10477486
Descripción
Test por Carley Moffatt, actualizado hace más de 1 año
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Creado por Carley Moffatt
hace alrededor de 7 años
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Pregunta 1
Pregunta
The AV node is made up of specialized cells located in
Respuesta
-
lower portion of the left atrium
-
upper portion of the right atrium
-
upper portion of the left atrium
-
lower portion of the right atrium
Pregunta 2
Pregunta
The delay of electrical impulses in the AV Node
Respuesta
-
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
Pregunta 3
Pregunta
The bundle of His
Respuesta
-
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
Pregunta 4
Pregunta
AV Junction is comprised of
Respuesta
-
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
Pregunta 5
Pregunta
If the rate of discharge of SA node is slower than AV junction
Respuesta
-
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
Pregunta 6
Pregunta
the AV junction may assume responsibility for pacing the heart if:
Respuesta
-
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
Pregunta 7
Pregunta
When the AV junction is pacing the heart
Respuesta
-
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
Pregunta 8
Pregunta
When an AV junction has assumed responsibility for pacing the heart, the P wave may appear
Respuesta
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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
Pregunta 9
Pregunta
a QRS of <0.12 seconds
Respuesta
-
is usually indicative of a premature junctional complex
-
is always followed by a non-compensatory (incomplete pause)
-
is fast
Pregunta 10
Pregunta
We can recognize a PJC
Respuesta
-
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
Pregunta 11
Pregunta
The PJC replaces normal beats
Respuesta
- True
- False
Pregunta 12
Pregunta
The ability to recognize a PJC wave include all of the following symptoms except;
Respuesta
-
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
Pregunta 13
Pregunta
In a PJC, heart rates are usually...
Respuesta
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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
Pregunta 14
Pregunta
When trying to recognize a PJC, the rhythm should be
Respuesta
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regular, but depends on the QRS
-
above average, with premature beats
-
regular, with premature beats
Pregunta 15
Pregunta
To recognize a PJC, we should look at...
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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
Pregunta 16
Pregunta
In recognizing PJC's, P waves...
Respuesta
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may occur before or afterQRS
-
may occur only before or during QRS
-
can occur before, during, or after QRS
Pregunta 17
Pregunta
In recognizing PJC's, if visible, P waves...
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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
Pregunta 18
Pregunta
If P wave occurs before QRS in a PJC,
Respuesta
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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
Pregunta 19
Pregunta
If no P wave occurs before QRS in a PJC,
Respuesta
-
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
Pregunta 20
Pregunta
QRS in a PJC,
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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
Pregunta 21
Pregunta
When recognizing a PJC, all except the following are true:
Respuesta
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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
Pregunta 22
Pregunta
Causes for PJC include all of the following except;
Respuesta
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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
Pregunta 23
Pregunta
Most individuals with PJCs are asymptomatic
Respuesta
- True
- False
Pregunta 24
Pregunta
PJCs...
Respuesta
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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
Pregunta 25
Pregunta
Which of the following are true about junctional rhythms
Respuesta
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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
Pregunta 26
Pregunta
when the rhythm is slower than expected, it is called
Respuesta
-
junctional bradycardia
-
deceletrated junctional rhythm
-
junctional tachycardia
Pregunta 27
Pregunta
what are the two types of rapid junctional rhythms
Respuesta
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accelerated junctional rhythm and junctional tachycardia
-
junctional tachycardia and rapid junctional rhythm
-
rapid junctional rhythm and accelerated junctional rhythm
-
junctional tachycardia and junctional bradycardia
Pregunta 28
Pregunta
the two types of rapid junctional rhythms have bpms that range between
Respuesta
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60-100 and 100-140
-
55-100 and 100-140
-
60-100 and 100-130
-
55-100 and 100-130
Pregunta 29
Pregunta
what is the difference between the two types of rapid junctional rhythms
Respuesta
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rate
-
rhythm
-
p waves
Pregunta 30
Pregunta
all but the following are causes of accelerated junctional rhythm
Respuesta
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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
Pregunta 31
Pregunta
ventricles may assume responsibility for pacing the heart in all but which case;
Respuesta
-
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
Pregunta 32
Pregunta
ventricles may assume responsibility for pacing heart if the SA node discharge is slower than ventricles
Respuesta
- True
- False
Pregunta 33
Pregunta
when the SA node fails or its impulse is blocked as it exists the SA node, [blank_start]ventricles[blank_end] may assume responsibility
Respuesta
-
ventricles
Pregunta 34
Pregunta
select all that apply. Ventricles may assume responsibility for pacing the heart if:
Respuesta
-
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
Pregunta 35
Pregunta
we can recognize premature ventricular complexes by observing that the T wave is usually
Respuesta
-
in the opposite direction of QRS
-
parallel to QRS
-
in the same direction of QRS
-
non-existant
Pregunta 36
Pregunta
in premature ventricular complexes, all but which of the following are true
Respuesta
-
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
Pregunta 37
Pregunta
premature ventricular complexes arise from irritable focus in either ventricle
Respuesta
- True
- False
Pregunta 38
Pregunta
a PVC is usually followed by a
Respuesta
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full compensatory pause
-
backward electrical impulse
-
a non-compensatory pause
Pregunta 39
Pregunta
2 sequential PVCs are called
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runs or bursts
-
couplets
-
ventricular bigeminy
-
bigeminal PVCs
-
ventricular trigeminy
Pregunta 40
Pregunta
3 sequential PVCs are called
Respuesta
-
runs or bursts
-
ventricular trigeminy
-
trigeminal PVCs
-
bigeminal PVCs
Pregunta 41
Pregunta
Bigeminal PVCs are when ____________ occurs
Respuesta
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more than 3 sequential PVCs
-
2 sequential PVCs
-
every other beat is a PVC
-
every 3rd beat is a PVC
Pregunta 42
Pregunta
When every 3rd beat is a PVC, it is known as
Respuesta
-
runs or bursts
-
bigeminal PVCs
-
ventricular trigeminy
-
trigeminal PVCs
-
ventrucular quadrigeminy
-
C and D
-
A and C
Pregunta 43
Pregunta
Quadrigeminal PVCs are when
Respuesta
-
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
Pregunta 44
Pregunta
uniform PVCs are distinct in that they
Respuesta
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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'
Pregunta 45
Pregunta
when PVCs have different morphology in the same lead they are easily recognized as...
Respuesta
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uniform PVCs
-
multiform PVCs
-
R-on-T PVCs
-
ventricular rhythms
Pregunta 46
Pregunta
multiform PVC's
Respuesta
-
often (but not always) arise from different foci
-
always arise from different foci
-
never arise from different foci
Pregunta 47
Pregunta
PVCs are named R-on-T PVCs, because the
Respuesta
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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
Pregunta 48
Pregunta
2 PVCs in a row are called
Respuesta
-
paired PVCs
-
couplets
-
bursts
-
salvo
-
A and C
-
A and B
Pregunta 49
Pregunta
"salvo," "run," or "burst" of VT are all ways of describing
Respuesta
-
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
Pregunta 50
Pregunta
The rate of a PVC is
Respuesta
-
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
Pregunta 51
Pregunta
The rhythm of a PVC
Respuesta
-
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
Pregunta 52
Pregunta
P waves in a PVC
Respuesta
-
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
Pregunta 53
Pregunta
In PVCs, QRS is
Respuesta
-
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
Pregunta 54
Pregunta
All of the following are causes of Premature Ventricular complex, except
Respuesta
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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
Pregunta 55
Pregunta
Patients of PVC may be asymptomatic
Respuesta
- True
- False
Pregunta 56
Pregunta
patients of PVC who are symptomatic may complain of all the following except;
Respuesta
-
palpitations, racing heart, lower back discomfort
-
racing heart, neck discomfort, skipped beats
-
chest discomfort
Pregunta 57
Pregunta
if PVCs are frequent,
Respuesta
-
decreased cardiac output possible
-
increased cardiac output possible
-
no cardiac output possible
Pregunta 58
Pregunta
treatment of PVCs is dependent on all except which of the following
Respuesta
-
cause
-
signs and symptoms
-
clinical situation
-
mental and physical fatigue
Pregunta 59
Pregunta
These look just like a PVC, but appear LATE instead of early.
Respuesta
-
ventricular escape beats
-
'safety' mechanisms
-
AV junctions
-
compensatory pauses
Pregunta 60
Pregunta
three or more ventricular escape beats in row, with a rate of 20-40 bpm is indicative of
Respuesta
-
idiocentricular rhythm
-
agonal rhythm
-
ventricular escape beats
-
premature junctional complexes
Pregunta 61
Pregunta
agonal rhythm shows a ventricular rate of
Respuesta
-
less than 20 bmp
-
greater than 20 bmp
-
equal to 30 bpm
-
greater than 30 bpm
-
between 20 and 30 bpm
Pregunta 62
Pregunta
you are given the following information...
rate:20-bpm
rhythm: essentially regular
P waves: usually absent
PRI: none
What do you diagnose?
Respuesta
-
idioventricular rhythm
-
premature junctional complex
-
agonal rhythm
-
ventricular escape beats
-
premature ventricular complex
-
accelerated idioventricular rhythm
Pregunta 63
Pregunta
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)
Respuesta
-
after
-
before
Pregunta 64
Pregunta
if no P wave occurs before QRS in _____________, then there is no PRI. In ____________, there is always no PRI.
Respuesta
-
PJCs, idioventricular rhythms
-
idioventricular rhythms, PJCs
-
rapid junctional rhythms, accelerated idioventricular rhythms
-
accelerated idioventricular rhythms, rapid junctional rhythms
Pregunta 65
Pregunta
in this rhythm, the T wave is frequently in the opposite direction of QRS complex
Respuesta
-
idioventricular rhythm
-
acceletated junctional rhythm
-
premature junctional complexes
-
premature ventricular complexes
Pregunta 66
Pregunta
introventricular rhythms may occur in all of the following cases, except for
Respuesta
-
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
Pregunta 67
Pregunta
slow rate and loss of atrial kick in idioventricular rhythms may result in upwards cardiac output
Respuesta
- True
- False
Pregunta 68
Pregunta
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?
Respuesta
-
lidocaine
-
TCP or atropine
-
increase MVO2
-
predispose patient to ventricular dysrythmmias
Pregunta 69
Pregunta
three or more ventricular escape beats occur in a row, rate of 41-100 bpm. What do you diagnose?
Respuesta
-
accelerated idioventricular rhythm
-
idioventricular rhythm
-
premature ventricular complex
-
ventricular tachycardia
Pregunta 70
Pregunta
some physicians consider ventricular rate range of AVIR to be 41-100, while others consider it to be 41-120 bpm
Respuesta
- True
- False
Pregunta 71
Pregunta
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)
Respuesta
-
accelerated idioventricular rhythm
-
idioventricular rhythm
-
premature ventricular complex
-
torsades de pointes
-
A and B
-
A and D
Pregunta 72
Pregunta
acelerated idioventricular rhythm appears in all of the following, with the exception of;
Respuesta
-
often seen during the first 12 hours of MI
-
post-reperfusion therapy (successful)
-
accelerated sinus rate
-
decelerated sinus rate
-
acute mypocarditis
Pregunta 73
Pregunta
accelerated idioventricular rhythm appears in all of the following, with the exception of;
Respuesta
-
digitalis toxicity
-
cocaine toxicity
-
subarachnoid hemorrhage
-
acute myocarditis
-
hypertensive heart disease
-
all of the above are causes of accelerated idioventricular rhythm
Pregunta 74
Pregunta
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;
Respuesta
-
atropine
-
atrial pacing
-
ventricular antiarrhythmics
Pregunta 75
Pregunta
treatment is usually unnecessary in patients with accelerated idioventricular rhythms
Respuesta
- True
- False
Pregunta 76
Pregunta
your patient is displaying three or more PVCs in a row, rate of greater than 100 bpm. What are you observing?
Respuesta
-
ventricular tachycardia
-
accelerated idioventricular
-
idioventricular
-
asystole
Pregunta 77
Pregunta
nonsustained ventricular tachycardia lasts ____________, while sustained VT ________________
Respuesta
-
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
Pregunta 78
Pregunta
all of the following are possible causes of ventricular tachycardia, with the exception of;
Respuesta
-
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
Pregunta 79
Pregunta
this phenomenon is a chaotic rhythm originating in the ventricles. It is always pulseless
Respuesta
-
ventricular fibrillation
-
idioventricular
-
torsades de pointes
-
asystole
Pregunta 80
Pregunta
ventricular fibrillation is not caused by
Respuesta
-
environment
-
electrolyte imbalance
-
hypertrophy
-
electrolyte imbalances
-
decreased SNS activity
Pregunta 81
Pregunta
the absence of any (ventricular) rhythm
Respuesta
-
asystole
-
ventricular fibrillation
-
ventricular tachycardia
Pregunta 82
Pregunta
all of the following are causes of first degree AV blocks, with the exception of which of the following;
Respuesta
-
AV node ischemia/injury
-
acute MI
-
some meds
-
decreased vagal tone
Pregunta 83
Pregunta
This type of block is defined as a prolongation of the PR interval on an ECG to more than 0.20 seconds
Respuesta
-
1st degree AV block
-
type 1, 2nd degree AV block
-
type 2, 2nd degree AV block
-
3rd degree AV block
Pregunta 84
Pregunta
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?
Respuesta
-
2nd degree AV block, type 1
-
2nd degree AV block, type 2
-
ischemic heart disease
-
3rd degree AV block
Pregunta 85
Pregunta
2nd degree av block type 1 is more serious than 2nd degree av block type 2
Respuesta
- True
- False
Pregunta 86
Pregunta
which of the following is not a cause for type 1, 2nd degree AV blocks
Respuesta
-
increased parasympathetic tone
-
anterior wall MI
-
aortic valve disease
-
mitral valve prolapse
Pregunta 87
Pregunta
left coronary artery disease, anterior wall MI, and fibrosis of conduction system are all causes of which type of AV block
Respuesta
-
2nd degree, type 1
-
2nd degree, type 2
-
1st degree
-
3rd degree
Pregunta 88
Pregunta
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
Respuesta
-
2nd degree AV block, type 1
-
2nd degree AV block, type 2
-
1st degree AV block
-
3rd degree AV block
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