Hall: Guyton and Hall Textbook of Medical Physiology, 12th Edition

Chapter 13: Cardiac Arrhythmias and Their Electrocardiographic Interpretation

Test Bank

1. A forty-year-old man reported to his cardiologist that he had unusual feelings 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 II and III are shown. What is the
likely diagnosis?
A. Premature contraction originating in the atrium
B. Premature contraction originating high in the A-V node
C. Premature contraction originating low in the A-V node
D. Premature contraction originating in the apex of the ventricle
E. Premature contraction originating in the base of the ventricle

ANS: E

2. A ninety-year-old man had an EKG taken at his local doctors office, and the diagnosis
was atrial fibrillation. Which of the following statements are likely conditions in
someone with atrial fibrillation?
A. Ventricular fibrillation normally accompanies atrial fibrillation
B. The P waves of the EKG are strong
C. The rate of ventricular contraction is irregular and fast
D. The atrial a wave is normal
E. The atria have a smaller volume than normal

ANS: C

Copyright 2011, 2006 by Saunders, an imprint of Elsevier Inc.

Test Bank 13-2

3. Circus movements in the ventricle can lead to ventricular fibrillation. Which of the
following conditions in the ventricular muscle will increase the tendency for circus
movements?
A. Decreased refractory period
B. Low extracellular potassium concentration
C. Increased refractory period
D. Shorter conduction pathway (decreased ventricular volume)
E. Increase in parasympathetic impulses to the heart

ANS: A

4. A 55-year-old woman had the following EKG recorded at her annual physical. She
reported to her doctor that sometimes her pulse rate feels strong and at other times it feels
weak. Standard limb lead II is shown.

What is her likely diagnosis?

A. Atrial paroxysmal tachycardia
B. First degree A-V block
C. Second degree A-V block, Mobitz type I (Wenckebach)
D. Second degree A-V block, Mobitz type II
E. Third degree A-V block

ANS: D

5. A fifty-year-old man has been having fainting spells for about two weeks. During the
fainting episodes, his EKG shows a ventricular beat of 25 per minute and 100 P waves
per minute. After about 30 seconds of fainting a normal sinus rhythm reoccurs. What is
his likely diagnosis?
A. Atrial flutter
B. First degree A-V block
C. Second degree A-V block
D. Third degree A-V block
E. Stokes-Adams syndrome

ANS: E

Copyright 2011, 2006 by Saunders, an imprint of Elsevier Inc.

Test Bank 13-3

6. A 65-year-old woman had the following EKG recorded at her annual physical. She
reported to her doctor that sometimes her pulse rate feels a little irregular. Standard limb
lead III is shown. What is her likely diagnosis?
A. Atrial paroxysmal tachycardia
B. First degree A-V block
C. Second degree A-V block, Mobitz type I (Wenckebach)
D. Normal sinus rhythm
E. Third degree A-V block

ANS: E

7. Circus movements in the ventricle can lead to ventricular fibrillation. Which of the
following conditions in the ventricular muscle will increase the tendency for circus
movements?
A. Decreased conduction velocity
B. Low extracellular potassium concentration
C. Increased refractory period
D. Shorter conduction pathway (decreased ventricular volume)
E. Increase in parasympathetic impulses to the heart

ANS: A

8. Which of the following statements about a premature atrial contraction is true?

A. The radial artery pulse associated with the premature contraction will be weak
B. Stroke volume associated with the premature contraction will be increased
C. The P wave is never seen
D. The probability of these premature contractions occurring is decreased in
people with a large caffeine intake
E. It causes the QRS interval to be lengthened.

ANS: A
9. A 65-year-old man reported some unusual sensations in his chest. His blood pressure is
135/85 mmHg, and he weighs 200 pounds. He had an EKG taken, and it is shown below.
What is his likely diagnosis?
A. Atrial paroxysmal tachycardia
B. First degree A-V block
C. Second degree A-V block
D. Premature atrial contractions
E. Premature ventricular contractions

ANS: D

Copyright 2011, 2006 by Saunders, an imprint of Elsevier Inc.

Test Bank 13-4

Questions 10-11: A sixty-year-old female was admitted to the UMC emergency room
following an automobile accident, and the following EKG was taken. Chest lead V2 is
shown.

10. What is her heart rate in beats/minute?

A. 40
B. 60
C. 75
D. 100
E. 150

ANS: B

11. What is her diagnosis?

A. Atrial paroxysmal tachycardia
B. First degree A-V block
C. Second degree A-V block
D. Third degree A-V block
E. Atrial flutter

ANS: B

12. Which of the following will usually result in an inverted P wave that occurs after the
QRS complex?
A. Premature contraction originating in the atrium
B. Premature contraction originating high in the A-V junction
C. Premature contraction originating in the middle of the A-V junction
D. Premature contraction originating low in the A-V junction
E. atrial fibrillation

ANS: D

Copyright 2011, 2006 by Saunders, an imprint of Elsevier Inc.

Test Bank 13-5

13. A fifty-year-old man has a blood pressure of 140/85 and weighs 200 lbs. He reports that
he is not feeling well, his EKG has no P waves, and he has a heart rate of 42. What is his
condition?
A. First degree heart block
B. Second degree heart block
C. Third degree heart block
D. Sinoatrial heart block
E. Sinus bradycardia

ANS: D

14. A 48-year-old man had unusual sensations in his chest during exercise. His EKG is
shown below, and lead aVF is shown. What is the diagnosis?
A. Premature contraction originating in the atrium
B. Premature contraction originating high in the A-V node
C. Premature contraction originating low in the A-V node
D. Premature contraction originating in the inferior part of the ventricle
E. Premature contraction originating in the base of the ventricle

ANS: D

15. Which of the following decrease the risk of occurrence of ventricular fibrillation?
A. An enlarged ventricle
B. A lengthened ventricular refractory period
C. Decreased electrical conduction velocity
D. Exposure of the heart to 60-cycle alternating current
E. Epinephrine administration

ANS: D

Copyright 2011, 2006 by Saunders, an imprint of Elsevier Inc.

Test Bank 13-6

16. Which of the following occur after electrical shock of the heart with a 60-cycle
alternating current?
A. A normal arterial pressure
B. A lengthened ventricular refractory period
C. Decreased electrical conduction velocity
D. A shortened conduction pathway around the heart
E. Normal cardiac output

ANS: C

Copyright 2011, 2006 by Saunders, an imprint of Elsevier Inc.