Week 1/2 - A(4) - ECG Module Assessment questions

Question 1

1. Sinus tachycardia 2. Atrial fibrillation 3. Atrial flutter 4. Ventricular tachycardia 5. AV nodal re-entry tachycardis

Answer 1

2. Atrial Fibrillation

Question 2

1. Sinus tachycardia 2. Atrial flutter 3. Atrial fibrillation 4. Ventricular flutter 5. Ventricular fibrillation

Answer 2

2. Atrial Flutter

Question 3

1. Sinus tachycardia 2. AV re-entry tachycardia 3. Ventricular tachycardia 4. Atrial fibrillation 5. Ventricular fibrillation

Answer 3

2. AV re-entry tachycardia Regular, tachycardia Often no clear P-waves Narrow complex

Question 4

1. Coronary artery spasm resulting in STEMI 2. Occlusion of the left anterior coronary artery due to athermatous plaque rupture 3. Pericarditis 4. Ruptured papilliary muscle 5. Pulmonary embolism

Answer 4

Pericarditis

Question 5

1. Sinus rhythm 2. Sinus tachycardia 3. Atrial fllutter 4. Ventricular tachycardia 5. Atrial fibrillation with abberant conduction

Answer 5

4. Ventricular tachycardia Regular broad complex tachycardia Always abnormal and must be acted upon

Question 6

1. Sinus tachycardia 2. AV re-entry tachycardia 3. Ventricular tachycardia 4. Atrial flutter 5. Atrial fibrillation

Answer 6

2. AV re-entry tachycardia

Question 7

1. Spontaneous dissection of the right coronary artery 2. Pericarditis 3. Occlusion of the circumflex coronary artery 4. Atrial flutter 5. Co-incidental long standing hypertension

Answer 7

2. Pericarditis

Question 8

1. Ventricular tachycardia 2. Ventricular fibrillation 3. Atrial fibrillation 4. Atrial flutter 5. Aystole

Answer 8

2. ventricular fibrillation Irregular random baseline No clear discernible waveforms Always associated with a LOC

Question 9

1. Sinus tachycardia 2. Atrial flutter 3. AV nodal re-entry tachycardia 4. AV re-entry tachycardia 5. Atrial fibrillation

Answer 9

2. Atrial flutter

Question 10

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Answer 10

2nd degree AV block with mobitz 2 Constant PR interval and then a subsequent missed beat (pwave without a QRS) Always abnormal and must be treated

Question 11

1. Statin therapy 2. Clopidogrel 3. Asprin 4. Anti-coagulation 5. Beta-blocker therapy

Answer 11

4. Anti-coagulation should be the next step

Question 12

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Answer 12

Unsure of the answer (Not Option A)- Potentially option B

Question 13

She will require a pacemaker She does not require any specific treatment She should receive anticoagulation She should be given a beta-blocker She should be investigated for a likely pulmonary embolism

Answer 13

1. She will require a pacemaker This lady has 2nd degree AV block with mobitz type 2 Can see the constant PR interval and then a dropped QRS after a pwave

Question 14

1. I agree with the FY2 2. I think this is left bundle branch block not right 3. There is right axis deviation 4. This patient has wolffe parkinson whyte syndrome 5. I think the ECG is normal

Answer 14

4. This patient has wolf parkinson white syndrome

Question 15

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Answer 15

Unsure of the answer (Not option A) - Possibly option B

Question 16

1. Complete AV block 2. 2nd degree AV block mobitz type 2 3. 2nd degree AV block mobitz type 1 4. Sinus rhythm 5. Ventricular tachycardia

Answer 16

1. Complete AV block No relationship between P waves and QRS Broad complex QRS

Question 17

1. Anti platelets 2. Primary coronary intervention 3. Arrange a CT pulmonary angiogram 4. Arrange an Echocardiogram - the ECG suggests hypertrophy 5. Anti coagulate for atrial fibriallation

Answer 17

5. Anti-coagulate for atrial fibrillation

Question 18

He suffered an anterior STEMI in the past week He has suffered a non STEMI He most likely has pericarditis He has just occluded his left anterior descending coronary artery The only coronary disease he is likely to have is in his right coronary artery.

Answer 18

1. He has suffered an anterior STEMI in the past week

Question 19

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Answer 19

b- Atrial fibrillation

Question 20

1. I agree with the machine - they are all correct 2. ‘Consider old inferior myocardial infarction 3. “Right bundle branch block” 4. “Atrial fibrillation” 5. “Abnormal ECG”

Answer 20

Unsure of the answer (Not option B) - Possibly option A

Question 21

1. Sinus rhythm 2. 2:1 AV block 3. 2nd degree AV block - mobitz type 1 4. Junctional rhythm 5. 2nd degree AV block mobitz type 2

Answer 21

3. 2nd degree AV block mobitz type 1 Progressive PR lengthening, with an eventual missed beat Not treated unless severe or accompanied by collapse or haemodynamic compromise

Question 22

1. Sinus rhythm 2. 1st degree AV block 3. 2nd degree AV block - Type 1 4. 2nd degree Av block - Type 2 5. Right bundle branch block

Answer 22

3. 2nd degree AV block Mobitz type 1

Question 23

1. Left main stem 2. Left anterior descending 3. Left circumflex coronary artery 4. Right coronary artery 5. 1st diagonal coronary artery

Answer 23

Unsure

Question 24

1. The patient is in AF 2. The patient has RBBB 3. The patient may have had a PE 4. There is right axis deviation 5. The patient should be considered for anticoagulation prior to being discharged

Answer 24

4. This is incorrect as the patient has left axis deviation

Question 25

1. Arrange for PCI 2. Repeat the ECG in 10 minutes to see if the changes are evolving 3. Arrange an urgent CXR 4. Arrange an urgent echocardiogram 5. Arrange transfer to the coronary care unit urgently

Answer 25

1. Arrange for PCI Looks like a V1-6, I STEMI - occlusion of the left coronary artery (will affect left anterior descending and left circumflex)

Question 26

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Answer 26

Polymorphic Ventricular Tachycardia - Torsades de pointes

Question 27

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Answer 27

UNSURE

Question 28

1. Urgent echocardiogram 2. Determine his blood pressure 3. Arrange transfer to the cardiac catheter laboratory 4. Administer verapamil 5. Administer Atenolol

Answer 28

Determine his blood pressure If he is haemodynamically unstable then will need DC cadioversion If haemodynamically stable, treat with medication - amiodarone