ECG Course Final Quiz

Which of the following is a shockable cardiac arrest rhythm?

Ventricular Fibrillation (VF)

Correct Incorrect Correct answer

Pulseless Electrical Activity (PEA)

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Asystole

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Sinus Bradycardia

Correct Incorrect Correct answer

What defines Ventricular Fibrillation (VF) on an ECG?

Chaotic, disorganised electrical activity with no identifiable complexes

Correct Incorrect Correct answer

Narrow, regular complexes with visible P waves

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A flat line with no activity

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Regular wide complexes at a fast rate

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Which form of VF has waveforms greater than 3 mm in amplitude?

Coarse VF

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Fine VF

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Pulseless VT

Correct Incorrect Correct answer

Asystole

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Fine VF can be easily mistaken for which of the following?

Asystole

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SVT

Correct Incorrect Correct answer

PEA

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Sinus tachycardia

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Which of the following is required before delivering a shock in suspected VT?

Checking for a pulse to confirm pulselessness

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Performing a 12-lead ECG

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Administering adrenaline

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Starting CPR for 10 minutes first

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What is the ECG hallmark of Ventricular Tachycardia (VT)?

Wide, regular QRS complexes with no visible P waves

Correct Incorrect Correct answer

Narrow, irregular complexes

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Irregular baseline with no complexes

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Flatline tracing

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Which mnemonic helps remember the appearance of VF?

“Very Fuzzy”

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“Very Flat”

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“Very Fine”

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“Very Fast”

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Which escape rhythm is likely to produce wide QRS complexes and a rate of 20–40 bpm?

Idioventricular rhythm

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Atrial escape rhythm

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Junctional escape rhythm

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Sinus bradycardia

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What is the classic ECG triad seen in Wolff-Parkinson-White (WPW) syndrome?

Delta wave, short PR, wide QRS

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ST depression, U waves, short PR

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Delta wave, long PR, narrow QRS

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Peaked T waves, delta wave, prolonged QT

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What ECG feature is often present in hypertrophic cardiomyopathy?

Deep S waves in V1–V3 and tall R waves in V4–V6

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Narrow QRS in V1–V3

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Flattened P waves in limb leads

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ST elevation in inferior leads

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Which electrolyte abnormality is associated with a visible U wave and prolonged QT interval?

Hypokalaemia

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Hyperkalaemia

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Hypercalcaemia

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Hyponatraemia

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Which electrolyte imbalance is most commonly associated with peaked T waves and bradyarrhythmias?

Hyperkalaemia

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Hypocalcaemia

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Hypomagnesaemia

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Hypernatraemia

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What is a classic ECG finding of hypocalcaemia?

Prolonged QT interval

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Delta wave

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Peaked P waves

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Shortened QT interval

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What feature indicates a ventricular-paced rhythm on ECG?

Pacing spike before a wide QRS with no preceding P wave

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Pacing spike before the P wave

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Narrow QRS and no pacing spike

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P wave followed by a normal QRS

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What heart rate defines sinus tachycardia in adults?

Above 100 bpm

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Below 60 bpm

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Between 60–80 bpm

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Above 80 bpm

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What is a key ECG finding in LBBB?

Broad monophasic R wave in lateral leads

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Narrow QRS in V1

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ST depression in all leads

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Q waves in lead I

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What typically causes left axis deviation with RBBB?

Left anterior fascicular block

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Right ventricular hypertrophy

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AVRT

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Hypercalcaemia

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Which rhythm may be confused with AF but shows sawtooth waves?

Atrial flutter

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Sinus arrhythmia

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Mobitz I

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AVRT

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What is the expected QRS complex duration in a normal ECG?

< 120 ms

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> 140 ms

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Exactly 160 ms

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Between 140–180 ms

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Which is a sign of haemodynamic instability?

Systolic BP < 90 mmHg

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RR > 20

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SpO2 > 95%

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2 second capillary refill

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What defines a trigeminy PVC pattern?

Every third beat is a PVC

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Every beat is a PVC

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Two consecutive PVCs

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Four PVCs in a row

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Which of the following can be a cause of sinus tachycardia?

Hypovolaemia

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Hypothermia

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Bradycardia

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Hypertension

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What is an expected finding after a PVC?

Compensatory pause

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Shortened PR interval

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Narrow QRS

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Inverted P wave

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Which rhythm is considered a type of SVT?

AVNRT

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Ventricular fibrillation

Correct Incorrect Correct answer

Sinus bradycardia

Correct Incorrect Correct answer

Mobitz Type II block

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What is a hallmark ECG feature of atrial flutter?

Sawtooth baseline

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Wide QRS

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Inverted T waves

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Absent P waves

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What is the PR interval status in PACs from near the AV node?

Shortened

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Prolonged

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Normal

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Absent

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What is the QRS complex appearance in PVCs?

Broad and abnormal

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Narrow and normal

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Short and peaked

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Inverted and sharp

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Which rhythm lacks distinct P waves and is irregularly irregular?

Atrial fibrillation

Correct Incorrect Correct answer

Atrial flutter

Correct Incorrect Correct answer

Sinus tachycardia

Correct Incorrect Correct answer

AVNRT

Correct Incorrect Correct answer

Which drug is typically first-line for bradycardia in the pre-hospital setting when indicated?

Atropine

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Adrenaline

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Lidocaine

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Amiodarone

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Which ECG pattern is seen in RBBB in lead V1?

RSR’ pattern

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Sawtooth waves

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Flat baseline

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ST elevation

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Which leads provide a horizontal (transverse) view of the heart?

Precordial leads (V1–V6)

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Limb leads I, II, III

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Augmented leads aVR, aVL, aVF

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Posterior leads V7–V9

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What is a useful rule of thumb for evaluating the QT interval?

QT should be less than half the RR interval

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QT equals the RR interval

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QT should be longer than the PR interval

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QT is irrelevant in normal rhythms

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What is the correct position for lead V4R in a right-sided ECG?

5th intercostal space, mid-clavicular line on the right side

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4th intercostal space, mid-clavicular line on the right

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5th intercostal space, left anterior axillary line

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4th intercostal space, left sternal border

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Which ECG leads are typically repositioned to obtain posterior leads V7–V9?

V4–V6

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V1–V3

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Lead I, II, III

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aVR, aVL, aVF

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Where is lead V9 placed when recording posterior ECG leads?

Paraspinal region

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At the tip of the left scapula

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Left mid-axillary line

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Right posterior axillary line

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Which condition is most closely associated with the appearance of an epsilon wave?

Arrhythmogenic right ventricular dysplasia (ARVD)

Correct Incorrect Correct answer

Myocardial infarction

Correct Incorrect Correct answer

Pericarditis

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Atrial fibrillation

Correct Incorrect Correct answer

Which ECG feature reflects the beginning of the ST segment?

J point

Correct Incorrect Correct answer

P wave

Correct Incorrect Correct answer

T wave

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QRS apex

Correct Incorrect Correct answer

What is the purpose of grouping ECG leads into contiguous lead sets?

To localise cardiac pathology like infarction

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To measure heart rate variability

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To identify pacemaker malfunction

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To reduce artefact on the ECG

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Which artery is most commonly associated with changes in the anterior leads?

Left anterior descending artery (LAD)

Correct Incorrect Correct answer

Right coronary artery (RCA)

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Left circumflex artery (LCx)

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Posterior descending artery (PDA)

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Why might right precordial leads V3R and V4R be used?

To detect right ventricular infarction

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To monitor atrial fibrillation

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To assess left atrial size

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To detect pericarditis

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Which method is best for calculating heart rate in irregular rhythms?

10-second strip method

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Large square method

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Small square method

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QRS count method

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What can the RR interval be used for?

Calculating heart rate

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Measuring ST elevation

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Identifying P waves

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Assessing axis deviation

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Which electrode acts as the neutral ground in a 3-lead ECG setup?

Right leg

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Left arm

Correct Incorrect Correct answer

Right arm

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Left leg

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Which electrode should be placed in the 4th intercostal space, right of the sternum?

V1

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V2

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V4

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V6

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How long does one small square represent on the horizontal axis?

0.04 seconds

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0.2 seconds

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1 second

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0.1 seconds

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What is the normal range for the PR interval?

0.12–0.2 seconds

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0.04–0.1 seconds

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0.2–0.3 seconds

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0.06–0.12 seconds

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Who recorded the first human ECG?

Augustus Waller

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Willem Einthoven

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Andreas Grüntzig

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James Herrick

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What is the role of Purkinje fibres?

Distribute electrical impulse through ventricles

Correct Incorrect Correct answer

Delay signal at the AV node

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Initiate heartbeat

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Receive impulses from the atria

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