ECGs for AIIMS and NEET PG – Early revision tips

ECG Image MCQs – A practical approach

A practical evaluation of ECG Image MCQ for AIIMS PG, DNB or NEET PG 2019?

Most people think of the pattern and try to connect it to what they have seen before. This guesswork can surprise you when you learn your mistakes. Here is a simple way of looking at the critical aspects of ECG. This explanation is not all-inclusive, but it can help solve most of the MCQs asked in the exams.

The best approach is to be systematic but not to think too deep like a cardiologist when you solve an ECG MCQ in AIIMS PG, NEET PG 2019, DNB or JIPMER.

How to be systematic when you approach an Image or Clinical ECG questions for AIIMS PG and NBE exams?

Look at the ECG, and you will have a first intuition or gut instinct. Write it down but don’t answer yet! Follow the steps below:

Seven quick steps to answer an ECG image question accurately. Follow the order given below.

Look for the Rhythm. Keep it simple. Is it regular or irregular? Check the distance between 2 QRS complexes. Also, see if P ways are always present before QRS (and equidistant).
What is the Rate? Watch for high or low rate (Tachy or Bradi arrhythmias). Are the rates of P wave and QRS the same?
How good is Conduction? Look for PQ interval or PR interval, QRS duration, QT interval and conduction indicators.
P wave morphology: A P wave variant makes your diagnosis easier. Make sure you look for and see a P wave.
QRS morphology: Are there Q waves and R waves? See QRS interval. Is there narrowing or prolongation of QRS?
ST Morphology: Watch for ST elevation, ST Depression or T wave variations.
Conclusion: Quickly write down what you see. Do not jump into diagnosis. Practice this on at least 70 ECGs.

Attempt a sample question below for the above practice.

In the ECG given below, which of the following conditions explains the abnormalities?

A. 3rd Degree Heart Block
B. Bundle Branch Block
C. Junctional Rhythm
D. Wenckebach Phenomenon

Answer - Click Here

Use the 7-step practical approach to describe the ECG:

Rhythm. Regular rhythm. Sinus rhythm – P & QRS related.
What is the Rate? Normal rate
How good is Conduction? QRS duration is prolonged; PR interval normal
P wave morphology: Normal, 1:1 Ratio, normal rate
QRS morphology: QRS duration is extended, and it is broad
ST Morphology: S wave is broader than R wave. ST Normal.
Conclusion: Increased QRS duration + S wave > R wave. Normal rate, normal rhythm, normal ST and normal P waves. Diagnosis is RBBB, Right Bundle Branch Block. You need to know how to convert your interpretation to a diagnosis. This requires the practice of theory.

When it comes to ECGs practice is what matters the most. It is recommended that you revise and learn at least 70 Image ECG MCQs to be sure of scoring the questions. It is good to learn early. GateToMedicine (g2m) 101 MCQs capsule can be revised online on mobiles or a laptop. It is your constant companion in your pocket. Platinum Access includes all ECG MCQs and 22,000 MCQs along with 616 mock exams.

Get the appropriate courses for you from the G2M Store link below. Note: New Android App releasing in February is Free for Platinum access candidates.

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Recommended: Learn the most important ECG MCQs from 101 ECG MCQs package. Image ECG MCQs for NEET-PG is important and must revise. It also covers all Medical PG exams including NEET PG and ECG knowledge questions for NBE exams and key areas related to the functioning of heart relevant to ECG.