EKG Rhythm Strip Quiz 46
Identify the following rhythms.
1.
a. Atrial flutter with an occasional PVC
b. 2nd degree heart block type II with 3:1 conduction
c. Atrial fibrillation with slow ventricular response
d. Sinus tachycardia with PACs
2.
a. Atrial paced with a multifocal PAC
c. AV pacing with a unifocal PVC
d. Biventricular pacing with occasional PVCs
3.
a. Sinus rhythm with an frequent PJCs
c. Sinus rhythm with a bigeminal PACs
d. Sinus rhythm with premature junctional contractions
4.
a. Sinus bradycardia with trigeminal PACs
c. Sinus tachycardia with frequent multiform PVCs
d. Sinus arrhythmia with an occasional PVC
5.
a. Sinus bradycardia with 1st degree block
c. Sinus tachycardia with junctional ectopy
d. Sinus arrhythmia with 2nd degree block
1.
a. Atrial flutter with an occasional PVC
b. 2nd degree heart block type II with 3:1 conduction
c. Atrial fibrillation with slow ventricular response
d. Sinus tachycardia with PACs
2.
c. AV pacing with a unifocal PVC
d. Biventricular pacing with occasional PVCs
3.
c. Sinus rhythm with a bigeminal PACs
d. Sinus rhythm with premature junctional contractions
4.
c. Sinus tachycardia with frequent multiform PVCs
d. Sinus arrhythmia with an occasional PVC
5.
c. Sinus tachycardia with junctional ectopy
d. Sinus arrhythmia with 2nd degree block
6.
a. Sinus bradycardia
c. Sinus tachycardia
d. Sinus arrhythmia
7.
a. Ventricular standstill
c. Agonal rhythm
d. Atrial fibrillation
8.
a. Accelerated idioventricular rhythm
c. Junctional tachycardia
d. Supraventricular tachycardia
9.
a. Normal sinus rhythm
c. Atrial fibrillation
d. Junctional rhythm
10.
a. Sinus rhythm with an frequent PJCs
b. Sinus arrhythmia with PJCs
c. Sinus rhythm with junctional escape beats
d. Sinus rhythm with sinus pauses
Answers
1.
a. Atrial flutter with an occasional PVC. There are prominent flutter waves noted in lead V1. The rhythm is regular except for the PVC. There is a 3:1 conduction.
2.
d. Biventricular pacing with occasional PVCs
3.
a. Sinus rhythm with an frequent PJCs. The inverted or retrograde P waves noted with the ectopic beats are characteristic of premature junctional beats.
4.
b. Normal sinus rhythm with an occasional PAC and PVC. A compensatory pause follows the PVC. There is ST depression in lead II and ST elevation in lead V1 suggesting an anterior infarct, though you would first need to verify the elevation in two contiguous leads.
5.
a. Sinus bradycardia with 1st degree block. The PR interval is 0.36.
6.
c. Sinus tachycardia
7.
b. Ventricular fibrillation
8.
b. Ventricular tachycardia. Compare this with the rhythm above and you can see how much more organized the QRS complexes.
9.
d. Junctional rhythm. Somewhat irregular rhythm. This particular patient was took too much of his beta blockers. He had a history of atrial fibrillation. So theoretically this could be an an fibrillation with a very slow ventricular response.
10.
c. Sinus rhythm with junctional escape beats. They cannot be premature junctional beats because they occur later, not earlier, in the cardiac cycle. The R-R interval is longer so a junctional focus takes over. This particular patient would alternate between a sinus rhythm and an junctional rhythm.
Reviewed 6/4/13, 3/6/16
c. Sinus tachycardia
d. Sinus arrhythmia
7.
c. Agonal rhythm
d. Atrial fibrillation
8.
c. Junctional tachycardia
d. Supraventricular tachycardia
9.
c. Atrial fibrillation
d. Junctional rhythm
10.
a. Sinus rhythm with an frequent PJCs
b. Sinus arrhythmia with PJCs
c. Sinus rhythm with junctional escape beats
d. Sinus rhythm with sinus pauses
Answers
1.
a. Atrial flutter with an occasional PVC. There are prominent flutter waves noted in lead V1. The rhythm is regular except for the PVC. There is a 3:1 conduction.
2.
d. Biventricular pacing with occasional PVCs
3.
a. Sinus rhythm with an frequent PJCs. The inverted or retrograde P waves noted with the ectopic beats are characteristic of premature junctional beats.
4.
b. Normal sinus rhythm with an occasional PAC and PVC. A compensatory pause follows the PVC. There is ST depression in lead II and ST elevation in lead V1 suggesting an anterior infarct, though you would first need to verify the elevation in two contiguous leads.
5.
a. Sinus bradycardia with 1st degree block. The PR interval is 0.36.
6.
7.
8.
9.
10.
c. Sinus rhythm with junctional escape beats. They cannot be premature junctional beats because they occur later, not earlier, in the cardiac cycle. The R-R interval is longer so a junctional focus takes over. This particular patient would alternate between a sinus rhythm and an junctional rhythm.
Reviewed 6/4/13, 3/6/16
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