Xray and ECG practice exam questions with answers PDF

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Tutor’s Time Killer Questions18 key ECGsECG 1:Diagnosis: Justification:ECG 2:Diagnosis: Justification:ECG 3:Diagnosis: Justification:ECG 4:Diagnosis: Justification:ECG 7:Diagnosis: Justification:ECG 8:Diagnosis: Justification:ECG 9:Diagnosis: Justification:ECG 10:Diagnosis: Justification:ECG 13:Diag...

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Tutor’s Time Killer Questions

18 key ECGs ECG 1: Diagnosis: Justification:

ECG 2: Diagnosis: Justification:

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ECG 3: Diagnosis: Justification:

ECG 4: Diagnosis: Justification:

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ECG 5: Diagnosis: Justification:

ECG 6: Diagnosis: Justification:

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ECG 7: Diagnosis: Justification:

ECG 8: Diagnosis: Justification:

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ECG 9: Diagnosis: Justification:

ECG 10: Diagnosis: Justification:

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ECG 11: Diagnosis: Justification:

ECG 12: Diagnosis: Justification:

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ECG 13: Diagnosis: Justification:

ECG 14: Diagnosis: Justification:

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ECG 15: Diagnosis: Justification:

ECG 16: Diagnosis: Justification:

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ECG 17: Diagnosis: Justification:

ECG 18: Diagnosis: Justification:

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ECG ANSWERS: ECG 1: Diagnosis: Normal sinus rhythm Justification: Every P wave followed by a QRS, normal rate, nil ST elevation or heart blocks ECG 2: Diagnosis: Atrial Fibrillation Justification: No clear P waves, rapid ventricular rate 150/min, irregularly irregular rhythm ECG 3: Diagnosis: Sinus tachycardia 150/min Justification: Rate approx. 150/min, each P wave (best seen in Lead V1) is followed by QRS, normal axis, nil blocks, nil ischaemia ECG 4: Diagnosis: Ventricular tachycardia Justification: Broad complex tachycardia 160/min ECG 5: Diagnosis: Sinus rhythm with first degree heart block Justification: Every P wave is followed by a QRS, however PR interval prolonged >200ms ECG 6: Diagnosis: Atrial flutter with 3 to 1 block Justification: Regular rhythm, P wave rate of 300/min, QRS ventricular rate of 70/min, “Saw tooth pattern” in lead 2 ECG 7: Diagnosis: Ventricular fibrillation Justification: Nil discernible organised rhythm, rapidly alternating axis, rate 120ms, Deep S wave in V1 + Upright “M” pattern in V6 = “WiLLiaM” ECG 12: Week 13 – Revision

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Diagnosis: High lateral STEMI Justification: ST elevation in I and aVL ECG 13: Diagnosis: Complete heart block (3rd degree heart block) Justification: No relationship between P waves and QRS complexes, P wave rate of 7090/min, QRS rate of 42/min, Narrow QRS complexes suggesting escape rhythm is from AV node rather than lower in ventricles ECG 14: Diagnosis: Sinus bradycardia 36/min Justification: Regular rhythm, narrow complex, every P wave followed by a QRS ECG 15: Diagnosis: Inferior STEMI Justification: ST elevation in II, III, aVF ECG 16: Diagnosis: Right bundle branch block Justification: Sinus rhythm, widened QRS >120ms, RsR “M” pattern in V1 + S wave in V6 = “MaRRoW” ECG 17: Diagnosis: Pericarditis Justification: Widespread concave ST elevation with PR depression and reciprocal PR elevation in AVR, Spodick’s sign in lead II ECG 18: Diagnosis: Supraventricular tachycardia (Atrioventricular nodal re-entrant tachycardia) Justification: Narrow complex tachycardia, absent P waves, Rate >140

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Tutor’s Time Killer Questions

18 key Xrays The only 6 types of X-rays to know for the X-ams  Pneumonia – recognize the 5 lobes  COPD / Asthma – hyperinflation, reduced lung markings, flattened hemidiaphragms, small heart  Free air – pneumothorax, subcutaneous emphysema, free air under the diaphragm, lateral decubitus abdominal free air, pneumomediastinum  Heart failure – cardiomegaly, pulmonary oedema, pleural effusions  Trauma chest xray – aortic dissection, haemothorax  Bowel obstruction – small bowel dilated loops, small bowel air-fluid levels, large bowel dilated loops XRAY 1

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XRAY 2

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XRAY 3

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XRAY 4

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XRAY 5

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XRAY 6

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XRAY 7

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XRAY 8

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XRAY 9

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XRAY 10

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XRAY 11

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XRAY 12

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XRAY 13

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XRAY 14 – Presents with acute breathlessness, no cough, no fever

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XRAY 15

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XRAY 16

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XRAY 17

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XRAY 18

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XRAY ANSWERS: XRAY 1 – Left lower lobe pneumonia with loss of left hemidiaphragm and preservation left heart border XRAY 2 – Free air under the diaphragm, likely from bowel perforation XRAY 3 – Widened mediastinum from aortic dissection – either traumatic or atraumatic XRAY 4 – Left upper lobe pneumonia involving lingular segment of left upper lobe, demonstrated by loss of left heart border XRAY 5 – Bilateral pleural effusions eg congestive heart failure XRAY 6 – Right large pleural effusion with meniscus sign eg haemothorax if trauma, exudate / pus if empyema, transudate or exudate if malignancy related effusion XRAY 7 – Right upper lobe pneumonia with preservation of right heart border and opacification sitting above right horizontal fissure XRAY 8 – Right pneumothorax with absent peripheral lung markings XRAY 9 – COPD with hyperinflation (>7 anterior ribs), flattened hemidiaphragms, reduced lung markings, small heart size. Caution bilateral breast shadows may be misinterpreted as pneumonia / opacification. XRAY 10 - Cardiomegaly XRAY 11 – Right middle lobe pneumonia with loss of right heart border but preservation of right hemidiaphragm XRAY 12 – Subcutaneous emphysema (free air in skin and soft tissues) demonstrated by free air seen in left and right lower chest wall soft tissues and right upper neck soft tissues. eg from chest trauma, free air leaking from lungs into soft tissues XRAY 13 – Pneumomediastinum (free air in mediastinum), eg from Boerhaave’s syndrome perforated oesophagus. Incidentally, note the subcutaneous emphysema in right lateral chest wall soft tissues and neck soft tissues. XRAY 14 – Acute pulmonary oedema demonstrated by opacification of both lung fields in the context of no fever or cough. Note: If clinical history suggested fever and cough then this Xray could be interpreted as bilateral pneumonia! XRAY 15 – Right lower lobe pneumonia with preservation of right heart border XRAY 16 – Large bowel obstruction with dilated loops of bowel. Large bowel because there are plicae semilunares that do not cross bowel lumen. XRAY 17 – Small bowel obstruction with dilated loops of bowel. Small bowel because there are plicae circulares that cross the entire lumen. XRAY 18 – Small bowel obstruction with dilated loops of bowel AND air fluid levels. Small bowel because there are plicae circulares that cross the entire lumen.

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