Internal Medicine
Review Questions
Course Introduction
Internal Medicine is a branch of medicine dedicated to the diagnosis, treatment, and prevention of adult diseases, focusing on comprehensive care across a broad spectrum of health conditions affecting internal organs and systems. This course covers foundational principles in clinical reasoning, patient assessment, and evidence-based management of chronic and acute illnesses, including cardiovascular, respiratory, endocrine, gastrointestinal, renal, and infectious diseases. Students will develop diagnostic skills, learn pharmacological and non-pharmacological intervention strategies, and understand the importance of preventive care and multidisciplinary collaboration in managing complex medical cases. Emphasis is placed on patient-centered care, ethical considerations, and lifelong learning to prepare future internists for diverse clinical settings.
Recommended Textbook
EKG Plain and Simple 4th Edition by Karen Ellis
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15 Chapters
875 Verified Questions
875 Flashcards
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Page 2
Chapter 1: Cardiac Anatomy and Physiology
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66 Verified Questions
66 Flashcards
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Sample Questions
Q1) The job of the heart valves is to prevent backflow of blood.
A)True
B)False
Answer: True
Q2) The cardiac cycle's two phases are
A)systole and diastole.
B)isovolumetric relaxation and contraction.
C)preload and afterload.
D)atrial kick and ventricular filling.
Answer: A
Q3) The parasympathetic nervous system causes
A)slowed digestion.
B)decrease in heart rate.
C)pupillary dilation.
D)increase in blood pressure.
Answer: B
Q4) The layer of the heart that does the work of contracting is the endocardium.
A)True
B)False
Answer: False
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Chapter 2: Electrophysiology
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68 Verified Questions
68 Flashcards
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Sample Questions
Q1) Depolarization is the changing of the cardiac cell to an electrically ________ charge.
Answer: positive
Q2) If the sinus node,atria,and AV node all fail,the heart rate will be between
A)40 to 60 beats per minute.
B)20 to 40 beats per minute.
C)10 to 20 beats per minute.
D)60 to 100 beats per minute.
Answer: B
Q3) The PR interval measures the time it takes for the impulse to travel from the A)AV node to the bundle branches.
B)bundle of His to the ventricular myocardium.
C)sinus node to the internodal tracts.
D)atria to the ventricle.
Answer: D
Q4) Normal QRS interval is ________ seconds or less than three small blocks. Answer: <0.12
Q5) Transmembrane potential is the electrical charge at the ________. Answer: cell membrane
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Chapter 3: Lead Morphology and Placement
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56 Flashcards
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Sample Questions
Q1) V 's lead is located at the ________.
Answer: 4th ICS,LSB; 4th intercostal space,left sternal border; fourth intercostal space,left sternal border
Q2) The precordial leads are placed on the arms and legs.
A)True
B)False
Answer: False
Q3) Why is it advantageous to use Lead II for continuous monitoring?
A)It is located at the most comfortable location for the patient.
B)It provides excellent views of P waves and QRS complexes.
C)It provides the clearest hexiaxial and triaxial diagrams.
D)It does not require the right leg to serve as the ground.
Answer: B
Q4) Lead II connects which limbs?
A)Right arm and left leg
B)Right arm and right leg
C)Right arm and left arm
D)Left arm and right leg
Answer: A
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Chapter 4: Technical Aspects of the EKG
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54 Verified Questions
54 Flashcards
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Sample Questions
Q1) Artifact is an unwanted interference or jitter on the EKG tracing.
A)True
B)False
Q2) Your patient is having chills.What kind of artifact can this produce?
A)60-cycle interference
B)Baseline sway
C)Broken recording
D)Somatic tremors
Q3) CPR artifact is caused by chest compressions obscuring the real ________.
Q4) If you think the rhythm is artifact,check your patient for any symptoms of decreased cardiac output first,then check his monitor wires and patches and observe the rhythm in another lead.
A)True
B)False
Q5) Life-threatening arrhythmias will cause symptoms of decreased cardiac output.
A)True
B)False
Q6) ________ is unwanted jitter or interference on the EKG tracing.
Q7) The word "somatic" means ________.
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Q8) Troubleshooting involves determining and alleviating the cause of ________.
Chapter 5: Calculating Heart Rate
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Sample Questions
Q1) The most accurate way to calculate heart rate on an irregular rhythm is the six-second strip method.
A)True
B)False
Q2) The heart rate in Figure 2 is closest to A)180.
B)250.
C)75.
D)50.
Q3) Regularity of a rhythm is determined by measuring the A)P-P intervals.
B)QRS intervals.
C)R-R intervals.
D)distance between consecutive U waves.
Q4) Which of the following is a method of calculating heart rate?
A)Six-second strip method
B)The QT interval method
C)The P-P interval method
D)All of the above
Q5) If the QRS complexes are all 15 little blocks apart,the heart rate is ________.
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Chapter 6: How to Interpret a Rhythm Strip
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Sample Questions
Q1) The normal rhythm originating in the sinus node should have a heart rate that is
A)greater than 100.
B)less than 60.
C)between 40 and 60.
D)between 60 and 100.
Q2) A rhythm with a heart rate less than 60 is a tachycardia.
A)True
B)False
Q3) A rhythm originating in the sinus node should NOT have which of the following?
A)Narrow QRS complexes of uniform shape
B)Regularly spaced QRS complexes
C)Absent QRS complexes
D)Heart rate of 60-100
Q4) A rhythm with a heart rate greater than 100 is a tachycardia.
A)True
B)False
Q5) What are the five steps in rhythm interpretation?
Q6) An abnormal rhythm is called an arrhythmia.
A)True
B)False
Page 8
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Chapter 7: Rhythms Originating in the Sinus Node
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Sample Questions
Q1) Sinus bradycardia's heart rate is
A)60-100.
B)greater than 100.
C)less than 60.
D)greater than 170.
Q2) Which of the following is an irregular rhythm originating in the sinus node?
A)Sinus arrhythmia
B)Sinus rhythm
C)Sinus tachycardia
D)Sinus bradycardia
Q3) Sinus rhythms all have
A)uniform shape P waves preceding the QRS complexes.
B)multiple shapes of P waves preceding the QRS complexes.
C)a wavy baseline without P waves or QRS complexes.
D)inverted P waves in Lead II.
Q4) Treatment for sinus tachycardia associated with a high fever would be to
A)give atropine.
B)start CPR.
C)give acetaminophen or ibuprofen to get the temperature down.
D)give beta-blockers.
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Chapter 8: Rhythms Originating in the Atria
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Sample Questions
Q1) Name three causes of PACs.________.
Q2) Flutter waves are often described as sawtooth- or picket-fence-shaped waves.
A)True
B)False
Q3) Atrial flutter is characterized by what kind of atrial waves?
A)Zigzag or sawtooth-shaped waves between the QRS complexes
B)P waves of uniform shape
C)No atrial waves at all
D)Tall,pointy P waves following the QRS complexes
Q4) Paroxysmal means
A)starting and stopping suddenly.
B)life-threatening.
C)premature.
D)prolonged.
Q5) Atrial flutter is characterized by
A)P waves of varying shapes and regularly spaced QRS complexes.
B)irregularly irregular pattern of QRS complexes.
C)regularly spaced V-shaped waves.
D)a run of six or more PACs in a row.
Q6) The atrial rate in atrial flutter is ________.
Page 10
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Chapter 9: Rhythms Originating in the AV Junction
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51 Flashcards
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Sample Questions
Q1) PJC and junctional tachycardia are similar in that A)both have regular but interrupted regularity.
B)both can have hidden P waves.
C)both have heart rates less than 40.
D)both require electrical shock to the heart.
Q2) Treatment for the rhythm in Figure 8 could include ALL BUT A)atropine.
B)oxygen.
C)electrical shock to the heart.
D)no treatment.
Q3) Junctional tachycardia is usually a result of escape. A)True
B)False
Q4) P waves hidden inside the QRS are a hallmark of junctional rhythms originating ________ in the AV junction.
Q5) The rhythm in Figure 9 is A)sinus rhythm.
B)accelerated junctional rhythm.
C)atrial fibrillation.
D)junctional bradycardia.
11
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Chapter 10: Rhythms Originating in the Ventricles
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Sample Questions
Q1) Ventricular tachycardia is usually a result of escape.
A)True
B)False
Q2) QRS complexes in ventricular rhythms should be ________ seconds wide.
Q3) P wave asystole differs from asystole in that P wave asystole has P waves; asystole is
Q4) Agonal rhythm has a heart rate less than ________.
Q5) Torsades de pointes can be treated with magnesium.
A)True
B)False
Q6) In Figure 12,there are only A)P waves.
B)QRS complexes.
C)T waves.
D)U waves.
Q7) The rhythm in Figure 10 is
A)sinus rhythm with occasional PACs.
B)sinus bradycardia with PVC.
C)sinus rhythm with a sinus arrest and a ventricular escape beat.
D)idioventricular rhythm.
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Chapter 11: AV Blocks
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Sample Questions
Q1) Third-degree AV block usually needs no treatment.
A)True
B)False
Q2) In Figure 18,which of the heart's pacemakers is controlling the ventricle?
A)Sinus node
B)Atrium
C)AV node
D)Ventricle
Q3) The rhythm in Figure 18 is
A)Wenckebach.
B)Mobitz II second-degree AV block.
C)third-degree AV block.
D)junctional bradycardia.
Q4) 2:1 AV block can be caused by either
A)third-degree AV block or Wenckebach.
B)Wenckebach or Mobitz II second-degree AV block.
C)first-degree AV block or Wenckebach.
D)Mobitz II second-degree AV block or third-degree AV block.
Q5) Why does atropine not work when the block is at the bundle branches?
Q6) AV blocks involve a block in conduction between ________.
Page 13
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Chapter 13: How to Interpret a 12-Lead EKG
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Sample Questions
Q1) Which of the following is a criterion for a diagnosis of BBB?
A)P wave wider than the QRS
B)Heart rate greater than 100
C)More P waves than QRS complexes
D)QRS of 0.12 seconds or greater
Q2) Ventricular hypertrophy is
A)excessive growth of ventricular myocardial tissue.
B)excessive growth of atrial tissue.
C)characterized by low-voltage QRS complexes.
D)characterized by tall,pointy P waves.
Q3) ________ is potassium deficit in the bloodstream.
Q4) An axis of -120 degrees is
A)normal axis.
B)left axis deviation.
C)right axis deviation.
D)indeterminate axis.
Q5) Hypercalcemia is a calcium deficit in the bloodstream.
A)True
B)False
Q6) RVH stands for ________.
Page 14
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Chapter 14: Myocardial Infarction
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Sample Questions
Q1) Ischemia causes myocardial tissue to turn black.
A)True
B)False
Q2) To detect right ventricular infarction,one must do a right-sided EKG.
A)True
B)False
Q3) Smiley-face ST elevation is concave and often seen in pericarditis.
A)True
B)False
Q4) 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.
Q5) 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.
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Chapter 16: Medications and Electrical Therapy
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113 Flashcards
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Sample Questions
Q1) An AICD is
A)a defibrillator meant for use by the lay public.
B)an implanted defibrillator.
C)a cardiac monitor and defibrillator meant for use by health care professionals.
D)the same as a monitor-defibrillator.
Q2) Treatment for V-fib is to immediately ________.
Q3) Your patient is in pulseless ventricular tachycardia.Your first intervention should be A)defibrillation.
B)amiodarone bolus IV.
C)electrical cardioversion.
D)to encourage the patient to try vagal maneuvers.
Q4) AICDs can be found at malls,airports,and on airplanes.
A)True
B)False
Q5) AEDs are intended for use only by professional healthcare providers.
A)True
B)False
Q6) AED stands for ________.
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Chapter 17: Diagnostic Electrocardiography
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Sample Questions
Q1) A MET is a
A)measurement of energy absorption during exercise.
B)measurement of oxygen consumption during exercise.
C)method of exercise.
D)pharmacologic agent used in stress testing.
Q2) A patient is thought to be experiencing sporadic ST segment abnormalities.Which type of monitoring device would be most appropriate for this patient?
A)Event monitor
B)SAEKG
C)Holter monitor
D)Ergometer
Q3) A positive stress test implies that
A)ischemia is present.
B)ischemia is absent.
C)infarction is present.
D)infarction is absent.
Q4) Bayes' theorem is concerned with the ________ of stress test results.
Q5) A true positive stress test is one in which the stress test is ________ and the angiogram is ________.
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