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Cardiology - ABIM
EKG, TIMI, JVP
| Question | Answer |
|---|---|
| a wave | Max atrial contraction |
| c wave | The beginning of ventricular systole and the closing of the tricuspid valve |
| x wave | The nadir of ventricular systole, point of least pressure transmitted to JVP |
| v wave | Maximum ventricular contraction, after which the tricuspid opens and diastole starts |
| y descent | Ventricular diastole |
| How to calculate the beats a minute on an EKG? | 300 divided by (# of large boxes between two R waves). 300, 150 100, 75 |
| What is the length of the P-wave in seconds and boxes? | 0.08 seconds 0.11 seconds, 2 to 3 small boxes |
| what is the length of the QRS wave in seconds and boxes? | Normal is less than 0.12 seconds (three small boxes) |
| What is the length of a wide QRS in seconds and boxes? | Wide is greater than 0.12 seconds ( wider than three small boxes) |
| What is the normal length of it PR interval? | 0.12 tp 0.20 (3 to 5 small boxes) |
| What is a short PR interval? | < 0.12 (<3 small boxes) |
| What is a long PR interval? | >0.20 seconds (>5 boxes) |
| What is a normal QRS duration? | <0.1 seconds (<3 small boxes) |
| Normal axis | Positive in I and aVF |
| Normal variant axis | Positive in I and II |
| Left axis deviation | Positive in I |
| Right axis deviation | positive in aVF |
| Name the components of the TIMI score | T: troponin, CAD > = 50% stenosis, ST changes on EKG. I: >= 3 risk factors – diabetes, hypertension, hyperlipidemia, tobacco smoking, family history of early MI. M I: aspirin in the last seven days, age greater than 65, two episodes of angina in 24 hours |
| Name the categories for the TIMI score | 0 to 2 points - low risk; 3 to 4 point – intermediate risk – gets heparin; 5 to 7 – high risk – gets heparin and eptifibatide |
| What axis deviation is associated with ostium primum ASD? | Left axis deviation >-30, fixed S2, mitral regurg murmur |
| What axis deviation is associated with ostium secundum ASD? | Right axis deviation >100 |
| left atrial enlargement include... | a widened (≥120 ms), M-shaped (notched) P wave (P mitrale) in one or more of the mitral leads (I, II, or aVL) or a deep negative component to the P wave in V1. |
| Criteria for left ventricular hypertrophy | The sum of the deepest S wave in lead V1 or V2 and the tallest R wave in lead V5 or V6 is 35 mm or more; or The R wave in lead aVL is 11 mm or more. |
| Strain pattern on an EKG | asymmetric ST-segment depression and T-wave inversion |
| What condition prolongs all EKG intervals? | Hypothermia |
| J point elevation, Osborne wave | Hypothermia on EKG |
| Criteria for posterior MI | EKG changes in V1 to V3, with increased R – wave amplitude and duration. Often with evidence of inferior wall MI, with cue waves in leads II, III, and aVF. |
| Criteria for inferior MI | ST segment elevation in the inferior leads (II, III, aVF)and reciprocal changes (ST dep) in I, aVL, V2 |
| hypercalcemia on EKG | Shortened QT interval, decreased initial portion of the T wave, prolongation of the PR interval, increase in QRS complex amplitude, nonspecific ST – T wave changes |
| A patient with pulmonary hypertension, 1/6 hole of systolic murmur at the left lower sternal border, toes with cyanosis and digital clubbing, hands normal. What is the diagnosis? | Patient ductus with Eisenmenger syndrome |
| What to do for a patient with a patent foramen oval and cryptogenic stroke | Aspirin |
| What to do for a patient with patent foramen oval with oxygen desaturation from a right to left shunt? | Surgical closure of PFO |
| What to do for a patient with a thrombus trapped in the PFO? | Surgical closure of PFO |
| What to do for patient with PFO and recurrent stroke? | Warfarin |
| Hypocalcemia on EKG | Prolongation of the QT interval |
| Criteria for accelerated atrioventricular rhythm on EKG | Rate between 50 and 120, wide QRS that is regular |
| Criteria for left bundle branch block | (1) QRS widening of at least 120 ms; (2) upright monophasic QRS complex in leads I and V6 (the QRS complex may also be notched); and (3) a predominantly negative QRS complex in lead V1. In the electrocardiogram shown, all three features are evident. |
| criteria for left posterior fascicular block | neg QRS complexes - small r waves and deep S waves in leads I and aVL; positive tall R waves - qR complexes in leads II, III, and aVF; Pathologic right axis (>+90 degrees) |
| Criteria for junctional rhythm | p wave in II is negative, 40 to 60 bpm |
| Criteria for accelerated junctional rhythm | p wave in II is negative, 61 to 99 bpm |
| What changes on EKG do you see in hypokalemia? | Appearance of U wave after the T wave, eventually replacing the T wave |
Created by:
christinapham
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