Answer 20

20.  Answer B is the correct answer.  Torsades de point translated means "turning on a point."  It literal looks like it is rotating around the point.  Ventricular fibrillation is a fine wavy baseline and ventricular tachycardia is a wide complex tachycardia.  Supraventricular tachycardia is a narrow complex tachycardia because its pacemaker is coming from outside of the ventricles.

Question 20

20.  What is the diagnosis of the rhythm listed below:

A.  Ventricular Fibrillation
B.  Torsades de Point
C.  Supraventricular Tachycardia
D.  Ventricular Tachycardia

Answer 19

19.  Answer B is the correct answer.  With left ventricular hypertrophy, the QRS complexes become bigger in height and depth in leads V1-V6.  The S wave will be even deeper in V1.  The largest R wave will be in lead V5 because it lays over the left ventricle.  The T wave will often be inverted or cause asymmetry.  With right ventricular hypertrophy, there is large R wave in lead V1, there is amore positive deflection toward the V1 electrode and the QRS complex more upright than nomad.  The R wave gets progressively smaller in leads V2-V6.  With right atrial hypertrophy, the P wave is affected.

Question 19

19.  Please identify the abnormality seen on the EKG below:

A.  Right Ventricular Hypertrophy
B.  Left Ventricular Hypertrophy
C.  Right Atrial Hypertrophy
D.  Normal EKG

Answer 18

18.  Answer D is the correct answer.  With extreme right axis deviation, there is a negative deflection of the QRS complex is leads I and avF.  With a right axis deviation, there is a negative deflection in lead I and a positive deflection in lead avF.  With a normal axis, there is a positive deflection in leads I and avF.  With a left axis deviation, there is a positive deflection in lead I and a negative deflection in lead avF.

Question 18

18.  Please identify the pathology listed below on the EKG:

A.  Normal Axis
B.  Left Axis Deviation
C.  Right Axis Deviation
D.  Extreme Right Axis Deviation

Answer 17

17.  Answer B is the correct answer.  With hypokalemia, the T wave becomes flattened, and there may be a U wave associated with it.  With hyperkalemia, the P wave is flattened, the QRS complex is widened, and the T wave is peaked.  With hypercalcemia, the QT interval is shortened.  With hypocalcemia, the QT interval is lengthened.

Question 17

17.  Please identify the pathology listed below on the EKG:

A.  Hyperkalemia
B.  Hypokalemia
C.  Hypercalcemia
D.  Hypocalcemia

Answer 16

16.  Choice A is the correct answer.  Since the P wave is atrial depolarization, the P wave is what we assess to determine hypertrophy.  Lead V1 is over the atria, so it is the best indicator of hypertrophy.  If the initial component of the P wave in V1 is the largest, it is right atrial hypertrophy.  If the last portion of the P wave is biphasic in lead V1, this represents left atrial hypertrophy.  With junctional tachycardia, there is inverted P waves occurring before, during or immediately after the QRS complex.  There is a rate greater than 60.  With a premature junctional contraction, the inverted P wave is only on one beat occurring earlier in the cycle.

Question 16

16.  Please identify the pathology on the EKG listed below:

A.  Right Atrial Hypertrophy
B.  Left Atrial Hypertrophy
C.  Junctional Tachycardia
D.  Premature Junctional Contraction

Answer 15

15.  Choice D is the correct answer.  There is ST depression seen in V1 and V2 and also in V3.  Since the posterior wall of the left ventricle depolarizes in the opposite direction of anterior wall it is seen as ST depression.  When in doubt you can obtain an eighteen lead EKG to prove it by putting the chest leads on the the patients posterior chest wall.  With an anterior MI you would see ST elevation in leads V1-V4.

Question 15

15.   Please interpret the EKG listed below:

A.  Septal Ischemia
B.  Anterior Ischemia
C.  Anterior STEMI
D.  Posterior STEMI

Answer 14

14.  Choice B is the correct answer.  With second degree type I AV block the PR interval lengthens until the QRS complex is dropped.  The PR interval is greater than 0.2 seconds.  This rhythm is also called Wenckebach.  With second degree type II AV block there is a normal PR interval and there is a dropped QRS complex.  It is also referred to as Mobitz Type II.  With first degree AV block there is just a prolonged PR interval greater than 0.2 seconds.  Third degree AV block is complete AV dissociation.

Question 14

14.  Please identify the rhythm listed below:

A.  First degree AV Block
B.  Second degree type I AV block
C.  Second degree type II AV Block
D.  Third degree AV Block

Answer 13

13.  Choice A is the correct answer.  Normally both ventricle depolarize to the ventricles at the same time.  When there is a bundle branch block, there is a delay in the stimulus which leads to the widened QRS complex with the classic R and R' waves.  With a right bundle branch block, lead V1 and V2 are the closest to the right ventricle and that is where you see the changes.  With a left bundle branch block leads V5 and V6 are the closest to the left ventricle, and the changes to the QRS complex occur with these leads.  With lateral ischemia, you see T wave inversion or ST depression in leads I, avL, V5 or V6.  With premature ventricular contractions, you just see an isolated widened QRS complex occurring earlier in the cycle with a compensatory pause.

Question 13

13.  Please identify the pathology listed below in the EKG:

A. Right Bundle Branch Block
B. Left Bundle Branch Block
C. Lateral ischemia
D. Premature Ventricular Contractions

Answer 12

12.  Choice C is the correct answer.  A premature atrial contraction originates from an ectopic focus in the atrium that appears much earlier than normal P wave in the EKG.  With a wandering atrial pacemaker, the pacer maker wanders from focus to focus.  The P waves are various shapes since the origin of the pacemaker comes from different areas in the atria.  With a premature junctional contraction the contraction occurs from an ectopic focus in the AV junction and fires before the normal cycle.  Usually inverted P waves occur before, during, or immediately after the QRS complex.  With premature ventricular contractions, there is a widened QRS complex occurring early then expected with a compensatory pause.

Question 12

12.  Please identify the pathology listed in the EKG below:

A.  Wandering atrial pacemaker
B.  Premature Junctional Contraction
C.  Premature Atrial Contraction
D.  Premature Ventricular Contraction

Answer 11

11.  Choice A is the correct answer.  Ventricular Tachycardia is a wide complex tachycardia that comes from a single ectopic focus within the ventricle.  Ventricular fibrillation comes from multiple foci in the ventricle that is why it is irregular and wavy.  Supraventricular tachycardia comes from outside of the ventricle that is why it is a narrow complex tachycardia.  Torsades is usually from a magnesium deficiency and is wavy but the rhythm looks like it is turning on a point.

Question 11

11.  What is the diagnosis of the EKG strip listed below?

A.  Ventricular Tachycardia
B.  Ventricular Fibrillation
C.  SVT
D.  Torsades