NEW 2023 RELIAS BASIC DYSRHYTHMIA WITH
CORRECT QUESTIONS AND ANSWERS FROM
EXPERTS n the T wave ate originatin -flutter
with 2 1. normal sinus rhythm: heart rhythm
originating in the sinoatrial node with a rate in
patients at rest of 60 to 100 beats per
1 Big Box - ans0.20 sec
1 Small Box - ans0.04 sec
1st Degree AV Block - ansRegular
Rate: 60-100
P Wave: Present, upright
PR interval: >0.20 sec CONSISTENTLY LONG
QRS: <0.12 sec
Husband stays late till 9 consistently
2nd Degree AV Block Type I Mobitz, Wenckebach - ansIRREGULAR
Rate: 60-100
P wave: Present, upright
PR Interval: Progressively longer until drop (PR interval longer and longer until drop)
QRS: <0.12 sec
Husband stays late till 9, then 11, then 1, then doesn't come home at all
2nd Degree AV Block Type II - ansIrregular or regular
Rate: <60
P wave: Present, upright
PR Interval: PR interval consistently LONGER like type 1 but then a QRS will drop
QRS: <0.12 sec
Husband stays late till 9 consistently, then wife goes out and doesn't come home
3rd Degree AV Block - ansAtrials and ventricles don't communicate
Rate: regular atrial
P wave: Present, upright
No relationship between P waves and QRS
PR Interval: VARIABLE
QRS: variable
P-P ad R-R consistent but NO correlation
,NEW 2023 RELIAS BASIC DYSRHYTHMIA WITH
CORRECT QUESTIONS AND ANSWERS FROM
EXPERTS n the T wave ate originatin -flutter
with 2 1. normal sinus rhythm: heart rhythm
originating in the sinoatrial node with a rate in
patients at rest of 60 to 100 beats per
Husband and wife live separate lives and don't communicate
A fib RVR - ansIRREGULAR
Ventricular rate: 100-175
P wave: unable to see
PR Interval: N/A
QRS <0.12 sec
Accelerated Idoventricular Rhythm - ansRegular
Rate: 50-100
P wave: NONE
PR Interval: N/A
QRS: WIDE, >0.12 sec
Accelerated Junctional Rhythm - ansRegular
Rate: 60-100
P Wave: NONE or INVERTED
PR Interval: None or <0.12
QRS: <0.12 sec
Atrial Fibrillation - ansIRREGULAR
Atrial rate: UNMEASURABLE
Ventricular rate: variable
P wave: unable to see
PR Interval: N/A
QRS: <0.12 sec
Atrial Flutter - ansUsually REGULAR can be irregular
Atrial rate: 250-350
Ventricular rate: variable BUT < atrial rate
P Wave: Flutter
PR Interval: N/A
QRS: <0.12 sec
Atrially Paced - ansSpike comes before P
AV Node - ans2nd
,NEW 2023 RELIAS BASIC DYSRHYTHMIA WITH
CORRECT QUESTIONS AND ANSWERS FROM
EXPERTS n the T wave ate originatin -flutter
with 2 1. normal sinus rhythm: heart rhythm
originating in the sinoatrial node with a rate in
patients at rest of 60 to 100 beats per
40-60
AV Node Firing, SA Node Failed Rhythms - ans*Fires normally @ 40-60*
-Junctional rhythm 40-60
-Accelerated junctional rhythm 60-100
-Junctional tachycardia 100-150
AV Paced - ansSpike before P and before QR
Bigeminy - ansPVC occurs every OTHER beat
Bundle of His - ans3rd
40-45
Calculate Irregular Rate - ans# of Rs in 6 sec strip X 10
Calculate Regular Rate - ans1500/ # boxes R-R
Coarse V Fib - ansChopy but not as high as polymorphic V tach
Couplet - ans2 PVCs together
Failure to Capture - ansSpikes with no QRS
Failure to Sense - ansSpikes happen regardless of QRS on their own
Fine V Fib - ansFine and fibrillatory
How to determine the rhythm - ansRegular or irregular?
Rate?
P before every QRS? QRS for every P?
QRS wide or narrow?
Idioventricular - ansRegular
Rate: 20-50
P wave: NONE
PR Interval: N/A
, NEW 2023 RELIAS BASIC DYSRHYTHMIA WITH
CORRECT QUESTIONS AND ANSWERS FROM
EXPERTS n the T wave ate originatin -flutter
with 2 1. normal sinus rhythm: heart rhythm
originating in the sinoatrial node with a rate in
patients at rest of 60 to 100 beats per
QRS: WIDE, >0.12 sec
Idioventricular Rhythms - ansOnly purkinje fibers firing
WIDE QRS always
Junctional Rhythm - ansRegular
Rate: 40-60
P Wave: ABSENT or INVERTED
PR Interval: None or <0.12
QRS: <0.12 sec
Junctional Rhythms - ansSA Node DID NOT FIRE
AV Node fired
NO P WAVE bc SA node didn't fire
Narrow QRS
Junctional Tachycardia - ansRegular
Rate: >100
P Wave: NONE or INVERTED
PR Interval: None or <0.12
QRS: <0.12 sec
Monomorphic V Tach - ansSame Shapes V Tach
Multifocal - ansMultiple shapes
Normal sinus rhythm - ansRegular
Rate: 60-100
P Wave: Present, upright
PR Interval: 0.12-0.20 sec
QRS: <0.12 sec
Only Purkinje Fibers Firing Rhythms (Everything else has failed) - ans*Fires normally @
20-50*
-Idioventricular 20-50
-Accelerated idioventricular 50-100
CORRECT QUESTIONS AND ANSWERS FROM
EXPERTS n the T wave ate originatin -flutter
with 2 1. normal sinus rhythm: heart rhythm
originating in the sinoatrial node with a rate in
patients at rest of 60 to 100 beats per
1 Big Box - ans0.20 sec
1 Small Box - ans0.04 sec
1st Degree AV Block - ansRegular
Rate: 60-100
P Wave: Present, upright
PR interval: >0.20 sec CONSISTENTLY LONG
QRS: <0.12 sec
Husband stays late till 9 consistently
2nd Degree AV Block Type I Mobitz, Wenckebach - ansIRREGULAR
Rate: 60-100
P wave: Present, upright
PR Interval: Progressively longer until drop (PR interval longer and longer until drop)
QRS: <0.12 sec
Husband stays late till 9, then 11, then 1, then doesn't come home at all
2nd Degree AV Block Type II - ansIrregular or regular
Rate: <60
P wave: Present, upright
PR Interval: PR interval consistently LONGER like type 1 but then a QRS will drop
QRS: <0.12 sec
Husband stays late till 9 consistently, then wife goes out and doesn't come home
3rd Degree AV Block - ansAtrials and ventricles don't communicate
Rate: regular atrial
P wave: Present, upright
No relationship between P waves and QRS
PR Interval: VARIABLE
QRS: variable
P-P ad R-R consistent but NO correlation
,NEW 2023 RELIAS BASIC DYSRHYTHMIA WITH
CORRECT QUESTIONS AND ANSWERS FROM
EXPERTS n the T wave ate originatin -flutter
with 2 1. normal sinus rhythm: heart rhythm
originating in the sinoatrial node with a rate in
patients at rest of 60 to 100 beats per
Husband and wife live separate lives and don't communicate
A fib RVR - ansIRREGULAR
Ventricular rate: 100-175
P wave: unable to see
PR Interval: N/A
QRS <0.12 sec
Accelerated Idoventricular Rhythm - ansRegular
Rate: 50-100
P wave: NONE
PR Interval: N/A
QRS: WIDE, >0.12 sec
Accelerated Junctional Rhythm - ansRegular
Rate: 60-100
P Wave: NONE or INVERTED
PR Interval: None or <0.12
QRS: <0.12 sec
Atrial Fibrillation - ansIRREGULAR
Atrial rate: UNMEASURABLE
Ventricular rate: variable
P wave: unable to see
PR Interval: N/A
QRS: <0.12 sec
Atrial Flutter - ansUsually REGULAR can be irregular
Atrial rate: 250-350
Ventricular rate: variable BUT < atrial rate
P Wave: Flutter
PR Interval: N/A
QRS: <0.12 sec
Atrially Paced - ansSpike comes before P
AV Node - ans2nd
,NEW 2023 RELIAS BASIC DYSRHYTHMIA WITH
CORRECT QUESTIONS AND ANSWERS FROM
EXPERTS n the T wave ate originatin -flutter
with 2 1. normal sinus rhythm: heart rhythm
originating in the sinoatrial node with a rate in
patients at rest of 60 to 100 beats per
40-60
AV Node Firing, SA Node Failed Rhythms - ans*Fires normally @ 40-60*
-Junctional rhythm 40-60
-Accelerated junctional rhythm 60-100
-Junctional tachycardia 100-150
AV Paced - ansSpike before P and before QR
Bigeminy - ansPVC occurs every OTHER beat
Bundle of His - ans3rd
40-45
Calculate Irregular Rate - ans# of Rs in 6 sec strip X 10
Calculate Regular Rate - ans1500/ # boxes R-R
Coarse V Fib - ansChopy but not as high as polymorphic V tach
Couplet - ans2 PVCs together
Failure to Capture - ansSpikes with no QRS
Failure to Sense - ansSpikes happen regardless of QRS on their own
Fine V Fib - ansFine and fibrillatory
How to determine the rhythm - ansRegular or irregular?
Rate?
P before every QRS? QRS for every P?
QRS wide or narrow?
Idioventricular - ansRegular
Rate: 20-50
P wave: NONE
PR Interval: N/A
, NEW 2023 RELIAS BASIC DYSRHYTHMIA WITH
CORRECT QUESTIONS AND ANSWERS FROM
EXPERTS n the T wave ate originatin -flutter
with 2 1. normal sinus rhythm: heart rhythm
originating in the sinoatrial node with a rate in
patients at rest of 60 to 100 beats per
QRS: WIDE, >0.12 sec
Idioventricular Rhythms - ansOnly purkinje fibers firing
WIDE QRS always
Junctional Rhythm - ansRegular
Rate: 40-60
P Wave: ABSENT or INVERTED
PR Interval: None or <0.12
QRS: <0.12 sec
Junctional Rhythms - ansSA Node DID NOT FIRE
AV Node fired
NO P WAVE bc SA node didn't fire
Narrow QRS
Junctional Tachycardia - ansRegular
Rate: >100
P Wave: NONE or INVERTED
PR Interval: None or <0.12
QRS: <0.12 sec
Monomorphic V Tach - ansSame Shapes V Tach
Multifocal - ansMultiple shapes
Normal sinus rhythm - ansRegular
Rate: 60-100
P Wave: Present, upright
PR Interval: 0.12-0.20 sec
QRS: <0.12 sec
Only Purkinje Fibers Firing Rhythms (Everything else has failed) - ans*Fires normally @
20-50*
-Idioventricular 20-50
-Accelerated idioventricular 50-100
