A 55-year-old patient with a history of hypertension is undergoing a routine ECG as part of their annual check-up. The ECG reveals a first-degree AV block. Which of the following statements about first-degree AV block is correct?

First-degree AV block is characterized by a prolonged PR interval greater than 0.20 seconds.

First-degree AV block is a type of heart block where some atrial impulses fail to reach the ventricles.

Patients with first-degree AV block typically present with symptoms such as syncope or dizziness.

First-degree AV block often requires immediate treatment with a pacemaker.

Answer and Explanation

The Correct Answer is A

Rationale:

A. In first-degree atrioventricular (AV) block, all atrial impulses reach the ventricles, but conduction through the AV node is delayed. This delay is reflected on the ECG as a PR interval longer than 0.20 seconds, while the QRS complex remains normal. First-degree AV block is usually asymptomatic and often does not require treatment.

B. This description fits second-degree AV block, not first-degree. In first-degree block, no impulses are blocked, only delayed.

C. First-degree AV block is generally asymptomatic, and patients rarely experience symptoms. Symptoms such as syncope are more characteristic of higher-degree AV blocks.

D. Pacemaker therapy is not indicated for first-degree AV block unless it progresses to higher-degree AV block with symptomatic bradycardia. Immediate intervention is not needed in asymptomatic patients.

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Correct Answer is D

Explanation

Rationale:
A. A normal QRS duration is 0.06–0.10 seconds. A duration of 0.20 seconds indicates a ventricular conduction delay or bundle branch block, which is not normal sinus rhythm.

B. A normal PR interval is 0.12–0.20 seconds. A measurement of 0.22 seconds suggests a first-degree heart block, which is an abnormal finding.

C. Normally, T waves are upright in most leads. Inverted T waves can indicate ischemia, infarction, or electrolyte disturbances, which are not consistent with normal sinus rhythm.

D. In normal sinus rhythm, the P wave precedes each QRS complex, reflecting proper atrial depolarization followed by ventricular depolarization. This relationship confirms that the electrical impulse is originating from the sinoatrial (SA) node, which defines normal sinus rhythm.

A. "Endocarditis is an infection of the endocardium resulting from a bloodborne pathogen that adheres to an injured part of the endocardium. B. "Only children with congenital heart disease are at risk for endocarditis, so your child likely has an underlying condition." C. "Endocarditis and its sequalae are localized to the heart and do not typically impact other parts of the body." D. "Endocarditis only occurs in children who are immunocompromised, because they are not able to fight off the bacterial infection in the heart."

Correct Answer is A

Explanation

Rationale:
A. This statement is accurate. Infective endocarditis occurs when bacteria or other pathogens in the bloodstream attach to damaged areas of the endocardium or heart valves, leading to vegetation formation and potential systemic complications.

B. This is incorrect because anyone with predisposing factors, such as prosthetic heart valves, previous endocarditis, or certain cardiac lesions, can develop endocarditis. It is not limited to children or congenital heart disease.

C. This is incorrect because infective endocarditis can have systemic effects, including septic emboli, stroke, renal infarction, and other organ involvement.

D. While immunocompromised patients are at increased risk, endocarditis can occur in any patient with susceptible cardiac endothelium or exposure to pathogens, regardless of age or immune status.

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A 55-year-old patient with a history of hypertension is undergoing a routine ECG as part of their annual check-up. The ECG reveals a first-degree AV block. Which of the following statements about first-degree AV block is correct?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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