rida
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An alteration of a patient's EKG shows higher frequency of P waves than for the QRS complexes. Both showed a regular pattern. Which of the following would be the most likely cause of the change?
A) Increased sympathetic tone to the SA node
B) Increased parasympathetic tone to the SA node
C) Prolonged PR interval
D) Conduction failure of the AV node
E) Atrial fibrillation
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| mash
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seems second degree AV block,
i ll go with D ) conduction failure of AV node
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| rida
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Yes you are absolutely right!
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| intern_doc
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Mash,
You mean second degree AV block type II (Mobitz) right ?
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| mani
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nops, its 3rd degree block. concecntrate on "regular pattern"
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| mash
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mani, 3rd degree block is complete AV dissociation
intern doc , yeah it is type II mobitz
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| dranuragagrawal
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mashs right
its type ii mobitz
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| mani
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in 3rd degree block, p waves will have there own regular pattern and QRS wil have its own regular pattern, but rates of both will b different. so i think to interprete this question, one mor ething is needed ie rate of P and QRS
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| dranuragagrawal
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u are right but i think we should interpret regular to mean that p n qrs are mutually coordinated n regular together as a unit and not consider them separately
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| mani
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there is no clue in the question that p and qrs are "mutually " regular, anyhow i think exam questions are never too ambiguos like this, so we shouldnt worry about it
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| dranuragagrawal
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if at all u want to associate the word irregular with... wuld u associate with type 2 or type 3 block
i know exam ques are not like that but still we shuld learn to pick the best choice..
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| mani
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what i m trying to emphasize is that in 3rd degree block Ps will be regular with respect to each other and QRS will be regular wrt other QRS and both will have a definite rate which will be different for P and QRS. in 2nd degree block, there wil be some qrs missing, so qrs may be irregular wrt each other
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| Idiopathic
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To diagnose 3rd degree, you would need a ventricular rate (i.e. 45 bpm).
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| mjl1717
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There is disassociation of the P waves and QRS complex.
According to Robert Dunn -[Physio at Kaplan] impulses are not conducted from atria to ventricle. He also states the frequency of p waves is greater than the frequency of QRS complexes.
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| Idiopathic
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That is true, BUT P waves and QRS are both regular, just not connected to each other.
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| mani
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yep, ideopathic, u got my point!!
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| rubyduby
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me too. u right anyways its just a simple mobitzII, but i wish they give such a pices of cake questions
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