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Slater's Basic Steps for EKG
rhythm, rate, axis, intervals/segments, complexes/waves
criteria for normal sinus rhythm
p-wave w/ QRS complex, p-wave upright in I, II, & III, depolarization initiated by SA, PR interval 3-5 cubitas
How do you determine axis?
"rule of thumb", thumb up = deviation, both up = normal axis, both down = extreme right
Atrial Hypertrophy
Picture
What does an inverted T wave mean?
ischemia
Levine Scale
Murmurs: 1-faint, 2-quiet heard w/steth, 3-moderately loud no thrill, 4-moderately loud w/thrill, 5-v loud w/thrill steth part on, 6-v loud w/thrill steth off
17 y/o male, sports physical, split S2 that varies in duration @ LUSB
physiological split S2, not a true murmur, normal variant
16 y/o, sports physical, systolic murmur @ ULSB, physiological splitting of S2, crescendo-decrescendo, II/VI, murmur disappears when she stands
innocent murmur
What should be evaluated with an echocardiogram always?
ALL diastolic murmurs
48 y/o, ER, SOB last 2 weeks, unable to climb stairs, hx of asthma, romantic fever, mild JVD, PMI displaced, lift @ mid-ULSB, rumbling diastolic murmur, opening snap, best hear w/bell in left lateral position
mitral stenosis (also tricuspid regurgitation)
Modifiable ASCVD Risk Factors
smoking/tobacco use, HTN, obesity, dyslipidemia, diabetes
Non-modifiable ASCVD Risk Factors
age, sex, family hx.
MI management with continuous chest pain?
MONA
Time line in going to cardiac catheter lab?
stent under 90 minutes
Describe the utility of pulse oximetry?
non-invasive, rapid diagnosis, accurate, normal (95-100) abnormal (<95)
Describe the utility peak expiratory flow?
flow rate during forced expiration, asthma action plan (green, yellow, red zones), accurate (but spirometry is more accurate)
