ECG Interpretation: ABFM practice questions

9 board-style questions on ecg interpretation in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 50-year-old woman with no prior cardiac history presents to the emergency department with acute-onset crushing chest pain and diaphoresis for 30 minutes. Her 12-lead ECG shows 4 mm ST-segment elevation in leads V1 through V4 with reciprocal ST depression in leads II, III, and aVF. Which coronary artery territory is most likely involved?

  1. Right coronary artery (inferior wall)
  2. Left circumflex artery (lateral wall)
  3. Left anterior descending artery (anterior wall)
  4. Posterior descending artery (posterior wall)

Sample question 2

A 76-year-old man is brought to the emergency department after a witnessed syncopal episode at home. He has a history of prior inferior myocardial infarction. His heart rate is 34 bpm and blood pressure is 88/54 mmHg. He appears lethargic. ECG shows a regular atrial rate of 82 bpm, a ventricular rate of 34 bpm with wide QRS complexes (0.14 seconds), and no consistent relationship between P waves and QRS complexes. What is the most likely diagnosis and most appropriate management?

  1. Second-degree Mobitz type I (Wenckebach) block; observe and monitor on telemetry
  2. Atrial fibrillation with slow ventricular response; administer IV fluids
  3. Third-degree (complete) heart block; transcutaneous pacing followed by permanent pacemaker placement
  4. Second-degree Mobitz type II block; administer IV atropine

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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