Cardiac exam hints October 2020

Undergraduate 

Multichoice questions

Practice exam multichoice questions:
 
 The width of the QRS complex in ventricular tachycardia (VT) would be:
  1. within normal range
  2. shorter than 0.12 second
  3. equal to or greater than 0.12 second
  4. narrow QRS complex                                                                           
 
A patient suffering from stable angina would most commonly show the following changes in their 12 lead ECG.
  1. flat T wave
  2. ST elevation
  3. T wave inversion
  4. ST depression
 
  A patient with Long QT Interval Syndrome may have a past history of:
  1. syncope, or light-headedness
  2. chest pain
  3. high blood pressure
  4. irregular heart beat
  
A patient has a greater chance of cardiac arrest in Long QT Interval Syndrome due to the development of:
  1. heart block arrhythmias
  2. episodes of asystole
  3. chest pain and myocardial infarction
  4. episodes of polymorphic ventricular tachycardia.
 
 In an acute inferior STEMI the ST elevation and Q waves will be present in the following leads:
  1. 11, 111, and aVF 
  2. V1 to V4
  3. V1 and V2
  4. 1 and aVL                                                                               
 
 The significance of a young person developing the Wolf Parkinson White  Syndrome  (WPW) is:
  1. is a benign condition so no problems
  2. frequent runs of bradycardia
  3. predisposes to myocardial infarction
  4. frequent episodes of atrial tachycardia (SVT)
 
 
Identify the most common arrhythmia that causes patients to be admitted into hospital.
  1. ventricular fibrillation
  2. atrial fibrillation
  3. supraventricular tachycardia
  4. heart block
 
 The S3 heart sound is an early clinical sign of which of the following conditions?
  1. STEMI
  2. NSTEMI
  3. large pulmonary embolus
  4. decompensated heart failure
 
 Beck’s Triad is associated with which condition?
       1. endocarditis
       2. pulmonary embolus
       3. aortic aneurysm
       4. cardiac tamponade

Rhythm strips:
Are you able to recognise: VT, VF, AF, SVT,  ventricular paced rhythm, bigeminy, trigeminy, asystole, tachy-brady syndrome, PEA, Anterior or Inferior MI on an ECG?

Check that you understand the following concepts:
Wolf Parkinson White syndrome
Afterload and preload
When do you administer oxygen to a patient with a myocardial infarction? 
How is VT treated, how is PEA treated?
​Why is a stress test performed?

Do you understand the following?
ST elevation,
ST depression,
T wave inversion
P Mitale 
P. Pulmonale
​
Would you be able to draw an example of ST elevation, ST depression, T wave inversion
Are you familiar with the PQRST complex and be able to label and indicate its values, eg you should know the PT interval, QRS width.
You need to be able to recognise the J point and the QT interval, you don't need to know the QT values, but you should be able to label the QT interval. 

Are you able to relate to the significance of extra heart sounds?
Endocarditis, HCM, Heart Failure, Wolf Parkinson White Syndrome?

Short answer section for UNDERGRADUATES
Answer questions from the four topics. 

1. Heart Failure:
2. Takotsubo syndrome.  
3. Endocarditis.
4. Atrial Fibrillation

You are encouraged to study those four topics thoroughly.
The content of the course was very indepth with a variety of disorders, so ensure you understand these four topics and Atrial Fibrillation will assist you with the exam. The multichoice questions are a brief overview of some of the other lectures.

 Part 2, Clinical Case Scenario 
Answer questions relating to a clinical scenario. 
1. LQT interval case study

​Hints: 
Are you familiar with the two types of LQT : inherited and acquired, what does that mean
What is the arrhythmia that might cause signs and symptoms of LQT
How does it look on the 12 lead ECG



Details of cardiac exam 
Date: To be discussed
Time:  10.30 am

​(You may have arranged other dates/time with Anne as unable to attend above - ensure you attend for these concessional dates or cancel if unable to attend)

Venue: 10 Enterprise Street, Unit 12, Molendinar.

Hint:
Spend time working through your Exercise Practice Handout, analyzing and answering the questions. Ensure you understand the cardiac PQRST and its values thoroughly.
Ensure your knowledge of AF is adequate.
Read the chapter in your text book on Atrial Fibrillation / LQT interval syndrome and other references and information on LQT / AF.