THE WRITTEN EMERGENCY MEDICINE FELLOWSHIP COURSE
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MODULE 6 short answer questions - ECG.
Below are the module 6 ECG SAQs. You have 30 minutes. Good luck!
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Module 6 ECG saQS
SAQ 1.
A 79 year old man presents with "palpitations". He has never had them before, and says they began yesterday. He has developed a productive cough and intermittent fevers over the last three days.
His presentation ECG is shown below. Although not specified please assume standard calibration. (25mm/s & 1mV to 10mm)
Question 1. What is the rate? (1 mark)
Question 1. What is the rate? (1 mark)
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Question 2. Is the rhythm regular or irregular? (1 mark)
Question 2. Is the rhythm regular or irregular? (1 mark)
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Question 3. What is the association of atrial beats to ventricular complexes? (1 mark)
Question 3. What is the association of atrial beats to ventricular complexes? (1 mark)
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Question 4. Comment on the PR and QT interval. (1 mark)
Question 4. Comment on the PR and QT interval. (1 mark)
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Question 5. What is the axis? (1 mark)
Question 5. What is the axis? (1 mark)
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Question 6. Is there an interventricular conduction defect? Why or why not? (2 marks)
Question 6. Is there an interventricular conduction defect? Why or why not? (2 marks)
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Question 7. Comment on the ST segments. (1 mark)
Question 7. Comment on the ST segments. (1 mark)
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Question 8. What is the diagnosis? (2 marks)
Question 8. What is the diagnosis? (2 marks)
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SAQ 2.
A 54 year old man presents with acute central chest pain that occurred while exercising. His pain has now gone away completely. On close questioning he describes a history of exertional dyspnoea and chest discomfort over the prior month.
His ECG on presentation is shown below. Assume standard calibration of the ECG (25mm/s and 10mm to 1mV).
Question 1. Give 5 important normal findings on this ECG. (5 marks)
Question 1. Give 5 important normal findings on this ECG. (5 marks)
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Question 2. What is the major electrocardiographic abnormality? (1 mark)
Question 2. What is the major electrocardiographic abnormality? (1 mark)
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Question 3. What is the diagnosis? (1 mark)
Question 3. What is the diagnosis? (1 mark)
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Question 4. Describe how the results of a troponin will affect your disposition of this patient. (3 marks)
Question 4. Describe how the results of a troponin will affect your disposition of this patient. (3 marks)
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SAQ 3
A 26 year old woman is brought to your emergency department after taking an overdose of an unknown susbtance. She has a prior history of depression and multiple overdoses in the past.
Her ECG on arrival is shown below.
Question 1. What are the major abnormalities? (4 marks)
Question 1. What are the major abnormalities? (4 marks)
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Question 2. Name four drugs from different classes which could cause this ECG and give an example of each. (4 marks)
Question 2. Name four drugs from different classes which could cause this ECG and give an example of each. (4 marks)
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Question 3. What treatment will you administer as a matter of priority? (2 marks)
Question 3. What treatment will you administer as a matter of priority? (2 marks)
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SAQ 4
A 67 year old dialysis patient presents feeling weak and lethargic. He has missed his prior dialysis session because of a migraine.
His ECG on presentation to ED is shown below.
Question 1. What are the major abnormalities? (4 marks)
Question 1. What are the major abnormalities? (4 marks)
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Question 2. What is the likely diagnosis? (1 mark)
Question 2. What is the likely diagnosis? (1 mark)
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Question 3. What treatments will you administer? (5 marks)
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Question 3. What treatments will you administer? (5 marks)
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SAQ 5
A 72 year old woman presents to your department with a history of sudden syncope while at church. The nurse looking after her brings you her ECG, which is shown below.
Question 1.
What are the major abnormalities? (5 marks)
Question 1. What are the major abnormalities? (5 marks)
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Question 2.
What is the diagnosis and its implications? (2 marks)
Question 2. What is the diagnosis and its implications? (2 marks)
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Question 3.
30 minutes after arrival another ECG is taken as the patient is noted to be unconscious. The ECG is shown below. What are the two major abnormalities and what therefore does the ECG show? (3 marks)Question 3. 30 minutes after arrival another ECG is taken as the patient is noted to be unconscious. The ECG is shown below. What are the two major abnormalities and what therefore does the ECG show? (3 marks)
What are the two major abnormalities and what therefore does the ECG show? (3 marks)
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