This set of Biomedical Instrumentation Question Bank focuses on “Clinical Data Interchange/Exchange Standards”.
1. What is an arrhythmia monitor?
a) Patient monitoring system
b) Sophisticated alarm system
c) Sophisticated monitoring system
d) ECG interpretation system
Explanation: An arrhythmia monitor is basically a sophisticated alarm system. It is not an ECG interpretation system. It constantly scans ECG rhythm patterns and issues alarms to events that may be premonitory or life threatening.
2. Which task is performed after the Ventricular fibrillation detection in automated arrhythmia monitoring system?
a) Noise detection
b) Beat labeling
c) Atrial fibrillation detection
d) Rhythm definition
Explanation: In automated arrhythmia monitoring system, Rhythm definition is performed after the Ventricular fibrillation detection. Rhythm definition is also performed after the beat labeling and atrial fibrillation detection in automated arrhythmia monitoring and analysis system.
3. In arrhythmia monitoring system, it gives alarm light signals whenever the prematured or widened ectopic beats exist up to the rate of __________
a) 6/min to 10/min
b) 6/min to 12/min
c) 6/min or 10/min
d) 6/min or 12/min
Explanation: In the arrhythmia monitoring instrument, it gives alarm light signals whenever the prematured or widened ectopic beat exist up to the rate of 6/min or 12/min.It is one of the operating sequences of the arrhythmia monitoring instrument.
4. ECG signal is amplified and filtered with 0.05-100 Hz for diagnostic purposes and 1-40 Hz for monitoring purposes in signal conditioning.
Explanation: It is True. ECG signal is amplified and filtered with 0.05-100 Hz for diagnostic purposes and 1-40 Hz for monitoring purposes in signal conditioning.
5. _________ resolution analog-to-digital converter is used in digitization of ECG signal in signal conditioning.
a) 16 bit
b) 12 bit
c) 32 bit
d) 64 bit
Explanation: In signal conditioning, ECG signal is amplified, filtered and digitized using an 8- or 12- bit analog-to-digital converter with a typical sampling rate of 250 Hz.
6. A disturbance in the heart’s normal rhythmic contraction is called ____________
a) Heart stroke
b) Cardiac arrest
d) Premature contraction
Explanation: Any disturbance in the heart’s normal rhythmic contraction is called an arrhythmias or cardiac dysrhythmia. In this arrhythmias heart can’t beat in a regular rhythm. In arrhythmia heart-rate will be higher than normal rate or will be less than the normal rate.
7. The steep, large amplitude variation of the QRS complex is the obvious characteristics to use and this is the function of the Q wave detector.
Explanation: It is False. Arrhythmia monitors require reliable R wave detectors as a prerequisite for subsequent analysis. The steep, large amplitude variation of the QRS complex is the obvious characteristics to use and this is the function of the R wave detector.
8. Which of the following two elements are removed by the detection filter in the process of the ECG waveform?
a) Low frequency noise, motion noise
b) Muscle artifact, motion noise
c) Baseline wander, motion noise
d) Baseline wander, muscle artifact
Explanation: The detection filter removes low frequency noise (baseline wander) and muscle artifact. The ECG waveform is processed by two digital filters: a detection filter and a classification filter. P waves and T waves are diminished.
9. The number of steps involved in the detection of QRS complex is ______
a) One step
b) Two steps
c) Three steps
d) Four steps
Explanation: The ECG is first preprocessed to enhance the QRS complex while suppressing noise, artifact and non-QRS portions of the ECG. QRS detection is now almost universally performed digitally in a two-step process. The output of the preprocessor stage is subjected to a decision rule that confirms detection of QRS if the processor output exceeds a threshold.
10. Which of the following is based on analyzing the shape of the QRS complexes and separating beats into groups or clusters?
a) Morphology characterization
b) Noise detection
c) Beat labeling
d) Timing classification
Explanation: Morphology characterization is based on analyzing the shape of the QRS complexes and separating beats into groups or clusters of similar morphology. Most algorithms for real time arrhythmia analysis maintain no more than 10-20 clusters at a time, order to limit the amount of computation needed to assign a QRS complex to a cluster.
11. What is the condition in which the R-R interval is declared premature?
a) If it is less than 75% of the predicted interval
b) If it is greater than 75% of the predicted interval
c) If it is less than 85% of the predicted interval
d) If it is greater than 85% of the predicted interval
Explanation: In timing classification, the observed R-R interval is compared to an estimate of the expected R-R interval. An R-R interval will be declared premature if it is less than 85% of the predicted interval. Similarly, an R-R interval is long if it is greater than 110% of the predicted value.
12. ___________ is the final stage in arrhythmia analysis.
a) Summary statistics
c) Rhythm labeling
d) Beat labeling
Explanation: It is based on defined sequences of QRS complexes. Rhythm labeling is the final stage in arrhythmia analysis. The analysis systems are heavily oriented towards detecting ventricular arrhythmias, particularly single PVCs.
13. ______________ techniques are used in a new algorithm proposed by Jen and Hwang to obtain the long term ECG signal feature and extract the meaningful information hiding in the QRS complex.
a) Cepstrum time warping and Dynamic coefficient
b) Cepstrum coefficient and Dynamic time warping
c) QRS detection and Dynamic coefficient
d) QRS detection and Cepstrum time warping
Explanation: This algorithm may also be used for arrhythmia detection by simply checking the difference of R-R wave intervals through signal feature extraction comparison for a certain period of time. Jen and Hwang proposed a new algorithm using cepstrum coefficient and the dynamic time warping techniques to obtain the long term ECG signal feature and extract the meaningful information hiding in the QRS complex.
14. Which of the following is used to detect Ventricular Fibrillation?
a) Shape of the QRS complexes
b) Frequency domain analysis
c) Timing sequence of QRS complexes
d) Difference of the R-R interval
Explanation: Ventricular fibrillation is usually detected by frequency domain analysis. It can be distinguished from noise by appropriately designing band-pass filters. The system is characterized as a narrow-band, low frequency signal with energy concentrated in a band around 5-6 Hz.
15. ____________ is the sampling rate of analog-to-digital converter in digitizing of ECG signal in signal conditioning.
a) 200-215 Hz
b) 215 Hz
c) 40-100 Hz
d) 250 Hz
Explanation: In signal conditioning, ECG signal is amplified, filtered (0.05-100 Hz for diagnostic purposes, 1-40 Hz for monitoring purposes) and digitized using an 8- or 12-bit analog-to-digital converter with a typical sampling rate of 250 Hz.
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