PROPHECY EKG TEST PAPER 2025/2026 ANSWERS AND
QUESTIONS GRADED A+
✔✔junctional tachycardiac - ✔✔100-180bpm, distorted P-waves
regular rate w/ inverted or hidden P-wave before/in/after QRS
caused by: digoxin toxicity, HF (put on pads!!) or LVAD
✔✔ST depression - ✔✔s-wave does NOT level back to isoelectric line
caused by: ischemia, digitalis, rapid HR, low temp/BG, high K+
✔✔right sided 15 lead EKG - ✔✔obtain if ST elevation is on II, III and aVF
✔✔1st heart block - ✔✔long and consistent PR interval >0.20 or 1 large box
caused by: MI, inferior MI, myocarditis, enhanced vagal tone (in athletes), abx?
✔✔2nd heart block, type 1 - ✔✔PR intervals progressively extend until QRS drops and
leaves P-wave hanging
caused by: open heart surgery, beta blockers or lupus
✔✔2nd heart block, type 2 - ✔✔randomly missing QRS w/ consistent PR intervals, P-
waves are independent and remain
if QOB drops --> transcutaneously pace w/ defib pads! b/c 2nd HB2 can lead to 3rd
heart block and change into vfib
caused by beta blockers, calcium channel blockers or amiodarone
✔✔3rd heart block - ✔✔"marching Ps" regardless of QRS
place on bedside pacemaker and defib pads! or transfer to heart transplant
caused by: congential defect, inferior MI, Lymes (tx w/ abx)
do NOT give atropine b/c it increased ventricular rate, risks R-on-T which can lead to
vtach
✔✔idioventricular rhythm - ✔✔20-40bpm, regular with no P-wave and wide QRS
✔✔accelerated idioventricular rhythem - ✔✔50-100bpm, no P-waves and wide QRS
regular conduction only by ventricles
QUESTIONS GRADED A+
✔✔junctional tachycardiac - ✔✔100-180bpm, distorted P-waves
regular rate w/ inverted or hidden P-wave before/in/after QRS
caused by: digoxin toxicity, HF (put on pads!!) or LVAD
✔✔ST depression - ✔✔s-wave does NOT level back to isoelectric line
caused by: ischemia, digitalis, rapid HR, low temp/BG, high K+
✔✔right sided 15 lead EKG - ✔✔obtain if ST elevation is on II, III and aVF
✔✔1st heart block - ✔✔long and consistent PR interval >0.20 or 1 large box
caused by: MI, inferior MI, myocarditis, enhanced vagal tone (in athletes), abx?
✔✔2nd heart block, type 1 - ✔✔PR intervals progressively extend until QRS drops and
leaves P-wave hanging
caused by: open heart surgery, beta blockers or lupus
✔✔2nd heart block, type 2 - ✔✔randomly missing QRS w/ consistent PR intervals, P-
waves are independent and remain
if QOB drops --> transcutaneously pace w/ defib pads! b/c 2nd HB2 can lead to 3rd
heart block and change into vfib
caused by beta blockers, calcium channel blockers or amiodarone
✔✔3rd heart block - ✔✔"marching Ps" regardless of QRS
place on bedside pacemaker and defib pads! or transfer to heart transplant
caused by: congential defect, inferior MI, Lymes (tx w/ abx)
do NOT give atropine b/c it increased ventricular rate, risks R-on-T which can lead to
vtach
✔✔idioventricular rhythm - ✔✔20-40bpm, regular with no P-wave and wide QRS
✔✔accelerated idioventricular rhythem - ✔✔50-100bpm, no P-waves and wide QRS
regular conduction only by ventricles
