Multiple Choice Questions MCQ

Question 23# Print Question

The ECG in the figure below:

shows changes suggestive of:

A. Nonspecific ST- and/or T-wave changes

B. ST-T segment changes secondary to intraventricular conduction distribution or hypertrophy

C. ST- and/or T-wave changes suggesting myocardial ischemia

D. ST- and/or T-wave changes suggesting myocardial injury

E. ST- and/or T-wave changes suggesting acute pericarditis

Question 21# The ECG in the figure below: is suggestive of:
A. Inferoposterior Infarction
B. Inferior Infarction
C. Posterior Infarction
D. Preexcitation (Wolff-Parkinson-White) syndrome(s)
E. Anterior Infarction
Preexcitation (Wolff-Parkinson-White) syndrome(s). This electrocardiogram shows a sinus rhythm. There are inferior Q waves and prominent R vector in leads V1 and V2 . This might suggest inferoposterior infarction, but in leads V3 and V4 , especially there is a short PR interval and a delta wave suggesting that this is preexcitation or Wolff-Parkinson-White syndrome.

Question 22# The ECG in the figure below: shows changes suggestive of:
A. Atrial Septal Defect, primum
B. Digitalis toxicity
C. Hyperkalemia
D. Hypokalemia
E. Hypercalcemia
Atrial Septal Defect, primum. This patient has a sinus rhythm. Lead II does suggest left atrial enlargement with a P wave that is broad and notched. There is an rSR′ pattern in lead V1 with T-wave inversion and R′ greater than S. This type of pattern is commonly seen in volume-overload-type RVH. Volume-overload RVH and left axis should suggest ostium primum ASD. Usually an ASD will not affect P waves greatly, at least in the early phases of the process. Ostium primum ASDs, however, very often have mitral valve and notable mitral insufficiency plus left atrial enlargement.

Question 24# The ECG in the figure below: shows:
A. AV dissociation (without complete AV block)
B. Ventricular tachycardia
C. Ventricular tachycardia + AV dissociation (without complete AV block)
D. Ventricular capture beats
E. Reciprocal (echo) beats
Ventricular tachycardia + AV dissociation (without complete AV block). This patient has a wide complex tachycardia. There is AV dissociation and there is anterior, positive concordance in the chest leads. This is ventricular tachycardia.

Question 25# The ECG in the figure below: is suggestive of:
A. Mitral valve disease
B. Dextrocardial, mirror image
C. Chronic lung disease
D. Pericardial effusion
E. Acute pericarditis
Dextrocardial, mirror image. This patient has marked right axis deviation and loss of voltage across the precordium. The P waves are inverted in leads I and aVL. Inverted P waves in leads I and aVL (if it is not an ectopic atrial rhythm) are caused by either dextrocardial or switched arm wires. Loss of voltage across the precordium suggests that this is dextrocardia.

Question 23# The ECG in the figure below: shows changes suggestive of:
A. Nonspecific ST- and/or T-wave changes
B. ST-T segment changes secondary to intraventricular conduction distribution or hypertrophy
C. ST- and/or T-wave changes suggesting myocardial ischemia
D. ST- and/or T-wave changes suggesting myocardial injury
E. ST- and/or T-wave changes suggesting acute pericarditis
ST- and/or T-wave changes suggesting acute pericarditis. This electrocardiogram shows a sinus rhythm. There was a very prominent vector in lead V1 associated with upright T waves. This drops down to a more typical appearance in lead V2 . This is not an example of posterior infarction but instead is an example of switched leads, V1 and V5 having been transposed. There is also ST-segment elevation throughout and perhaps some PR-segment elevation in aVR. This suggests acute pericarditis.