Deck 14: Myocardial Infarction

Question 1

ST segment elevation is indicative of

A)myocardial necrosis.
B)myocardial ischemia.
C)myocardial injury.
D)abnormal atrial depolarization.

Answer 1

C

Question 2

Which of the following is a reciprocal change seen in the area opposite an infarct?

A)ST elevation
B)ST depression
C)Tall,pointy T waves
D)Widened QRS complexes

Answer 2

B

Question 3

An anterior MI is caused by occlusion of which coronary artery?

A)Left anterior descending
B)Posterior descending
C)Right
D)Circumflex

Answer 3

A

Question 4

If you were told that Figure 19's EKG was of a young black male,you would think of what cause of mild widespread ST elevation?

A)Pericarditis
B)Inferior MI
C)Early repolarization
D)Right ventricular infarction

Question 5

In a lateral wall MI,which coronary artery is occluded?

A)Right
B)Left anterior descending
C)Circumflex
D)Aorta

Question 6

The MI in Figure 20 is

A)extensive anterior (anterior-lateral).
B)posterior.
C)lateral.
D)inferior.

Question 7

The age of the MI in Figure 20 is

A)acute.
B)age indeterminate.
C)old.
D)impossible to tell.

Question 8

A posterior infarction is usually caused by occlusion of which coronary artery?

A)Left main
B)Circumflex
C)Left anterior descending
D)Right coronary artery

Question 9

A STEMI typically

A)damages only the innermost layer of myocardium.
B)does not cause the development of significant Q waves on the EKG.
C)is dangerous because it can herald a subendocardial MI soon to come.
D)is an MI that damages the full thickness of the myocardium in a certain area.

Question 10

An acute inferior wall STEMI has ST elevation in leads

A)I,aVL,V₅-6.
B)V₁-4.
C)II,III,aVF.
D)V₁-2.

Question 11

An inverted T wave is indicative of

A)myocardial necrosis.
B)myocardial ischemia.
C)myocardial injury.
D)abnormal ventricular depolarization.

Question 12

In Figure 21,there is evidence of

A)anterior wall ischemia.
B)anterior MI.
C)NSTEMI.
D)inferior/posterior MI.

Question 13

An inferior MI is most often caused by occlusion of which coronary artery?

A)Right coronary artery
B)Left main
C)Circumflex
D)Left anterior descending

Question 14

Most MIs are caused by a

A)blood clot in the pulmonary artery.
B)coronary artery spasm.
C)blood clot in a coronary artery.
D)arrhythmia.

Question 15

The ________ of an old STEMI typically remains on the EKG forever.

A)ST segment elevation
B)ST segment depression
C)inverted T waves
D)significant Q wave

Question 16

Which of the following is indicative of myocardial necrosis?

A)ST elevation
B)ST depression
C)Significant Q wave
D)Inverted T wave

Question 17

Mr.Johnson came to the hospital within the hour after his heart attack started.You would expect to see what indication of acute STEMI on his EKG?

A)ST segment elevation in the leads over the damaged area
B)ST segment depression in the leads over the damaged area
C)Significant Q waves in the leads over the damaged area
D)Tall,pointy P waves greater than 2.5 mms in Lead II or V₁

Question 18

There is evidence of which of the following in Figure 19?

A)Slight ST segment elevation in multiple leads
B)Significant Q waves in II,III,and aVF
C)Inverted T waves in V₁-6
D)Widespread ST depression and T wave inversions

Question 19

Which of the following is indicative of myocardial injury?

A)ST elevation
B)ST depression
C)Significant Q wave
D)Inverted T wave

Question 20

The ST segment depressions in leads II,III,and aVF in Figure 20 are

A)indicative changes of the MI.
B)reciprocal changes.
C)an indication of imminent extension of the MI.
D)evidence of a new NSTEMI.

Question 21

Occlusion is

A)blockage.
B)an EKG finding seen in NSTEMIs.
C)an EKG finding consistent with ischemia.
D)the opening of a coronary artery.

Question 22

The coronary artery that feeds blood to the damaged area of the heart in Figure 21 is the

A)right coronary artery.
B)left anterior descending.
C)circumflex.
D)popliteal.

Question 23

What color is an injured tissue?

A)Pale whitish
B)Black
C)Bluish
D)Bright red

Question 24

Mr.Henry has ST segment elevations in II,III,and aVF along with reciprocal ST depression in I,aVL,and V₁-4.Right-sided EKG shows ST elevation in V₃-4R.His blood pressure is quite low.Mr.Henry is normally hypertensive.This description is consistent with

A)pericarditis.
B)early repolarization.
C)inferior MI complicated by a right ventricular infarction.
D)extensive anterior MI complicated by cardiogenic shock.

Question 25

Which of the following is a reciprocal change?

A)ST elevation
B)T wave inversion
C)ST depression
D)Significant Q waves

Question 26

The baseline for evaluating ST segments for elevation is the

A)PR interval.
B)PR segment.
C)QRS interval.
D)T wave.

Question 27

In which leads is a posterior MI evident?

A)I and II
B)V₁-6
C)II,III,and aVR
D)V₁-2

Question 28

Mrs.Campho had a previous inferior MI about 20 years ago.What would you expect to see on her EKG that would be consistent with her old inferior MI?

A)ST elevation in II,III,and aVF
B)ST depression in II,III,and aVF
C)Significant Q wave in II,III,and aVF
D)Reciprocal ST depression in the anterior leads

Question 29

Which kind of MI is best seen by looking at the EKG upside down from behind?

A)Inferior
B)Anteroseptal
C)Posterior
D)Lateral

Question 30

The normal R wave transition zone occurs around leads

A)II and III.
B)V₁-2.
C)V₃-4.
D)V₅-6.

Question 31

Indicative changes of a STEMI include which of the following?

A)ST segment elevation.
B)ST segment depression.
C)T wave flattening.
D)Fish-hook in V₃.

Question 32

The order in which an MI progresses through "the three Is" is which of these?

A)Ischemia,injury,infarction
B)Ischemia,infarction,injury
C)Infarction,ischemia,injury
D)Injury,infarction,ischemia

Question 33

A significant Q wave

A)is either 0.04 seconds wide or 1/3 to 1/4 the size of the R wave.
B)is taller than the peak of the T wave.
C)implies myocardial injury.
D)is seen only in subendocardial MIs.

Question 34

Which leads look at the lateral wall of the left ventricle?

A)II,III,and aVF
B)I,II,and III
C)I,aVL,and V₅-6
D)V₁-2

Question 35

What kind of MI is indicated by significant Q waves in II,III,aVF,and V₅-6?

A)Anterior-lateral
B)Inferior-posterior
C)Inferior-lateral
D)Anteroseptal

Question 36

Subendocardial MI is an old term for

A)inferior MI.
B)NSTEMI.
C)STEMI.
D)transmural MI.

Question 37

Mac Jacob is a 21-year-old black man who complains of shortness of breath and comes to the ER.His cardiac enzymes are normal,but his EKG shows some slight ST segment elevations with a "fish-hook" at the end of the QRS complexes in V₂-4.This is consistent with

A)inferior MI.
B)early repolarization.
C)pericarditis.
D)right ventricular infarction.

Question 38

An MI that has ST elevation is

A)age indeterminate.
B)acute.
C)old.
D)not an MI,just ischemia.

Question 39

If the transition zone is between V₁ and V₂,the EKG is said to have

A)malrotation.
B)clockwise rotation.
C)counterclockwise rotation.
D)normal R wave progression.

Question 40

Which kind of MI usually damages only the innermost layer of the myocardium?

A)NSTEMI
B)Transmural
C)Posterior
D)Anteroseptal

Question 41

Which of the following should you expect to see if the transition zone in the precordial leads is between V₁ and V₂?

A)R waves that remain the same size in V₁ and V₂
B)R waves that remain flat in V₁ and V₂
C)R waves that progress from very small in V₁ to unusually large in V₂
D)R waves that progress from unusually large in V₁ to very small in V₂

Question 42

Where is the lateral wall of the left ventricle located?

A)On the left side of the heart
B)On the front side of the heart
C)On the bottom side of the heart
D)On the back side of the heart

Question 43

The normal T wave is tall and pointy.

Question 44

Which of the following symptoms is often associated with the angina equivalent in women?

A)Diaphoresis
B)Pallor
C)Nausea and vomiting
D)Fatigue

Question 45

Gwen is experiencing an acute STEMI and was taken by ambulance to a large metropolitan hospital with a cardiac center.Which of the following courses of treatment is Gwen MOST likely to receive in the 90 minutes following her arrival at the hospital?

A)Performance of an angiogram to determine the location of the coronary artery blockage
B)Administration of antiplatelet and anticoagulant medications and beta blockers
C)Administration of thrombolytics following tests to assess her bleeding risk
D)Reperfusion via PCI and placement of a stent at the site of the blockage

Question 46

Normal R wave transition is between V₅ and V₆.

Question 47

Which of the following EKG complications can be expected following an acute anterior STEMI?

A)Junctional bradycardia and third-degree AV block with narrow QRS
B)Wenckebach and first degree AV block
C)Mobitz II second degree AV block and right bundle branch block
D)Sinus bradycardia and accelerated junctional rhythm

Question 48

Why are patients experiencing MI given nitroglycerin?

A)It dilates the narrowed coronary artery and allows more blood into the myocardium.
B)It dissolves the blood clot causing the MI and reduces stresses on the heart.
C)It decreases platelet aggregation and prevents growth of blood clots in the coronary artery.
D)It improves the return of venous blood to the heart and helps prevent heart failure.

Question 49

A coved ST segment is concave.

Question 50

Which of the following BEST describes the progression of electrical conductivity in an EKG with normal transition?

A)V₁ and V₂ are mostly positive,V₃ and V₄ are isoelectric,and V₅ and V₆ are mostly negative.
B)V₁ through V₃ are isoelectric,V₄ is mostly negative,and V₅ and V₆ are mostly positive.
C)V₁ through V₃ are mostly negative,V₄ is isoelectric,and V₅ and V₆ are mostly positive.
D)V₁ through V₃ are mostly negative,V₃ through V₅ are mostly positive,and V₆ is isoelectric.

Question 51

Ischemia is a reversible process.

Question 52

To detect right ventricular infarction,one must do a right-sided EKG.

Question 53

An acute STEMI that causes injury to the front wall of the left ventricle is most appropriately referred to as a(n)

A)lateral STEMI.
B)inferior STEMI.
C)posterior STEMI.
D)anterior STEMI.

Question 54

A right ventricular infarction is most often seen along with inferior MI.

Question 55

Ischemia causes myocardial tissue to turn black.

Question 56

Why are arrhythmias a common EKG complication of MI?

A)The myocardium is irritable during and after an MI.
B)The heart pumps more often following an MI.
C)The heart has a decreased diastolic filling time after an MI.
D)The heart experiences bundle branch blocks during an MI.

Question 57

Where is the V₂ lead placed for a right-sided EKG?

A)The 5th intercostal space on the right mid-axillary line
B)The 4th intercostal space on the right sternal border
C)The 4th intercostal space on the left sternal border
D)The 5th intercostal space on the right midclavicular line

Question 58

Hyperacute changes of an MI are those seen in the MI's earliest stages.

Question 59

Which of the following individuals would be MOST likely to exhibit typical symptoms of an MI?

A)A 63-year-old postmenopausal woman who is in generally good health
B)A 45-year-old man who is in generally good health
C)A 53-year-old woman who has Type 1 diabetes
D)A 38-year-old man who has Type 1 diabetes

Question 60

Counterclockwise rotation is indicated from R wave transition in V₁-2.

Question 61

Explain where the leads are placed for a right-sided EKG.

Question 62

Inferior-lateral MI has indicative changes in leads ________.

Question 63

The leads one looks at to find an inferior MI are ________.

Question 64

An age-indeterminate MI should have a significant Q wave along with T wave inversion,but the ST segment should be back to baseline.

Question 65

Leads V₂-4 are inferior leads.

Question 66

Name the three Is of infarction.

Question 67

Anterior MI has indicative changes in leads ________.

Question 68

Pericarditis is ________ of the pericardium.

Question 69

Reciprocal ST depression is seen only when there is ________ in the indicative leads.

Question 70

An acute MI is indicated by ST segment depression.

Question 71

ST elevation indicates ischemia.

Question 72

A ________ MI is seen as a mirror image of an anterior MI.

Question 73

Smiley-face ST elevation is concave and often seen in pericarditis.

Question 74

An age-indeterminate MI is called a ________ by some authorities.

Question 75

An old inferior MI should show significant Q waves in II,III,and aVF even after several years.

Question 76

Early repolarization often has a unique EKG finding that makes recognition easier.What is that finding?