This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: ECG and Arrhythmias 1, Subject name: Medicine
A 35 year old lady with following skin lesion and repeated episodes of syncope on sudden change of position. ECG shows? 
Select and explain. 
A. Complete hea Block, B. First degree hea block, C. Second degree hea block, D. 2:1 hea block
A: Complete hea Block
Answer: A: Complete hea Block 
Explanation: The rhythm strip shows lack of relation between P wave and QRS complexes. Notice a P wave followed by another P wave. (RED). P-P interval is about 100/min (BLUE). RR interval is 40/min (ORANGE). PR interval is changing with every beat. These findings are seen in complete hea block. The picture of nose of patient indicates lupus pernio. The patient is suffering from cardiac complications of sarcoidosis.