EKG certification Certification EKG Arrhythmias & Dysrhythmias 2 — Questions and Answers
Question 1: A patient's EKG shows a regular rhythm with sawtooth-shaped flutter waves at a rate of 300 bpm and a ventricular rate of 150 bpm. What is the most likely diagnosis?
- Atrial flutter with 2:1 block (Correct answer)
- Atrial fibrillation with rapid ventricular response
- Supraventricular tachycardia
- Multifocal atrial tachycardia
Correct answer: Atrial flutter with 2:1 block
Sawtooth flutter waves at 300 bpm with a ventricular rate of 150 bpm indicate atrial flutter with 2:1 conduction block.
Question 2: Which arrhythmia is characterized by the absence of P waves and an irregularly irregular rhythm on EKG?
- Atrial fibrillation (Correct answer)
- Atrial flutter
- Junctional rhythm
- Wandering atrial pacemaker
Correct answer: Atrial fibrillation
Atrial fibrillation is defined by absent P waves replaced by fibrillatory waves and an irregularly irregular ventricular rhythm.
Question 3: On a rhythm strip, you observe a wide-complex tachycardia at 180 bpm with AV dissociation. What is the most likely interpretation?
- Ventricular tachycardia (Correct answer)
- SVT with aberrant conduction
- Atrial flutter with bundle branch block
- Wolff-Parkinson-White syndrome
Correct answer: Ventricular tachycardia
AV dissociation in the setting of a wide-complex tachycardia is highly indicative of ventricular tachycardia.
Question 4: A patient presents with a heart rate of 40 bpm, a regular rhythm, and narrow QRS complexes with no visible P waves. What rhythm is most likely?
- Junctional escape rhythm (Correct answer)
- Third-degree heart block
- Sinus bradycardia
- Idioventricular rhythm
Correct answer: Junctional escape rhythm
A regular narrow-complex rhythm at 40 bpm without visible P waves is consistent with a junctional escape rhythm.
Question 5: Which EKG finding is most characteristic of Torsades de Pointes?
- Polymorphic QRS complexes that appear to twist around the baseline (Correct answer)
- Monomorphic wide QRS complexes at a regular rate
- Narrow QRS complexes with delta waves
- Alternating tall and short QRS complexes with a normal axis
Correct answer: Polymorphic QRS complexes that appear to twist around the baseline
Torsades de Pointes is a polymorphic ventricular tachycardia with QRS complexes that rotate around the isoelectric baseline, creating a twisting appearance.
Question 6: A patient's EKG shows progressively lengthening PR intervals until a QRS complex is dropped, followed by a shorter PR interval. What type of heart block is this?
- Second-degree AV block Type I (Wenckebach) (Correct answer)
- Second-degree AV block Type II
- Third-degree AV block
- First-degree AV block
Correct answer: Second-degree AV block Type I (Wenckebach)
Progressive PR prolongation followed by a dropped QRS and then a shorter PR interval is the hallmark Wenckebach pattern of second-degree Type I AV block.
EKG certification Certification EKG Arrhythmias & Dysrhythmias 2
A patient's EKG shows a regular rhythm with sawtooth-shaped flutter waves at a rate of 300 bpm and a ventricular rate of 150 bpm.
What is the most likely diagnosis?