Deck 13: Myocardial Infarction

Question 1

In Figure 21,there is evidence of

A)Anterior wall ischemia.
B)Anterior MI.
C)NSTEMI.
D)Inferior/posterior MI

Answer 1

D

Question 2

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.

Answer 2

C

Question 3

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

Answer 3

A

Question 4

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 5

Which of the following is indicative of myocardial injury?

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

Question 6

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

Question 7

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 8

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

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

Question 9

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 10

The MI in Figure 20 is

A)Extensive anterior (anterior-lateral).
B)Posterior.
C)Lateral.
D)Inferior.

Question 11

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 12

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 13

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

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

Question 14

The age of the MI in Figure 20 is

A)Acute.
B)Age indeterminate.
C)Old.
D)Impossible to tell.

Question 15

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)Dysrhythmia.

Question 16

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 17

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 18

ST segment elevation is indicative of

A)Myocardial necrosis.
B)Myocardial ischemia.
C)Myocardial injury.
D)Abnormal atrial depolarization.

Question 19

Which of the following is indicative of myocardial necrosis?

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

Question 20

An inverted T wave is indicative of

A)Myocardial necrosis.
B)Myocardial ischemia.
C)Myocardial injury.
D)Abnormal ventricular depolarization.

Question 21

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 22

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 23

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

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

Question 24

The baseline for evaluating ST segments for elevation is the

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

Question 25

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 26

What color is an injured tissue?

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

Question 27

The normal R wave transition zone occurs around leads

A)II and III.
B)V1-2.
C)V3-4.
D)V5-6.

Question 28

Subendocardial MI is an old term for

A)Inferior MI.
B)NSTEMI.
C)STEMI.
D)Transmural MI.

Question 29

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 30

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 31

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 32

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 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

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 35

Which of the following is a reciprocal change?

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

Question 36

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 37

An MI that has ST elevation is

A)Age indeterminate.
B)Acute.
C)Old.
D)Not an MI,just ischemia.

Question 38

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 39

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 40

In which leads is a posterior MI evident?

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

Question 41

Pericarditis is _____ of the pericardium.

Question 42

Leads V2-4 are inferior leads.

Question 43

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

Question 44

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

Question 45

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

Question 46

Normal R wave transition is between V5 and V6.

Question 47

Ischemia is a reversible process.

Question 48

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

Question 49

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 50

The normal T wave is tall and pointy.

Question 51

A coved ST segment is concave.

Question 52

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

Question 53

Ischemia causes myocardial tissue to turn black.

Question 54

ST elevation indicates ischemia.

Question 55

An acute MI is indicated by ST segment depression.

Question 56

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

Question 57

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

Question 58

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

Question 59

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

Question 60

Name the three Is of infarction._____.

Question 61

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

Question 62

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

Question 63

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

Question 64

Inferior-lateral MI has indicative changes in leads _____.

Question 65

Anterior MI has indicative changes in leads _____.