CPO ECG STANDARDIZED EXAM 2025/2026 QUESTIONS
WITH SOLUTIONS GRADED A+
✔✔What is the last pacemaker of the heart? What is the rate? - ✔✔The Purkinje fibers
They are small fibers that branch off the right and left bundle branches and extend into
the myocardium. They are the last back up pacemaker and have a rate of 20-40 bpm
✔✔Where are the ECG leads placed? - ✔✔White on right
Smoke over fire
Green is Right Leg
Brown is R chest, 4th intercostal space
✔✔What leads have positive deflections? - ✔✔Lead 1, 2 and 3
Lead 2 will usually be your most upright view
✔✔What lead will give you negative deflections? - ✔✔Lead v1
✔✔If your U wave is too prominent, what should you expect? - ✔✔It is usually <1/3 of T
wave
If too prominent, suspect hypokalemia, hypercalcemia, or hyperthyroidism
✔✔What does ST elevation indicate? - ✔✔myocardial injury / infarction
✔✔What does ST depression indicate? - ✔✔myocardial ischemia
✔✔How do you define myocardial injury using an ECG? - ✔✔You need to have ST
changes in at least two leads - so you need a 12 lead ECG
✔✔What does ST elevation after 6 weeks post MI indicate? - ✔✔Ventricular aneurysm
✔✔When you should be concerned with the length of your QT interval? - ✔✔> 0.44 sec
and patient is bradycardic
✔✔What is Bazett's formula? - ✔✔QTc = QT / Square root of RR
✔✔What are the risk factors for long QT? - ✔✔Bradycardia
Female > male
Time frame between menarche and menopause
Congenital alterations to cardiac ion channels
Hypocalcemia
Hypokalemia
Hypoagnesemia
Stimulants
Hypothermia
, Insecticide Exposure
Multiple meds
✔✔What drugs are associated with a Long QT? - ✔✔amiodarone, procainamide,
biaxin/clarithromycin, haldol, domperidone/motilium, zofran, most tricyclic
antidepressants
✔✔What drugs are associated with Torsades? - ✔✔choral hydrate, lithium, serevent,
ventolin, zithromax
✔✔What drugs are to be avoided in people with suspected or known congenital LQTS?
- ✔✔dopamine, ephedrine, epinephrine, levophed, appetite suppressants, ritalin
✔✔What are other drugs known to be associated with long QT? - ✔✔ampicillin, bactrim,
ciprofloxacin, sulfa, tamoxifin, doxapin
✔✔How do you treat Long QT? - ✔✔In an emergency: IV Mg, Defib, Pacing, Meds that
increase HR
Long term: monitor the interval, discontinue drugs that increase QT interval if it
increases over 0.5 sec
✔✔What are the number intervals used in the 300 method? - ✔✔300, 150, 100, 75, 60,
50, 43, 37
✔✔What is the normal PR interval? - ✔✔0.12-0.20
✔✔What is the normal QRS interval? - ✔✔0.06 - 0.12 seconds
✔✔What are the causes of sinus bradycardia? - ✔✔1. May be normal (Well trained
athlete)
2. Meds (Beta blockers)
3. Vagal stimulation (inhibits Sympathetic NS)
4. Increased ICP
5. Hypoxia
6. Hypothyroidism
7. Hypothermia
8. MI or CAD
✔✔What is the treatment for sinus bradycardia? - ✔✔If asymptomatic, may need no
treatment
If symptomatic:
- Pacemaker (TCP or TV)
- Medications (atropine (0.5mg), dopamine, epinephrine)
WITH SOLUTIONS GRADED A+
✔✔What is the last pacemaker of the heart? What is the rate? - ✔✔The Purkinje fibers
They are small fibers that branch off the right and left bundle branches and extend into
the myocardium. They are the last back up pacemaker and have a rate of 20-40 bpm
✔✔Where are the ECG leads placed? - ✔✔White on right
Smoke over fire
Green is Right Leg
Brown is R chest, 4th intercostal space
✔✔What leads have positive deflections? - ✔✔Lead 1, 2 and 3
Lead 2 will usually be your most upright view
✔✔What lead will give you negative deflections? - ✔✔Lead v1
✔✔If your U wave is too prominent, what should you expect? - ✔✔It is usually <1/3 of T
wave
If too prominent, suspect hypokalemia, hypercalcemia, or hyperthyroidism
✔✔What does ST elevation indicate? - ✔✔myocardial injury / infarction
✔✔What does ST depression indicate? - ✔✔myocardial ischemia
✔✔How do you define myocardial injury using an ECG? - ✔✔You need to have ST
changes in at least two leads - so you need a 12 lead ECG
✔✔What does ST elevation after 6 weeks post MI indicate? - ✔✔Ventricular aneurysm
✔✔When you should be concerned with the length of your QT interval? - ✔✔> 0.44 sec
and patient is bradycardic
✔✔What is Bazett's formula? - ✔✔QTc = QT / Square root of RR
✔✔What are the risk factors for long QT? - ✔✔Bradycardia
Female > male
Time frame between menarche and menopause
Congenital alterations to cardiac ion channels
Hypocalcemia
Hypokalemia
Hypoagnesemia
Stimulants
Hypothermia
, Insecticide Exposure
Multiple meds
✔✔What drugs are associated with a Long QT? - ✔✔amiodarone, procainamide,
biaxin/clarithromycin, haldol, domperidone/motilium, zofran, most tricyclic
antidepressants
✔✔What drugs are associated with Torsades? - ✔✔choral hydrate, lithium, serevent,
ventolin, zithromax
✔✔What drugs are to be avoided in people with suspected or known congenital LQTS?
- ✔✔dopamine, ephedrine, epinephrine, levophed, appetite suppressants, ritalin
✔✔What are other drugs known to be associated with long QT? - ✔✔ampicillin, bactrim,
ciprofloxacin, sulfa, tamoxifin, doxapin
✔✔How do you treat Long QT? - ✔✔In an emergency: IV Mg, Defib, Pacing, Meds that
increase HR
Long term: monitor the interval, discontinue drugs that increase QT interval if it
increases over 0.5 sec
✔✔What are the number intervals used in the 300 method? - ✔✔300, 150, 100, 75, 60,
50, 43, 37
✔✔What is the normal PR interval? - ✔✔0.12-0.20
✔✔What is the normal QRS interval? - ✔✔0.06 - 0.12 seconds
✔✔What are the causes of sinus bradycardia? - ✔✔1. May be normal (Well trained
athlete)
2. Meds (Beta blockers)
3. Vagal stimulation (inhibits Sympathetic NS)
4. Increased ICP
5. Hypoxia
6. Hypothyroidism
7. Hypothermia
8. MI or CAD
✔✔What is the treatment for sinus bradycardia? - ✔✔If asymptomatic, may need no
treatment
If symptomatic:
- Pacemaker (TCP or TV)
- Medications (atropine (0.5mg), dopamine, epinephrine)
