How to answer an ECG Image MCQ for NEET PG, AIIMS & DNB?

Steps to remember when you answer an ECG Image Question (MCQ)


How to approach an ECG MCQ for NEET PG, DNB or AIIMS?

Most people think of the pattern and try to connect it to what they have seen before. This can lead to unwanted surprises when you leave the exam and discuss it with friends.

Here is a simple way of looking at the important aspects of ECG. This 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, NEET, DNB or other medical PG entrance exams.

How to be systematic when you approach a Medical PG Image MCQ?

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:

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

  1. Look for the Rhythm. Keep it simple. Is it regular or irregular?
  2. What is the Rate? This is important to differentiate arrhythmias. 
  3. How good is Conduction? See PQ interval or PR interval, QRS duration and QT interval
  4. P wave morphology: An abnormal P wave makes your diagnosis easier
  5. QRS morphology: Are there Q waves? How is QRS interval? Is R wave normal?
  6. ST Morphology: Look for ST elevation, ST Depression and T wave changes. 
  7. Conclusion: Write down what you see in the ECG before thinking of diagnosis. You have few seconds to do this in an exam setting. So practice is important. 

Now see the sample MCQ on the right column. See how a diagnosis is reached using this method. 


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

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How to find answer for this ECG image MCQ using the G2M 7-steps approach?


  1. Rhythm. Regular
  2. What is the Rate? Normal
  3. How good is Conduction? QRS duration is prolongedPR interval normal
  4. P wave morphology: Normal, 1:1 Ratio, normal rate
  5. QRS morphology: QRS duration is prolonged and it is broad
  6. ST Morphology: S wave is broader than R wave. ST Normal. 
  7. 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.

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