ECG Arrhythmia Quiz
Welcome to the ECG Arrhythmia Quiz, a comprehensive learning tool designed for medical students, healthcare professionals, and anyone interested in mastering the art of electrocardiogram (ECG) interpretation. This quiz offers an excellent opportunity to test and refine your ability to identify various cardiac arrhythmias, a crucial skill in emergency and cardiovascular medicine.
The ECG Arrhythmia Quiz is structured to simulate real-life scenarios, using authentic ECG traces and clinical vignettes that you might encounter in a clinical setting. This practical approach helps bridge the gap between theoretical knowledge and clinical application, ensuring a deeper understanding and readiness to act in real Read morepatient care situations.
Dive into our ECG Arrhythmia Quiz today and take a significant step towards excellence in ECG interpretation, boosting your confidence and competence in identifying and managing cardiac arrhythmias.
ECG Arrhythmia Questions and Answers
- 1.
Prolonged but constant P-R interval (+0.2 secs or +5 small squares). Regular poppin Ps. P then QRS. QRS normal. Impulse from SA node. Impulses slows through AV node.
- A.
1st degree heart block
- B.
2nd degree heart block, type 1
- C.
2nd degree heart block, type 2
- D.
3rd degree (complete) heart block
Correct Answer
A. 1st degree heart blockExplanation
The given information describes a prolonged but constant P-R interval, regular poppin Ps, P then QRS, and a normal QRS complex. This pattern indicates a delay in the conduction of electrical impulses from the atria to the ventricles, specifically through the AV node. This is characteristic of a 1st degree heart block, where there is a delay in the conduction but all atrial impulses are eventually conducted to the ventricles.Rate this question:
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- 2.
Progressively prolonged P-R interval. QRS gets dropped. Ps regular, QRS Irreg. Not every P followed by QRS. QRS normal. Impulse from the SA node. Impulse delayed at AV node for longer each time.
- A.
1st degree heart block
- B.
2nd degree heart block, type 1
- C.
2nd degree heart block, type 2
- D.
3rd degree (complete) heart block
Correct Answer
B. 2nd degree heart block, type 1Explanation
The given answer is correct because the description matches the characteristics of 2nd degree heart block, type 1. In this condition, there is a progressively prolonged P-R interval, meaning that the time between the P wave and the QRS complex becomes longer with each beat. Eventually, a QRS complex is dropped, resulting in an irregular pattern where not every P wave is followed by a QRS complex. The QRS complex itself is normal, indicating that the impulse from the SA node is able to reach the ventricles, but it is delayed at the AV node for a longer time with each beat.Rate this question:
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- 3.
Constant P-R interval. Sudden drop of QRS. Irregular (can be regular). Not every P followed by a QRS. Impulse from SA node. Every 2nd, 3rd or 4th impulse is blocked. Dangerous.
- A.
1st degree heart block
- B.
1st degree heart block, type 1
- C.
2nd Degree heart block, type 2
- D.
3rd degree (complete) heart block
Correct Answer
C. 2nd Degree heart block, type 2Explanation
The description provided matches the characteristics of a type 2 2nd degree heart block, also known as Mobitz type 2.
In this type of heart block, there is a constant PR interval (indicating the impulse from the atria to the ventricles is consistently delayed), sudden drop of QRS (indicating some impulses are blocked from reaching the ventricles), and not every P wave is followed by a QRS complex. This is considered dangerous because it can lead to further complications, such as complete heart block.Rate this question:
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- 4.
The P waves have no relationship with the QRS complexes. Usually regualr QRS . Not every P followed by QRS. Norm or wide QRS. AV node fails to conduct, impulse from ventricular site. Dangerous.
- A.
1st degree heart block
- B.
2nd degree heart block, type 1
- C.
2nd degree heart block, type 2
- D.
3rd degree (complete) heart block
Correct Answer
D. 3rd degree (complete) heart blockExplanation
In a 3rd degree (complete) heart block, there is a complete blockage of the electrical signals between the atria and the ventricles. This means that the P waves, which represent atrial depolarization, have no relationship with the QRS complexes, which represent ventricular depolarization. The QRS complexes may be regular or wide, and not every P wave is followed by a QRS complex. In this type of heart block, the AV node fails to conduct the electrical impulses from the atria to the ventricles, so the ventricles generate their own impulses. This can be dangerous as it disrupts the normal coordination of the heart's electrical system.Rate this question:
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- 5.
Rate 100-150. P waves present (or hidden in T wave if very fast). Originates from SA node. Usually has a cuase (ie pain/temperature/excercise/anxiety/CCF). Over 140 reduced cardiac output.
- A.
Sinus tachycardia
- B.
Atrial fibrilation
- C.
Atrial flutter
- D.
Supraventricular tachycardia
Correct Answer
A. Sinus tachycardiaExplanation
Sinus tachycardia is the correct answer because the given information suggests that there are P waves present, which indicates that the electrical impulses are originating from the SA node. Additionally, the presence of a cause such as pain, temperature, exercise, anxiety, or congestive heart failure suggests that the increased heart rate is a physiological response. The mention of a heart rate over 140 also aligns with sinus tachycardia, as it is defined as a heart rate greater than 100 beats per minute.Rate this question:
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- 6.
Always irregular. No clear P waves - fibrilating base line. Slow/norm/fast. Atria fibrilating, not contracting = clots = high risk of strokes. If chronic pt; on Digoxin and Warfarin.
- A.
Sinus tachycardia
- B.
Atrial fibrilation
- C.
Atrial flutter
- D.
Supraventricular tachycardia
Correct Answer
B. Atrial fibrilationExplanation
The given answer, atrial fibrillation, is the correct explanation for the description provided. Atrial fibrillation is characterized by an irregular heart rhythm with no clear P waves on the ECG. The baseline appears fibrillating, and the heart rate can be slow, normal, or fast. In atrial fibrillation, the atria are fibrillating and not contracting properly, which can lead to the formation of blood clots and an increased risk of strokes. If the patient has a chronic condition, they may be prescribed medications such as Digoxin and Warfarin to manage their symptoms and reduce the risk of complications.Rate this question:
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- 7.
Norm regular. Saw tooth pattern, F (flutter) wave. Abnormal circuit in right atrium at 300 bpm. Conduction predicts rate. 1:1 - 300 bpm, 2:1 - 150 bpm, 3:1 - 100bpm, 4:1 - 75bpm. Only at these rates.
- A.
Sinus tachycardia
- B.
Atrial fibrilation
- C.
Atrial flutter
- D.
Supraventricular tachycardia
Correct Answer
C. Atrial flutterExplanation
The given information describes a sawtooth pattern and a flutter wave, which are characteristic features of atrial flutter. Atrial flutter is caused by an abnormal circuit in the right atrium, leading to a rapid heart rate of 300 bpm. The conduction pattern described in the question also matches the different ratios of atrial to ventricular contractions seen in atrial flutter. Therefore, the correct answer is atrial flutter.Rate this question:
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- 8.
Rate 150-280. Regular. P waves absent or difficult to identify. QRS narrow. Consider valsalava manoeuvre.
- A.
Sinus tachycardia
- B.
Atrial fibrilation
- C.
Atrial flutter
- D.
Supraventricular tachycardia
Correct Answer
D. Supraventricular tachycardiaExplanation
The given ECG findings are suggestive of supraventricular tachycardia (SVT). SVT is characterized by a fast heart rate originating above the ventricles. In this case, the absence or difficulty in identifying P waves suggests that the atrial activity is not clearly visible, which is common in SVT. The narrow QRS complex also indicates that the electrical conduction through the ventricles is normal. Considering the valsalva maneuver is a common approach to terminate SVT episodes, further supporting the diagnosis.Rate this question:
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- 9.
Most common cardiac death. Electrical anarchy in ventricles.
- A.
Ventricular fibrilation - coarse/fine
- B.
Torsades de pointes
- C.
Stoke adams attack
- D.
Ventricular standstill
- E.
Agonal rhythm
Correct Answer
A. Ventricular fibrilation - coarse/fineExplanation
Ventricular fibrillation is a type of cardiac arrhythmia characterized by the rapid and chaotic electrical activity in the ventricles of the heart. This abnormal rhythm prevents the heart from effectively pumping blood, leading to a lack of oxygen supply to the body's organs and tissues. Ventricular fibrillation can present in two forms: coarse and fine. Coarse ventricular fibrillation refers to a more visible and disorganized pattern on an electrocardiogram (ECG), while fine ventricular fibrillation appears as a finer and more irregular pattern. Both forms of ventricular fibrillation are life-threatening emergencies that require immediate medical intervention to restore a normal heart rhythm.Rate this question:
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- 10.
Normally in short bursts of seconds. Causes dizziness and brief LOC. Wave forms point mainly upwards then twist and point downwards.
- A.
Ventricular fibrillation - coarse/fine
- B.
Torsades de pointes
- C.
Stoke adams attack
- D.
Ventricular standstill
- E.
Agonal rhythm
Correct Answer
B. Torsades de pointesExplanation
Torsades de pointes is the correct answer because it matches the given description. Torsades de pointes is a type of ventricular tachycardia characterized by a twisting of the QRS complex on an electrocardiogram (ECG). It usually occurs in short bursts and can cause dizziness and a brief loss of consciousness. The waveforms on the ECG typically point mainly upwards and then twist and point downwards.Rate this question:
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- 11.
Usually in elderley. Brief dysrhythmia - VF or ventricular standstill. Normally brief LOC then recovery. Sometimes no spontaneous recovery.
- A.
Ventricular fibrillation - coarse/fine
- B.
Torsades de pointes
- C.
Stoke adams attack
- D.
Ventricular standstill
- E.
Agonal rhythm
Correct Answer
C. Stoke adams attack -
- 12.
Total absence of ventricular activity = no cardiac output. May be from AMI or conduction system disease.
- A.
Ventricular fibrillation - coarse/fine
- B.
Torsades de pointes
- C.
Stoke adams attack
- D.
Ventricular standstill
- E.
Agonal rhythm
Correct Answer
D. Ventricular standstillExplanation
Ventricular standstill refers to the complete absence of any electrical activity in the ventricles of the heart. This means that there is no contraction or pumping of blood, resulting in no cardiac output. Ventricular standstill can occur due to various reasons, such as acute myocardial infarction (AMI) or conduction system disease. In this case, the correct answer is ventricular standstill because it aligns with the given explanation that the total absence of ventricular activity leads to no cardiac output.Rate this question:
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- 13.
Aystole with no P wave activity. To be PEA it must have QRS complexes - a rhythm that looks sustainable with life if it had a pulse.
- A.
Ventricular fibrillation - coarse/fine
- B.
Torsades de pointes
- C.
Stoke adams attack
- D.
Ventricular standstill
- E.
Agonal rhythm
Correct Answer
E. Agonal rhythmExplanation
The correct answer is agonal rhythm. Agonal rhythm refers to a slow, irregular, and wide QRS complex rhythm that occurs during cardiac arrest or near-death situations. It is characterized by a lack of organized electrical activity and is often seen as the last electrical activity before complete cessation of the heart. In contrast to other options such as ventricular fibrillation or torsades de pointes, agonal rhythm does not show the characteristic chaotic or twisting patterns. While ventricular standstill also lacks electrical activity, agonal rhythm is typically seen as a precursor to this state.Rate this question:
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- 14.
E*Always wide with no Q wave in V6 if it is under 120 bpm. *Looks like anterior MI.*QRS over 0.12 secs wide.*v6 - broad monomorphic R wave with no Q wave.*v1 - broad monmorphic S wave.
- A.
LBBB
- B.
RBBB
- C.
NSR
Correct Answer
A. LBBBExplanation
The given ECG findings are consistent with a left bundle branch block (LBBB). LBBB is characterized by a widened QRS complex (>0.12 seconds) and specific changes in the V1 and V6 leads. In V6, there is a broad monomorphic R wave with no Q wave, which is a typical finding in LBBB. In V1, there is a broad monomorphic S wave, which is also seen in LBBB. Additionally, the absence of Q waves in V6 and the fact that the rhythm is normal sinus rhythm (NSR) further support the diagnosis of LBBB.Rate this question:
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- 15.
Cg*Has an R-S-R wave in V1 and V2*QRS over 0.12 secs*Slurred S wave in V1 and V6
- A.
LBBB
- B.
RBBB
- C.
NSR
Correct Answer
B. RBBBExplanation
The given answer is RBBB (Right Bundle Branch Block). This is because RBBB is characterized by a wide QRS complex (>0.12 secs) and a slurred S wave in leads V1 and V6. Additionally, RBBB can also present with an R-S-R wave in leads V1 and V2, which is mentioned in the question. Therefore, based on the provided information, RBBB is the most appropriate diagnosis.Rate this question:
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- 16.
- A.
Sinus rhythm with unifocal ventricular ectopics
- B.
Sinus rhythm with multifocal ventricular ectopics
- C.
Sinus rhythm with unifocal couplet ventricular ectopics
- D.
Sinus rhythm with R on T ventricular ectopics
- E.
Ventricular tachycardia
Correct Answer
A. Sinus rhythm with unifocal ventricular ectopics -
- 17.
- A.
Sinus rhythm with unifocal ventricular ectopics
- B.
Sinus rhythm with multifocal ventricular ectopics
- C.
Sinus rhythm with unifocal couplet ventricular ectopics
- D.
Sinus rhythm with R on T ventricular ectopics
- E.
Ventricular tachycardia
Correct Answer
B. Sinus rhythm with multifocal ventricular ectopics -
- 18.
- A.
Sinus rhythm with unifocal ventricular ectopics
- B.
Sinus rhythm with multifocal ventricular ectopics
- C.
Sinus rhythm with unifocal couplet ventricular ectopics
- D.
Sinus rhythm with R on T ventricular ectopics
- E.
Ventricular tachycardia
Correct Answer
C. Sinus rhythm with unifocal couplet ventricular ectopics -
- 19.
- A.
Sinus rhythm with unifocal ventricular ectopics
- B.
Sinus rhythm with multifocal ventricular ectopics
- C.
Sinus rhythm with unifocal couplet ventricular ectopics
- D.
Sinus rhythm with R on T ventricular ectopics
- E.
Ventricular tachycardia
Correct Answer
D. Sinus rhythm with R on T ventricular ectopics -
- 20.
- A.
Sinus rhythm with unifocal ventricular ectopics
- B.
Sinus rhythm with multifocal ventricular ectopics
- C.
Sinus rhythm with unifocal couplet ventricular ectopics
- D.
Sinus rhythm with R on T ventricular ectopics
- E.
Ventricular tachycardia
Correct Answer
E. Ventricular tachycardia -
- 21.
- A.
Sinus bradycardia
- B.
Junctional nodal rhythm (high nodal)
- C.
Junctional nodal rhythm (low nodal)
- D.
Sinus rhythm with atrial ectopic beats
- E.
Idioventricular rhythm
Correct Answer
A. Sinus bradycardia -
- 22.
- A.
Sinus bradycardia
- B.
Junctional nodal rhythm (high nodal)
- C.
Junctional nodal rhythm (low nodal)
- D.
Sinus rhythm with atrial ectopic beats
- E.
Idioventricular rhythm
Correct Answer
B. Junctional nodal rhythm (high nodal) -
- 23.
- A.
Sinus bradycardia
- B.
Junctional nodal rhythm (high nodal)
- C.
Junctional nodal rhythm (low nodal)
- D.
Sinus rhythm with atrial ectopic beats
- E.
Idioventricular rhythm
Correct Answer
C. Junctional nodal rhythm (low nodal) -
- 24.
- A.
Sinus bradycardia
- B.
Junctional nodal rhythm (high nodal)
- C.
Junctional nodal rhythm (low nodal)
- D.
Sinus rhythm with atrial ectopic beats
- E.
Idioventricular rhythm
Correct Answer
D. Sinus rhythm with atrial ectopic beats -
- 25.
- A.
Sinus bradycardia
- B.
Junctional nodal rhythm (high nodal)
- C.
Junctional nodal rhythm (low nodal)
- D.
Sinus rhythm with atrial ectopic beats
- E.
Idioventricular rhythm
Correct Answer
E. Idioventricular rhythm -
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Apr 25, 2024Quiz Edited by
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Dec 19, 2010Quiz Created by
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