CCT Domain 5: Performing Rhythm Analysis Welcome to your CCT Domain 5: Performing Rhythm Analysis 1. CCT: Performing Rhythm Analysis When interpreting a 12-lead ECG, which lead is crucial for identifying atrial enlargement? Lead I Lead II Lead V1 Lead V5 None 2. CCT: Performing Rhythm Analysis In ECG analysis, how is the axis deviation determined in the presence of a right bundle branch block 'RBBB'? By the direction of the QRS complex in leads I and aVF By the S wave depth in lead V1 By the R wave progression in the chest leads By the PR interval in leads II and III None 3. CCT: Performing Rhythm Analysis What ECG feature is indicative of a ventricular tachycardia? Narrow QRS complex P wave before each QRS complex Wide QRS complex without preceding P wave Regular R-R interval with a rate of 60-100 bpm None 4. CCT: Performing Rhythm Analysis In the context of atrial flutter, which characteristic is most indicative of the condition on an ECG? Sawtooth-like flutter waves at a rate of 250-350 bpm Prolonged PR interval Consistently wide QRS complexes Randomly occurring P waves None 5. CCT: Performing Rhythm Analysis How is a premature ventricular contraction 'PVC' identified on an ECG? A QRS complex that is narrow and preceded by a P wave A QRS complex that occurs earlier than expected, is wide, and not preceded by a P wave A QRS complex that is wide and followed by a compensatory pause Both B and C are correct None 6. CCT: Performing Rhythm Analysis What is the significance of a U wave on an ECG? It indicates severe hypokalemia. It is a normal variant and has no clinical significance. It can be associated with conditions like hypercalcemia or hypokalemia. It signifies an imminent ventricular tachycardia. None 7. CCT: Performing Rhythm Analysis On an ECG, how is an atrial fibrillation identified? Regular R-R intervals Presence of distinct P waves before each QRS complex Irregularly irregular R-R intervals and absence of distinct P waves Wide QRS complexes at a rate of less than 60 bpm None 8. CCT: Performing Rhythm Analysis Which ECG finding is indicative of a first-degree atrioventricular block? PR interval less than 0.12 seconds PR interval consistently more than 0.20 seconds Alternating short and long PR intervals Absence of a QRS complex following each P wave None 9. CCT: Performing Rhythm Analysis What does a delta wave on an ECG signify? Presence of an accessory conduction pathway Indication of myocardial infarction Sign of a prolonged QT interval Evidence of a second-degree AV block None 10. CCT: Performing Rhythm Analysis How is electrical alternans best identified on an ECG? By varying amplitude of the QRS complexes Through the presence of an additional P wave By a consistent pattern of ST segment elevation Through the alternating polarity of T waves None 11. CCT: Performing Rhythm Analysis What is the most likely ECG finding in a case of hyperkalemia? Peaked T waves Absence of P waves Short QT interval Wide, flattened T waves None 12. CCT: Performing Rhythm Analysis In the context of ECG interpretation, what does a 'saddleback' ST segment represent? Myocardial infarction Brugada syndrome Pericarditis Early repolarization None 13. CCT: Performing Rhythm Analysis Which condition is characterized by a short PR interval and a broad QRS complex with slurred upstroke in the ECG? Wolff-Parkinson-White syndrome Long QT syndrome Atrial fibrillation Ventricular tachycardia None 14. CCT: Performing Rhythm Analysis On an ECG, what does an inverted T wave generally indicate? Normal cardiac function Myocardial ischemia Ventricular hypertrophy Atrial enlargement None 15. CCT: Performing Rhythm Analysis What rhythm is characterized by a sawtooth pattern of atrial activity with a variable ventricular response? Atrial flutter with variable conduction Ventricular fibrillation Sinus rhythm Atrial fibrillation None 16. CCT: Performing Rhythm Analysis What ECG changes are typical in a patient with left ventricular hypertrophy? Tall R waves in lead V1 Deep S waves in lead V1 and tall R waves in lead V5 or V6 Prolonged PR interval Decreased R wave amplitude in lead V5 None 17. CCT: Performing Rhythm Analysis An ECG that shows regular R-R intervals with a rate of 150 bpm, no visible P waves, and broad QRS complexes is most indicative of what? Sinus tachycardia Atrial fibrillation Supraventricular tachycardia Ventricular tachycardia None 18. CCT: Performing Rhythm Analysis Which of the following is a characteristic feature of a Mobitz Type II second-degree AV block on an ECG? Progressive lengthening of the PR interval until a QRS complex is dropped A dropped QRS complex without a preceding change in the PR interval Alternating long and short PR intervals Presence of an additional P wave for every QRS complex None 19. CCT: Performing Rhythm Analysis How is sinus arrhythmia identified on an ECG? By a consistent P wave morphology with varying R-R intervals By a consistent R-R interval with varying P wave morphology By the absence of P waves before each QRS complex By a consistent PR interval but variable QRS width None 20. CCT: Performing Rhythm Analysis On an ECG, what is the significance of a biphasic P wave in lead V1? Right atrial enlargement Left atrial enlargement Ventricular hypertrophy Myocardial ischemia None 21. CCT: Performing Rhythm Analysis In the context of ECG interpretation, what does the presence of Q waves in leads II, III, and aVF suggest? Normal cardiac activity Inferior wall myocardial infarction Anterior wall myocardial infarction Lateral wall myocardial infarction None 22. CCT: Performing Rhythm Analysis What is indicated by a PR interval greater than 0.20 seconds in a child's ECG? First-degree atrioventricular block Normal pediatric ECG pattern Sinus bradycardia Sinus tachycardia None 23. CCT: Performing Rhythm Analysis On an ECG, how is a junctional escape rhythm identified? By P waves that occur after the QRS complex By the absence of P waves with a narrow QRS complex By a wide QRS complex without preceding P waves By P waves with an inverted morphology preceding the QRS complex None 24. CCT: Performing Rhythm Analysis What ECG findings are typical of a patient with hypothermia? Tall T waves Osborn waves (J waves) Peaked P waves Widened QRS complexes None 25. CCT: Performing Rhythm Analysis Which rhythm is characterized by three or more consecutive premature ventricular contractions (PVCs)? Ventricular bigeminy Ventricular trigeminy Ventricular tachycardia Ventricular fibrillation None 26. CCT: Performing Rhythm Analysis An ECG shows a regular rhythm with a heart rate of 75 bpm, P waves inverted in leads II, III, and aVF, and a normal QRS complex. What is the most likely rhythm? Sinus rhythm Atrial tachycardia Junctional rhythm Ventricular rhythm None 27. CCT: Performing Rhythm Analysis What does a QR pattern in the V1 lead of an ECG suggest? Right ventricular hypertrophy Left ventricular hypertrophy Anterior myocardial infarction Posterior myocardial infarction None 28. CCT: Performing Rhythm Analysis In an ECG, what does a monomorphic V tachycardia imply? The ventricular tachycardia has varying QRS complex morphologies. The ventricular tachycardia originates from multiple ectopic foci. The ventricular tachycardia has a consistent QRS complex shape. The QRS complexes alternate in polarity. None 29. CCT: Performing Rhythm Analysis Which of the following ECG characteristics is consistent with a diagnosis of torsades de pointes? A rapid, regular ventricular rate with a narrow QRS complex A slow, irregular ventricular rate with a wide QRS complex A rapid, irregular ventricular rate with changing QRS morphology A consistent ventricular rate with biphasic QRS complexes None 30. CCT: Performing Rhythm Analysis On an ECG, which finding is characteristic of a Type 1 Brugada pattern? ST elevation in leads I and aVL with a negative T wave Coved ST elevation in leads V1 to V3 followed by a negative T wave Saddleback ST elevation in leads V1 to V3 ST depression and T wave inversion in leads V5 and V6 None 31. CCT: Performing Rhythm Analysis What is the primary ECG characteristic of Wolff-Parkinson-White (WPW) syndrome? Prolonged PR interval Delta wave Peaked T waves ST-segment elevation None 32. CCT: Performing Rhythm Analysis In ECG interpretation, what is the significance of a notched R wave in the right precordial leads? Right atrial enlargement Left atrial enlargement Right ventricular hypertrophy Left ventricular hypertrophy None 33. CCT: Performing Rhythm Analysis An ECG that displays a regular rhythm, heart rate of 100 bpm, P waves hidden within QRS complexes, and a PR interval less than 0.12 seconds is indicative of what? Sinus rhythm Atrioventricular nodal reentrant tachycardia (AVNRT) Ventricular tachycardia Atrial flutter None 34. CCT: Performing Rhythm Analysis On an ECG, a PR interval that progressively lengthens until a QRS complex is dropped characterizes which type of block? First-degree AV block Second-degree AV block, Mobitz Type I (Wenckebach) Second-degree AV block, Mobitz Type II Third-degree (complete) AV block None 35. CCT: Performing Rhythm Analysis An ECG showing a regular rhythm with a heart rate of 160 bpm, absent P waves, and a wide QRS complex most likely indicates what condition? Supraventricular tachycardia (SVT) Atrial fibrillation Ventricular tachycardia Ventricular fibrillation None 36. CCT: Performing Rhythm Analysis What is suggested by the presence of a significant Q wave and ST elevation in leads V1 to V4 on an ECG? Inferior myocardial infarction Anterior myocardial infarction Lateral myocardial infarction Posterior myocardial infarction None 37. CCT: Performing Rhythm Analysis An ECG with a heart rate of 120 bpm, narrow QRS complexes, and a 'sawtooth' appearance in the inferior leads is most indicative of what? Atrial tachycardia Atrial flutter Atrial fibrillation Ventricular fibrillation None 38. CCT: Performing Rhythm Analysis On an ECG, which finding is typically associated with digitalis effect? Peaked T waves ST-segment depression with a scooped appearance Elevated ST segment Biphasic P wave None 39. CCT: Performing Rhythm Analysis Which of the following is a classic ECG presentation of hypercalcemia? Prolonged QT interval Shortened QT interval Elevated ST segment Widened T wave None 40. CCT: Performing Rhythm Analysis How is an accelerated idioventricular rhythm identified on an ECG? By a heart rate less than 40 bpm with regular wide QRS complexes By a heart rate of 50-100 bpm with wide QRS complexes By a heart rate greater than 100 bpm with narrow QRS complexes By a heart rate of 100-120 bpm with alternating wide and narrow QRS complexes None 1 out of 40 Time is Up! Time's up
