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MDT: Week One Mock Test

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Quiz on MDT: Week One Mock Test, created by Carley Moffatt on 21/09/2017.
Carley Moffatt
Quiz by Carley Moffatt, updated more than 1 year ago
Carley Moffatt
Created by Carley Moffatt about 7 years ago
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Resource summary

Question 1

Question
The AV node is made up of specialized cells located in
Answer
  • lower portion of the left atrium
  • upper portion of the right atrium
  • upper portion of the left atrium
  • lower portion of the right atrium

Question 2

Question
The delay of electrical impulses in the AV Node
Answer
  • allow the junction to contract
  • allow the atria to complete filling of ventricles before next contraction
  • makes the rate of discharge of SA node slower
  • forces electrical impulses to travel retroactively
  • makes pacemaker cells capable of discharging at a rhythmic rate of 40-60 bpm

Question 3

Question
The bundle of His
Answer
  • connects AV node with bundle branches
  • has pacemaker cells capable of discharging at rythmic rate of 30-50 bpm
  • activates atria in a backward (retrograde direction)
  • transmits impluses from the AV to the left atrium
  • A and C

Question 4

Question
AV Junction is comprised of
Answer
  • the AV node and branching portion of bundle of His
  • the AV node, branching, and nonbranching portion of bundle of His
  • the non branching portion of bundle of His
  • nonbranching portion, AV node, and purkinje fibers
  • the AV node, nonbranching portion, and His bundle

Question 5

Question
If the rate of discharge of SA node is slower than AV junction
Answer
  • the SA node has failed to discharge
  • the AV junction has failed to discharge
  • an impulse from the SA node has been conducted through the atria but not to the ventricles
  • the His junction has failed to generate an impulse
  • the AV junction must assume responsibility for conducting impulses to the atria
  • the AV node and nonbranching portion of the bundle of His may assume responsibility for pacing the heart

Question 6

Question
the AV junction may assume responsibility for pacing the heart if:
Answer
  • the AV node fails to discharge
  • the SA node fails to discharge
  • the rate of discharge of SA node is faster than AV junction
  • an impulse from the SA node is generated and conducted through the ventricles but not to the atria
  • the rate of discharge of SA node is slower than AV junction
  • an impulse from the SA node is generated and conducted through the atria but not to ventricles
  • B, E, and F
  • B, C and F

Question 7

Question
When the AV junction is pacing the heart
Answer
  • electrical implulse must travel in a forwards direction to activate ventricles
  • electrical impulse must travel in a backwards direction to activate ventricles
  • electrical impulse must travel in a backward direction to activate atria
  • electrical impulses must travel in a retrograde direction to activate ventricles
  • electrical impulses must travel in a retrograde direction to activate ventricles and atria

Question 8

Question
When an AV junction has assumed responsibility for pacing the heart, the P wave may appear
Answer
  • before QRS complex
  • after QRS complex
  • during QRS complex
  • before or during QRS complex
  • during or after QRS complex
  • before, during or after QRS complex

Question 9

Question
a QRS of <0.12 seconds
Answer
  • is usually indicative of a premature junctional complex
  • is always followed by a non-compensatory (incomplete pause)
  • is fast

Question 10

Question
We can recognize a PJC
Answer
  • because it arises from irritable site within the SA junction
  • it fires before its next expected sinus beat
  • QRS is usually <0.21 sec
  • often followed by a non-compensatory pause
  • A and B
  • B and D
  • A, B and D

Question 11

Question
The PJC replaces normal beats
Answer
  • True
  • False

Question 12

Question
The ability to recognize a PJC wave include all of the following symptoms except;
Answer
  • a P wave, QRS <0.12 sec, a non-compensatory (incomplete) pause, rate within normal ranges
  • a P wave may/may not be present, regular heart rhythm with premature beats
  • QRS <0.12 sec unless aberrantly conducted or an intraventricular conduction delay exists
  • P waves may occur before, during, or after QRS, rate usually within normal range, regular rhythm with premature beats

Question 13

Question
In a PJC, heart rates are usually...
Answer
  • within normal range, but depends on underlying rhythm
  • outside of normal range, but depends on underlying rhythm
  • within normal range, but depends on medical history
  • outside of normal range, but depends on whether or not the PJC arises from an irritable site

Question 14

Question
When trying to recognize a PJC, the rhythm should be
Answer
  • regular, but depends on the QRS
  • above average, with premature beats
  • regular, with premature beats

Question 15

Question
To recognize a PJC, we should look at...
Answer
  • rate, rhythm, QRS and PRI
  • rhythm, QRS, P waves and PRI
  • rate, QRS, PRI, rhythm and P waves
  • QRS, P waves, ectopic beats, underlying rhythm
  • rhythm, rates, PRI, QRS, and ectopic beats

Question 16

Question
In recognizing PJC's, P waves...
Answer
  • may occur before or afterQRS
  • may occur only before or during QRS
  • can occur before, during, or after QRS

Question 17

Question
In recognizing PJC's, if visible, P waves...
Answer
  • is inverted in leads I, II, III and aVF
  • is inverted in leads II, III and aVF
  • is inverted in leads !, !! and aVF
  • is inverted in leads I, III and aVF

Question 18

Question
If P wave occurs before QRS in a PJC,
Answer
  • PRI will usually be equal to or less than 0.12 seconds
  • PRI will usually be less than 0.12 seconds
  • PRI will usually be 0.12 seconds
  • PRI will usually be greater than 0.12 seconds
  • there is no PRI

Question 19

Question
If no P wave occurs before QRS in a PJC,
Answer
  • then there is no PRI
  • PRI will usually be equal to or greater than 0.12 seconds
  • PRI will be less than 0.12 seconds
  • PRI will be 0.12 seconds
  • PRI will be greater than 0.12 seconds

Question 20

Question
QRS in a PJC,
Answer
  • is usually equal to or less than 0.12 seconds unless aberrantly conducted or an intraventricular conduction delay exists
  • is usually equal to or less than 0.21 seconds unless aberrantly conducted
  • is usually equal to or less than 0.12 seconds unless a P wave occurs before the QRS
  • is usually equal to or less than 0.21 seconds intraventricular conduction delay exists
  • is usually equal to or less than 0.12 seconds unless aberrantly conducted or accompanied by a PRI of greater than 0.12 seconds
  • is usually equal to or less than 0.12 seconds unless an intraventricular conduction delay exists, or accompanied by a PRI of greater than 0.12 seconds

Question 21

Question
When recognizing a PJC, all except the following are true:
Answer
  • rate is usually within normal range, rhythm is regular with premature beats, and p waves may occur before, during, or after QRS
  • QRS is usually greater than 0.12 seconds unless aberrantly conducted, rate is usually within normal ranges, and rhythm is regular with premature beats
  • PRI will usually be equal to, or less than 0.12 seconds if P wave occurs before QRS, rhythm will be regular with premature beats, and QRS is usually equal to or greater then 0.12 seconds
  • rate is usually within normal ranges but depends on underlying rhythm, QRS is usually equal to or greater than 0.12 seconds unless aberrantly conducted, and there will be no PRI if P wave occurs before QRS

Question 22

Question
Causes for PJC include all of the following except;
Answer
  • congestive heart failure, digitalis toxicity, stimulants, and mental and physical fatigue
  • acute coronary syndromes, mental and physical fatigue, valvular heart disease, and electrolyte imbalance
  • caffeine, only physical fatigue, valvular heart disease, and acute coronary syndromes
  • rheumatic heart disease, tobacco and other stimulants, acute coronary syndromes, and digitalis toxicity

Question 23

Question
Most individuals with PJCs are asymptomatic
Answer
  • True
  • False

Question 24

Question
PJCs...
Answer
  • may lead to symptoms of palpitations or feeling of skipped beats
  • always require treatment
  • are caused by stimulants, and thus should be avoided
  • are caused only by physical fatigue
  • A and C
  • A, C and D

Question 25

Question
Which of the following are true about junctional rhythms
Answer
  • rate: 40-60 rhythm: regular p waves: before and during QRS
  • rate: 30-50 rhythm: regular p waves: before, after and during QRS
  • rate: 40-60 rhythm: regular p waves: inverted if visible
  • rate: 40-60 rhythm: regular p waves: before, and after QRS
  • rate: 40-70 rhythm: regular p waves: before, after and during QRS; inverted if visible

Question 26

Question
when the rhythm is slower than expected, it is called
Answer
  • junctional bradycardia
  • deceletrated junctional rhythm
  • junctional tachycardia

Question 27

Question
what are the two types of rapid junctional rhythms
Answer
  • accelerated junctional rhythm and junctional tachycardia
  • junctional tachycardia and rapid junctional rhythm
  • rapid junctional rhythm and accelerated junctional rhythm
  • junctional tachycardia and junctional bradycardia

Question 28

Question
the two types of rapid junctional rhythms have bpms that range between
Answer
  • 60-100 and 100-140
  • 55-100 and 100-140
  • 60-100 and 100-130
  • 55-100 and 100-130

Question 29

Question
what is the difference between the two types of rapid junctional rhythms
Answer
  • rate
  • rhythm
  • p waves

Question 30

Question
all but the following are causes of accelerated junctional rhythm
Answer
  • acute myocardial infarction, CODP, rheumatic fever
  • hypokalemia, COPD, cardiac surgery and rheumatic fever
  • digitalis toxicity, acute myocardial infarction, caridac surgery and hypokalemia
  • acute myocardial infarction, digitalis toxicity and rheumatic fever

Question 31

Question
ventricles may assume responsibility for pacing the heart in all but which case;
Answer
  • SA node fails
  • SA node generates impulse but is blocked as it exists SA node
  • SA node discharge is faster than ventricles
  • irritable site in either ventricle produces early beat or rapid rhythm

Question 32

Question
ventricles may assume responsibility for pacing heart if the SA node discharge is slower than ventricles
Answer
  • True
  • False

Question 33

Question
when the SA node fails or its impulse is blocked as it exists the SA node, [blank_start]ventricles[blank_end] may assume responsibility
Answer
  • ventricles

Question 34

Question
select all that apply. Ventricles may assume responsibility for pacing the heart if:
Answer
  • SA node fails
  • impulse from SA node generated but blocked as it exists SA node
  • SA node discharge slower than ventricles
  • irritable site in either ventricle produces early beat or rapid rhythm

Question 35

Question
we can recognize premature ventricular complexes by observing that the T wave is usually
Answer
  • in the opposite direction of QRS
  • parallel to QRS
  • in the same direction of QRS
  • non-existant

Question 36

Question
in premature ventricular complexes, all but which of the following are true
Answer
  • QRS typically greater than 0.12 seconds
  • occurs earlier than next expected sinus beat
  • T wave usually in opposite direction of QRS
  • arise from irritable focus in either ventricle

Question 37

Question
premature ventricular complexes arise from irritable focus in either ventricle
Answer
  • True
  • False

Question 38

Question
a PVC is usually followed by a
Answer
  • full compensatory pause
  • backward electrical impulse
  • a non-compensatory pause

Question 39

Question
2 sequential PVCs are called
Answer
  • runs or bursts
  • couplets
  • ventricular bigeminy
  • bigeminal PVCs
  • ventricular trigeminy

Question 40

Question
3 sequential PVCs are called
Answer
  • runs or bursts
  • ventricular trigeminy
  • trigeminal PVCs
  • bigeminal PVCs

Question 41

Question
Bigeminal PVCs are when ____________ occurs
Answer
  • more than 3 sequential PVCs
  • 2 sequential PVCs
  • every other beat is a PVC
  • every 3rd beat is a PVC

Question 42

Question
When every 3rd beat is a PVC, it is known as
Answer
  • runs or bursts
  • bigeminal PVCs
  • ventricular trigeminy
  • trigeminal PVCs
  • ventrucular quadrigeminy
  • C and D
  • A and C

Question 43

Question
Quadrigeminal PVCs are when
Answer
  • there are 4 sequential PVCs
  • every other beat is a PVC
  • every other beat is a PVC, for greater than 4 occasions
  • every 4th beat is a PVC

Question 44

Question
uniform PVCs are distinct in that they
Answer
  • have similar morphology in same lead, and originate from the same ectopic focus
  • have similar morphology in same lead, and originate from different ectopic focus'
  • have different morphology, and originate from the same ectopic focus
  • have different morphology, and originate from different ectopic focus'

Question 45

Question
when PVCs have different morphology in the same lead they are easily recognized as...
Answer
  • uniform PVCs
  • multiform PVCs
  • R-on-T PVCs
  • ventricular rhythms

Question 46

Question
multiform PVC's
Answer
  • often (but not always) arise from different foci
  • always arise from different foci
  • never arise from different foci

Question 47

Question
PVCs are named R-on-T PVCs, because the
Answer
  • R wave falls on the T wave of preceding beat
  • T wave falls on the R wave of preceding beat
  • R wave refracts on the T wave of preceding beat
  • T wave refracts on the R wave of preceding beat

Question 48

Question
2 PVCs in a row are called
Answer
  • paired PVCs
  • couplets
  • bursts
  • salvo
  • A and C
  • A and B

Question 49

Question
"salvo," "run," or "burst" of VT are all ways of describing
Answer
  • greater than 5 PVCs in a row at a rate greater than 100 bpm
  • greater than 3 PVCs in a row at a rate greater than 50 bpm
  • greater than 5 PVCs in a row at a rate greater than 50 bpm
  • greater than 3 PVCs in a row at a rate greater than 100 bpm
  • greater than 3 PVCs in a row at a rate greater than 120 bpm

Question 50

Question
The rate of a PVC is
Answer
  • usually normal, but depends on underlying rhythm
  • usually higher than normal, but depends on underlying rhythm
  • usually lower than normal, but depends on underlying rhythm
  • usually normal, but depends on past medical conditions

Question 51

Question
The rhythm of a PVC
Answer
  • depends on underlying rhythm
  • depends on past medical history
  • depends on the conditions the patient are currently in
  • depends on underlying rhythm, with premature beats

Question 52

Question
P waves in a PVC
Answer
  • are usually absent
  • with retrograde condiction to atria, may appear after QRS
  • may appear after QRS, usually upright in ST-segment or T wave
  • may occur before after or during QRS
  • if visible, P wave is inverted
  • A and B
  • B and C
  • A, B, and C

Question 53

Question
In PVCs, QRS is
Answer
  • greater than 0.12 seconds, narrow and bizarre
  • usually in the same direction as the T wave
  • greater than 0.12 seconds, wide and bizarre
  • usually in the opposite direction of P wave

Question 54

Question
All of the following are causes of Premature Ventricular complex, except
Answer
  • normal variant, exercise, stimulants, increased sympathetic tone and hypoxia
  • stress and anxiety, medications, congestive heart failure, and valvular heart disease
  • digitalis toxicity, stress, myocardial ischemia, acid-base imbalance, and increased sympathetic tone
  • caffiene, TCA's, acute coronary syndromes, exercise and normal variant

Question 55

Question
Patients of PVC may be asymptomatic
Answer
  • True
  • False

Question 56

Question
patients of PVC who are symptomatic may complain of all the following except;
Answer
  • palpitations, racing heart, lower back discomfort
  • racing heart, neck discomfort, skipped beats
  • chest discomfort

Question 57

Question
if PVCs are frequent,
Answer
  • decreased cardiac output possible
  • increased cardiac output possible
  • no cardiac output possible

Question 58

Question
treatment of PVCs is dependent on all except which of the following
Answer
  • cause
  • signs and symptoms
  • clinical situation
  • mental and physical fatigue

Question 59

Question
These look just like a PVC, but appear LATE instead of early.
Answer
  • ventricular escape beats
  • 'safety' mechanisms
  • AV junctions
  • compensatory pauses

Question 60

Question
three or more ventricular escape beats in row, with a rate of 20-40 bpm is indicative of
Answer
  • idiocentricular rhythm
  • agonal rhythm
  • ventricular escape beats
  • premature junctional complexes

Question 61

Question
agonal rhythm shows a ventricular rate of
Answer
  • less than 20 bmp
  • greater than 20 bmp
  • equal to 30 bpm
  • greater than 30 bpm
  • between 20 and 30 bpm

Question 62

Question
you are given the following information... rate:20-bpm rhythm: essentially regular P waves: usually absent PRI: none What do you diagnose?
Answer
  • idioventricular rhythm
  • premature junctional complex
  • agonal rhythm
  • ventricular escape beats
  • premature ventricular complex
  • accelerated idioventricular rhythm

Question 63

Question
P waves in idioventricular rhythms are usually absent, or with retrograde conduction to atria, may appear [blank_start]after[blank_end] QRS (usually upright in ST-segment or T wave)
Answer
  • after
  • before

Question 64

Question
if no P wave occurs before QRS in _____________, then there is no PRI. In ____________, there is always no PRI.
Answer
  • PJCs, idioventricular rhythms
  • idioventricular rhythms, PJCs
  • rapid junctional rhythms, accelerated idioventricular rhythms
  • accelerated idioventricular rhythms, rapid junctional rhythms

Question 65

Question
in this rhythm, the T wave is frequently in the opposite direction of QRS complex
Answer
  • idioventricular rhythm
  • acceletated junctional rhythm
  • premature junctional complexes
  • premature ventricular complexes

Question 66

Question
introventricular rhythms may occur in all of the following cases, except for
Answer
  • SA node and AV junction quit
  • rate of discharge of SA node or AV junction intrinsic rate is slower than ventricular rate
  • digitalis toxicity
  • impulses generated by the supracentricular pacemaker site are firing too quickly
  • metabolic imbalances

Question 67

Question
slow rate and loss of atrial kick in idioventricular rhythms may result in upwards cardiac output
Answer
  • True
  • False

Question 68

Question
Scenario: your patient has a QRS greater than 0.12 seconds, but an essentially regular rhythm. You notice three or more ventricular escape beats in a row, with a rate of 20-40 bpm. What should you do?
Answer
  • lidocaine
  • TCP or atropine
  • increase MVO2
  • predispose patient to ventricular dysrythmmias

Question 69

Question
three or more ventricular escape beats occur in a row, rate of 41-100 bpm. What do you diagnose?
Answer
  • accelerated idioventricular rhythm
  • idioventricular rhythm
  • premature ventricular complex
  • ventricular tachycardia

Question 70

Question
some physicians consider ventricular rate range of AVIR to be 41-100, while others consider it to be 41-120 bpm
Answer
  • True
  • False

Question 71

Question
P waves are usually absent in this rhythm, though with retrograde conduction to atria, may appear after QRS (usually upright in ST-segment or T wave)
Answer
  • accelerated idioventricular rhythm
  • idioventricular rhythm
  • premature ventricular complex
  • torsades de pointes
  • A and B
  • A and D

Question 72

Question
acelerated idioventricular rhythm appears in all of the following, with the exception of;
Answer
  • often seen during the first 12 hours of MI
  • post-reperfusion therapy (successful)
  • accelerated sinus rate
  • decelerated sinus rate
  • acute mypocarditis

Question 73

Question
accelerated idioventricular rhythm appears in all of the following, with the exception of;
Answer
  • digitalis toxicity
  • cocaine toxicity
  • subarachnoid hemorrhage
  • acute myocarditis
  • hypertensive heart disease
  • all of the above are causes of accelerated idioventricular rhythm

Question 74

Question
If a patient with accelerated idioventricular rhythms is symptomatic because of loss of atrial kick, treatment can include all of the following with the exception of;
Answer
  • atropine
  • atrial pacing
  • ventricular antiarrhythmics

Question 75

Question
treatment is usually unnecessary in patients with accelerated idioventricular rhythms
Answer
  • True
  • False

Question 76

Question
your patient is displaying three or more PVCs in a row, rate of greater than 100 bpm. What are you observing?
Answer
  • ventricular tachycardia
  • accelerated idioventricular
  • idioventricular
  • asystole

Question 77

Question
nonsustained ventricular tachycardia lasts ____________, while sustained VT ________________
Answer
  • less than 30 seconds, more than 30 seconds
  • more than 30 seconds, less than 30 seconds
  • less than 60 seconds, more than 60 seconds
  • more than 60 seconds, less than 60 seconds

Question 78

Question
all of the following are possible causes of ventricular tachycardia, with the exception of;
Answer
  • acute coronary syndromes, cardiomyopathy and TCA overdose
  • TCA overdose, cocaine abuse, trauma
  • acid-base imbalance, mitral valve prolapse, digitalis toxicity
  • brugada, electrolyte imbalance, invasive cardiac procedures
  • myocardial contusion, abnormal QT interval, stimulants such as caffeine and tobacco

Question 79

Question
this phenomenon is a chaotic rhythm originating in the ventricles. It is always pulseless
Answer
  • ventricular fibrillation
  • idioventricular
  • torsades de pointes
  • asystole

Question 80

Question
ventricular fibrillation is not caused by
Answer
  • environment
  • electrolyte imbalance
  • hypertrophy
  • electrolyte imbalances
  • decreased SNS activity

Question 81

Question
the absence of any (ventricular) rhythm
Answer
  • asystole
  • ventricular fibrillation
  • ventricular tachycardia

Question 82

Question
all of the following are causes of first degree AV blocks, with the exception of which of the following;
Answer
  • AV node ischemia/injury
  • acute MI
  • some meds
  • decreased vagal tone

Question 83

Question
This type of block is defined as a prolongation of the PR interval on an ECG to more than 0.20 seconds
Answer
  • 1st degree AV block
  • type 1, 2nd degree AV block
  • type 2, 2nd degree AV block
  • 3rd degree AV block

Question 84

Question
your patient reveals a history of congestive heart failure on digoxin. He does not have any complaints of nausea, palpaitations, or chest pain. You run an ECG, and notice that the rhythm is regularly irregular, and the ratio of Ps to QRSs is 1:1 underlying rhythm and 2:1 where dropped beat occurs. How do you diagnose?
Answer
  • 2nd degree AV block, type 1
  • 2nd degree AV block, type 2
  • ischemic heart disease
  • 3rd degree AV block

Question 85

Question
2nd degree av block type 1 is more serious than 2nd degree av block type 2
Answer
  • True
  • False

Question 86

Question
which of the following is not a cause for type 1, 2nd degree AV blocks
Answer
  • increased parasympathetic tone
  • anterior wall MI
  • aortic valve disease
  • mitral valve prolapse

Question 87

Question
left coronary artery disease, anterior wall MI, and fibrosis of conduction system are all causes of which type of AV block
Answer
  • 2nd degree, type 1
  • 2nd degree, type 2
  • 1st degree
  • 3rd degree

Question 88

Question
your patients ECG reflects a slow rate, with present and upright P waves. You notice that the rhythm is regular for P waves, but irregular for QRS. For instance, the last impulse appeared on the ECG as P wave with no QRS after. These are features of a
Answer
  • 2nd degree AV block, type 1
  • 2nd degree AV block, type 2
  • 1st degree AV block
  • 3rd degree AV block
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