Questão 1
Questão
The AV node is made up of specialized cells located in
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lower portion of the left atrium
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upper portion of the right atrium
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upper portion of the left atrium
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lower portion of the right atrium
Questão 2
Questão
The delay of electrical impulses in the AV Node
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allow the junction to contract
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allow the atria to complete filling of ventricles before next contraction
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makes the rate of discharge of SA node slower
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forces electrical impulses to travel retroactively
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makes pacemaker cells capable of discharging at a rhythmic rate of 40-60 bpm
Questão 3
Questão
The bundle of His
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connects AV node with bundle branches
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has pacemaker cells capable of discharging at rythmic rate of 30-50 bpm
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activates atria in a backward (retrograde direction)
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transmits impluses from the AV to the left atrium
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A and C
Questão 4
Questão
AV Junction is comprised of
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the AV node and branching portion of bundle of His
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the AV node, branching, and nonbranching portion of bundle of His
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the non branching portion of bundle of His
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nonbranching portion, AV node, and purkinje fibers
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the AV node, nonbranching portion, and His bundle
Questão 5
Questão
If the rate of discharge of SA node is slower than AV junction
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the SA node has failed to discharge
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the AV junction has failed to discharge
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an impulse from the SA node has been conducted through the atria but not to the ventricles
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the His junction has failed to generate an impulse
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the AV junction must assume responsibility for conducting impulses to the atria
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the AV node and nonbranching portion of the bundle of His may assume responsibility for pacing the heart
Questão 6
Questão
the AV junction may assume responsibility for pacing the heart if:
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the AV node fails to discharge
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the SA node fails to discharge
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the rate of discharge of SA node is faster than AV junction
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an impulse from the SA node is generated and conducted through the ventricles but not to the atria
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the rate of discharge of SA node is slower than AV junction
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an impulse from the SA node is generated and conducted through the atria but not to ventricles
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B, E, and F
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B, C and F
Questão 7
Questão
When the AV junction is pacing the heart
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electrical implulse must travel in a forwards direction to activate ventricles
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electrical impulse must travel in a backwards direction to activate ventricles
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electrical impulse must travel in a backward direction to activate atria
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electrical impulses must travel in a retrograde direction to activate ventricles
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electrical impulses must travel in a retrograde direction to activate ventricles and atria
Questão 8
Questão
When an AV junction has assumed responsibility for pacing the heart, the P wave may appear
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before QRS complex
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after QRS complex
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during QRS complex
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before or during QRS complex
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during or after QRS complex
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before, during or after QRS complex
Questão 9
Questão
a QRS of <0.12 seconds
Questão 10
Questão
We can recognize a PJC
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because it arises from irritable site within the SA junction
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it fires before its next expected sinus beat
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QRS is usually <0.21 sec
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often followed by a non-compensatory pause
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A and B
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B and D
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A, B and D
Questão 11
Questão
The PJC replaces normal beats
Questão 12
Questão
The ability to recognize a PJC wave include all of the following symptoms except;
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a P wave, QRS <0.12 sec, a non-compensatory (incomplete) pause, rate within normal ranges
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a P wave may/may not be present, regular heart rhythm with premature beats
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QRS <0.12 sec unless aberrantly conducted or an intraventricular conduction delay exists
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P waves may occur before, during, or after QRS, rate usually within normal range, regular rhythm with premature beats
Questão 13
Questão
In a PJC, heart rates are usually...
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within normal range, but depends on underlying rhythm
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outside of normal range, but depends on underlying rhythm
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within normal range, but depends on medical history
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outside of normal range, but depends on whether or not the PJC arises from an irritable site
Questão 14
Questão
When trying to recognize a PJC, the rhythm should be
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regular, but depends on the QRS
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above average, with premature beats
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regular, with premature beats
Questão 15
Questão
To recognize a PJC, we should look at...
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rate, rhythm, QRS and PRI
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rhythm, QRS, P waves and PRI
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rate, QRS, PRI, rhythm and P waves
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QRS, P waves, ectopic beats, underlying rhythm
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rhythm, rates, PRI, QRS, and ectopic beats
Questão 16
Questão
In recognizing PJC's, P waves...
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may occur before or afterQRS
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may occur only before or during QRS
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can occur before, during, or after QRS
Questão 17
Questão
In recognizing PJC's, if visible, P waves...
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is inverted in leads I, II, III and aVF
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is inverted in leads II, III and aVF
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is inverted in leads !, !! and aVF
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is inverted in leads I, III and aVF
Questão 18
Questão
If P wave occurs before QRS in a PJC,
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PRI will usually be equal to or less than 0.12 seconds
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PRI will usually be less than 0.12 seconds
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PRI will usually be 0.12 seconds
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PRI will usually be greater than 0.12 seconds
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there is no PRI
Questão 19
Questão
If no P wave occurs before QRS in a PJC,
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then there is no PRI
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PRI will usually be equal to or greater than 0.12 seconds
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PRI will be less than 0.12 seconds
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PRI will be 0.12 seconds
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PRI will be greater than 0.12 seconds
Questão 20
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is usually equal to or less than 0.12 seconds unless aberrantly conducted or an intraventricular conduction delay exists
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is usually equal to or less than 0.21 seconds unless aberrantly conducted
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is usually equal to or less than 0.12 seconds unless a P wave occurs before the QRS
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is usually equal to or less than 0.21 seconds intraventricular conduction delay exists
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is usually equal to or less than 0.12 seconds unless aberrantly conducted or accompanied by a PRI of greater than 0.12 seconds
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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
Questão 21
Questão
When recognizing a PJC, all except the following are true:
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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
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QRS is usually greater than 0.12 seconds unless aberrantly conducted, rate is usually within normal ranges, and rhythm is regular with premature beats
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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
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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
Questão 22
Questão
Causes for PJC include all of the following except;
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congestive heart failure, digitalis toxicity, stimulants, and mental and physical fatigue
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acute coronary syndromes, mental and physical fatigue, valvular heart disease, and electrolyte imbalance
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caffeine, only physical fatigue, valvular heart disease, and acute coronary syndromes
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rheumatic heart disease, tobacco and other stimulants, acute coronary syndromes, and digitalis toxicity
Questão 23
Questão
Most individuals with PJCs are asymptomatic
Questão 24
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may lead to symptoms of palpitations or feeling of skipped beats
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always require treatment
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are caused by stimulants, and thus should be avoided
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are caused only by physical fatigue
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A and C
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A, C and D
Questão 25
Questão
Which of the following are true about junctional rhythms
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rate: 40-60
rhythm: regular
p waves: before and during QRS
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rate: 30-50
rhythm: regular
p waves: before, after and during QRS
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rate: 40-60
rhythm: regular
p waves: inverted if visible
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rate: 40-60
rhythm: regular
p waves: before, and after QRS
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rate: 40-70
rhythm: regular
p waves: before, after and during QRS; inverted if visible
Questão 26
Questão
when the rhythm is slower than expected, it is called
Questão 27
Questão
what are the two types of rapid junctional rhythms
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accelerated junctional rhythm and junctional tachycardia
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junctional tachycardia and rapid junctional rhythm
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rapid junctional rhythm and accelerated junctional rhythm
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junctional tachycardia and junctional bradycardia
Questão 28
Questão
the two types of rapid junctional rhythms have bpms that range between
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60-100 and 100-140
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55-100 and 100-140
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60-100 and 100-130
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55-100 and 100-130
Questão 29
Questão
what is the difference between the two types of rapid junctional rhythms
Questão 30
Questão
all but the following are causes of accelerated junctional rhythm
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acute myocardial infarction, CODP, rheumatic fever
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hypokalemia, COPD, cardiac surgery and rheumatic fever
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digitalis toxicity, acute myocardial infarction, caridac surgery and hypokalemia
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acute myocardial infarction, digitalis toxicity and rheumatic fever
Questão 31
Questão
ventricles may assume responsibility for pacing the heart in all but which case;
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SA node fails
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SA node generates impulse but is blocked as it exists SA node
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SA node discharge is faster than ventricles
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irritable site in either ventricle produces early beat or rapid rhythm
Questão 32
Questão
ventricles may assume responsibility for pacing heart if the SA node discharge is slower than ventricles
Questão 33
Questão
when the SA node fails or its impulse is blocked as it exists the SA node, [blank_start]ventricles[blank_end] may assume responsibility
Questão 34
Questão
select all that apply. Ventricles may assume responsibility for pacing the heart if:
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SA node fails
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impulse from SA node generated but blocked as it exists SA node
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SA node discharge slower than ventricles
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irritable site in either ventricle produces early beat or rapid rhythm
Questão 35
Questão
we can recognize premature ventricular complexes by observing that the T wave is usually
Questão 36
Questão
in premature ventricular complexes, all but which of the following are true
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QRS typically greater than 0.12 seconds
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occurs earlier than next expected sinus beat
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T wave usually in opposite direction of QRS
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arise from irritable focus in either ventricle
Questão 37
Questão
premature ventricular complexes arise from irritable focus in either ventricle
Questão 38
Questão
a PVC is usually followed by a
Questão 39
Questão
2 sequential PVCs are called
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runs or bursts
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couplets
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ventricular bigeminy
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bigeminal PVCs
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ventricular trigeminy
Questão 40
Questão
3 sequential PVCs are called
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runs or bursts
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ventricular trigeminy
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trigeminal PVCs
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bigeminal PVCs
Questão 41
Questão
Bigeminal PVCs are when ____________ occurs
Questão 42
Questão
When every 3rd beat is a PVC, it is known as
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runs or bursts
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bigeminal PVCs
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ventricular trigeminy
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trigeminal PVCs
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ventrucular quadrigeminy
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C and D
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A and C
Questão 43
Questão
Quadrigeminal PVCs are when
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there are 4 sequential PVCs
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every other beat is a PVC
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every other beat is a PVC, for greater than 4 occasions
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every 4th beat is a PVC
Questão 44
Questão
uniform PVCs are distinct in that they
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have similar morphology in same lead, and originate from the same ectopic focus
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have similar morphology in same lead, and originate from different ectopic focus'
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have different morphology, and originate from the same ectopic focus
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have different morphology, and originate from different ectopic focus'
Questão 45
Questão
when PVCs have different morphology in the same lead they are easily recognized as...
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uniform PVCs
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multiform PVCs
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R-on-T PVCs
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ventricular rhythms
Questão 46
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often (but not always) arise from different foci
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always arise from different foci
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never arise from different foci
Questão 47
Questão
PVCs are named R-on-T PVCs, because the
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R wave falls on the T wave of preceding beat
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T wave falls on the R wave of preceding beat
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R wave refracts on the T wave of preceding beat
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T wave refracts on the R wave of preceding beat
Questão 48
Questão
2 PVCs in a row are called
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paired PVCs
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couplets
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bursts
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salvo
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A and C
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A and B
Questão 49
Questão
"salvo," "run," or "burst" of VT are all ways of describing
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greater than 5 PVCs in a row at a rate greater than 100 bpm
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greater than 3 PVCs in a row at a rate greater than 50 bpm
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greater than 5 PVCs in a row at a rate greater than 50 bpm
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greater than 3 PVCs in a row at a rate greater than 100 bpm
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greater than 3 PVCs in a row at a rate greater than 120 bpm
Questão 50
Questão
The rate of a PVC is
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usually normal, but depends on underlying rhythm
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usually higher than normal, but depends on underlying rhythm
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usually lower than normal, but depends on underlying rhythm
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usually normal, but depends on past medical conditions
Questão 51
Questão
The rhythm of a PVC
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depends on underlying rhythm
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depends on past medical history
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depends on the conditions the patient are currently in
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depends on underlying rhythm, with premature beats
Questão 52
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are usually absent
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with retrograde condiction to atria, may appear after QRS
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may appear after QRS, usually upright in ST-segment or T wave
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may occur before after or during QRS
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if visible, P wave is inverted
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A and B
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B and C
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A, B, and C
Questão 53
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greater than 0.12 seconds, narrow and bizarre
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usually in the same direction as the T wave
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greater than 0.12 seconds, wide and bizarre
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usually in the opposite direction of P wave
Questão 54
Questão
All of the following are causes of Premature Ventricular complex, except
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normal variant, exercise, stimulants, increased sympathetic tone and hypoxia
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stress and anxiety, medications, congestive heart failure, and valvular heart disease
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digitalis toxicity, stress, myocardial ischemia, acid-base imbalance, and increased sympathetic tone
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caffiene, TCA's, acute coronary syndromes, exercise and normal variant
Questão 55
Questão
Patients of PVC may be asymptomatic
Questão 56
Questão
patients of PVC who are symptomatic may complain of all the following except;
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palpitations, racing heart, lower back discomfort
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racing heart, neck discomfort, skipped beats
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chest discomfort
Questão 57
Questão
if PVCs are frequent,
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decreased cardiac output possible
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increased cardiac output possible
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no cardiac output possible
Questão 58
Questão
treatment of PVCs is dependent on all except which of the following
Questão 59
Questão
These look just like a PVC, but appear LATE instead of early.
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ventricular escape beats
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'safety' mechanisms
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AV junctions
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compensatory pauses
Questão 60
Questão
three or more ventricular escape beats in row, with a rate of 20-40 bpm is indicative of
Questão 61
Questão
agonal rhythm shows a ventricular rate of
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less than 20 bmp
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greater than 20 bmp
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equal to 30 bpm
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greater than 30 bpm
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between 20 and 30 bpm
Questão 62
Questão
you are given the following information...
rate:20-bpm
rhythm: essentially regular
P waves: usually absent
PRI: none
What do you diagnose?
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idioventricular rhythm
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premature junctional complex
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agonal rhythm
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ventricular escape beats
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premature ventricular complex
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accelerated idioventricular rhythm
Questão 63
Questão
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)
Questão 64
Questão
if no P wave occurs before QRS in _____________, then there is no PRI. In ____________, there is always no PRI.
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PJCs, idioventricular rhythms
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idioventricular rhythms, PJCs
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rapid junctional rhythms, accelerated idioventricular rhythms
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accelerated idioventricular rhythms, rapid junctional rhythms
Questão 65
Questão
in this rhythm, the T wave is frequently in the opposite direction of QRS complex
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idioventricular rhythm
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acceletated junctional rhythm
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premature junctional complexes
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premature ventricular complexes
Questão 66
Questão
introventricular rhythms may occur in all of the following cases, except for
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SA node and AV junction quit
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rate of discharge of SA node or AV junction intrinsic rate is slower than ventricular rate
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digitalis toxicity
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impulses generated by the supracentricular pacemaker site are firing too quickly
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metabolic imbalances
Questão 67
Questão
slow rate and loss of atrial kick in idioventricular rhythms may result in upwards cardiac output
Questão 68
Questão
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?
Questão 69
Questão
three or more ventricular escape beats occur in a row, rate of 41-100 bpm. What do you diagnose?
Questão 70
Questão
some physicians consider ventricular rate range of AVIR to be 41-100, while others consider it to be 41-120 bpm
Questão 71
Questão
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)
Questão 72
Questão
acelerated idioventricular rhythm appears in all of the following, with the exception of;
Questão 73
Questão
accelerated idioventricular rhythm appears in all of the following, with the exception of;
Questão 74
Questão
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;
Questão 75
Questão
treatment is usually unnecessary in patients with accelerated idioventricular rhythms
Questão 76
Questão
your patient is displaying three or more PVCs in a row, rate of greater than 100 bpm. What are you observing?
Questão 77
Questão
nonsustained ventricular tachycardia lasts ____________, while sustained VT ________________
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less than 30 seconds, more than 30 seconds
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more than 30 seconds, less than 30 seconds
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less than 60 seconds, more than 60 seconds
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more than 60 seconds, less than 60 seconds
Questão 78
Questão
all of the following are possible causes of ventricular tachycardia, with the exception of;
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acute coronary syndromes, cardiomyopathy and TCA overdose
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TCA overdose, cocaine abuse, trauma
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acid-base imbalance, mitral valve prolapse, digitalis toxicity
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brugada, electrolyte imbalance, invasive cardiac procedures
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myocardial contusion, abnormal QT interval, stimulants such as caffeine and tobacco
Questão 79
Questão
this phenomenon is a chaotic rhythm originating in the ventricles. It is always pulseless
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ventricular fibrillation
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idioventricular
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torsades de pointes
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asystole
Questão 80
Questão
ventricular fibrillation is not caused by
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environment
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electrolyte imbalance
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hypertrophy
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electrolyte imbalances
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decreased SNS activity
Questão 81
Questão
the absence of any (ventricular) rhythm
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asystole
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ventricular fibrillation
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ventricular tachycardia
Questão 82
Questão
all of the following are causes of first degree AV blocks, with the exception of which of the following;
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AV node ischemia/injury
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acute MI
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some meds
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decreased vagal tone
Questão 83
Questão
This type of block is defined as a prolongation of the PR interval on an ECG to more than 0.20 seconds
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1st degree AV block
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type 1, 2nd degree AV block
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type 2, 2nd degree AV block
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3rd degree AV block
Questão 84
Questão
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?
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2nd degree AV block, type 1
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2nd degree AV block, type 2
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ischemic heart disease
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3rd degree AV block
Questão 85
Questão
2nd degree av block type 1 is more serious than 2nd degree av block type 2
Questão 86
Questão
which of the following is not a cause for type 1, 2nd degree AV blocks
Questão 87
Questão
left coronary artery disease, anterior wall MI, and fibrosis of conduction system are all causes of which type of AV block
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2nd degree, type 1
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2nd degree, type 2
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1st degree
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3rd degree
Questão 88
Questão
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
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2nd degree AV block, type 1
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2nd degree AV block, type 2
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1st degree AV block
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3rd degree AV block