pgmee test series neet & aiims · pgmee test series for ... atypical abs sz-1-2hz...

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PGMEE TEsT sEriEs for neet & aiims

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34-ECG, EEG, EMG

ECGWilliam Einthoven discovered in 1895, got Nobel prize in 1924

12lead6precordial(V1-V6), 6limb(bipolar I,II,III+ unipolar aVR,aVL,aVF)V1-rt 4ICSV2-lt 4ICSV3-b/n V2&V4V4-5ICS MCLV5-5ICS AALV6-5ICS MAL

Einthoven triangle RA(––), LF(++)Einthoven rule II=I+III

1mm ht=0.1mV 1mm width=0.04s speed=25mm/s HR=1500/small sq HR in AF=no. of Rwave in 15large sq×20

jn rhythm intrinsic=50/min accelerated=50-100/min jn tachycardia>100/min

idioventric rhythm extra impulse fr ventricle, atria get impulse fr SA node intrinsic=40/min accelerated=40-100/min VT>100/min

lead II-tachycardia, bradyarrhythmia, AV block, dyselectrolemia, drug effect, atrial enlargement, P wave abnorm V1-RVH/RBBB V5/6-LVH,LBBB

P(atr depolarization)-II <2.5mm-duration, amplitude absent-AF, jn rhythm saw tooth-atrial flutter

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P-Mitrale-broad&notched, deep –ve in V1(Morris index+ve)-LA enlargem(MS) P-Pulmonale-tall&Pointed>2.5mm-RA enlargem inverted-jn tachycardia hidden-PSVT 2P wave-block of conduction through AV node small-hyperkalemia

PR interval=0.12-0.20s=3-5mm short-bypass tract(WPW synd) long-1st° AV block, βadr antag, digoxin, CCB, hyperkalemia, RF, atazanavir

delta(slurring of initial part of QRS) WPW synd, Ebstein

QRS complex(ventricular depolarisation)=0.12s=3mm naRRow-noRmal, hypeRcalcemia, a/c MI, hypeRmagnesemia broad-RBBB, LBBB, hyperkalemia, ventricular premature complex, WPW synd, hypocalcemia broad, M shape, Monophasic R-LBBB(V5,6) broad, rSR(RaBBit ear)-RBBB(V1) alternate sinus rhythm, ventricular premature complex-bigeminy(digoxin)

QRS tall-glycogen storage ds low-CCP, RCM

QRS axis-I,aVF normal=–30°-+100°↑ ↑ I- ,aVF- -normal↑ ↓ I- ,aVF- -LAD[LVH, inf wall MI(Q in aVF), lt ant fascicular block, TV atresia, AS, HTN,

HCM, ostium primum ASD]↓ ↑ I- ,aVF- -RAD(Rt hands meet)[RVH, lat wall MI(Q in I), lt post fasc block, TOF, ASD,

VSD]

R(ventr depol)→ → V1 V6(– +)

LVH-R(V5,V6)+S(V1)>35mm(Sokolov& Lyon criteria) RVH-R>S(V1)

QT interval=0.28-0.44s=7-11mm long-ventr arrhythmia(sudden death), hypocalcemia, hypomagnesemia, hypokalemia(false), torsades de pointes, quinidine(IA), sotalol(III), phenothiazine, TCA antidepressant, cisapride, mosapride, tegaserod, terfenadine, sevoflurane, bedaquiline, dolosetron, trimetazidine, ranolazine, ziprasidone, sibutramine, gatifloxacin shoRt-hypeRcalcemia, digoxin

ST elevation-a/c MI, prinzmetal angina, a/c pericarditis(all lead except aVR), a/c myocarditis, LV aneurysm, hyperkalemia, hypercalcemia, early repolarization variant

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depression-a/c post MI, stable angina, unstable angina, hypokalemia, AS(V5,V6)

T tall-a/c MI, hyperkalemia flat-hypokalemia inversion-unstable angina, hypokalemia

U hypokalemia, digoxin

electrical alternans-cardiac tamponade

hyperkalemia↑ ↓ ECF K, RMP more –ve, excitability

small P wave AV nodal block(PR prolong) broad QRS ST narrow, elevated tall(>10mm) T wave(1st sign) sine wave pattern ventr asystole heart stop in diastole

hypokalemia prolong PR interval flattening&inversion of T wave sagging of ST seg false QT prolong U wave

hypercalcemia narrow QRS short QT interval ST elevat heart stop in systole

hypocalcemia prolong QT interval

hypernatremia ECG-normal

hyponatremia decre QRS amplitude

hypothermia ST elevation Osborn J wave

digoxin

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prolong PR interval ST-T depression(invert tick/hockey sign) U wave bradycardia toxicity QT short Mobitz type1(never type2)

↑ tachyarrhythmia(d/t automaticity) ventr bigemini(ectopic) jn tachycardia bidirectional VT

change in MI ST seg elevation ant-V2-V5 sept-V1-V3 post wall-V1-V3 lat-V5-V6,I,aVL antlat-V2-V6,I,aVL inf-II,III,aVF RVMI-RV4

1st change-tall T↑ 2nd chang-ST (7-14d), >14d(LV aneurysm)

prom Q-6-24h-lifelong↓ T -24-48h

ECG poor in Dx-lt circumflex a

pericard effusion-low V ECG

AV block↑ 1st°- PR interval

2nd°-QRS absent intermittent, PR interval-variable-Mobitz type I, fixed-Mobitz type II 3rd°-wide QRS

VT=100-200/minV flutter>250/minV fibrillation-irreg irreg

pulm embolism-S1Q3,T3

HIS BUNDLE ECG A-SA nodal depolar H-His bundle depolar V-Ventricul depolar AH=55-130ms-AV nodal block HV=35-55ms-bundle br block

EEG atypical abs sz-1-2Hz spike&wave ppt by hyperventilation

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BDZ, barbiturate, etomidate, propofol, halothane-biphasic↓ ↑ → O2- cerebral excitability diffuse EEG slowing

delirium, hypocarbia, hypothermia-slowing of brain activity desflurane, sevoflurane-burst suspension HSV encephalitis-localised discharge temporal lobe↑ O2-low amplit, fast freq

infantile spasm(West synd)-hypsarrhythmic(large, irregular) wave ISOflurane-ISOelectric Juvenil myoclonic epilepsy(Janz synd)- 4-6Hz spike&wave ppt by photic stimulation

↑ ↑ ↓ ketamine- amplθ, amplγ, amplβ↑ NO2- freq,amplitude

opioid-monophasic pCO2

↓ ↑ 5-20%- cerebral excitability, sz threshold↑ 30%- cerebral excitability, epileptic change↓ 50%- wave

RAS on arousal-δblock rolandic epilepsy-centrotemporal spike typical absence sz-3Hz spike&dome

EMG infantile spasm(West synd)-rhomboid

Abbreviations a-artery, AA-amino acid, abtc-antibiotic, AI-autoimmune bef-before, bel-below, b/l-bilateral, bld-blood, b/n-between, bn-benign, br-branch, Bx-biopsy ca-carcinoma, carb-carbohydrate, c/i-contraindication, c/l-contralateral, conc-concentration, cong-congenital, Cx-cervix d-day, def-deficient, ds-disease, d/t-due to, Dx-diagnosis E-estrogen fem-female, fr-from gld-gland, glu-glucose h-hormone idiop-idiopathic, i/l-ipsilateral, inf-infection, inj-injury lig-ligament, LL-lower limb, l/t-leading to m-muscle, maj-major, mal-male, MC-most common, met-metastasis, min-minor, mtx-methotrexate, Mx-management n-nerve, norm-normal P-progesterone, pl-plasma, prot-protein, pt-patient Rx-treatment SCC-squamous cell carcinoma, sr-serum, Sx-surgery, sz-seizure tm-tumour, ts-tissue UL-upper limb, u/l-unilateral vag-vagina, VC-vocal cord, vel-velocity, vert-vertebra, vit-vitamin, vol-volume w-week, wt-weight Xr-X ray y-year #-fracture °-degree

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THESE NOTES ARE ONLY FOR THE PURPOSE OF GUIDANCE AND HELP TO PG ASPIRANTS, NOT FOR COMMERCIAL OR OTHER PURPOSE. REFERENCE HAS BEEN TAKEN FROM VARIOUS STANDARD TEXTBOOKS.

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pgmee test series neet & aiims · pgmee test series for ... atypical abs sz-1-2hz...

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