[MCQ] The Bradyarrhythmias- Part 2

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The Bradyarrhythmias- Part 2

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Congratulations - you have completed The Bradyarrhythmias- Part 2. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Which of the following statements is false ?

A	AV node is a subendocardial
B	Located at posterior-inferior right atrium
C	Located at apex of triangle of Koch
D	None of the above

Question 2

Boundaries of triangle of Koch include all except ?

A	Coronary sinus ostium
B	Septal tricuspid valve annulus
C	Septal mitral valve annulus
D	Tendon of Todaro

Question 2 Explanation:

Triangle of Koch is bordered by coronary sinus ostium posteriorly, septal tricuspid valve annulus anteriorly & tendon of Todaro superiorly

Question 3

Which of the following about His bundle & bundle branches is false ?

A	Minimally influenced by autonomic tone
B	Minimally influenced by autonomic tone
C	Insulated from ventricular myocardium
D	None of the above

Question 4

Myocytes that constitute the compact node have a resting membrane potential of about ?

A	- 50 mV
B	- 60 mV
C	- 70 mV
D	- 80 mV

Question 4 Explanation:

Myocytes that constitute the compact node are depolarized with a resting membrane potential of about –60 mV. Action potentials have low amplitudes, slow upstrokes of phase 0 (<10 V/s), and phase 4 diastolic depolarization, high-input resistance and relative insensitivity to external [K+].

Question 5

AV nodal cells lack which of the following ?

A	INa
B	ICa-L
C	ICa-T
D	If

Question 5 Explanation:

AV nodal cells lack I K1 and INa. ICa-L is responsible for phase 0. Phase 4 depolarization reflects the composite activity of the depolarizing currents If, ICa-L, ICa-T, and INCX and the repolarizing currents I Kr and IKACh.

Question 6

Which of the following is associated with SA node slowing and AV conduction block ?

A	Carotid sinus hypersensitivity
B	Cough
C	Micturition syncope
D	All of the above

Question 6 Explanation:

Heightened vagal tone during sleep or in well-conditioned individuals can lead to all grades of AV block. Carotid sinus hypersensitivity, vasovagal syncope, and cough and micturition syncope may be associated with SA node slowing and AV conduction block

Question 7

Conditions that can produce AV conduction block include ?

A	Tuberculosis
B	Lyme disease
C	Diphtheria
D	All of the above

Question 8

Conditions that can produce AV conduction block include ?

A	Chagas disease
B	Toxoplasmosis
C	Syphilis
D	All of the above

Question 9

Conditions that can produce AV conduction block include ?

A	Sarcoidosis
B	Systemic lupus erythematosus
C	Rheumatoid arthritis
D	All of the above

Question 9 Explanation:

Infectious diseases that lead to conducting system disturbances include Lyme disease, Chagas’ disease, and syphilis. Autoimmune and infiltrative diseases like SLE, RA, MCTD, scleroderma, amyloidosis (primary & secondary), sarcoidosis, and hemochromatosis may produce AV conduction block

Question 10

Mutation in which of the following gene causes accelerated forms of progressive familial heart block ?

A	KCNQ1
B	KCNH2 (HERG)
C	SCN5A
D	ANK2

Question 10 Explanation:

Accelerated forms of progressive familial heart block have been identified in families with mutations in cardiac sodium channel gene (SCN5A).

Question 11

AV conduction block has been associated with which of the following ?

A	Kearns-Sayre syndrome
B	Myotonic dystrophy
C	Facioscapulohumeral muscular dystrophy
D	All of the above

Question 12

Congenital AV block may be seen in which of the following ?

A	Transposition of the great arteries
B	Ostium primum atrial septal defect
C	Ventricular septal defect
D	All of the above

Question 13

Congenital AV block in a structurally normal heart is seen in children born to mothers with ?

A	SLE
B	Sarcoidosis
C	Rheumatoid arthritis
D	Hemochromatosis

Question 14

In acute MI, AV block transiently develops in what percentage of patients ?

A	5 - 10 %
B	10 - 25 %
C	10 - 25 %
D	30 - 45 %

Question 14 Explanation:

30 - 45 %

Question 15

PR interval is determined by ?

A	Atrial activation
B	AV nodal activation
C	His-Purkinje activation
D	All of the above

Question 15 Explanation:

I° AV block (PR interval > 200 ms) is a slowing of conduction through AV “junction”. The site of delay is typically in AV node but may be in atria, AV node bundle of His, or His-Purkinje system

Question 16

I° AV block with wide QRS suggests delay in ?

A	Proximal AV node
B	Mid AV node
C	Distal AV node
D	Distal conduction system

Question 16 Explanation:

I° AV block with wide QRS is suggestive of delay in the distal conduction system, whereas a narrow QRS suggests delay in the AV node proper or, less commonly, in the bundle of His

Question 17

Nationality of Woldemar Mobitz was ?

A	Russian German
B	British American
C	Spanish
D	Anglo Indian

Question 17 Explanation:

Woldemar Mobitz (1889 - 1951) was a Russian-German physician.

Question 18

Mobitz Type I is also named after ?

A	Karel Frederik Wenckebach
B	Karel Frederik Wenckebach
C	Robert Silverman
D	Jack Upshaw

Question 19

Mobitz Type II is also named after ?

A	Karel Frederik Wenckebach
B	John Hay
C	Robert Silverman
D	Robert Silverman

Question 20

In presence of a normal duration QRS complex, delay within AV node is the cause of prolonged PR interval if it is ?

A	> 0.21 second
B	> 0.22 second
C	> 0.23 second
D	> 0.24 second

Question 21

When some atrial impulses fail to conduct to ventricles, the type of AV block is ?

A	First-degree heart block
B	Second-degree heart block
C	Third-degree heart block
D	Sick sinus syndrome

Question 21 Explanation:

In II° AV block there is an intermittent failure of electrical impulse conduction from atrium to ventricle.

Question 22

Which of the following statements about Mobitz type I, second degree AV block is false ?

A	Also called AV Wenckebach block
B	Progressive PR prolongation prior to block of an atrial impulse
C	Pause that follows is fully compensatory
D	PR interval of first conducted impulse is shorter than last conducted atrial impulse prior to blocked P wave

Question 22 Explanation:

PR interval of first conducted impulse is shorter than last conducted atrial impulse prior to blocked P wave

Question 23

Which of the following statements about Mobitz type I second degree AV block is false ?

A	Usually the difference between the longest & shortest PR intervals exceeds 100 mseconds
B	Block is almost always localized to AV node
C	Usually associated with a normal QRS duration
D	Amiodarone therapy is a frequent cause

Question 24

Which of the following statements about Mobitz type I second degree AV block is false ?

A	Most often occurs transiently with inferior MI
B	Due to Digitalis, -blockers, and Ca++ channel blockers
C	Seen in normal individuals with heightened vagal tone
D	Leads to complete heart block

Question 24 Explanation:

In Mobitz type 1 II° AV block, difference between the longest & shortest PR intervals exceeds 100 mseconds. It is almost always localized to AV node & associated with a normal QRS duration. It is seen most often as a transient abnormality with inferior wall infarction or with drug intoxication (digitalis, beta and calcium channel blockers) or in normal individuals with heightened vagal tone. Progression to complete heart block is uncommon, except in acute inferior wall myocardial infarction. Even when it does, this heart block is well tolerated because the escape pacemaker usually arises in the proximal His bundle & provides a stable rhythm & rarely requiring aggressive therapy

Question 25

Which of the following statements about Mobitz type II second degree AV block is false ?

A	Conduction fails suddenly and unexpectedly without a preceding change in PR intervals
B	Due to disease of His-Purkinje system and associated with prolonged QRS duration
C	When Mobitz type II block occurs with a normal QRS duration, an intra-AV node block should be expected
D	High incidence of progression to complete heart block with an unstable, slow, lower escape pacemaker

Question 26

Which of the following statements about Mobitz type II second degree AV block is false ?

A	Occur in anteroseptal myocardial infarction
B	Occur in primary or secondary sclerodegenerative or calcific disorders of fibrous skeleton of heart
C	Block is usually in AV node
D	Block is usually in His-Purkinje system

Question 27

Which of the following statements about Mobitz type II second degree AV block is false ?

A	Intermittent failure of conduction of the P wave without changes in the preceding PR intervals
B	Intermittent failure of conduction of the P wave without changes in the preceding RR intervals
C	Typically occurs in distal or infra-His conduction system
D	None of the above

Question 27 Explanation:

None of the above

Question 28

It may be difficult to distinguish between type I from type II block when AV block is ?

A	2 : 1
B	3 : 1
C	4 : 1
D	5 : 1

Question 28 Explanation:

When AV block is 2:1, it may be difficult to distinguish type I from type II block. The finding of a His bundle electrogram after every atrial electrogram indicates that block is occurring in the distal conduction system

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See all quizzes of the The Bradyarrhythmias at here:

The Bradyarrhythmias- Part 1 | The Bradyarrhythmias- Part 2 | The Bradyarrhythmias- Part 3

1.Which of the following statements is false ?
A. AV node is a subendocardial
B. Located at posterior-inferior right atrium
C. Located at apex of triangle of Koch
D. None of the above

2. Boundaries of triangle of Koch include all except ?
A. Coronary sinus ostium
B. Septal tricuspid valve annulus
C. Septal mitral valve annulus
D. Tendon of Todaro

3. Which of the following about His bundle & bundle branches is false ?
A. Minimally influenced by autonomic tone
B. Have most rapid conduction in heart
C. Insulated from ventricular myocardium
D. None of the above

4. Myocytes that constitute the compact node have a resting membrane potential of about ?
A. – 50 mV
B. – 60 mV
C. – 70 mV
D. – 80 mV

5. AV nodal cells lack which of the following ?
A. INa
B. ICa-L
C. ICa-T
D. If

4. Which of the following is associated with SA node slowing and AV conduction block ?
A. Carotid sinus hypersensitivity
B. Cough
C. Micturition syncope
D. All of the above

5. Conditions that can produce AV conduction block include ?

A. Tuberculosis
B. Lyme disease
C. Diphtheria
D. All of the above

6. Conditions that can produce AV conduction block include ?
A. Chagas disease
B. Toxoplasmosis
C. Syphilis
D. All of the above

7. Conditions that can produce AV conduction block include ?
A. Sarcoidosis
B. Systemic lupus erythematosus
C. Rheumatoid arthritis
D. All of the above

8. Mutation in which of the following gene causes accelerated forms of progressive familial heart block ?
A. KCNQ1
B. KCNH2 (HERG)
C. SCN5A
D. ANK2

9. AV conduction block has been associated with which of the following ?
A. Kearns-Sayre syndrome
B. Myotonic dystrophy
C. Facioscapulohumeral muscular dystrophy
D. All of the above

10. Congenital AV block may be seen in which of the following ?
A. Transposition of the great arteries
B. Ostium primum atrial septal defect
C. Ventricular septal defect
D. All of the above

11. Congenital AV block in a structurally normal heart is seen in children born to mothers with ?
A. SLE
B. Sarcoidosis
C. Rheumatoid arthritis
D. Hemochromatosis

12. In acute MI, AV block transiently develops in what percentage of patients ?
A. 5 – 10 %
B. 10 – 25 %
C. 20 – 35 %
D. 30 – 45 %

13. PR interval is determined by ?
A. Atrial activation
B. AV nodal activation
C. His-Purkinje activation
D. All of the above

14. I° AV block with wide QRS suggests delay in ?
A. Proximal AV node
B. Mid AV node
C. Distal AV node
D. Distal conduction system

15. Nationality of Woldemar Mobitz was ?
A. Russian German
B. British American
C. Spanish
D. Anglo Indian

16. Mobitz Type I is also named after ?
A. Karel Frederik Wenckebach
B. John Hay
C. Robert Silverman
D. Jack Upshaw

17. Mobitz Type II is also named after ?
A. Karel Frederik Wenckebach
B. John Hay
C. Robert Silverman
D. Jack Upshaw

18. In presence of a normal duration QRS complex, delay within AV node is the cause of prolonged PR interval if it is ?
A. > 0.21 second
B. > 0.22 second
C. > 0.23 second
D. > 0.24 second

19. When some atrial impulses fail to conduct to ventricles, the type of AV block is ?
A. First-degree heart block
B. Second-degree heart block
C. Third-degree heart block
D. Sick sinus syndrome

20. Which of the following statements about Mobitz type I, second degree AV block is false ?
A. Also called AV Wenckebach block
B. Progressive PR prolongation prior to block of an atrial impulse
C. Pause that follows is fully compensatory
D. PR interval of first conducted impulse is shorter than last conducted atrial impulse prior to blocked P wave

21. Which of the following statements about Mobitz type I second degree AV block is false ?
A. Usually the difference between the longest & shortest PR intervals exceeds 100 mseconds
B. Block is almost always localized to AV node
C. Usually associated with a normal QRS duration
D. Amiodarone therapy is a frequent cause

22 .Which of the following statements about Mobitz type I second degree AV block is false ?
A. Most often occurs transiently with inferior MI
B. Due to Digitalis, -blockers, and Ca++ channel blockers
C. Seen in normal individuals with heightened vagal tone
D. Leads to complete heart block

23. Which of the following statements about Mobitz type II second degree AV block is false ?
A. Conduction fails suddenly and unexpectedly without a preceding change in PR intervals
B. Due to disease of His-Purkinje system and associated with prolonged QRS duration
C. When Mobitz type II block occurs with a normal QRS duration, an intra-AV node block should be expected
D. High incidence of progression to complete heart block with an unstable, slow, lower escape pacemaker

24. Which of the following statements about Mobitz type II second degree AV block is false ?
A. Occur in anteroseptal myocardial infarction
B. Occur in primary or secondary sclerodegenerative or calcific disorders of fibrous skeleton of heart
C. Block is usually in AV node
D. Block is usually in His-Purkinje system

25. Which of the following statements about Mobitz type II second degree AV block is false ?
A. Intermittent failure of conduction of the P wave without changes in the preceding PR intervals
B. Intermittent failure of conduction of the P wave without changes in the preceding RR intervals
C. Typically occurs in distal or infra-His conduction system
D. None of the above

26. It may be difficult to distinguish between type I from type II block when AV block is ?
A. 2 : 1
B. 3 : 1
C. 4 : 1
D. 5 : 1

The Bradyarrhythmias

[MCQ] The Bradyarrhythmias- Part 2

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The Bradyarrhythmias- Part 2

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[MCQ] The Bradyarrhythmias- Part 3

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