In the Name of Allah, the Most Gracious, the Most Merciful

Core Review Course, SBEM-KAMC, Riyadh, Saudi Arabia

22/8/1438 A.H
18/5/2017 A.D

Abdussalam A. Alshehri
 Drug
 Instrument
 Procedure
 Gross finding
 Radiological image
 EKG
 Laboratory interpretation
 Standard recommendation to keep refrigerated.

 Retains > 90% of its original activity at room

temperature for 3 months.
Post MVC
 Intratemporal
 Mastoiditis (most common)
 Hearing impairment
 TM perforation
 Spontaneous resolution
 Chronic OM
 Cholesteatoma
 Labrynthitis
 Facial paralysis
Intracranial
 Meningitis
 most common intracranial
complications
 Brain abscesses
 most commonly caused by
chronic otitis
 second most common
intracranial complication
 Extradural abscesses
 Subdural empyema
 Lateral venous sinus thrombosis
 WPW type A
 Posterior MI
 RBBB
 RAD
 RVH
 Acute RV dilation or strain (massive PE)
 Hypertrophic cardiomyopathy
 Na2+channel blocking drug toxicity
 Hyperkalemia
 Dextrocardia
 Misplaced electrodes
 Normal variant in neonates
 Heart Block

3rd Degree
1st Degree 2nd Degree
(complete)

Mobitz Type I
Mobitz Type II
(Wenckebach)
More P’s than Rs
yes

PR fixed? yes 2nd-degree

Mobitz II

no

RR fixed ? yes 3rd-degree

2nd-degree
Mobitz I
no
(Wenckebach)
 Sgarbossa
 A. Concordant STE ≥
1mm (in any lead)
 B. Concordant STD ≥
1mm in V1, V2, or V3
 C. Discordant STE ≥
5mm
 RBBB  RBBB
and and
 LAHB or LPHB  1st or 2nd degree AV
block
 RBBB
and
 LAHB or LPHB

and
 1st or 2nd degree AV block
 LAFB
 Left axis deviation (usually between -45
and -90 degrees)
 Small Q waves with tall R waves (= ‘qR
complexes’) in leads I and aVL
 Small R waves with deep S waves (= ‘rS
complexes’) in leads II, III, aVF
 QRS duration normal or slightly
prolonged (80-110 ms)
 Prolonged R wave peak time in aVL > 45
ms
 Increased QRS voltage in the limb leads
LPFB
 Right axis deviation (> +90 degrees)
 Small R waves with deep S waves (= ‘rS
complexes’) in leads I and aVL
 Small Q waves with tall R waves (= ‘qR
complexes’) in leads II, III and aVF
 QRS duration normal or slightly
prolonged (80-110ms)
 Prolonged R wave peak time in aVF
 Increased QRS voltage in the limb leads
 No evidence of any other cause for right
axis deviation