MEDICAL DIAGNOSIS TEST PAPER 2025/2026 QUESTIONS
AND ANSWERS GRADED A++
✔✔Normal range for sinus rhythm - ✔✔60-100 bpm
✔✔If the rhythm is regular, - ✔✔Look at the rate
(>100 Fast, 60-90 Normal, or <60 Slow)
✔✔if rhythm is irregular - ✔✔note the pattern of irregularity
(sporadic, regularly irregular, or irregularly irregular)
✔✔Fast >100 rates - ✔✔Sinus Tachycardia
Supraventricular (atrial or nodal) Tachycardia
Atrial Flutter with a regular ventricular response
Ventricular Tachycardia
✔✔Normal 60-90 rates - ✔✔Normal sinus rhythm
Second degree AV block
Atrial Flutter with a regular ventricular response
✔✔Slow <60 rates - ✔✔Sinus Bradycardia
Second-Degree AV block
Complete Heart Block
✔✔100-180 bpm - ✔✔sinus tachycardia
✔✔150-250 bpm - ✔✔supraventricular (atrial or nodal) tachycardia
✔✔100-175 bpm - ✔✔Atrial Flutter with a regular ventricular response (fast)
✔✔60-90 bpm - ✔✔normal sinus rhythm (heart rate)
✔✔60-100 bpm - ✔✔Second- degree AV Block (normal)
✔✔75-100 bpm - ✔✔Atrial Flutter with a regular ventricular response (normal)
✔✔<60 bpm - ✔✔sinus bradycardia
✔✔30-60 bpm - ✔✔second-degree AV block (slow)
✔✔<40 bpm - ✔✔Complete heart block
✔✔Premature or extra beats at random intervals, but normal underlying rhythm (e.g.,
atrial or ventricular premature contractions, sinus arrhythmia) - ✔✔Sporadic
, ✔✔Regular pattern of cadences (ventricular trigeminy) - ✔✔Regularly Irregular
✔✔No discernable regularity (atrial fibrillation, atrial flutter) - ✔✔Irregularly Irregular
✔✔Rhythm varies cyclically, speeding up with inspiration and slowing down with
expiration.
Heart sounds are normal, though S1 may vary with the heart rate. - ✔✔Sporadic Sinus
Arrhythmia
✔✔Atrial or nodal beat comes earlier than expected followed by a pause, and then
rhythm resumes.
Heart sounds: S1 may differ in intensity from the S1 of normal beats and S2 may be
decreased - ✔✔Atrial or nodal Premature contractions
(supraventricular)
✔✔Beat of ventricular origin comes early the expected, followed by a pause and the
rhythm resumes.
Heart sounds: S1 may differ in intensity from normal S1, and S2 may be decreased.
Both are likely to be split. - ✔✔Sporadic Ventricular Premature Contractions (ventricular
bigeminy or trigeminy
✔✔Ventricular rhythm is totally irregular, with short runs of the irregular ventricular
rhythm seeming regular.
Heart sounds: S1 varies in intensity - ✔✔Irregularly Irregular Atrial Fibrillation and Atrial
Flutter with Varying AV Block
✔✔Normal pulse pressure - ✔✔30-40 mmHg, pulse contour is smooth and rounded
(notch on descending slope not palapable)
✔✔Small, weak pulse - ✔✔- diminished pulse pressure
- weak and small on palpation
- slow upstroke
- prolonged systolic peak
✔✔Small, weak pulse causes - ✔✔- decreased Stroke volume
- Heart failure
- Hypovolemia
- Severe aortic stenosis
- increased peripheral resistance
- Hypothermia
- Severe heart failure
✔✔Large, bounding pulse - ✔✔- Increased pulse pressure
AND ANSWERS GRADED A++
✔✔Normal range for sinus rhythm - ✔✔60-100 bpm
✔✔If the rhythm is regular, - ✔✔Look at the rate
(>100 Fast, 60-90 Normal, or <60 Slow)
✔✔if rhythm is irregular - ✔✔note the pattern of irregularity
(sporadic, regularly irregular, or irregularly irregular)
✔✔Fast >100 rates - ✔✔Sinus Tachycardia
Supraventricular (atrial or nodal) Tachycardia
Atrial Flutter with a regular ventricular response
Ventricular Tachycardia
✔✔Normal 60-90 rates - ✔✔Normal sinus rhythm
Second degree AV block
Atrial Flutter with a regular ventricular response
✔✔Slow <60 rates - ✔✔Sinus Bradycardia
Second-Degree AV block
Complete Heart Block
✔✔100-180 bpm - ✔✔sinus tachycardia
✔✔150-250 bpm - ✔✔supraventricular (atrial or nodal) tachycardia
✔✔100-175 bpm - ✔✔Atrial Flutter with a regular ventricular response (fast)
✔✔60-90 bpm - ✔✔normal sinus rhythm (heart rate)
✔✔60-100 bpm - ✔✔Second- degree AV Block (normal)
✔✔75-100 bpm - ✔✔Atrial Flutter with a regular ventricular response (normal)
✔✔<60 bpm - ✔✔sinus bradycardia
✔✔30-60 bpm - ✔✔second-degree AV block (slow)
✔✔<40 bpm - ✔✔Complete heart block
✔✔Premature or extra beats at random intervals, but normal underlying rhythm (e.g.,
atrial or ventricular premature contractions, sinus arrhythmia) - ✔✔Sporadic
, ✔✔Regular pattern of cadences (ventricular trigeminy) - ✔✔Regularly Irregular
✔✔No discernable regularity (atrial fibrillation, atrial flutter) - ✔✔Irregularly Irregular
✔✔Rhythm varies cyclically, speeding up with inspiration and slowing down with
expiration.
Heart sounds are normal, though S1 may vary with the heart rate. - ✔✔Sporadic Sinus
Arrhythmia
✔✔Atrial or nodal beat comes earlier than expected followed by a pause, and then
rhythm resumes.
Heart sounds: S1 may differ in intensity from the S1 of normal beats and S2 may be
decreased - ✔✔Atrial or nodal Premature contractions
(supraventricular)
✔✔Beat of ventricular origin comes early the expected, followed by a pause and the
rhythm resumes.
Heart sounds: S1 may differ in intensity from normal S1, and S2 may be decreased.
Both are likely to be split. - ✔✔Sporadic Ventricular Premature Contractions (ventricular
bigeminy or trigeminy
✔✔Ventricular rhythm is totally irregular, with short runs of the irregular ventricular
rhythm seeming regular.
Heart sounds: S1 varies in intensity - ✔✔Irregularly Irregular Atrial Fibrillation and Atrial
Flutter with Varying AV Block
✔✔Normal pulse pressure - ✔✔30-40 mmHg, pulse contour is smooth and rounded
(notch on descending slope not palapable)
✔✔Small, weak pulse - ✔✔- diminished pulse pressure
- weak and small on palpation
- slow upstroke
- prolonged systolic peak
✔✔Small, weak pulse causes - ✔✔- decreased Stroke volume
- Heart failure
- Hypovolemia
- Severe aortic stenosis
- increased peripheral resistance
- Hypothermia
- Severe heart failure
✔✔Large, bounding pulse - ✔✔- Increased pulse pressure
