SCST-D1 SCST Diploma in ECG Interpretation Exam Test
Questions And Correct Answers (Verified Answers) Plus
Rationales 2025/2026 Q&A | Instant Download Pdf
1. A 65-year-old with chest pain: ECG shows ST elevation in II, III, aVF with
reciprocal depression in I and aVL. What is the culprit artery most likely?
A) LAD
B) Circumflex
C) Right coronary artery (RCA)
D) Left main
Inferior STEMI pattern with reciprocal high-lateral depression most often
reflects proximal/mid RCA occlusion.
2. Wide, slurred S in I and V6 with broad terminal R in V1 (rsR’), QRS 140 ms.
What block?
A) First-degree AV block
B) Right bundle branch block
C) Left bundle branch block
D) Left anterior fascicular block
rsR′ in V1 with wide QRS and broad S in I/V6 is classic RBBB.
3. Regular narrow-complex tachycardia at 180 bpm with no visible P waves;
retrograde P after QRS in V1. Diagnosis?
A) Atrial flutter
B) AVNRT
, C) Atrial fibrillation
D) AVRT (orthodromic)
Typical slow–fast AVNRT: narrow, regular, and “pseudo R′” in V1 from
retrograde atrial activation.
4. Sinus bradycardia at 40 bpm with PR 280 ms, constant; every P followed by
QRS. Interpretation?
A) Mobitz I
B) Mobitz II
C) First-degree AV block
D) Third-degree AV block
Prolonged but fixed PR with 1:1 conduction defines first-degree AV block.
5. ST elevation in V1–V4 with hyperacute T waves and loss of R-wave height.
Territory?
A) Inferior
B) Anterior
C) Lateral
D) Posterior
Anterior wall supplied by LAD corresponds to precordial leads V1–V4.
6. Irregularly irregular rhythm, no P waves, narrow QRS. Rate 120. Most
likely?
A) Multifocal atrial tachycardia
B) Atrial fibrillation with RVR
C) Atrial flutter with fixed block
D) Sinus tachycardia
, AF shows absence of organized P waves and irregularly irregular RR
intervals.
7. Deep symmetric T-wave inversion in V2–V4 after chest pain resolution.
Suggests?
A) Pericarditis
B) Acute anterior STEMI
C) Wellens syndrome (LAD stenosis)
D) Benign early repolarization
Wellens pattern: precordial T-wave inversion post-pain indicates critical
proximal LAD.
8. PR 120 ms, delta wave, QRS 120 ms. Diagnosis?
A) LBBB
B) Wolff–Parkinson–White (WPW)
C) RBBB
D) Hyperkalemia
Short PR and slurred upstroke (delta) indicate pre-excitation.
9. Tall peaked T waves, QRS widening, sine-wave trend. Electrolyte
abnormality?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypocalcemia
Hyperkalemia produces peaked T, widened QRS, and can progress to sine-
wave.
Questions And Correct Answers (Verified Answers) Plus
Rationales 2025/2026 Q&A | Instant Download Pdf
1. A 65-year-old with chest pain: ECG shows ST elevation in II, III, aVF with
reciprocal depression in I and aVL. What is the culprit artery most likely?
A) LAD
B) Circumflex
C) Right coronary artery (RCA)
D) Left main
Inferior STEMI pattern with reciprocal high-lateral depression most often
reflects proximal/mid RCA occlusion.
2. Wide, slurred S in I and V6 with broad terminal R in V1 (rsR’), QRS 140 ms.
What block?
A) First-degree AV block
B) Right bundle branch block
C) Left bundle branch block
D) Left anterior fascicular block
rsR′ in V1 with wide QRS and broad S in I/V6 is classic RBBB.
3. Regular narrow-complex tachycardia at 180 bpm with no visible P waves;
retrograde P after QRS in V1. Diagnosis?
A) Atrial flutter
B) AVNRT
, C) Atrial fibrillation
D) AVRT (orthodromic)
Typical slow–fast AVNRT: narrow, regular, and “pseudo R′” in V1 from
retrograde atrial activation.
4. Sinus bradycardia at 40 bpm with PR 280 ms, constant; every P followed by
QRS. Interpretation?
A) Mobitz I
B) Mobitz II
C) First-degree AV block
D) Third-degree AV block
Prolonged but fixed PR with 1:1 conduction defines first-degree AV block.
5. ST elevation in V1–V4 with hyperacute T waves and loss of R-wave height.
Territory?
A) Inferior
B) Anterior
C) Lateral
D) Posterior
Anterior wall supplied by LAD corresponds to precordial leads V1–V4.
6. Irregularly irregular rhythm, no P waves, narrow QRS. Rate 120. Most
likely?
A) Multifocal atrial tachycardia
B) Atrial fibrillation with RVR
C) Atrial flutter with fixed block
D) Sinus tachycardia
, AF shows absence of organized P waves and irregularly irregular RR
intervals.
7. Deep symmetric T-wave inversion in V2–V4 after chest pain resolution.
Suggests?
A) Pericarditis
B) Acute anterior STEMI
C) Wellens syndrome (LAD stenosis)
D) Benign early repolarization
Wellens pattern: precordial T-wave inversion post-pain indicates critical
proximal LAD.
8. PR 120 ms, delta wave, QRS 120 ms. Diagnosis?
A) LBBB
B) Wolff–Parkinson–White (WPW)
C) RBBB
D) Hyperkalemia
Short PR and slurred upstroke (delta) indicate pre-excitation.
9. Tall peaked T waves, QRS widening, sine-wave trend. Electrolyte
abnormality?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypocalcemia
Hyperkalemia produces peaked T, widened QRS, and can progress to sine-
wave.
