
What drug could cause this?
____
Answer
toxic levels of digitalis
Card 229
____ can cause diffuse ST-segment elevation and T-wave flattening or inversion
Answer
Acute pericarditis
Card 230
Acute pericarditis can cause diffuse ____-segment elevation and T-wave flattening or inversion
Answer
ST
Card 231
Acute pericarditis can cause diffuse ST-segment ____ and T-wave flattening or inversion
Answer
elevation
Card 232
Acute pericarditis can cause diffuse ST-segment elevation and ____-wave flattening or inversion
Answer
T
Card 233
Acute pericarditis can cause diffuse ST-segment elevation and T-wave ____
Answer
flattening or inversion
Card 234
The ST segment elevation in pericarditis is usually ____ (s)
Answer
concave upward
Card 235
The PR interval is often ____ in pericarditis
Answer
depressed
Card 236
Formation of a substantial pericardial effusion results in ____ voltage in all leads
Answer
low
Card 237
One of the sensitive criteria for low voltage is the sum of the total QRS voltage in leads ____, ____, and ____ is less than 15 mV
Answer
I
II
III
Card 238
One of the sensitive criteria for low voltage is the sum of the total QRS voltage in leads I, II, and III is less than ____ mV
Answer
15
Card 239
One of the sensitive criteria for low voltage is the sum of the total QRS voltage in leads ____, ____, and ____ is less than 30 mV
Answer
V1
V2
V3
Card 240
One of the sensitive criteria for low voltage is the sum of the total QRS voltage in leads V1, V2, and V3 is less than ____ mV
Answer
30
Card 241
One of the specific criteria for low voltage is the sum of the total QRS voltage in all leads is less than ____ mV
Answer
5
Card 242
One of the specific criteria for low voltage is the sum of the total QRS voltage in all precordial leads is less than ____ mV
Answer
10
Card 243
____ is a phenomenon in which the electrical axis of the heart varies with each beat
Answer
Electrical alternans
Card 244
In hypertrophic obstructive cardiomyopathy (HOCM), ____ Q waves may also be seen laterally and inferiorly
Answer
deep, narrow, dagger-like
Card 245
In hypertrophic obstructive cardiomyopathy (HOCM), deep, narrow, dagger-like Q waves may also be seen ____ and ____
Answer
laterally
inferiorly
Card 246
What does this show?
____
Answer
Right bundle branch block
Card 247
____ is a small notch in the QRS complexes in the inferior leads that is commonly seen in atrial septal defects (ASDs)
Answer
Crochetage pattern
Card 248
Crochetage pattern is a small notch in the QRS complexes in the ____ leads that is commonly seen in atrial septal defects (ASDs)
Answer
inferior
Card 249
Crochetage pattern is a small notch in the QRS complexes in the inferior leads that is commonly seen in ____
Answer
atrial septal defects (ASDs)
Card 250
The EKG of a patient with long-standing emphysema may show ____ voltage, right axis deviation, and poor R-wave progression in the precordial leads
Answer
low
Card 251
The EKG of a patient with long-standing emphysema may show low voltage, ____ axis deviation, and poor R-wave progression in the precordial leads
Answer
right
Card 252
The EKG of a patient with long-standing emphysema may show low voltage, right axis deviation, and ____ in the precordial leads
Answer
poor R-wave progression
Card 253
Acute pulmonary embolism may show ____ ventricular hypertrophy with repolarization changes
Answer
right
Card 254
Acute pulmonary embolism may show right ventricular hypertrophy with ____ changes
Answer
repolarization
Card 255
Acute pulmonary embolism may show ____ bundle branch block.
Answer
right
Card 256
The ____ pattern is a large S wave in lead I and a deep Q wave in lead III with T wave inversion which may be seen in acute pulmonary embolism
Answer
S1Q3T3
Card 257
What does this show?
____
Answer
S1Q3T3
Card 258
Central nervous system (CNS) catastrophes, such as a subarachnoid bleed or cerebral infarction, can produce ____ and ____
Answer
diffuse T-wave inversion
prominent U waves
Card 259
____ is right bundle branch block with T wave inversion in V1 and/or V2 and ST elevation in V1-V3
Answer
Brugada pattern
Card 260
What are the criteria for Brugada pattern?
1. ____
2. ____
3. ____
Answer
right bundle branch block with a slow, prolonged downslope of the R′ component of the QRS complex
T-wave inversion in leads V1 and/or V2
ST-segment elevation in leads V1, V2, and V3
Card 261
Brugada pattern shows ____ bundle branch block with a slow, prolonged downslope of the R′ component of the QRS complex
Answer
right
Card 262
Brugada pattern shows right bundle branch block with a ____ of the R′ component of the QRS complex
Answer
slow, prolonged downslope
Card 263
Brugada pattern shows right bundle branch block with a slow, prolonged downslope of the ____ component of the QRS complex
Answer
R′
Card 264
Brugada pattern shows ____-wave inversion in leads V1 and/or V2
Answer
T
Card 265
Brugada pattern shows T-wave ____ in leads V1 and/or V2
Answer
inversion
Card 266
Brugada pattern shows T-wave inversion in leads ____ and/or ____
Answer
V1
V2
Card 267
Brugada pattern shows ____-segment elevation in leads V1, V2, and V3
Answer
ST
Card 268
Brugada pattern shows ST-segment ____ in leads V1, V2, and V3
Answer
elevation
Card 269
Brugada pattern shows ST-segment elevation in leads ____, ____, and ____
Answer
V1
V2
V3
Card 270
Arrhythmogenic right ventricular cardiomyopathy (ARVC) shows ____ in leads V1-V3 and epsilon waves
Answer
T-wave inversion
Card 271
Arrhythmogenic right ventricular cardiomyopathy (ARVC) shows T-wave inversion in leads ____-____ and epsilon waves
Answer
V1
V3
Card 272
Arrhythmogenic right ventricular cardiomyopathy (ARVC) shows T-wave inversion in leads V1-V3 and ____
Answer
epsilon waves
Card 273
What does this show?
____
Answer
epsilon wave
Card 274
What does this show?
____.
Answer
The patient is in atrial fibrillation. There are no P waves, the baseline undulates, and the QRS complexes appear irregularly and are narrow
Card 275
What does this show?
____
Answer
1. Rate of 100 beats per minute.
2. A pattern of right ventricular hypertrophy with repolarization abnormalities is present.
3. S1Q3T3 (possible pulmonary embolism)
Card 276
What is the likely diagnosis in a patient who takes lisinopril who recently started TMP-SMX. The have the following EKG:
____
Answer
hyperkalemia
Card 277
What is the 9-step method for reading EKGs?
____
Answer
Picture
Card 278
____
Answer
Sinus tachycardia. Note also the presence of left axis deviation
Card 279
____
Answer
The rhythm is sinus tachycardia. Deep anterior Q waves and less prominent but significant lateral Q waves indicate an anterolateral myocardial infarction.
Card 280
____
Answer
The QRS complexes are wide and distorted. In leads V5 and V6, the QRS complexes are notched, and there is ST-segment depression and T-wave inversion. This patient has left bundle-branch block. The rabbit ear configurations in the QRS complexes in V5 and V6 are unusual for left bundle-branch block
Card 281
____
Answer
The broad, abnormal QRS complexes may immediately attract your attention, but notice the pacer spikes before each one. The spikes are preceded by a P wave (look at leads II, III, aVF, V1, and V2). This pacemaker fires whenever it senses a P wave, ensuring ventricular contraction
Card 282
____
Answer
There are deep Q waves in leads III and aVF. This tracing shows an inferior infarct
Card 283
____
Answer
The QRS complexes are greatly widened, with beautiful rabbit ears in lead V1. This patient has right bundle-branch block
Card 284
____
Answer
The rate is very fast and regular, and the QRS complexes are narrow. Retrograde P waves can be seen in lead III if you look carefully. This patient has AV nodal reentrant tachycardia
Card 285
____
Answer
The rhythm is irregularly irregular, and the QRS complexes are narrow. This patient is in atrial fibrillation
Card 286
____
Answer
Are you confused by what appears to be extreme right axis deviation? Actually, in this instance, the EKG electrodes were accidentally reversed—the right arm and left arm electrodes were placed on the wrong arms. When you see a tall R wave in lead aVR and a deep S wave in lead I, check your electrodes
Card 287
____
Answer
Everywhere you look, you see dramatic ST-segment elevation. This EKG shows an evolving infarct affecting the entire heart!
Card 288
____
Answer
the classic saw-toothed pattern of atrial flutter
Card 289
____
Answer
Left ventricular hypertrophy
Card 290
____
Answer
Wolff–Parkinson–White syndrome with delta waves and a short PR interval
Card 291
____
Answer
Extreme bradycardia resulting from hypoxemia in a patient with sleep apnea
Card 292
____
Answer
Atrial fibrillation with a rapid ventricular response. You can’t see the fibrillating baseline, but the rhythm is clearly irregularly irregular
Card 293
____
Answer
Ventricular tachycardia
Card 294
____
Answer
third-degree heart block
Card 295
____
Answer
There are two P waves for every QRS complex—this is 2:1 AV block
Card 296
____
Answer
The rhythm is normal sinus. The key finding is ST segment elevation in V1, V2 and aVR with reciprocal changes in the inferior leads and aVL - this patient is having a STEMI
Card 297
____
Answer
What is the rhythm that you see? It is irregular with one P wave for every QRS complex. This is a normal EKG, and what you are seeing is a sinus arrhythmia
Card 298
____
Answer
The most important finding here is diffuse ST-segment elevation without the upward bowing you typically see with an STEMI. This patient had acute pericarditis. You might also have picked up that the second beat is a bit premature—it is a PAC
Card 299
____
Answer
right bundle-branch pattern with ST-segment elevation most prominent in lead V2? This patient has Brugada syndrome