Toxicology ECG Findings

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Questions and Answers

A patient presents with a prolonged QRS interval on their ECG. Which of the following medications or conditions is least likely to be the cause?

  • Hyperkalemia
  • Beta-blockers (correct)
  • Cocaine
  • Tricyclic antidepressants (TCAs)

An ECG shows a prominent U wave. Which electrolyte imbalance is most likely present in this patient?

  • Hyponatremia
  • Hypercalcemia
  • Hypokalemia (correct)
  • Hyperkalemia

A patient's ECG shows a scooped ST segment. Which medication is most likely contributing to this finding?

  • Amiodarone
  • Warfarin
  • Lisinopril
  • Digoxin (correct)

Which of the following ECG changes is commonly associated with hypothermia?

<p>Osborn waves (C)</p> Signup and view all the answers

A patient's ECG shows an absent P wave. Which of the following could be a potential cause?

<p>Digoxin toxicity (C)</p> Signup and view all the answers

Which of the following medications is least likely to cause a prolonged QT interval?

<p>Lisinopril (D)</p> Signup and view all the answers

What ECG change is most indicative of hyperkalemia?

<p>Peaked T waves (B)</p> Signup and view all the answers

Which of the following sets of ECG changes is most likely associated with digoxin toxicity?

<p>Scooped ST segment, absent P wave (A)</p> Signup and view all the answers

Which of the following conditions is associated with the presence of Osborn waves on an ECG?

<p>Hypothermia (D)</p> Signup and view all the answers

A patient's ECG shows a prolonged PR interval. Which medication could be contributing to this finding?

<p>Beta-blockers (A)</p> Signup and view all the answers

Tricyclic antidepressants (TCAs) can cause which of the following ECG changes?

<p>Prolonged QRS interval (A)</p> Signup and view all the answers

Concurrent use of quinidine and alcohol may result in which of the following ECG abnormalities?

<p>Prominent U waves (A)</p> Signup and view all the answers

Which ECG finding is most likely associated with hypokalemia?

<p>Flattened or inverted T waves (A)</p> Signup and view all the answers

Which of the following will NOT cause a prolonged PR interval?

<p>Cocaine (A)</p> Signup and view all the answers

Which of the following is most likely to cause an absent P wave?

<p>Digitalis (C)</p> Signup and view all the answers

Which of the following is least likely to cause a prolonged QT interval?

<p>Aspirin (A)</p> Signup and view all the answers

Which of the following scenarios/substances will cause hyperkalemia?

<p>Digoxin (A)</p> Signup and view all the answers

Which of the following is most likely to cause a notched P wave?

<p>Quinidine (B)</p> Signup and view all the answers

Aside from hypothermia, what may someone who presents with alcohol withdrawal also experience?

<p>Bradycardia (C)</p> Signup and view all the answers

Which electrolyte imbalance is associated with flattened or inverted T waves on an ECG?

<p>Hypokalemia (A)</p> Signup and view all the answers

Flashcards

Absent P wave causes

Absent P waves on ECG can be caused by digoxin, cholinergics, and hyperkalemia.

Notched P wave cause

Notched P waves on ECG are associated with quinidine.

Prolonged PR causes

Prolonged PR interval can be caused by beta-blockers, calcium channel blockers (CCBs), magnesium, lacosamide, digoxin, and lithium.

Prolonged QRS causes

Prolonged QRS interval can be caused by TCAs, type 1 antiarrhythmics, cocaine, diphenhydramine, quinidine, and hyperkalemia.

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Scooped ST segment cause

Scooped ST segment can be caused by digoxin.

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Prolonged QT causes

Prolonged QT interval can be caused by methadone, haloperidol, TCAs, lithium, chloroquine, arsenic, low potassium or magnesium, and alcohol.

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Peaked T wave cause

Peaked T waves are associated with hyperkalemia.

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Inverted T wave cause

Flat or inverted T waves can be caused by hypokalemia.

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Scooped T wave cause

Scooped T waves can be caused by digoxin.

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Prominent U wave causes

Prominent U waves are associated with hypokalemia, quinidine, class Ia/III antiarrhythmics, and alcohol.

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Osborn wave cause

Osborn waves are associated with alcohol, hypothermia, bradycardia, and atrial fibrillation during withdrawal.

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Study Notes

  • ECG findings related to toxicology

P Wave

  • Digoxin, cholinergics, and hyperkalemia can cause the absence of a P wave
  • Quinidine can cause a notched P wave

PR Interval

  • Beta-blockers, calcium channel blockers (CCBs), magnesium, lacosamide, digoxin, and lithium can prolong the PR interval

QRS Complex

  • Tricyclic antidepressants (TCAs), type 1 antiarrhythmics, cocaine, diphenhydramine, quinidine, and hyperkalemia can prolong the QRS complex

ST Segment

  • Digoxin can cause a scooped ST segment

QT Interval

  • Methadone, haloperidol, TCAs, lithium, chloroquine, arsenic, low potassium (K), calcium (Ca), magnesium (Mg), and alcohol can prolong the QT interval

T Wave

  • Hyperkalemia can cause peaked T waves
  • Hypokalemia can cause flat or inverted T waves
  • Digoxin can cause a scooped T wave

U Wave

  • Hypokalemia, quinidine, class Ia/III antiarrhythmics, and alcohol can cause a prominent U wave

Alcohol

  • Alcohol can cause an Osborn wave (associated with hypothermia), bradycardia, and atrial fibrillation (during withdrawal)

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