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MDT: Week One Mock Test
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Questions in this quiz (88)
1The AV node is made up of specialized cells located in
- Alower portion of the left atrium
- Bupper portion of the right atrium
- Cupper portion of the left atrium
- Dlower portion of the right atrium
2The delay of electrical impulses in the AV Node
- Aallow the junction to contract
- Ballow the atria to complete filling of ventricles before next contraction
- Cmakes the rate of discharge of SA node slower
- Dforces electrical impulses to travel retroactively
- Emakes pacemaker cells capable of discharging at a rhythmic rate of 40-60 bpm
3The bundle of His
- Aconnects AV node with bundle branches
- Bhas pacemaker cells capable of discharging at rythmic rate of 30-50 bpm
- Cactivates atria in a backward (retrograde direction)
- Dtransmits impluses from the AV to the left atrium
- EA and C
4AV Junction is comprised of
- Athe AV node and branching portion of bundle of His
- Bthe AV node, branching, and nonbranching portion of bundle of His
- Cthe non branching portion of bundle of His
- Dnonbranching portion, AV node, and purkinje fibers
- Ethe AV node, nonbranching portion, and His bundle
5If the rate of discharge of SA node is slower than AV junction
- Athe SA node has failed to discharge
- Bthe AV junction has failed to discharge
- Can impulse from the SA node has been conducted through the atria but not to the ventricles
- Dthe His junction has failed to generate an impulse
- Ethe AV junction must assume responsibility for conducting impulses to the atria
- Fthe AV node and nonbranching portion of the bundle of His may assume responsibility for pacing the heart
6the AV junction may assume responsibility for pacing the heart if:
- Athe AV node fails to discharge
- Bthe SA node fails to discharge
- Cthe rate of discharge of SA node is faster than AV junction
- Dan impulse from the SA node is generated and conducted through the ventricles but not to the atria
- Ethe rate of discharge of SA node is slower than AV junction
- Fan impulse from the SA node is generated and conducted through the atria but not to ventricles
- GB, E, and F
- HB, C and F
7When the AV junction is pacing the heart
- Aelectrical implulse must travel in a forwards direction to activate ventricles
- Belectrical impulse must travel in a backwards direction to activate ventricles
- Celectrical impulse must travel in a backward direction to activate atria
- Delectrical impulses must travel in a retrograde direction to activate ventricles
- Eelectrical impulses must travel in a retrograde direction to activate ventricles and atria
8When an AV junction has assumed responsibility for pacing the heart, the P wave may appear
- Abefore QRS complex
- Bafter QRS complex
- Cduring QRS complex
- Dbefore or during QRS complex
- Eduring or after QRS complex
- Fbefore, during or after QRS complex
9a QRS of <0.12 seconds
- Ais usually indicative of a premature junctional complex
- Bis always followed by a non-compensatory (incomplete pause)
- Cis fast
10We can recognize a PJC
- Abecause it arises from irritable site within the SA junction
- Bit fires before its next expected sinus beat
- CQRS is usually <0.21 sec
- Doften followed by a non-compensatory pause
- EA and B
- FB and D
- GA, B and D
11The PJC replaces normal beats
- ATrue
- BFalse
12The ability to recognize a PJC wave include all of the following symptoms except;
- Aa P wave, QRS <0.12 sec, a non-compensatory (incomplete) pause, rate within normal ranges
- Ba P wave may/may not be present, regular heart rhythm with premature beats
- CQRS <0.12 sec unless aberrantly conducted or an intraventricular conduction delay exists
- DP waves may occur before, during, or after QRS, rate usually within normal range, regular rhythm with premature beats
13In a PJC, heart rates are usually...
- Awithin normal range, but depends on underlying rhythm
- Boutside of normal range, but depends on underlying rhythm
- Cwithin normal range, but depends on medical history
- Doutside of normal range, but depends on whether or not the PJC arises from an irritable site
14When trying to recognize a PJC, the rhythm should be
- Aregular, but depends on the QRS
- Babove average, with premature beats
- Cregular, with premature beats
15To recognize a PJC, we should look at...
- Arate, rhythm, QRS and PRI
- Brhythm, QRS, P waves and PRI
- Crate, QRS, PRI, rhythm and P waves
- DQRS, P waves, ectopic beats, underlying rhythm
- Erhythm, rates, PRI, QRS, and ectopic beats
16In recognizing PJC's, P waves...
- Amay occur before or afterQRS
- Bmay occur only before or during QRS
- Ccan occur before, during, or after QRS
17In recognizing PJC's, if visible, P waves...
- Ais inverted in leads I, II, III and aVF
- Bis inverted in leads II, III and aVF
- Cis inverted in leads !, !! and aVF
- Dis inverted in leads I, III and aVF
18If P wave occurs before QRS in a PJC,
- APRI will usually be equal to or less than 0.12 seconds
- BPRI will usually be less than 0.12 seconds
- CPRI will usually be 0.12 seconds
- DPRI will usually be greater than 0.12 seconds
- Ethere is no PRI
19If no P wave occurs before QRS in a PJC,
- Athen there is no PRI
- BPRI will usually be equal to or greater than 0.12 seconds
- CPRI will be less than 0.12 seconds
- DPRI will be 0.12 seconds
- EPRI will be greater than 0.12 seconds
20QRS in a PJC,
- Ais usually equal to or less than 0.12 seconds unless aberrantly conducted or an intraventricular conduction delay exists
- Bis usually equal to or less than 0.21 seconds unless aberrantly conducted
- Cis usually equal to or less than 0.12 seconds unless a P wave occurs before the QRS
- Dis usually equal to or less than 0.21 seconds intraventricular conduction delay exists
- Eis usually equal to or less than 0.12 seconds unless aberrantly conducted or accompanied by a PRI of greater than 0.12 seconds
- Fis usually equal to or less than 0.12 seconds unless an intraventricular conduction delay exists, or accompanied by a PRI of greater than 0.12 seconds
21When recognizing a PJC, all except the following are true:
- Arate is usually within normal range, rhythm is regular with premature beats, and p waves may occur before, during, or after QRS
- BQRS is usually greater than 0.12 seconds unless aberrantly conducted, rate is usually within normal ranges, and rhythm is regular with premature beats
- CPRI will usually be equal to, or less than 0.12 seconds if P wave occurs before QRS, rhythm will be regular with premature beats, and QRS is usually equal to or greater then 0.12 seconds
- Drate is usually within normal ranges but depends on underlying rhythm, QRS is usually equal to or greater than 0.12 seconds unless aberrantly conducted, and there will be no PRI if P wave occurs before QRS
22Causes for PJC include all of the following except;
- Acongestive heart failure, digitalis toxicity, stimulants, and mental and physical fatigue
- Bacute coronary syndromes, mental and physical fatigue, valvular heart disease, and electrolyte imbalance
- Ccaffeine, only physical fatigue, valvular heart disease, and acute coronary syndromes
- Drheumatic heart disease, tobacco and other stimulants, acute coronary syndromes, and digitalis toxicity
23Most individuals with PJCs are asymptomatic
- ATrue
- BFalse
24PJCs...
- Amay lead to symptoms of palpitations or feeling of skipped beats
- Balways require treatment
- Care caused by stimulants, and thus should be avoided
- Dare caused only by physical fatigue
- EA and C
- FA, C and D
25Which of the following are true about junctional rhythms
- Arate: 40-60
rhythm: regular
p waves: before and during QRS - Brate: 30-50
rhythm: regular
p waves: before, after and during QRS - Crate: 40-60
rhythm: regular
p waves: inverted if visible - Drate: 40-60
rhythm: regular
p waves: before, and after QRS - Erate: 40-70
rhythm: regular
p waves: before, after and during QRS; inverted if visible
- Arate: 40-60
26when the rhythm is slower than expected, it is called
- Ajunctional bradycardia
- Bdeceletrated junctional rhythm
- Cjunctional tachycardia
27what are the two types of rapid junctional rhythms
- Aaccelerated junctional rhythm and junctional tachycardia
- Bjunctional tachycardia and rapid junctional rhythm
- Crapid junctional rhythm and accelerated junctional rhythm
- Djunctional tachycardia and junctional bradycardia
28the two types of rapid junctional rhythms have bpms that range between
- A60-100 and 100-140
- B55-100 and 100-140
- C60-100 and 100-130
- D55-100 and 100-130
29what is the difference between the two types of rapid junctional rhythms
- Arate
- Brhythm
- Cp waves
30all but the following are causes of accelerated junctional rhythm
- Aacute myocardial infarction, CODP, rheumatic fever
- Bhypokalemia, COPD, cardiac surgery and rheumatic fever
- Cdigitalis toxicity, acute myocardial infarction, caridac surgery and hypokalemia
- Dacute myocardial infarction, digitalis toxicity and rheumatic fever
31ventricles may assume responsibility for pacing the heart in all but which case;
- ASA node fails
- BSA node generates impulse but is blocked as it exists SA node
- CSA node discharge is faster than ventricles
- Dirritable site in either ventricle produces early beat or rapid rhythm
32ventricles may assume responsibility for pacing heart if the SA node discharge is slower than ventricles
- ATrue
- BFalse
33when the SA node fails or its impulse is blocked as it exists the SA node, [blank_start]ventricles[blank_end] may assume responsibility
- Aventricles
34select all that apply. Ventricles may assume responsibility for pacing the heart if:
- ASA node fails
- Bimpulse from SA node generated but blocked as it exists SA node
- CSA node discharge slower than ventricles
- Dirritable site in either ventricle produces early beat or rapid rhythm
35we can recognize premature ventricular complexes by observing that the T wave is usually
- Ain the opposite direction of QRS
- Bparallel to QRS
- Cin the same direction of QRS
- Dnon-existant
36in premature ventricular complexes, all but which of the following are true
- AQRS typically greater than 0.12 seconds
- Boccurs earlier than next expected sinus beat
- CT wave usually in opposite direction of QRS
- Darise from irritable focus in either ventricle
37premature ventricular complexes arise from irritable focus in either ventricle
- ATrue
- BFalse
38a PVC is usually followed by a
- Afull compensatory pause
- Bbackward electrical impulse
- Ca non-compensatory pause
392 sequential PVCs are called
- Aruns or bursts
- Bcouplets
- Cventricular bigeminy
- Dbigeminal PVCs
- Eventricular trigeminy
403 sequential PVCs are called
- Aruns or bursts
- Bventricular trigeminy
- Ctrigeminal PVCs
- Dbigeminal PVCs
41Bigeminal PVCs are when ____________ occurs
- Amore than 3 sequential PVCs
- B2 sequential PVCs
- Cevery other beat is a PVC
- Devery 3rd beat is a PVC
42When every 3rd beat is a PVC, it is known as
- Aruns or bursts
- Bbigeminal PVCs
- Cventricular trigeminy
- Dtrigeminal PVCs
- Eventrucular quadrigeminy
- FC and D
- GA and C
43Quadrigeminal PVCs are when
- Athere are 4 sequential PVCs
- Bevery other beat is a PVC
- Cevery other beat is a PVC, for greater than 4 occasions
- Devery 4th beat is a PVC
44uniform PVCs are distinct in that they
- Ahave similar morphology in same lead, and originate from the same ectopic focus
- Bhave similar morphology in same lead, and originate from different ectopic focus'
- Chave different morphology, and originate from the same ectopic focus
- Dhave different morphology, and originate from different ectopic focus'
45when PVCs have different morphology in the same lead they are easily recognized as...
- Auniform PVCs
- Bmultiform PVCs
- CR-on-T PVCs
- Dventricular rhythms
46multiform PVC's
- Aoften (but not always) arise from different foci
- Balways arise from different foci
- Cnever arise from different foci
47PVCs are named R-on-T PVCs, because the
- AR wave falls on the T wave of preceding beat
- BT wave falls on the R wave of preceding beat
- CR wave refracts on the T wave of preceding beat
- DT wave refracts on the R wave of preceding beat
482 PVCs in a row are called
- Apaired PVCs
- Bcouplets
- Cbursts
- Dsalvo
- EA and C
- FA and B
49"salvo," "run," or "burst" of VT are all ways of describing
- Agreater than 5 PVCs in a row at a rate greater than 100 bpm
- Bgreater than 3 PVCs in a row at a rate greater than 50 bpm
- Cgreater than 5 PVCs in a row at a rate greater than 50 bpm
- Dgreater than 3 PVCs in a row at a rate greater than 100 bpm
- Egreater than 3 PVCs in a row at a rate greater than 120 bpm
50The rate of a PVC is
- Ausually normal, but depends on underlying rhythm
- Busually higher than normal, but depends on underlying rhythm
- Cusually lower than normal, but depends on underlying rhythm
- Dusually normal, but depends on past medical conditions
51The rhythm of a PVC
- Adepends on underlying rhythm
- Bdepends on past medical history
- Cdepends on the conditions the patient are currently in
- Ddepends on underlying rhythm, with premature beats
52P waves in a PVC
- Aare usually absent
- Bwith retrograde condiction to atria, may appear after QRS
- Cmay appear after QRS, usually upright in ST-segment or T wave
- Dmay occur before after or during QRS
- Eif visible, P wave is inverted
- FA and B
- GB and C
- HA, B, and C
53In PVCs, QRS is
- Agreater than 0.12 seconds, narrow and bizarre
- Busually in the same direction as the T wave
- Cgreater than 0.12 seconds, wide and bizarre
- Dusually in the opposite direction of P wave
54All of the following are causes of Premature Ventricular complex, except
- Anormal variant, exercise, stimulants, increased sympathetic tone and hypoxia
- Bstress and anxiety, medications, congestive heart failure, and valvular heart disease
- Cdigitalis toxicity, stress, myocardial ischemia, acid-base imbalance, and increased sympathetic tone
- Dcaffiene, TCA's, acute coronary syndromes, exercise and normal variant
55Patients of PVC may be asymptomatic
- ATrue
- BFalse
56patients of PVC who are symptomatic may complain of all the following except;
- Apalpitations, racing heart, lower back discomfort
- Bracing heart, neck discomfort, skipped beats
- Cchest discomfort
57if PVCs are frequent,
- Adecreased cardiac output possible
- Bincreased cardiac output possible
- Cno cardiac output possible
58treatment of PVCs is dependent on all except which of the following
- Acause
- Bsigns and symptoms
- Cclinical situation
- Dmental and physical fatigue
59These look just like a PVC, but appear LATE instead of early.
- Aventricular escape beats
- B'safety' mechanisms
- CAV junctions
- Dcompensatory pauses
60three or more ventricular escape beats in row, with a rate of 20-40 bpm is indicative of
- Aidiocentricular rhythm
- Bagonal rhythm
- Cventricular escape beats
- Dpremature junctional complexes
61agonal rhythm shows a ventricular rate of
- Aless than 20 bmp
- Bgreater than 20 bmp
- Cequal to 30 bpm
- Dgreater than 30 bpm
- Ebetween 20 and 30 bpm
62you are given the following information...
rate:20-bpm
rhythm: essentially regular
P waves: usually absent
PRI: none
What do you diagnose?- Aidioventricular rhythm
- Bpremature junctional complex
- Cagonal rhythm
- Dventricular escape beats
- Epremature ventricular complex
- Faccelerated idioventricular rhythm
63P waves in idioventricular rhythms are usually absent, or with retrograde conduction to atria, may appear [blank_start]after[blank_end] QRS (usually upright in ST-segment or T wave)
- Aafter
- Bbefore
64if no P wave occurs before QRS in _____________, then there is no PRI. In ____________, there is always no PRI.
- APJCs, idioventricular rhythms
- Bidioventricular rhythms, PJCs
- Crapid junctional rhythms, accelerated idioventricular rhythms
- Daccelerated idioventricular rhythms, rapid junctional rhythms
65in this rhythm, the T wave is frequently in the opposite direction of QRS complex
- Aidioventricular rhythm
- Bacceletated junctional rhythm
- Cpremature junctional complexes
- Dpremature ventricular complexes
66introventricular rhythms may occur in all of the following cases, except for
- ASA node and AV junction quit
- Brate of discharge of SA node or AV junction intrinsic rate is slower than ventricular rate
- Cdigitalis toxicity
- Dimpulses generated by the supracentricular pacemaker site are firing too quickly
- Emetabolic imbalances
67slow rate and loss of atrial kick in idioventricular rhythms may result in upwards cardiac output
- ATrue
- BFalse
68Scenario:
your patient has a QRS greater than 0.12 seconds, but an essentially regular rhythm. You notice three or more ventricular escape beats in a row, with a rate of 20-40 bpm. What should you do?- Alidocaine
- BTCP or atropine
- Cincrease MVO2
- Dpredispose patient to ventricular dysrythmmias
69three or more ventricular escape beats occur in a row, rate of 41-100 bpm. What do you diagnose?
- Aaccelerated idioventricular rhythm
- Bidioventricular rhythm
- Cpremature ventricular complex
- Dventricular tachycardia
70some physicians consider ventricular rate range of AVIR to be 41-100, while others consider it to be 41-120 bpm
- ATrue
- BFalse
71P waves are usually absent in this rhythm, though with retrograde conduction to atria, may appear after QRS (usually upright in ST-segment or T wave)
- Aaccelerated idioventricular rhythm
- Bidioventricular rhythm
- Cpremature ventricular complex
- Dtorsades de pointes
- EA and B
- FA and D
72acelerated idioventricular rhythm appears in all of the following, with the exception of;
- Aoften seen during the first 12 hours of MI
- Bpost-reperfusion therapy (successful)
- Caccelerated sinus rate
- Ddecelerated sinus rate
- Eacute mypocarditis
73accelerated idioventricular rhythm appears in all of the following, with the exception of;
- Adigitalis toxicity
- Bcocaine toxicity
- Csubarachnoid hemorrhage
- Dacute myocarditis
- Ehypertensive heart disease
- Fall of the above are causes of accelerated idioventricular rhythm
74If a patient with accelerated idioventricular rhythms is symptomatic because of loss of atrial kick, treatment can include all of the following with the exception of;
- Aatropine
- Batrial pacing
- Cventricular antiarrhythmics
75treatment is usually unnecessary in patients with accelerated idioventricular rhythms
- ATrue
- BFalse
76your patient is displaying three or more PVCs in a row, rate of greater than 100 bpm. What are you observing?
- Aventricular tachycardia
- Baccelerated idioventricular
- Cidioventricular
- Dasystole
77nonsustained ventricular tachycardia lasts ____________, while sustained VT ________________
- Aless than 30 seconds, more than 30 seconds
- Bmore than 30 seconds, less than 30 seconds
- Cless than 60 seconds, more than 60 seconds
- Dmore than 60 seconds, less than 60 seconds
78all of the following are possible causes of ventricular tachycardia, with the exception of;
- Aacute coronary syndromes, cardiomyopathy and TCA overdose
- BTCA overdose, cocaine abuse, trauma
- Cacid-base imbalance, mitral valve prolapse, digitalis toxicity
- Dbrugada, electrolyte imbalance, invasive cardiac procedures
- Emyocardial contusion, abnormal QT interval, stimulants such as caffeine and tobacco
79this phenomenon is a chaotic rhythm originating in the ventricles. It is always pulseless
- Aventricular fibrillation
- Bidioventricular
- Ctorsades de pointes
- Dasystole
80ventricular fibrillation is not caused by
- Aenvironment
- Belectrolyte imbalance
- Chypertrophy
- Delectrolyte imbalances
- Edecreased SNS activity
81the absence of any (ventricular) rhythm
- Aasystole
- Bventricular fibrillation
- Cventricular tachycardia
82all of the following are causes of first degree AV blocks, with the exception of which of the following;
- AAV node ischemia/injury
- Bacute MI
- Csome meds
- Ddecreased vagal tone
83This type of block is defined as a prolongation of the PR interval on an ECG to more than 0.20 seconds
- A1st degree AV block
- Btype 1, 2nd degree AV block
- Ctype 2, 2nd degree AV block
- D3rd degree AV block
84your patient reveals a history of congestive heart failure on digoxin. He does not have any complaints of nausea, palpaitations, or chest pain. You run an ECG, and notice that the rhythm is regularly irregular, and the ratio of Ps to QRSs is 1:1 underlying rhythm and 2:1 where dropped beat occurs. How do you diagnose?
- A2nd degree AV block, type 1
- B2nd degree AV block, type 2
- Cischemic heart disease
- D3rd degree AV block
852nd degree av block type 1 is more serious than 2nd degree av block type 2
- ATrue
- BFalse
86which of the following is not a cause for type 1, 2nd degree AV blocks
- Aincreased parasympathetic tone
- Banterior wall MI
- Caortic valve disease
- Dmitral valve prolapse
87left coronary artery disease, anterior wall MI, and fibrosis of conduction system are all causes of which type of AV block
- A2nd degree, type 1
- B2nd degree, type 2
- C1st degree
- D3rd degree
88your patients ECG reflects a slow rate, with present and upright P waves. You notice that the rhythm is regular for P waves, but irregular for QRS. For instance, the last impulse appeared on the ECG as P wave with no QRS after. These are features of a
- A2nd degree AV block, type 1
- B2nd degree AV block, type 2
- C1st degree AV block
- D3rd degree AV block
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- Quiz on MDT: Week One Mock Test, created by Carley Moffatt on 21/09/2017.
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- Carley Moffatt
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- English
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