12 Lead Peer Quiz

Question 1

What are the two main reasons for the need to put the limb leads on the limbs.

Angle and Amplitude
Angle and size
Amplitude and area
Time and rate

Answer 1

Angle and Amplitude

Question 2

If lead I is positive, Lead II is negative and Lead III is negative, what is the axis and if there is a block what type is it?
Left axis, Anterior Hemiblock
Right axis, posterior Hemiblock.
Extreme right axis, no block
Left axis, no block

Answer 2

Left axis, Anterior Hemiblock

Question 3

For each point increase in HR the heart requires 2 times the amount of oxygen.
True
False

Answer 3

True

Question 4

Under what circumstances should we consider a DeBakey 1 aneurysm

Answer 4

patient with a history of hypertension, with elevation in inferior, right and posterior leads

Question 5

What condition cause not only RAD, but physical abnormalities of the heart?

Answer 5

dextrocardia

Question 6

True or false: RBBB is a bifascicular block

Answer 6

False

Question 7

Difference between monitoring and assessing?
Monitor for changes and changes prompt assessment
Monitor vitals and changes prompt treatment
12 lead monitor and treat the changes
Monitor changes and treatment

Answer 7

Monitor for changes & changes prompt assessment

Question 8

Where do limb leads go?

Hands and feet
Wrist andankles
Forearm and calf
Shoulder and thighs

Answer 8

Shoulder & thighs

Question 9

Right ventricle myocardial infarction does not get?
Aspirin
Nitro
Oxygen
Normal Saline

Answer 9

Nitro

Question 10

What patients are always sicker than they appear?
Pt with past cardiac hx
Diabetics
Pt > 65 yr
Females

Answer 10

Diabetics

Question 11

For every 1 beat increase in heart rate how many oxygen demand does it require?
1 oxygen demand increase
2 oxygen demand 
5 oxygen demand
10 oxygen demand

Answer 11

2 oxygen demand

Question 12

If there is greater elevation in lead III than lead II what is suspected?
Posterior involvement
Right sided involvement
Inferior stemi
Pericarditis

Answer 12

Right sided involvement

Question 13

A QRS complex in lead v1 greater than \_\_\_\_\_ is a sign of a left branch bundle block?
100 ms
120 ms
140 ms
160 ms

Answer 13

120 milliseconds

Question 14

Which of the following v1 morphology criteria proves ventricular tachycardia?
Big mountain, little mountain
Steeple sign
Firemans hat
All of the above

Answer 14

All of the above

Question 15

Normal axis deflection in leads 1,2, and 3 is read as?
Up down down
Down down down
Up up up 
Up, ½ way, down

Answer 15

Up up up

Question 16

You have a positive deflection in leads I, II, and III. Your lead 12-lead gives you a QRS axis of 45. What is the axis of the heart?
Normal axis
Physiological left axis
Pathological left axis
Extreme right axis

Answer 16

Normal axis

Question 17

You have a supraventricular QRS complex greater than 0.12 seconds wide. Using the “Turn Signal Criteria”, what lead will you look at to determine the type of Bundle Branch Block?
I
II
III
V1

Answer 17

V1

Question 18

You obtain a 15 lead ECG. What do you relabel v4, v5, and v6?
V4r, v5r, v6r
V4r, v8, v9 
V7, v8, v9
You do not relabel

Answer 18

V4r, v8, v9

Question 19

With elevation in leads v4r, v8, v9, and a medical history of hypertension. You should have a high index of suspicion that your patient may have an:
Dissecting aortic aneurysm 
Pulmonary embolism
Pericarditis
Cardiac tamponade

Answer 19

Dissecting aortic aneurysm

Question 20

A hemiblock is characterized by a block of one of the fascicles in the?
Left Bundle Branch
Right Bundle Branch
AV Node
SA Node

Answer 20

Left Bundle Branch

Question 21

While looking at the 12 lead ECG the QRS must be longer than ___ to determine a bundle branch block. Any 2 block in the conduction system is a contraindication for what class of medication?

0. 12, antiarrhythmic
1. 12 antiemetic
2. 08 beta-blocker
3. 08 anti-cholinergic

Answer 21

0.12, antiarrhythmic

Question 22

What is the QTc duration cut off for giving medication or synchronized cardioversion?

0. 420 s
1. 450 s
2. 460 s
3. 640 s

Answer 22

0.460 s

Question 23

What leads do you have to move to perform a right sided ECG?
V1 v2 v3
V4 v5 v6 
RA RL LA
All of them

Answer 23

V4 v5 v6

Question 24

A tear/aneurysm in the aorta that activates the RCA is classified as…
Lefort I
Debakey I 
Mobitz I
DM type I

Answer 24

Debakey I

Question 25

``` An upward deflection in lead I with negative deflection in lead II and lead III is what type of hemiblock? Anterior hemiblock Posterior hemiblock Ventricular in origin No hemiblock ```

Answer 25

Anterior hemiblock

Question 26

``` A QRS complex greater than 120 ms is a sign of? Bundle Branch Block 2nd degree AV block type 2 SVT Normal Sinus ```

Answer 26

Bundle Branch Block

Question 27

``` What is a contraindication in lidocaine that was discussed in Bob Pages lecture? Heart block Cardiac arrest Frequent PVCs Allergic to contrast dye ```

Answer 27

Heart block

Question 28

What do you need to do before giving Nitro to a pt with an inferior MI? Put the patient on a 15 lead to rule out right sided involvement Establish an IV just in case Do a 12 lead to rule out right sided involvement Put the pads on pt for when he goes into shock and cardiac arrest

Answer 28

Put the patient on a 15 lead to rule out right sided involvement

Question 29

``` What is the treatment for right sided MI? Lidocaine Thrombolytics Liter of fluid Nitro ```

Answer 29

Liter of fluid

Question 30

``` If the QRS axis is -50 what does this indicate? Right axis deviation Normal axis Physiological left axis deviation Pathological left axis deviation ```

Answer 30

Pathological left axis deviation

Question 31

It is not important for the limb leads to be attached to the limbs, they can be placed on the torso and still give an accurate reading. True False

Answer 31

False

Question 32

``` Pathological left axis deviation is a sign of what block? LBBB RBBB Anterior Hemiblock Posterior Hemiblock ```

Answer 32

Anterior Hemiblock

Question 33

``` What lead is used to assess for “Turn Signal Criteria?” II V6 V1 aVL ```

Answer 33

V1