Wednesday, November 19, 2014

EKG Rhythm Quiz 285

Identify the following rhythm.

1.











a. Atrial paced
b. Ventricular paced
c. Biventricular paced
d. AV paced with

2.

a. Sinus arrhythmia
b. 2nd degree heart block type II
c. Wenckebach
d. Complete heart block

3.

a. Sinus bradycardia
b. Atrial fibrillation with slow ventricular response
c. Junctional rhythm
d. Idioventricular rhythm

4.

a. Junctional rhythm changing to sinus bradycardia
b. Sinus arrest changing to Idioventricular rhythm
c. Idioventricular rhythm changing to sinus rhythm
d. 2nd degree heart block type I changing to junctional rhythm


5.

a. First degree block with inverted T waves
b. Sinus bradycardia with inverted T waves
c. Sinus rhythm with inverted T waves
d. Sinus arrest with inverted T waves

6.













a. Normal sinus rhythm with multifocal PVCs
b. Normal sinus rhythm with bigeminal PVCs
c. Normal sinus rhythm with a couplet of PVCs
d. Normal sinus rhythm with unifocal PVCs


7.












a. Sinus rhythm with first degree block
b. Sinus exit block with first degree block
c. Sinus bradycardia with first degree block
d. Sinus arrest with first degree block

8.

a. Supraventricular tachycardia
b. Multifocal atrial tachycardia
c. Sinus tachycardia
d. Ventricular tachycardia

9.












a. Sinus rhythm with bigeminal PVCs
b. Sinus rhythm with unifocal PACs
c. Sinus rhythm with multifocal PVCs
d. Sinus rhythm with couplets

10.









a. Sinus rhythm with unifocal PVCs
b. Sinus rhythm with trigeminal PACs
c. Sinus rhythm with multifocal PVCs
d. Sinus rhythm with trigeminal PVCs


Answers.

01. c. Biventricular paced
02. b. 2nd degree heart block type II. The PR interval is constant on the conducted beats.  There are 2 nonconducted P waves which follow each QRS complex.
03. b. Atrial fibrillation with slow ventricular response. The rhythm is irregular with a rate of around 50 bpm. No P waves are seen. Some fibrillation can be seen in lead V1. No ectopic beats are noted. .
04. a. Junctional rhythm changing to sinus bradycardia. No P waves are seen on the 1st and 2nd complexes
05. c. Sinus rhythm with inverted T waves. The rhythm is regular with a ventricular rate of 71 beats/min. No ectopic beats are seen. The PR interval is .20 sec. The QRS complex is wide: .12 sec, QT: .44 sec. There are inverted T waves suggesting ischemia. The deep Q wave suggest an old or recent infarct.
06. d. Normal sinus rhythm with unifocal PVCs. In lead II, a slight difference in the size of the T wave is present in the 2nd PVC. So if you chose multifocal PVC as because of this, that's okay too. The over all morphology of the QRS complexes are the same in both lead so I chose unifocal PVCs.
07. c. Sinus bradycardia with first degree block
08. c. Sinus tachycardia.  The criteria for SVT is a rate > 150, absent P waves, and a narrow QRS complex.
09. c. Sinus rhythm with bigeminal PVCs.   Unifocal PVCs are seen every other beat
10. d. Sinus rhythm with trigeminal PVCs.  Unfocal PVCs are seen every third beat.




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