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Cardiology

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Question
Answer
Diffuse ST elevation in most leads, peaked T waves in V leads =   pericarditis  
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Irregular irregular   Atrial fibrillation; (if > 48 or chronic: anticoagulate)  
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ECG arrhythmia assoc w/COPD   multifocal atrial tachy  
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LVH on ECG   S in V1 + R in V5-V6 > 35; aVL (R) > 11; LAD; wide QRS; ST/TW changes  
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RVH on ECG   RAD. R>S in V1 (R gets smaller V1 -> V6). S wave persists V5-V6. Wide QRS  
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tachy on ECG (regular/narrow) =   sinus; atrial tachy or flutter; re-entrant (AVNRT/PSVT)(usu after p wave); give adenosine  
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tachy on ECG (irreg/narrow) =   sinus tach w/PAC; MAT; A fib; atrial flutter w/variable block  
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tachy on ECG (regular/wide) =   V-tach; SVT w/aberrancy (BBB); SVT w/WPW; pacemaker tachy  
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tachy on ECG (irreg/wide) =   V-fib; torsades; irreg SVT w/aberrancy; irreg SVT w/WPW  
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RBBB on ECG   RSR' in V1-V4. QRS wide (>.12). Slurred S wave at I, aVL, V5-V6. Biphasic QRS at I. STD & TWI  
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LBBB on ECG   QRS >120; notched/slurred R in I, aVL, V5-V6; teepee (big pos R) V5-V6, no Q waves in same; ST & T usually opp direction of QRS (=ischemia) (occ QRS-T concordance); V1-V2: broad negative rS or QS  
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Hypercalcemia on ECG   Shortened QT, Wide QRS, absent ST segment  
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Hypocalcemia on ECG   Prolonged QT in II, V1, and V5, predisposition to V-tach  
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Hyperkalemia on ECG   short QT, wide QRS, flat P wave, peaked T waves  
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Hypokalemia on ECG   U waves, ST flattening, TWI, ST depression; areflexia, paralysis, ortho hypotension, ileus  
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Hypomagnesemia on ECG   prolonged PR & QT, and wide QRS  
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Electrolyte imbalance: Shortened QT, Wide QRS, absent ST segment =   hypercalcemia  
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Lyte imbalance: Prolonged QT in V1, II, and V5, predisposition to V-tach =   hypocalcemia  
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Electrolyte imbalance: short QT, wide QRS, peaked T waves =   Hyperkalemia  
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Electrolyte imbalance: U waves, ST flattening, TWI, ST depression; areflexia, paralysis, ortho hypotension, ileus =   Hypokalemia  
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Antiarrhythmic: pos inotrope, neg chronotrope, decreases conduction velocity thru AV node =   digoxin  
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Effects of CCB:   Class IV, vasodilator; neg chronotrope, neg inotrope  
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Effects of beta blockers:   Class II; neg chronotrope, neg inotrope  
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COPD on ECG   Right axis deviation (RAD = RAD)  
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S1 Q3 TIII (Large S wave (I), ST depression (II), Q wave (III)) and TWI in V1-V4 =   PE  
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Hypermagnesemia on ECG:   wide QRS, long PR & QT  
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Short PR, wide QRS, Delta wave   Wolf-parkinson-white; avoid Digoxin  
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Most common cause of tachyarrhythmia   reentry; >1 pathway  
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Inferior STEMI reciprocates to which leads?   AVL and I  
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Anterior STEMI reciprocates to which leads?   Inferior leads (II, III, AVF)  
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Lateral STEMI reciprocates to which leads?   Inferior leads (II, III, AVF)  
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What type of STEMI reciprocates to the anterior leads?   None  
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Inferior MI: ECG correlation   MOST COMMON MI. (II, III, aVF); RCA; left circumflex if left-dominant  
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Anterior MI: ECG correlation   V1-V5; LAD  
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Lateral MI: ECG correlation   I, aVL, V5-V6; Circumflex  
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Inferolateral MI: ECG correlation   II, III, aVF, I, aVL; large RCA, or left-dominant Left circumflex  
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Septal / Posterior MI: ECG correlation   Large R in V1-V2. Possible Q wave in V6. Do mirror test. LCx (or septal branch of LAD) or RCA  
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EKG changes, N/V, yellow-green visual disturbances =   Digoxin toxicity (Hypokalemia will make worse)  
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Q waves in an MI usually develop within:   12-36 hours  
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MVP on ECG:   often normal; ST depression or TWI in III & aVF  
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HCM on ECG =   LVH, nonspecific ST-T abnormalities, deep septal Q waves in inferior leads, or tall narrow R waves in V1-V2  
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VSD on ECG   LVH, RVH, atrial enlargement  
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ASD on ECG:   RAD, rsR' pattern; RVH -> RBBB  
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PDA on ECG:   LVH, LAH  
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Alcoholic with palpitations, arrhythmia =   Atrial fibrillation (Holiday heart)  
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Kawasaki on ECG   Peaked T waves, 1st degree block, STE or STD, QT prolongation  
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Mitral stenosis ECG   P-mitrale: broad notched P wave  
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Acute infarct on ECG   Q waves, ST elevation  
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Age-indeterminate infarct on ECG   Q waves, ST at baseline, T wave inversion  
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Old infarct on ECG   Q waves, ST at baseline, T wave upright  
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Anterolateral MI: ECG correlation   Q waves in V5-V6 (and I, aVL). LCx > LAD  
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Idioventricular rhythm on ECG   Usually 30-40 bpm. Slow V-tach. Atria failed or blocked  
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Anterior hemiblock is associated with:   LAD. Normal-to-slightly wide QRS. Q1-S3 (assoc with MI, etc)  
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Posterior hemiblock is associated with:   RAD. Normal-to-slightly wide QRS. S1-Q3.  
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Atrial enlargement is best seen in which lead   VI. Right atrial enlargement: initial component larger. Left: terminal component larger.  
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Right atrial enlargement   Initial part of P wave taller (with notching downslope). P>2.5mm in any limb lead. "P pulmonale"  
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Left atrial enlargement   See VI (and II). Wide notched P wave >.12. Taller terminal point; notching upstroke. Large biphasic P wave with wide, negative terminal part. "P mitrale"  
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RVH may cause:   extreme RAD (if V1 and aVF both very deflected)  
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LVH with strain on ECG   Asymmetric ST depression / T wave inversion  
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Inherent rate of SA node   60-100  
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Inherent rate of atrial focus   60-80  
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Inherent rate of AVN / junction   40-60  
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Inherent rate of ventricles   20-40  
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Atrial escape beat   60-100. PR <.20. QRS <.12. QT <.44 (1/2 of RR). P waves present, pause, then different shape  
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Junctional escape beat   40-60. PR variable. QRS normal, QT normal. P waves inverted before, during, and after QRS  
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Ventricular escape beat   20-40. P waves absent. QRS wide, bizarre >.10. Potentially life threatening.  
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Wandering atrial pacemaker   60-100. P waves present, difference appearance. P to P differences. R to R differences.  
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Multifocal atrial tachycardia   100-200. Irregular. WAP, but faster  
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Paroxysmal atrial tachycardia   160-240. Regular. P waves regular (often inverted?). May be hidden in previous T wave  
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Paroxysmal SVT   150-250. Regular. P wave slurred in QRS  
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Atrial flutter   240-360 (atrial). Regular, sawtooth. Ventricular rate depends on block (2:1, 3:1). Danger: allow clots to form  
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A-fib   400-800 (atrial). P waves indistinguishable; irregular, charotic. Ventricular rate varies  
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Ischemia on ECG   ST depression. TWI. Symmetric T waves (inverted) esp in V leads; often corresponds to angina  
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Injury on ECG   ST elevation. Hyperacute T waves  
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Injury (STEMI) on ECG: ___ mm above baseline (limb) and ___ mm above baseline (chest leads)   = acute damage. 1 mm limb leads; 2 mm in chest leads  
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Injury (STEMI) on ECG: J point   .08 seconds to right of J point. Find in 2 leads facing same area  
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Infarct on ECG   =necrosis. Significant Q wave (>1 mm wide and 1/3 of QRS height). Often see ST depression  
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Pericarditis on ECG   Diffuse ST elevation in most leads (does not resolve, as MI does). PR depression. Peaked T waves (often above baseline) in V leads  
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Down-sloping (depressed) ST segment =   specific for ischemia  
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Significant Q waves =   >0.04 seconds (1 little box or 1/3 QRS height)  
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