Final Exam Multiple Choice Questions 2020 Flashcards
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1
Q
Left ventricular hypertrophy (LVH) is evidenced on EKG by:
A. Significant Q wave in Precordial leads
B. R wave in V5 or V6 (whichever is taller) + the S wave
in V1 or V2 ≥ 35 mm
C. ST segment elevation in Precordial leads
D. Tall R wave in V1 (greater than or equal to the size of
S wave) accompanied by a right axis deviation
A
B. R wave in V5 or V6 (whichever is taller) + the S wave in V1 or V2 ≥ 35 mm
Submitted by OL
2
Q
Significant Q wave on the EKG is the evidence of:
A. Infarction
B. Injury
C. Ischemia
D. Hypertension
A
A. Infarction
Submitted by OL
3
Q
Normal Axis is:
A. 0° to -90°
B. -90° to 180°
C. 0° to 90°
D. 90° to 180°
A
C. 0° to 90°
Submitted by OL
4
Q
Which class of medications slow the heart rate by blocking the sympathetic nervous system’s beta-receptors:
A. Sodium Channel Blockers
B. Potassium Channel Blockers
C. Beta-Blockers
D. Calcium Channel Blockers
A
C. Beta-Blockers
Submitted by OL
5
Q
One of the absolute contraindications to stress test is:
A. Unstable Angina
B. Left Main Coronary artery stenosis
C. Electrolyte abnormalities
D. High degree AV Block
A
A. Unstable Angina
Submitted by OL
6
Q
Which of the following typically implies cardiac disease?
A. RBBB
B. LBBB
C.RVH
D.LVH
A
B. LBBB
Submitted by KP
7
Q
Which of following is seen as a normal variant in young african american males?
A. pericarditis
B. Inferior MI
C. Early repolarization
D. Digitalis
A
C. Early Repolarization
Submitted by KP
8
Q
In leads II, III, AVF we only see significant Q waves, what type of MI is it?
A. Old Inferior
B. Old Anterior
C. Old Anteroseptal
D. Acute Lateral
A
A. Old Inferior
Submitted by KP
9
Q
Which medication could be used for a patient with bradycardia? A. Dopamine B. Epinephrine C. Adenosine D. None
A
A. Dopamine, but note Epinephrine raises HR as well
Submitted by KP
10
Q
5. These are all indications of a positive stress test except: A. ST elevation B. Downsloping ST Depression C. Upsloping ST Depression D. J point depression
A
D. J point depression
Submitted by KP
11
Q
Which one of these is NOT a cause of ventricular axis deviation? A. Ventricular hypertrophy B. Arrhythmias C. Atrial Enlargement D. Hemiblocks
A
C. Atrial Enlargement
Submitted by BS
12
Q
A right ventricular infarction accompanies a/an:
A. Anterior wall MI
B. Inferior wall MI
C. Posterior wall MI
D. Lateral wall MI
A
B. Inferior wall MI
Submitted by BS
13
Q
The following are miscellaneous effects except:
A. Hypochromia
B. Digitalis
C. Hyperkalemia
D. Hypocalcemia
A
A. Hypochromia
Submitted by BS
14
Q
Beta blockers are a what class of antiarrhythmic?
A. I
B. III
C. II
D. IV
A
C. II
Submitted by BS
15
Q
The predicative value of any test is based not just on its accuracy but also on the patients probability of disease is _____ theorem.
A. Ellis
B. Beyer’s
C. Holter’s
D. Baye’s
A
D. Baye’s
Submitted by BS
16
Q
What can cause a low voltage EKG? A. Hypertrophy B. A skinny individual C. Obesity D. Pericardial diffusion
A
C. Obesity (note pericardial effusion causes low voltage as well)
Submitted by LM
17
Q
What demographic type tends to experience atypical symptoms with an MI A. White B. Black C. Male D. Postmenopausal female
A
D. Postmenopausal Female
Submitted by LM
18
Q
The QRS complexes are >.12 sec with a tall, notched R wave in V1. A. LBBB B. RBBB C. Lateral MI D. Anterior MI
A
A. RBBB
Submitted by LM
19
Q
The 34 year old female is coming in for a stress test using the Bruce protocol. What is the heart rate she must reach in order for the test to be diagnostic? A. 159 bpm B. 158 bpm C. 130 bpm D. 186 bpm
A
B. 158 bpm
Submitted by LM
20
Q
Which class of antiarrythmics is used for ventricular arrhythmias only A. Class 1 A B. Class 1 B C. Cass 1 C D. none
A
B. Class 1B
Submitted by LM
21
Q
Which miscellaneous effect presents on the EKG with prominent U waves and flattened T waves? A. Hyperkalemia B. Hypercalcemia C. Hypokalemia D. Hypocalcemia
A
C. Hypokalemia
Submitted by CF
22
Q
Which wall of the left ventricle is fed by the circumflex artery? A. Anterior B. Inferior C. Lateral D. Posterior
A
C. Lateral
Submitted by CF
23
Q
ST elevation in V2 - V6 indicates: A. Anterior and inferior MI B. Anterior and septal MI C. Anterior, Septal, and lateral MI D. Anterior and lateral MI
A
D. Anterior and Lateral MI
Submitted by CF
24
Q
All of the following medications increase heart rate except: A. Adenosine B. Epinephrine C. Dopamine D. Atropine
A
A. Adenosine
Submitted by CF
25
```
The ability of heart rate to increase with exercise is known as:
A. Inotropic reserve
B. Inotropic ability
C. Chronotropic reserve
D. Chronotropic ability
```
C. Chronotropic reserve
Submitted by CF
26
```
Bundle branch blocks are seen in which type of rhythm(s)
*more than one answer may be correct:
A.) Ventricular
B.) Sinus
C.) Junctional
D.) Atrial
```
B.) Sinus
C.) Junctional
D.) Atrial
Submitted by SG
27
```
Which of the following phases places occurrences of an MI in order from first to last.
A.) Infarct, Injury, Ischemia
B.) Injury, Ischemia, Infarct
C.) Ischemia, Injury, Infarct
D.) Ischemia, Infarct, Injury
```
C.) Ischemia , Injury, Infarct
Submitted by SG
28
```
A 12 lead-ECG has an irregular rhythm with a heart rate range of 70 to 110 bpm, no P waves present and a QRS interval measurement of 0.08 seconds. The interpretation of these findings would be…
A.) A. Fib
B.) Sinus Arrythmia
C.) Accelerated Junctional
D.) Sinus Tach
```
A.) A. Fib
Submitted by SG
29
Two differences between electrical cardioversion and defibrillation is that electrical cardioversion must be ______________ to the patient’s cardiac cycle while defibrillation is used to treat __________ and ______________.
A.) randomized ; V. Tach and SVT
B.) unplanned ; A. fib and SVT
C.) synchronized ; V. Fib and Pulseless V. Tach
D.) coordinated ; asystole and AIVR
C.) synchronized ; V. Fib and Pulseless V. Tach
Submitted by SG
30
```
The sensitivity of a stress test refers to number of patients with __________ stress test and angiogram results while the specificity refers to number of patients with ____________ stress test and angiogram results.
A.) positive ; negative
B.) negative ; positive
C.) indeterminate ; negative
D.) positive ; indeterminate
```
A.) positive ; negative
Submitted by SG
31
Digitalis effect on EKG is evidenced as:
A. Sagging, rounded ST segment depression
B. prolonged PR interval
C. A and B
D. none is correct
C. A and B
Sagging, rounded ST segment depression and prolonged PR interval are signs of Digitalis effect on EKG
Submitted by JK
32
Posterior wall MI is:
A. diagnosed by right sided EKG
B. diagnosed based on indicative changes in leads II,III and aVF
C. impossible to diagnose because no leads look directly at posterior wall
D. diagnosed by reciprocal changes in V1 and V2
D. diagnosed by reciprocal changes in V1 and V2
Submitted by JK
33
Axis quadrant is indeterminate when:
A. leads I and aVL are both negative
B. lead I is positive and lead aVF is negative
C. lead I is negative and lead aVF is positive
D. lead I and aVF are both negative
D. lead I and aVF are both negative
Submitted by JK
34
Medications given to increase a urine output that include but are not limited to furosemide, bumetanide, ethacrynic acid and mannitol are:
A. Nitrates
B. Diuretics
C. Glaucoma medications
D. Bronchodilators
B. Diuretics
Submitted by JK
35
All of these are relative contraindications for stress testing except:
A. Moderate stenotic heart valve disease
B. Severe hypertension (systolic >200, diastolic>110)
C. Acute myocarditis or pericarditis
D. High degree AV block (second and third degree)
C. Acute myocarditis or pericarditis
Submitted by JK
36
COPD causes what type of axis deviation?
A. Normal
B. Left
C. Right
D. Indeterminate
C. Right Axis Deviation
Submitted by NM
37
Sudden cardiac death during an MI is usually caused by which arrhythmia?
A. V-Fib
B. V-Tach
C. A-Fib
D. SVT
A. V-Fib
Submitted by NM
38
Severe Hyperkalemia causes what EKG change?
A. Prominent U waves
B. Scooping ST segments
C. Tall pointy P waves
D. Wide QRS complexes
D. Wide QRS complexes
Submitted by NM
39
The “A” in MONA stands for which medication?
A. Adenosine
B. Amiodarone
C. Aspirin
D. Atropine
C. Aspirin
Submitted by NM
40
Which is not a normal sign/symptom during a stress test?
A. J point depression
B. Cold, clammy skin
C. Increased heart rate
D. Muscle cramping
B. Cold, clammy skin
Submitted by NM
41
Which of the following has the QRS configuration RSR'?
A. Left Bundle Branch Block
B. Right Bundle Branch Block
C. Right Ventricular Hypertrophy
D. Left Posterior Hemiblock
B. Right Bundle Branch Block
Submitted by VT
42
Infarctions occur mostly in which quadrant of the heart?
A. Left Atrium
B. Right Atrium
C. Left Ventricle
D. Right Ventricle
C. Left Ventricle
Submitted by VT
43
Which of the following exhibits Hypocalcemia?
A. Tall, pointy, narrow T waves
B. Prominent U waves, flattened T waves
C. Shortened ST segment causing short QT interval
D. Prolonged ST segment causing prolonged QT interval
D. Prolonged ST segment causing prolonged QT interval
Submitted by VT
44
What type of arrhythmia(s) are treated with class III potassium channel blockers?
A. Supraventricular
B. Ventricular or Supraventricular
C. Atrial
D. Ventricular
B. Ventricular or Supraventricular
Submitted by VT
45
Which of the following are normal signs and symptoms during a stress test?
A. Decreased systemic vascular resistance due to vasodilation.
B. Increased systemic vascular resistance due to vasoconstriction.
C. Dizziness or feeling faint with exercise.
D. Decreased blood pressure more than 10 mmHg with mild chest pain.
A. Decreased systemic vascular resistance due to vasodilation.
Submitted by VT
46
If QRS in Leads I and AVF are Negative, What axis quadrant would this determine?
A. Normal Axis +0 to +90 degrees
B. Right Axis -90 to +180 degrees
C. Left Axis +0 to -90 degrees
D. Indeterminate axis +90 to +180 degrees
D. Indeterminate axis +90 to +180 degrees
Submitted by GR
47
```
Which one of these is NOT included in the 3 I's of infarction?
A. Ischemia
B. Intervention
C. Injury
D. Infarction
```
B. intervention
Submitted by GR
48
```
When ruling out LVH what is a main thing we are looking for in the 12 lead?
A. ST depression Lateral leads
B. RSR prime in V1
C. Deep S + Tall R = >35
D. Sagging ST segment in V6
```
C. Deep S + Tall R = >35
Submitted by GR
49
```
The SAEKG collects about how many consecutive QRS complexes to analyze?
A. 350
B. 150
C. 100
D. 250
```
D. 250
Submitted by GR
50
```
When identifying an MI, you want to look for all of the following except:
A. P waves
B. R wave progression
C. ST segment abnormalities
D. T wave abnormalities
```
A. P waves
Submitted by CW
51
```
Which leads would you expect to find R wave progression in?
A. I, II, III
B. V1-V6
C. all of them
D. aVR, aVL, aVF
```
B. V1-V6
Submitted by CW
52
```
Which medication is typically given to dilate the coronary arteries?
A. Diuretics
B. Thrombolytics
C. Nitrates
D. Anticoagulants
```
C. Nitrates
Submitted by CW
53
```
Which ST segment depression is MOST indicative of coronary artery disease?
A. Horizontal
B. Baseline
C. Upsloping
D. Downsloping
```
D. Downsloping
Submitted by CW
54
```
What is NOT a cause of axis deviation?
A. Ventricular Hypertrophy
B. Bundle Branch Block
C. Normal Variant
D. Myocardial Infarction
E. All of the above can cause axis deviation
```
E. All can cause axis deviation, though BBB was not listed in the book
Submitted by MO
55
```
Which wall of the left ventricle is supplied by the circumflex coronary artery?
A. Anterior Wall
B. Inferior Wall
C. Lateral Wall
D. Posterior Wall
```
C. Lateral Wall
Submitted by MO
56
```
An anterior MI has ST elevation and/or significant Q waves in which leads?
A. V2-V4
B. II, III, aVF
C. I, aVL, V5-V6
D. aVL, V2-V3
```
A. V2-V4
Submitted by MO
57
```
What kind of medication is Adenosine?
A. Antihypertensive
B. Class IV antiarrhythmic
C. Emergency Anticholinergic
D. Emergency antiarrhythmic
```
D. Emergency antiarrhythmic
Submitted by MO
58
```
What type of axis shift occurs with pulmonary embolism?
A. Mixed
B. Right
C. Indeterminate
D. Left
```
B. Right
Submitted by NR
59
```
What condition can make patients with diabetes have what appears to be a “silent” MI?
A. Hypoglycemia
B. Hyperglycemia
C. Angina
D. Neuropathy
```
D. Neuropathy
Submitted by NR
60
Which of the following miscellaneous effects in a 12 lead is incorrect?
A. Digitalis effect = sagging ST segments, prolonged PR interval
B. Hyperkalemia = Tall, pointy, narrow T waves
C. Hypokalemia = Prominent U waves, flattened T waves
D. Hypercalcemia = Wide QRS
D. Hypercalcemia = Wide QRS
Submitted by NR
61
```
Esmolol, metoprolol, and labetolol are all what type of medication?
A. Beta-blockers
B. Vasodilators
C. Anticoagulants
D. Diuretics
```
A. Beta-blockers
Submitted by NR
62
```
What type of ST segment depression is more indicative of coronary artery disease?
A. J-point depression
B. Horizontal
C. Downsloping
D. Upsloping
```
C. Downsloping
Submitted by NR
63
```
Which of the following can be a cause of a Left Bundle Branch Branch Block?
A. Congenital heart disease
B. All listed
C. Hypertension
D. Ventricular dilation
```
B. LBBB can be caused by hypertension and various types of cardiac disease
Submitted by CM
64
Signs/symptoms associated with the injury stage of infarction include all of the following except:
A. Significant Q waves will develop on the EKG
B. The tissue becomes blueish in appearance
C. The ST segment rises
D. The EKG will indicate the beginning of an acute STEMI
A. Significant Q waves will develop on the EKG
Submitted by CM
65
```
Potassium Channel Blockers work to decrease the movement of Potassium into the cardiac cell. This can reflect on the EKG in the following ways except :
A. Shortened QRS interval
B. Prolonged QRS interval
C. Prolonged PR interval
D. Prolonged QT interval
```
A. Shortened QRS interval
Submitted by CM
66
```
Common medications used for a pharmacologic stress test include all of the following except:
A. Dipyridamole
B. Adenosine
C. Regadenoson
D. Dopamine
```
D. Dopamine
Submitted by CM
67
```
Which of the following agents in not used to simulate exercise in a pharmacologic stress test?
A. Dobutamine
B. Technetium 99 sestamibi
C. Adenosine
D. Regadenoson
```
B. Technetium 99 sestamibi
Submitted by MO
68
```
If the QRS complexes in Leads I and aVF are both negative, the axis quadrant is considered
a. Normal
b. Indeterminate
c. Right axis deviation
d. Left axis deviation
```
Answer: B
Submitted by VS
69
```
The circumflex coronary artery supplies the lateral wall of the ______ _________.
a. Left ventricle
b. Right ventricle
c. Left atrium
d. Right atrium
```
Answer: A
Submitted by VS
70
```
Atropine _________the heart rate.
a. Decreases
b. Steadies
c. Increases
d. Does not affect
```
Answer: C
Submitted by VS
