Hall: Guyton and Hall Textbook of Medical Physiology, 12th Edition Chapte 1!: Cadiac "hyth#ias and Thei Electocadiogaphic $ntepetation Test %ank
1. A fortyforty-year year-old -old man reported reported to his his cardiologist cardiologist that that he had unusual feeling feelingss in his chest after drinking his fourth cup of coffee in the morning. The cardiologist recorded the following EKG during an exercise stress test. Leads and are shown. !hat is the likely diagnosis" A. #rem #remat atur uree con contr trac acti tion on orig origin inat atin ing g in in the the atri atrium um $. #rem #remat atur uree cont contra ract ctio ion n orig origin inat atin ing g high high in in the the A-% A-% node node &. #rem #remat atur uree cont contra ract ctio ion n orig origin inat atin ing g low low in the the A-% A-% nod nodee '. #rem #remat atur uree con contr tract actio ion n ori origi ginat natin ing g in in the the apex apex of of the the (entr (entric icle le E. #rem #remat atur uree con contr tract actio ion n ori origi ginat natin ing g in in the the )ase )ase of of the the (en (entr tric icle le A*+, E
. A ninety-ye ninety-yearar-old old man had an EKG taken taken at his local doctor doctorss office/ office/ and the diagnosis diagnosis was atrial fi)rillation. !hich of the following statements are likely conditions in someone with atrial fi)rillation" A. %entri entricu cula larr fi)ri fi)rill llat atio ion n normal normally ly accom accompa panie niess atria atriall fi)ri fi)rill llat atio ion n $. The # wa(es of of the EK EKG ar are st strong &. The The rat ratee of (ent (entri ricu cula larr cont contra ract ctio ion n is irre irregu gula larr and and fast fast '. The atrial 0a wa(e is normal E. The atri atriaa ha( ha(ee a smal smalller (ol (olume ume tha than n nor norma mall A*+, &
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5. &ircus mo(ements in the (entricle can lead to (entricular fi)rillation. !hich of the following conditions in the (entricular muscle will increase the tendency for circus mo(ements" A. 'ecreased refractory period $. Low extracellular potassium concentration &. ncreased refractory period '. +horter conduction pathway 6decreased (entricular (olume7 E. ncrease in parasympathetic impulses to the heart A*+, A 8. A 99-year-old woman had the following EKG recorded at her annual physical. +he reported to her doctor that sometimes her pulse rate feels strong an d at other times it feels weak. +tandard lim) lead is shown.
!hat is her likely diagnosis" A. Atrial paroxysmal tachycardia $. :irst degree A-% )lock &. +econd degree A-% )lock/ ;o)it< type 6!encke)ach7 '. +econd degree A-% )lock/ ;o)it< type E. Third degree A-% )lock A*+, ' 9. A fifty-year-old man has )een ha(ing fainting 0spells for a)out two weeks. 'uring the fainting episodes/ his EKG shows a (entricular )eat of 9 per minute and 133 # wa(es per minute. After a)out 53 seconds of fainting a normal sinus rhythm reoccurs. !hat is his likely diagnosis" A. Atrial flutter $. :irst degree A-% )lock &. +econd degree A-% )lock '. Third degree A-% )lock E. +tokes-Adams syndrome A*+, E
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4. A 49-year-old woman had the following EKG recorded at her annual physical. +he reported to her doctor that sometimes her pulse rate feels a little irregular. +tandard lim) lead is shown. !hat is her likely diagnosis" A. Atrial paroxysmal tachycardia $. :irst degree A-% )lock &. +econd degree A-% )lock/ ;o)it< type 6!encke)ach7 '. *ormal sinus rhythm E. Third degree A-% )lock A*+, E
=. &ircus mo(ements in the (entricle can lead to (entricular fi)rillation. !hich of the following conditions in the (entricular muscle will increase the tendency for circus mo(ements" A. 'ecreased conduction (elocity $. Low extracellular potassium concentration &. ncreased refractory period '. +horter conduction pathway 6decreased (entricular (olume7 E. ncrease in parasympathetic impulses to the heart A*+, A >. !hich of the following statements a)out a premature atrial contraction is true" A. The radial artery pulse associated with the premature contraction will )e weak $. +troke (olume associated with the premature contraction will )e increased &. The # wa(e is ne(er seen '. The pro)a)ility of these premature contractions occurring is decreased in people with a large caffeine intake E. t causes the ?@+ inter(al to )e lengthened. A*+, A . A 49-year-old man reported some unusual sensations in his chest. Bis )lood pressure is 159C>9 mmBg/ and he weighs 33 pounds. Be had an EKG taken/ and it is shown )elow. !hat is his likely diagnosis" A. Atrial paroxysmal tachycardia $. :irst degree A-% )lock &. +econd degree A-% )lock '. #remature atrial contractions E. #remature (entricular contractions A*+, '
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?uestions 13-11, A sixty-year-old female was admitted to the D;& emergency room following an automo)ile accident/ and the following EKG was taken. &hest lead %2 is shown.
13. !hat is her heart rate in )eatsCminute" A. 83 $. 43 &. =9 '. 133 E. 193 A*+, $ 11. !hat is her diagnosis" A. Atrial paroxysmal tachycardia $. :irst degree A-% )lock &. +econd degree A-% )lock '. Third degree A-% )lock E. Atrial flutter A*+, $ 1. !hich of the following will usually result in an in(erted # wa(e that occurs after the ?@+ complex" A. #remature contraction originating in the atrium $. #remature contraction originating high in the A-% unction &. #remature contraction originating in the middle of the A-% unction '. #remature contraction originating low in the A-% unction E. atrial fi)rillation A*+, '
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15. A fifty-year-old man has a )lood pressure of 183C>9 and weighs 33 l)s. Be reports that he is not feeling well/ his EKG has no # wa(es/ and he has a heart rate of 8. !hat is his condition" A. :irst degree heart )lock $. +econd degree heart )lock &. Third degree heart )lock '. +inoatrial heart )lock E. +inus )radycardia A*+, ' 18. A 8>-year-old man had unusual sensations in his chest during exercise. Bis EKG is shown )elow/ and lead a%: is shown. !hat is the diagnosis" A. #remature contraction originating in the atrium $. #remature contraction originating high in the A-% node &. #remature contraction originating low in the A-% node '. #remature contraction originating in the inferior part of the (entricle E. #remature contraction originating in the )ase of the (entricle A*+, '
19. !hich of the following decrease the risk of occurrence of (entricular fi)rillation" A. An enlarged (entricle $. A lengthened (entricular refractory period &. 'ecreased electrical conduction (elocity '. Exposure of the heart to 43-cycle alternating current E. Epinephrine administration A*+, '
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14. !hich of the following occur after electrical shock of the heart with a 43-cycle alternating current" A. A normal arterial pressure $. A lengthened (entricular refractory period &. 'ecreased electrical conduction (elocity '. A shortened conduction pathway around the heart E. *ormal cardiac output A*+, &
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