EKG Refresher Practice Flashcards

Flashcards covering EKG interpretation, lead-wall correlations, wave durations, heart blocks, and common cardiac pathologies based on the ACM-I lecture.

What are the logistical details for the EKG Exam scheduled for June 15, 2026?

The exam is a 25-question objective, computer-based test including 12-lead EKG tracings, rhythm strips, and stand-alone MCQs, taking place from 7:30 - 8:30 AM in the Testing Center with a pass requirement of $> 70\%$.

In EKG paper measurements, what time durations do one small box and five small boxes represent?

One small box represents $0.04\,\text{sec}$ and five small boxes represent $0.2\,\text{sec}$.

Which EKG leads correspond to the Inferior Wall of the heart?

Leads II, III, and aVF.

Which leads represent the Septal Wall and the Anterior Wall according to the simplified approach?

The Septal Wall is represented by V1 and V2, while the Anterior Wall is represented by V3 and V4.

According to the transcript, what does ST elevation in lead aVR indicate in the presence of anterior ST depression?

It indicates left main coronary artery disease, specifically when the ST elevation in aVR is more than in lead V1.

What is the standard criteria for a "Normal" QRS axis in the frontal plane?

A normal QRS axis is present if the main deflection of QRS complexes is positive ($+$) in both lead I and lead aVF.

What are the specific EKG findings associated with Right Atrial Enlargement (RAE)?

Tall, narrow, peaked P-waves in lead II; if biphasic P in V1, the initial deflection amplitude is $\ge 2$ small boxes; and a shift of the P-wave axis to the right.

What is the normal duration of a PR interval, and what does an interval exceeding this suggest?

The normal PR interval is between $0.12$ and $0.20\,\text{seconds}$; a fixed interval $> 0.20\,\text{sec}$ suggests 1st degree AV block (AVB).

What QRS duration threshold indicates Bundle Branch Block (BBB) versus Intraventricular Conduction Delay (IVCD)?

BBB is indicated by a QRS duration $> 0.12\,\text{sec}$, while IVCD is indicated by a duration between $0.10$ and $0.12\,\text{sec}$.

What are the components of the 'S1-Q3-T3' EKG pattern and what diagnosis does it suggest?

A deep S wave in I, a Q-wave in III, and an inverted T-wave in III; this pattern is highly suggestive of Pulmonary Embolism (PE).

What is the hallmark EKG finding for Wellens syndrome?

Marked T-wave inversion (TWI) in leads V2 and V3, indicating stenosis of the LAD.

What specific voltage criteria for the precordial leads are used to diagnose Left Ventricular Hypertrophy (LVH)?

S-code depth in V1 plus R-wave height in V5 or V6 $> 35\,\text{mm}$ amplitude, or adding any R-wave plus any S-wave in precordial leads $> 45\,\text{mm}$.

How does the transcript distinguish between the PR intervals of 2nd-degree AV block Type I and Type II?

In Type I (Wenckebach), the PR interval steadily increases before dropping a QRS complex; in Type II (Mobitz II), the PR interval remains fixed (constant) before suddenly dropping a QRS complex.

What is a Delta wave and which condition is it associated with?

A Delta wave is an initial "slurring" of the upstroke of the QRS complex, associated with Wolff-Parkinson-White (WPW) Syndrome.

What are the characteristics of a Junctional rhythm's heart rate and P-waves?

The heart rate is typically $40$ to $60\,\text{bpm}$, and P-waves may be absent or retrograde/inverted (preceding or following the QRS).