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07-12-2011

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USMLE-Syndrome
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High Yield Electrocardiographs for the Step 2 CK Exam

High Yield ECGs for the USMLE Step 2 CK Exam 1- Wolff-Parkinson-White (WPW) syndrome. The upper tracing is a 12-lead electrocardiogram in a patient with WPW and reveals a short PR interval and slurring of the upstroke of the QRS complex in multiple leads (delta waves). The lower tracing demonstrates rapid atrial fibrillation in a patient with WPW. The irregular cycle lengths, wide QRS complexes with occasional normal QRS complexes, and very rapid rate should suggest the diagnosis of atrial fibrillation in the presence of an atrioventricular bypass tract.

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2- ECG indicates severe mitral stenosis. Note the right axis deviation (frontal plane axis = +120), the left atrial conduction abnormality (large terminal negative component of the P wave in V1), and the right ventricular hypertrophy (R wave in V1 and right axis deviation). This is the murmur of mitral stenosis.

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3- 2:1 second-degree atrioventricular [AV] block) There are two P waves to each QRS complex. The P-R interval prior to the dropped P wave is always the same. It is not possible to define this type of AV block as type I or type II Mobitz block, and it is, therefore, a third variety of second-degree AV block (arrows show P waves).

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4- Heart block. A, First-degree atrioventricular (AV) block; the PR interval is prolonged (>200 msec). B, Second-degree AV block, type I (Wenckebach). There is progressive PR prolongation preceding a nonconducted P wave (arrows). C, Second-degree AV block, type II. Nonconducted P waves are seen (arrows) in the absence of progressive PR prolongation. D, Third-degree (complete) AV block with AV dissociation and a narrow-complex (AV nodal) escape rhythm

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5- Ventricular fibrillation: bizarre, disorganized rhythm with waves that vary in size.

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6- right bundle branch block pattern

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7- electrocardiogram (ECG) demonstrates ST segment elevation in I, aVL, and V2V6 consistent with an acute anterolateral myocardial infarction (MI).

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8- ECG of an inferior myocardial infarction. Note the raised ST-segment and Q waves in the inferior leads (II, III, aVF). The additional Twave inversion in V4 and V5 probably represents anterior wall ischemia.

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9- This ECG shows a constant P-R interval with a nonconducted P wave, which is most consistent with type II second-degree AV block and often progresses to third-degree block

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10- pericarditis. diffuse ST elevation

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05-30-2012

#2 Steps History: Not yet Posts: 1 Threads: 0 Thanked 0 Times in 0 Posts Reputation: 10

sangash
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thank you so much its highly useful

06-18-2012

#3 Steps History: 1 + C K Posts: 5 Threads: 0 Thanked 8 Times in 3 Posts Reputation: 18

raymd

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Good one miss patho __________________ http://countdown2ck.blogspot.com/

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