Internal Medicine
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Course Introduction
Internal Medicine is a comprehensive course designed to introduce students to the prevention, diagnosis, and management of adult diseases. The course covers key systems such as cardiovascular, respiratory, gastrointestinal, endocrine, renal, and hematologic, presenting a wide range of commonly encountered acute and chronic conditions. Through lectures, case studies, and clinical rotations, students develop critical clinical reasoning, patient communication, and examination skills. Emphasis is placed on evidence-based practice, multidisciplinary care, and understanding the complexities of adult patient care across different settings, preparing students for effective, compassionate practice in internal medicine and related specializations.
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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Chapter 1: Cardiac Anatomy and Physiology
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66 Verified Questions
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Sample Questions
Q1) The coronary circulation supplies oxygenated blood to the myocardium during A)ventricular ejection.
B)diastole.
C)the entire cardiac cycle.
D)isovolumetric contraction.
Answer: B
Q2) The normal amount of blood circulated by the heart every minute is ________ liters.
Answer: 4-8; 4 to 8; four to eight
Q3) The heart valve found at the opening of the pulmonary artery is the A)aortic valve.
B)tricuspid valve.
C)mitral valve.
D)pulmonic valve.
Answer: D
Q4) The cardiac cycle refers to the mechanical events that occur to ________. Answer: Pump blood
Q5) The two phases of the cardiac cycle are systole and ________. Answer: Diastole
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Chapter 2: Electrophysiology
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Sample Questions
Q1) One small block on the EKG paper measures ________ seconds.
Answer: 0.04
Q2) The P wave represents atrial depolarization.
A)True
B)False
Answer: True
Q3) The PR interval measures the time it takes for the impulse to travel from the atrium down to the ventricle.
A)True
B)False
Answer: True
Q4) The job of the cardiac conduction system's pacemaker is to A)propagate electrical impulses.
B)conduct electrical impulses.
C)cause depolarization of myocardial cells.
D)all of the above.
Answer: A
Q5) Depolarization is the changing of the cardiac cell to an electrically ________ charge.
Answer: positive
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Chapter 3: Lead Morphology and Placement
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56 Verified Questions
56 Flashcards
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Sample Questions
Q1) Einthoven's law states that ________.
Answer: Lead I + Lead III = Lead II
Q2) If Lead I's QRS is positive,the heart's current is traveling toward the right arm.
A)True
B)False
Answer: False
Q3) Which of the following leads would be most appropriate for continuous monitoring of an individual with an abnormality in ventricular conduction?
A)Lead II
B)MCL
C)AVR
D)V
Answer: B
Q4) The normal QRS deflection in Lead III should be negative.
A)True
B)False
Answer: False
Q5) Normal current of the heart travels top to bottom and ________. Answer: Right to left
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Chapter 4: Technical Aspects of the EKG
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Sample Questions
Q1) Artifact does not cause symptoms of decreased cardiac output.
A)True
B)False
Q2) It is possible to have artifact in the midst of a dangerous rhythm.
A)True
B)False
Q3) Macroshock and microshock are two kinds of electrical shock the patient can sustain from faulty equipment.
A)True
B)False
Q4) If there is artifact in leads II,III,and aVF,on which limb(s)would you expect to find the cause of the artifact?
A)Right arm
B)Right arm and left leg
C)Left leg
D)Left arm
Q5) Broken recording is caused by ________.
Q6) The word "somatic" means ________.
Q7) The EKG machine control feature that controls the size of the waves and complexes is the ________.
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Chapter 5: Calculating Heart Rate
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27 Flashcards
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Sample Questions
Q1) The heart rate in Figure 1 is closest to A)100.
B)70.
C)150.
D)50.
Q2) The mean rate in Figure 2 is A)60.
B)70.
C)80.
D)100.
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) Regardless of the method used,what are you doing when you calculate heart rate?
A)Counting the number of P waves in a minute-long rhythm strip
B)Counting the number of QRS complexes in a minute-long rhythm strip
C)Counting the number of premature beats or pauses in a minute-long rhythm strip
D)Counting the number of irregular blocks in a minute-long rhythm strip
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Chapter 6: How to Interpret a Rhythm Strip
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Sample Questions
Q1) The normal rhythm of the heart has P waves that are A)upright,matching,and precede the QRS complex.
B)variable in shape and location.
C)often hidden inside QRS complexes.
D)multiple in number,preceding the QRS complex.
Q2) The normal rhythm of the heart is called ________.
Q3) The sinus rhythm has a heart rate of 60-80.
A)True
B)False
Q4) A heart rate less than 60 is said to be a A)tachycardia.
B)bradycardia.
C)tachyarrhythmia.
D)bundle branch block.
Q5) The distance between consecutive P waves is called the ________.
Q6) Multiple P waves preceding the QRS complexes are typical of sinus rhythm.
A)True B)False
Q7) The normal PR interval in sinus rhythm should be ________.
Q8) What are the five steps in rhythm interpretation?
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Chapter 7: Rhythms Originating in the Sinus Node
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Sample Questions
Q1) Sinus arrest can occur at any heart rate.
A)True
B)False
Q2) QRS interval in Figure 4 is closest to
A)0.42 seconds.
B)0.10 seconds.
C)0.28 seconds.
D)0.30 seconds.
Q3) Diaphoresis is a cold sweat.
A)True
B)False
Q4) Possible causes of sinus tachycardia include which of the following?
A)Fever
B)Anxiety
C)Congestive heart failure
D)All of the above
Q5) Sinus arrest is best treated by anti-anxiety medication.
A)True
B)False
Q6) In sinus rhythms,P waves are found ________ the QRS complexes.
Page 9
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Chapter 8: Rhythms Originating in the Atria
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Sample Questions
Q1) A PAC is a
A)premature beat from the sinus node.
B)late beat from the atria.
C)premature beat from the ventricle.
D)premature beat from the atrium.
Q2) The most common cause of an unexplained pause is a(n)
A)nonconducted PAC.
B)sinus arrest.
C)sinus block.
D)atrial tachycardia.
Q3) The difference between wandering atrial pacemaker and multifocal atrial tachycardia is
A)wandering atrial pacemaker has a faster heart rate.
B)multifocal atrial tachycardia has a faster heart rate.
C)wandering atrial pacemaker has uniform shape P waves; multifocal atrial tachycardia has P waves of at least three different shapes.
D)wandering atrial pacemaker has only two different shape P waves; multifocal atrial tachycardia has at least five different shaped P waves.
Q4) The most common cause of an unexplained pause is a ________.
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Chapter 9: Rhythms Originating in the AV Junction
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Sample Questions
Q1) Junctional rhythms originate in the A)sinoatrial junction.
B)atrioventricular junction.
C)sinoventricular junction.
D)sinus node junction.
Q2) Electrical shock is used to treat frequent PJCs.
A)True
B)False
Q3) P waves hidden inside the QRS are a hallmark of junctional rhythms originating ________ in the AV junction.
Q4) Junctional tachycardia is associated with which medication toxicity?
A)Quinidine
B)Digitalis
C)Atropine
D)Oxygen
Q5) Mid-junctional rhythms originate midway between the sinus node and the atria.
A)True
B)False
Q6) PJCs are ________ beats from the AV junction.
Q7) Conduction to the ventricle is said to be ________ in junctional rhythms.
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Chapter 10: Rhythms Originating in the Ventricles
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Sample Questions
Q1) What causes fusion beats?
A)Depolarization of the ventricle by a sinus impulse that coincides with polarization by a premature ventricular impulse
B)Polarization of the ventricle by a sinus impulse that coincides with depolarization by a premature ventricular impulse
C)Simultaneous depolarization of the ventricle by a sinus impulse and a premature ventricular impulse
D)Simultaneous polarization of the ventricle by a sinus impulse and a premature ventricular impulse
Q2) All ventricular rhythms are life-threatening.
A)True
B)False
Q3) Following PVCs is usually a(n)
A)complete compensatory pause.
B)incomplete compensatory pause.
C)escape beat.
D)tall,pointy P wave.
Q4) Ventricular bigeminy is a term that means the PVCs occur every ________ beat.
Q5) PVC stands for ________.
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Chapter 11: AV Blocks
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Sample Questions
Q1) In AV blocks,the site of the block is either the AV node or the bundle branches.
A)True
B)False
Q2) What kind of symptoms does first-degree AV block cause?
Q3) Third-degree AV block has
A)one P wave to each QRS.
B)a varying R-R interval.
C)a constant PR interval.
D)a varying PR interval.
Q4) Wenckebach is characterized by
A)gradually prolonging PR intervals.
B)constant PR intervals.
C)absent P waves.
D)wide bizarre QRS complexes.
Q5) First-degree AV block is characterized by a prolonged QRS interval. A)True
B)False
Q6) The origin of the P waves in AV blocks is the ________.
Q7) In AV blocks,the underlying rhythm is ________.
Q8) Why does atropine not work when the block is at the bundle branches?
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Chapter 13: How to Interpret a 12-Lead EKG
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Sample Questions
Q1) A disorder in which there is too much potassium in the bloodstream is called A)hyperkalemia.
B)hypokalemia.
C)hypercalcemia.
D)hypocalcemia.
Q2) Which of the following findings suggest the presence of a hemiblock?
A)Axis deviation with widened QRS complex
B)Axis deviation with normal width QRS complex
C)Normal axis with widened QRS complex
D)Normal axis with narrowed QRS complex
Q3) If the QRS in leads I and aVF are both positive,the axis is A)normal.
B)right axis deviation.
C)left axis deviation.
D)indeterminate axis.
Q4) Which of the following is NOT a step in 12-lead EKG interpretation?
A)Assess the basics-rhythm,rate,and intervals
B)Determine the axis quadrant
C)Check for ventricular hypertrophy
D)Check the patient for symptoms
Page 14
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Chapter 14: Myocardial Infarction
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Sample Questions
Q1) Ischemia is a reversible process.
A)True
B)False
Q2) An inverted T wave is indicative of
A)myocardial necrosis.
B)myocardial ischemia.
C)myocardial injury.
D)abnormal ventricular depolarization.
Q3) 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 V
Q4) 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
Q5) Name the three Is of infarction.
Page 15
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Chapter 16: Medications and Electrical Therapy
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Sample Questions
Q1) Capture is evidenced on the EKG by the presence of A)P waves or QRS complexes following the pacemaker spikes.
B)pacemaker spikes at regular intervals.
C)paced beats on top of intrinsic beats.
D)an appropriate distance between intrinsic beats and paced beats.
Q2) Which medication used to treat SVT can cause several seconds of asystole before the rhythm converts? ________.
Q3) Treatment for V-fib is to immediately ________.
Q4) Emergency cardiac medications should be given by mouth during a cardiac arrest. A)True
B)False
Q5) Which of the following describes undersensing?
A)The pacemaker fires but does not cause depolarization in the chamber being paced.
B)The pacemaker incorrectly interprets something as a depolarization and is inhibited from firing.
C)The pacemaker fails to sense intrinsic beats and paces on top of them.
D)The pacemaker fails to generate an impulse.
Q6) When a pacemaker fires,it causes a ________ on the EKG.
Q7) AED stands for ________.
Page 16
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Chapter 17: Diagnostic Electrocardiography
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Sample Questions
Q1) A relative contraindication is one that means
A)don't do the test under any circumstances.
B)don't do the test unless the benefits outweigh the risks.
C)do the test as soon as possible.
D)do the test only if the patient's other relatives have had the same problem also.
Q2) Stress testing is a diagnostic procedure done to determine the likelihood of A)CAD.
B)ventricular arrhythmias.
C)myocardial ischemia.
D)myocardial infarction.
Q3) The J-point is the point at which the A)P wave and PR segment join together.
B)PR segment and QRS complex join together.
C)QRS complex and ST segment join together.
D)ST segment and T wave join together.
Q4) Bayes' theorem is concerned with the ________ of stress test results.
Q5) The most commonly used device for exercise stress testing is the arm ergometer. A)True
B)False
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