ECG module 4

Question 1

What is the primary step in interpreting an ECG according to the provided notes?
A) Detailed PQRST wave analysis
B) Rhythm diagnosis
C) PR interval assessment
D) QT interval analysis

Answer 1

B) Rhythm diagnosis

Question 2

Which lead is the P-wave best seen in for assessing its size and shape?
A) Lead I
B) Lead II
C) Lead V5
D) Lead aVR

Answer 2

B) Lead II

Question 3

Which condition is associated with a peaked P-wave in lead II and may be secondary to pulmonary disorders?
A) Left atrial enlargement (LAE)
B) Right atrial enlargement (RAE)
C) Bi-atrial enlargement
D) Pericarditis

Answer 3

B) Right atrial enlargement (RAE)

Question 4

What is the criteria for a PR interval in Wolf Parkinson White syndrome (WPW)?
A) PR interval longer than 200 ms
B) PR interval shorter than 120 ms with a delta wave
C) PR interval longer than 400 ms
D) PR interval shorter than 100 ms

Answer 4

B) PR interval shorter than 120 ms with a delta wave

Question 5

Which condition is characterized by a PR interval that lengthens progressively across a few cycles until a non-conducted P-wave occurs?
A) 1st degree block
B) 2nd degree type I block (Wenckebach)
C) 2nd degree type II block (Mobitz type II)
D) 3rd degree block

Answer 5

B) 2nd degree type I block (Wenckebach)

Question 6

What is the characteristic pattern of QRS complexes in right bundle branch block (RBBB)?
A) rSR pattern in V1
B) ‘M’ pattern in V6
C) Narrow QRS complexes
D) ‘Notch’ in specific leads

Answer 6

A) rSR pattern in V1

Question 7

Which condition is typically associated with pathological Q-waves in contiguous leads II, III, and aVF?
A) Right ventricular hypertrophy (RVH)
B) Left ventricular hypertrophy (LVH)
C) Right bundle branch block (RBBB)
D) Myocardial infarction (MI)

Answer 7

D) Myocardial infarction (MI)

Question 8

What is the criteria for ST segment elevation indicative of a myocardial infarction (MI)?
A) ST > 1mm in any lead
B) ST > 1mm in 2 or more contiguous limb leads or > 2mm in 2 or more chest leads
C) ST > 2mm in any lead
D) ST > 0.5mm in 2 or more contiguous leads

Answer 8

B) ST > 1mm in 2 or more contiguous limb leads or > 2mm in 2 or more chest leads

Question 9

Which condition may present with PR segment changes in aVR and lead II, along with widespread ST elevation in most leads except aVR?
A) Right bundle branch block (RBBB)
B) Left ventricular hypertrophy (LVH)
C) Pericarditis
D) Myocardial infarction (MI)

Answer 9

C) Pericarditis

Question 10

What is the primary criterion for diagnosing prolonged QT interval?
A) QT is longer than half of preceding R-R
B) QT > 0.44s in men and > 0.46s in women
C) QT > 200 ms
D) QT > 0.5s in men and > 0.6s in women

Answer 10

B) QT > 0.44s in men and > 0.46s in women

Question 11

Which condition is characterized by a widened QRS complex and non-conducted P-waves, and is always suspicious of pathology, such as ischemia at the AV node or bundle of His?
A) Right bundle branch block (RBBB)
B) Left bundle branch block (LBBB)
C) Second-degree type II block (Mobitz type II)
D) Third-degree block (complete heart block)

Answer 11

C) Second-degree type II block (Mobitz type II)

Question 12

In a patient with left ventricular hypertrophy (LVH), what additional evidence might be seen on the ECG beyond specific criteria?
A) PR interval shortening
B) Biphasic P-waves in V1
C) ST segment elevation in V6
D) T-wave inversion in lead III

Answer 12

D) T-wave inversion in lead III

Question 13

Which condition can mimic right bundle branch block (RBBB) shapes in the ECG and is characterized by an irritable focus firing prematurely, resulting in abnormal QRS complexes?
A) Left ventricular hypertrophy (LVH)
B) Premature ventricular complexes (PVC)
C) Right ventricular hypertrophy (RVH)
D) Atrial tachycardia

Answer 13

B) Premature ventricular complexes (PVC)

Question 14

What is the key feature that distinguishes incomplete right bundle branch block (RBBB) from complete RBBB on an ECG?
A) Incomplete RBBB has a narrower QRS complex than complete RBBB.
B) Incomplete RBBB is always associated with atrial tachycardia.
C) Incomplete RBBB has a delta wave.
D) Incomplete RBBB has a longer PR interval.

Answer 14

A) Incomplete RBBB has a narrower QRS complex than complete RBBB.

Question 15

Which electrolyte abnormality is associated with “peaking” or “tenting” of T-waves on the ECG, along with widening of QRS complexes?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hyponatremia

Answer 15

A) Hyperkalemia