Friday, November 21, 2014

EKG Rhythm Quiz 287

Identify the following rhythms.


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


a. Normal sinus rhythm
b. First degree block
c. Sinus tachycardia
d. Atrial fibrillation


a. Sinus rhythm with unifocal PVCs
b. Sinus rhythm with bigeminal PVCs
c. Sinus tachycardia with multiform PVCs
d. First degree block with multifocal PVCs


a. Sinus tachycardia
b. Supraventricular tachycardia
c. Junctional tachycardia
d. Ventricular tachycardia


a.  Normal sinus rhythm with a multifocal PVCs and a triplet of PVCs
b. Normal sinus rhythm with trigeminal PVCs
c. First degree block with a salvo of unifocal PVCs
d. Sinus rhythm with sinus arrest and multiform PVCs


a. Atrial fibrillation
b. Ventricular tachycardia
c. Supraventricular tachycardia
d. Multifocal atrial tachycardia

 a. Ventricular tachycardia changing to sinus rhythm
 b. AIVR changing to sinus rhythm
 c. Complete heart block changing to sinus rhythm
 d. Junctional rhythm changing to sinus rhythm


a. Multifocal atrial tachycardia
b. Atrial tachycardia
c. Atrial fibrillation with rapid ventricular rate
d. Supraventricular tachycardia


a. Sinus bradycardia
b. Complete heart block
c. 2nd degree heart block type II
d. Idioventricular rhythm


a. NSR with PJCs
b. NSR with PACs
c. NSR with PVCs
d. Sinus arrhythmia


01. a. Atrial paced.  Pacer spikes are seen before some very small, flattened, P waves.
02. b. First degree block.  The PR interval is 0.24 seconds
03. d. First degree block with multifocal PVCs.  The PR interval is between 0.22 and 0.24 seconds, depending upon where you begin your measurement.  Multiform and multifocal are synonyms. Both are used to describe PVCs arising from different foci.
04. a. Sinus tachycardia.  The rhythm is regular.  There is an upright P wave before each QRS complex.  The QRS complexes are narrow.  The rate is around 125 bpm.
05. a.  Normal sinus rhythm with a multifocal PVCs and a triplet of PVCs
06. b. Ventricular tachycardia.   The second waveform is a CVP reading.  The normal CVP reading is between 1 - 5 mm/Hg.  This patient had pulmonary hypertension and some right heart hypertrophy which greatly elevated the CVP.
07. c. Atrial fibrillation with rapid ventricular rate
08. AIVR changing to sinus rhythm.   The initial complexes have a very wide QRS complexes and are without P waves.  This points toward a ventricular rhythm.   The rate is less than 100 so this rules out a ventricular tachycardia as being the source of the ectopic rhythm.
09. b. Complete heart block. No association between the P waves and the QRS complexes. If you follow the P waves you will see that some of them are buried in the QRS complexes and T waves.
10. b. NSR with PACs.   The PAC is the 6th complex.  The morphology of the P wave is different from the sinus P waves.

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