Friday, May 22, 2015

Sinus Rhythm Quiz

Identify the following sinus rhythms.

1.







a. Sinus arrhythmia
b. Normal sinus rhythm
c. Sinus bradycardia
d. Sinus tachycardia
e. Sinus arrest or pause


2.







a. Sinus arrhythmia
b. Normal sinus rhythm
c. Sinus bradycardia
d. Sinus tachycardia
e. Sinus arrest or pause

3.







a. Sinus arrhythmia
b. Normal sinus rhythm
c. Sinus bradycardia
d. Sinus tachycardia
e. Sinus arrest or pause

4.












a. Sinus arrhythmia
b. Normal sinus rhythm
c. Sinus bradycardia
d. Sinus tachycardia
e. Sinus arrest or pause

5.








a. Sinus arrhythmia
b. Normal sinus rhythm
c. Sinus bradycardia
d. Sinus tachycardia
e. Sinus arrest or pause


6.







a. Sinus arrhythmia
b. Normal sinus rhythm
c. Sinus bradycardia
d. Sinus tachycardia
e. Sinus arrest or pause

7.








a. Sinus arrhythmia
b. Sinus rhythm with a pause
c. Sinus bradycardia with a pause
d. Sinus tachycardia
e. Sinus rhythm with sinus arrhythmia

8.








a. Sinus arrhythmia
b. Normal sinus rhythm
c. Sinus bradycardia
d. Sinus tachycardia
e. Sinus arrest or pause

9.








a. Sinus rhythm with sins arrhythmia
b. Sinus rhythm with sinus arrest
c. Sinus bradycardia with a pause
d. Sinus bradycardia with sinus arrhythmia
e. Sinus arrhythmia

10.








a. Sinus arrhythmia
b. Normal sinus rhythm
c. Sinus bradycardia
d. Sinus tachycardia
e. Sinus arrest or pause


Answer

1.  b. Normal sinus rhythm. The rhythm is regular.  The heart rate is 78.  There are P waves before each QRS complex.  The P waves are biphasic suggesting biatrial enlargement.  The QRS complexes are narrow.  No ectopic beats are noted.  PR. 10 sec, QRS: .08 sec, QT: .28 sec


2. d. Sinus tachycardia.  The rhythm is regular with a rate of 136 bpm.  The P waves are uniform and upright.  The QRS complexes are narrow. No ectopic beats are seen.  PR: .12 sec, QRS: .08 sec, QT: .28 sec

3. e. Sinus arrest or pause.  The rhythm is irregular.  The rate is 30 bpm.  The P waves are small but are uniform and precede each QRS complex.  There is a long is a 2.8 sec pause that follows the first complex.  After the pause sinus rhythm resumes. The QRS complexes are narrow.  No ectopic beats are seen. PR: .16 sec, QRS: .08 sec, QT: .48 sec

4. a. Sinus arrhythmia. The rhythm is irregular and the heart rate is 70 bpm.  With the exception of the first P waves, all the P waves look uniform and are paired up with a QRS complex. The QRS complexes are narrow.  No ectopic beats are seen.  PR: .12 sec, QRS: .08 sec, QT: .40 sec.
 5. c. Sinus bradycardia.  The rhythm is regular.  The heart rate is extremely slow at 30 bpm. The P waves axis are positive.  The P waves are associated with a QRS complex.  The QRS complexes are wide.  No ectopic beats are seen.  PR: .20 sec, QRS: .16 sec, QT: .44 sec.
 6. b. Normal sinus rhythm.  The rhythm is regular.  The rate is 93 bpm.  There are small upright P waves that are paired with a QRS complex.  The QRS complexes are wide.  A deep Q wave is seen with the QRS complexes.  This may represent an old or recent infarct.  ST depression is seen, this represent ischemia. No ectopic beats are seen. PR: .12 sec, QRS: .12 sec, QT: .36 sec.

7. b. Sinus rhythm with a pause.  The rhythm is irregular with a rate of 90 bpm. Uniform, upright P waves are seen before each QRS complex.  A brief .84 sec pause is seen.  The QRS complexes are narrow.  No ectopic beats are present. PR: .18 sec, QRS: .08 sec, QT: .32 sec

8. d. Sinus tachycardia.  The rhythm is regular with a rate of 125 bpm.  The P waves are positive and are associated with a QRS complex.  The QRS complexes are narrow.  No ectopic beats are present. PR: .12 sec, QRS: .08 sec, QT: .38 sec.

 9.  d. Sinus bradycardia with sinus arrhythmia.  The rhythm is irregular.  The rate is 60 bpm. The P waves are associated with a QRS complex and are uniform and upright.  The QRS complexes are wide.  There is ST elevation seen in lead II.  No ectopic beats are present.  PR: .20 sec, QRS: .16 sec, QT: .44 sec.

 10. b. Normal sinus rhythm.  The rhythm is irregular with a rate of 62 bpm.  The P waves look the same and they are paired with a QRS complex.  The QRS complexes are narrow.  There is 1 mm ST depression with T wave inversion in lead II.  No ectopic beats are seen.  PR: .16 sec, QRS: .08 sec, QT: .36 sec


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