ADVANCED DYSRHYTHMIA MASTERY
EXAM QUESTIONS AND ANSWERS
1. Which of the following ECG features is most characteristic of a Third-Degree (Complete) AV
Block?
A. A progressive lengthening of the PR interval until a QRS complex is dropped.
B. Complete dissociation between P waves and QRS complexes with regular R-R intervals.
C. A constant PR interval with intermittently dropped QRS complexes.
D. A PR interval greater than 0.20 seconds with every P wave followed by a QRS.
Answer: B
Conceptual Explanation: In third-degree heart block, the atria and ventricles beat
independently because the electrical signal is completely blocked at the AV node or bundle
of His, resulting in no relationship between P waves and QRS complexes.
2. A patient presents with Torsades de Pointes. Which medication is the first-line treatment
of choice for this rhythm?
A. Amiodarone
B. Magnesium Sulfate
,C. Lidocaine
D. Epinephrine
Answer: B
Conceptual Explanation: Magnesium Sulfate is the preferred treatment for Torsades de
Pointes, a specific form of polymorphic ventricular tachycardia associated with a prolonged
QT interval.
3. What is the hallmark finding of Wolff-Parkinson-White (WPW) syndrome on a resting 12-
lead ECG?
A. Osborn wave
B. Delta wave
C. Epsilon wave
D. U wave
Answer: B
Conceptual Explanation: The delta wave is a slurred upstroke in the QRS complex caused
by premature ventricular activation via an accessory pathway (Bundle of Kent).
4. In the Brugada Criteria, which finding helps distinguish Ventricular Tachycardia (VT) from
Supraventricular Tachycardia (SVT) with aberrancy?
A. The presence of a P wave before every QRS.
B. Absence of an RS complex in all precordial leads (V1-V6).
, C. A QRS duration of exactly 0.12 seconds.
D. A regular R-R interval.
Answer: B
Conceptual Explanation: The absence of an RS complex in all precordial leads (V1-V6) is
highly suggestive of VT according to the Brugada algorithm.
5. What is the primary hemodynamic concern when a patient develops Atrial Fibrillation with
a Rapid Ventricular Response (RVR)?
A. Ventricular hypertrophy.
B. Increased coronary artery perfusion.
C. Loss of atrial kick and decreased diastolic filling time.
D. Decreased systemic vascular resistance.
Answer: C
Conceptual Explanation: RVR reduces the time the ventricles have to fill during diastole,
and the lack of organized atrial contraction (atrial kick) further reduces cardiac output.
6. Which rhythm is characterized by a rate of 40–120 bpm, no visible P waves, and a wide QRS
complex, often occurring post-reperfusion?
A. Ventricular Tachycardia
B. Idioventricular Rhythm
C. Accelerated Idioventricular Rhythm (AIVR)
EXAM QUESTIONS AND ANSWERS
1. Which of the following ECG features is most characteristic of a Third-Degree (Complete) AV
Block?
A. A progressive lengthening of the PR interval until a QRS complex is dropped.
B. Complete dissociation between P waves and QRS complexes with regular R-R intervals.
C. A constant PR interval with intermittently dropped QRS complexes.
D. A PR interval greater than 0.20 seconds with every P wave followed by a QRS.
Answer: B
Conceptual Explanation: In third-degree heart block, the atria and ventricles beat
independently because the electrical signal is completely blocked at the AV node or bundle
of His, resulting in no relationship between P waves and QRS complexes.
2. A patient presents with Torsades de Pointes. Which medication is the first-line treatment
of choice for this rhythm?
A. Amiodarone
B. Magnesium Sulfate
,C. Lidocaine
D. Epinephrine
Answer: B
Conceptual Explanation: Magnesium Sulfate is the preferred treatment for Torsades de
Pointes, a specific form of polymorphic ventricular tachycardia associated with a prolonged
QT interval.
3. What is the hallmark finding of Wolff-Parkinson-White (WPW) syndrome on a resting 12-
lead ECG?
A. Osborn wave
B. Delta wave
C. Epsilon wave
D. U wave
Answer: B
Conceptual Explanation: The delta wave is a slurred upstroke in the QRS complex caused
by premature ventricular activation via an accessory pathway (Bundle of Kent).
4. In the Brugada Criteria, which finding helps distinguish Ventricular Tachycardia (VT) from
Supraventricular Tachycardia (SVT) with aberrancy?
A. The presence of a P wave before every QRS.
B. Absence of an RS complex in all precordial leads (V1-V6).
, C. A QRS duration of exactly 0.12 seconds.
D. A regular R-R interval.
Answer: B
Conceptual Explanation: The absence of an RS complex in all precordial leads (V1-V6) is
highly suggestive of VT according to the Brugada algorithm.
5. What is the primary hemodynamic concern when a patient develops Atrial Fibrillation with
a Rapid Ventricular Response (RVR)?
A. Ventricular hypertrophy.
B. Increased coronary artery perfusion.
C. Loss of atrial kick and decreased diastolic filling time.
D. Decreased systemic vascular resistance.
Answer: C
Conceptual Explanation: RVR reduces the time the ventricles have to fill during diastole,
and the lack of organized atrial contraction (atrial kick) further reduces cardiac output.
6. Which rhythm is characterized by a rate of 40–120 bpm, no visible P waves, and a wide QRS
complex, often occurring post-reperfusion?
A. Ventricular Tachycardia
B. Idioventricular Rhythm
C. Accelerated Idioventricular Rhythm (AIVR)
