APEX EKG TEST PRACTICE
EXAMINATION 2026 QUESTIONS
WITH ANSWERS GRADED A+
◍ 2nd Degree Heart BlockMobitz Type I"Longer, longer, longer drop, then
you have a Wenckebach....".
Answer: PR gets longer w/ each cycleLast P does not conduct to ventricles
b/c it gets to AV node in absolute refractory pd Affected region:- AV node
Causes:- structural conduction defect- myocardial injury/infarction- beta
blockers- CCBs- digoxin- sympatholytic agents
◍ 2nd Degree Heart BlockMobitz Type II"If some Ps don't get through, then
you have a Mobitz I
I. ..".
Answer: Some Ps conduct to ventricles, others don't (ratio of 2:1 or
3:1)Affected region:- His bundle or bundle branchesCauses:- structural
conduction defect- infarctionTx:- often symptomatic (palp, syncope)-
pacemaker- atropine often not effectiveKey point:- high risk of progressing
to complete heart block
◍ 3rd Degree Heart Block"If Ps and Qs don't agree, then you have a 3rd
degree...".
Answer: Atria and ventricles each have their own rates (AV dissociation)-
block in AV node has narrow QRS w/ rate 45 - 55- block below AV node
has wide QRS w/ rate 30 - 40Caused by:- fibrotic degen of atrial conduction
system- Lenegre's dzTx:- often symptomatic (dyspnea, syncope, weakness,
vertigo)- pacemaker- isoproterenol Key pts:- can cause CHF d/t dec. HR and
CO- Stokes-Adams attack = dec. CO ---dec. cerebral perf--syncope
◍ Antiarrhythmics Class IMOA.
Answer: Na+ channel blockersinhibit fast sodium channels
, ◍ Antiarrhythmics Class IIA MOA.
Answer: moderate depression of phase 0prolongs phase 3 repol
◍ Antiarrhythmics Class IADrugs.
Answer: QuinidineProcainamideDisopyramide
◍ Antiarrhythmics Class IIB MOA.
Answer: weak depression of phase 0shortened phase 3 repol
◍ Antiarrhythmics Class IBDrugs.
Answer: LidocainePhenytoin
◍ Antiarrhythmics Class IIC MOA.
Answer: strong depression of phase 0little fx on phase 3 repol
◍ Antiarrhythmics Class ICDrugs.
Answer: FlecainidePropafenone
◍ Antiarrhythmics Class IIMOA.
Answer: Beta blockersslows phase 4 depolarization in SA node
◍ Antiarrhythmics Class IIDrugs.
Answer: EsmololMetoprololAtenololPropranolol
◍ Antiarrhythmics Class IIIMOA.
Answer: K+ channel blockers
◍ Antiarrhythmics Class IIIDrugs.
Answer: AmiodaroneBretylium
◍ Antiarrhythmics Class IV MOA.
Answer: Ca+2 channel blockers decreased conduction through AV node
◍ Antiarrhythmics Class IV Drugs.
Answer: VerapamilDiltiazem
◍ What is the MOA of adenosine?.
Answer: endogenous nucleoside that slows conduction through AV node by
stimulating cardiac adenosine-1 receptor
EXAMINATION 2026 QUESTIONS
WITH ANSWERS GRADED A+
◍ 2nd Degree Heart BlockMobitz Type I"Longer, longer, longer drop, then
you have a Wenckebach....".
Answer: PR gets longer w/ each cycleLast P does not conduct to ventricles
b/c it gets to AV node in absolute refractory pd Affected region:- AV node
Causes:- structural conduction defect- myocardial injury/infarction- beta
blockers- CCBs- digoxin- sympatholytic agents
◍ 2nd Degree Heart BlockMobitz Type II"If some Ps don't get through, then
you have a Mobitz I
I. ..".
Answer: Some Ps conduct to ventricles, others don't (ratio of 2:1 or
3:1)Affected region:- His bundle or bundle branchesCauses:- structural
conduction defect- infarctionTx:- often symptomatic (palp, syncope)-
pacemaker- atropine often not effectiveKey point:- high risk of progressing
to complete heart block
◍ 3rd Degree Heart Block"If Ps and Qs don't agree, then you have a 3rd
degree...".
Answer: Atria and ventricles each have their own rates (AV dissociation)-
block in AV node has narrow QRS w/ rate 45 - 55- block below AV node
has wide QRS w/ rate 30 - 40Caused by:- fibrotic degen of atrial conduction
system- Lenegre's dzTx:- often symptomatic (dyspnea, syncope, weakness,
vertigo)- pacemaker- isoproterenol Key pts:- can cause CHF d/t dec. HR and
CO- Stokes-Adams attack = dec. CO ---dec. cerebral perf--syncope
◍ Antiarrhythmics Class IMOA.
Answer: Na+ channel blockersinhibit fast sodium channels
, ◍ Antiarrhythmics Class IIA MOA.
Answer: moderate depression of phase 0prolongs phase 3 repol
◍ Antiarrhythmics Class IADrugs.
Answer: QuinidineProcainamideDisopyramide
◍ Antiarrhythmics Class IIB MOA.
Answer: weak depression of phase 0shortened phase 3 repol
◍ Antiarrhythmics Class IBDrugs.
Answer: LidocainePhenytoin
◍ Antiarrhythmics Class IIC MOA.
Answer: strong depression of phase 0little fx on phase 3 repol
◍ Antiarrhythmics Class ICDrugs.
Answer: FlecainidePropafenone
◍ Antiarrhythmics Class IIMOA.
Answer: Beta blockersslows phase 4 depolarization in SA node
◍ Antiarrhythmics Class IIDrugs.
Answer: EsmololMetoprololAtenololPropranolol
◍ Antiarrhythmics Class IIIMOA.
Answer: K+ channel blockers
◍ Antiarrhythmics Class IIIDrugs.
Answer: AmiodaroneBretylium
◍ Antiarrhythmics Class IV MOA.
Answer: Ca+2 channel blockers decreased conduction through AV node
◍ Antiarrhythmics Class IV Drugs.
Answer: VerapamilDiltiazem
◍ What is the MOA of adenosine?.
Answer: endogenous nucleoside that slows conduction through AV node by
stimulating cardiac adenosine-1 receptor
