Answer 10

10.  Choice B is the correct answer.  With left axis deviation there is a positive deflection in lead I, and a negative deflection in lead avF.   A normal axis has positive deflections in leads I and avF.  Right axis deviation has a negative deflection in lead I, and a positive deflection in lead avF.  Extreme right axis deviation has negative deflections in leads I and and avF.

Question 10

10.  Please determine the axis on the EKG listed below:

A.  Normal Axis
B.  Left axis deviation
C.  Right axis deviation
D.  Extreme right axis deviation

Answer 9

9.  Choice D is the correct answer.  This patient has ST elevation in the inferior leads which are leads II, III, and avF.  Pericarditis usually has ST elevation in all leads.  The septal leads are leads V1 and V2 and there is no ST elevation there.  The lateral leads, leads I, avL, V5 and V6 have no ST elevation.

Question 9

9.  What is the diagnosis on the EKG listed below?

A.  Pericarditis

B.  Lateral Wall STEMI

C.  Septal Wall STEMI

D.  Inferior Wall STEMI

Answer 8

8.  Choice B is the correct answer.  A key characteristic with hyperkalemia is that the P wave is flattened, the QRS complex is widened, and the T waves are peaked.  This is contrasted with hypokalemia where the T waves become flattened and there can be a U wave.  Calcium affect the QT interval.  With hypercalcemia, the QT interval is shortened.  With hypocalcemia, the QT interval is prolonged.

Question 8

8.  Please identify the pathology listed below in the EKG:

A.  Hypokalemia
B.  Hyperkalemia
C.  Hypocalcemia
D.  Hypercalcemia

Answer 7

7.  Choice B is the correct answer.  A key characteristic of atrial fibrillation is that is an irregularly irregular rhythm.  Since the impulse is coming from multiple foci in the the atria there is a wavy irregular baseline.  This can be contrasted with atrial flutter that has only one ectopic focus in the atria, the baseline is sawtooth and regular.  Sinus arrhythmia is an irregular rhythm that varies with the patients respiration.  The difference is the P waves, QRS complex, and T waves vary with the patients respirations.  Sinus block is when the SA node quits pacing activity for one complete cycle.  The P waves are the same because the SA node is functioning before and after the pause.

Question 7

7.  Please identify the EKG listed below:

A.  Atrial Flutter
B.  Atrial Fibrillation
C.  Sinus Arrhythmia
D.  Sinus Block

Answer 6

6.  Choice A is the correct answer.  Wolff Parkinson White Syndrome is when there is an accessory pathway for ventricular stimulation between the SA and AV node.  This produces the characteristic delta wave.  There is a defect in the Q wave causing the up sloping but this is not what we see in left bundle block.  Ventricular Tachycardia is much faster (usually a rate over 150 beats per minute) and the QRS complex is widened.  Patients with Wolff Parkinson White are prone to paroxysmal atrial tachycardia.

Question 6

6.  Please interpret the EKG listed below:

A.  Wolff Parkinson White Syndrome
B.  Wandering Atrial Pacer
C.  Left Bundle Branch Block
D.  Ventricular Tachycardia

Answer 5

5.  Choice C is the correct answer.  Normal PR interval is 0.12-0.20 seconds.  This is important for diagnosing AV blocks and the various types.

Question 5

5.  A normal PR interval is:

A.  Less than 0.12 seconds
B.  0.12-0.16 seconds
C.  0.12-0.20 seconds
D.  Over 0.2 seconds

Answer 4

4.  Choice D is the correct answer.  The P wave represents atrial depolarization not repolarization.  The T wave represents ventricular repolarization.  The R wave which is the peak of the QRS complex represents ventricular depolarization.

Question 4

4.  Which of the following EKG waves represent atrial repolarization?

A.  P Wave
B.  T Wave
C.  R Wave
D.  U Wave

Answer 3

3.  Choice D is the correct answer.  With First Degree AV Block, there is just lengthening of the PR intervals.  There is no dropped QRS complexes.  Atrial Fib is irregularly irregular without P waves.  Second Degree Type I AV Block there is lengthening of the PR interval until the QRS complex drops. Third degree or complete heart block is when the P waves and QRS complexes are occurring independently of each other.  Each P wave does not necessarily have a QRS complex after it, and there is equal distance between the P waves and equal distance between the QRS complexes.

Question 3

3. Please identify the rhythm strip listed below:

A.  First Degree AV Block
B.  Atrial Fib
C.  Second Degree Type I AV Block
D.  Complete Heart Block

Answer 2

2.  Choice B is the correct answer.  There are no p waves seen in this rhythm strip so choice A and C are incorrect.  With First Degree AV Block the PR interval is just length and there is no dropping of the QRS complex.  Junctional bradycardia has inverted P waves occurring before, during or immediately after the QRS complex.  Presumably, since there is no P waves seen they are within the QRS complex. The pacemaker is coming from the AV junction, which has an inherent rate of 40-60.  Faster then 60 is referred to as junctional tachycardia, slower than 40 is referred to a junctional bradycardia.  Atrial fibrillation does not have any discernible P waves but the rhythm is too slow for that.  In addition, it is an irregularly, irregular rhythm and this rhythm strip is regular.

Question 2

2.  Please identify the rhythm listed below rate is 36 :

A.  Sinus Bradycardia

B.  Junctional Bradycardia

C.  First Degree AV Block

D.  Atrial Fibrillation

Answer 1

1.  Choice C is the correct answer.  Wandering Atrial Pacemaker on an EKG has P waves that are of various shapes and places.  The reason the strip looks this way is that the origin of the pacemaker is coming from different areas in the atria.  In a junctional rhythm, there is inverted P waves occurring before during and after the QRS complex.  These P waves are not inverted.  Second Degree Type II is when there is just a dropping of the QRS complex without lengthening PR intervals.  This is not occurring either.  Third Degree AV Block is when there is complete AV disassociation which is not occurring either.  When this occurs there P waves and the QRS complexes are occurring independently and they occur equal distance between themselves between each beat.

Question 1

1.  Please identify the rhythm listed below in the EKG:

A.  Junctional rhythm
B.  Third Degree AV Block
C.  Wandering Atrial Pacemaker
D.  Second Degree Type II AV Block