[MCQ] The Tachyarrhythmias- Part 2

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The Tachyarrhythmias- Part 2

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

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Question 1

Tachycardia-induced cardiomyopathy’ is cause by ?

A	Digitalis
B	Atrial Fibrillation
C	Thyrotoxicosis
D	Acute alcoholic intoxication

Question 2

Which of the following is a precipitating factor for acute AF ?

A	Pulmonary emboli
B	CHF
C	Pericarditis
D	All of the above

Question 3

In AF, if a patient’s clinical status is severely compromised, which of the following is the treatment of choice ?

A	 adrenergic blocke
B	Calcium channel antagonist
C	Digitalis
D	Electrical cardioversion

Question 4

It is difficult to convert AF to sinus rhythm and/or maintain it, despite therapy, when the left atrial diameter exceeds ?

A	2.5 cm
B	3.5 cm
C	4.5 cm
D	4.5 cm

Question 5

IV heparin treatment is begun, if the duration of AF is ?

A	> 3 hours
B	> 6 hours
C	> 9 hours
D	> 12 hours

Question 5 Explanation:

IV heparin tt. is begun if duration of AF is >12 hours & risk factors for stroke with AF are present

Question 6

Ventricular rate control for acute AF is best established with ?

A	Adenosine
B	Beta blockers
C	Beta blockers
D	Digoxin

Question 6 Explanation:

Ventricular rate control for acute AF is best established with beta blockers and/or calcium channel blocking agents, verapamil or diltiazem. Digoxin may add to the rate-controlling benefit of other agents but is uncommonly used as a stand-alone agent, especially in acute AF

Question 7

In AF, conversion to sinus rhythm by cardioversion should be done after proper anticoagulation for ?

A	1 week
B	2 weeks
C	2 weeks
D	4 weeks

Question 7 Explanation:

For patients who do not warrant early cardioversion of AF, anticoagulation should be maintained for at least 3 weeks with the INR confirmed to be >1.8 on at least two separate occasions prior to attempts at cardioversion

Question 8

In AF, following cardioversion, anticoagulation must be maintained for ?

A	1 week
B	2 weeks
C	3 weeks
D	4 weeks

Question 9

Electrical cardioversion for AF is accomplished through delivery of ?

A	At least 40 J
B	At least 100 J
C	At least 200 J
D	At least 200 J

Question 9 Explanation:

Direct current transthoracic cardioversion during short-acting anesthesia is a reliable way to terminate AF. Conversion rates using a 200-J biphasic shock delivered synchronously with the QRS complex typically are >90%

Question 10

Electrical cardioversion for atrial flutter is accomplished through delivery of ?

A	20 - 40 J
B	50 - 100 J
C	100 - 150 J
D	150 - 300 J

Question 10 Explanation:

Organized atrial flutter activity can frequently be terminated with low-energy external cardioversion of 50 - 100 J.

Question 11

Electrical cardioversion for atrioventricular nodal reentrant tachycardia (AVNRT) is accomplished through delivery of ?

A	20 - 40 J
B	50 - 100 J
C	100 - 200 J
D	200 - 300 J

Question 11 Explanation:

R wave synchronous DC cardioversion using 100 - 200 J can terminate atrioventricular nodal reentrant tachycardia (AVNRT).

Question 12

What energy should be used for initial attempts at terminating VF ?

A	At least 100 W
B	At least 200 W
C	At least 300 W
D	At least 400 W

Question 13

In AF, pretreatment with which of the following drugs facilitates cardioversion ?

A	Ibutilide
B	Beta blocker
C	Calcium antagonist
D	Digitalis

Question 13 Explanation:

IV ibutilide is more effective and may be used in selected patients to facilitate termination with direct current (DC) cardioversion

Question 14

Which drug is preferred in AF to maintain sinus rhythm in patients without evidence of structural heart disease ?

A	Sotalol
B	Flecainide
C	Amiodarone
D	Dofetilide

Question 14 Explanation:

In AF patients without evidence of structural heart disease, use of flecainide or propafenone (class IC) is well tolerated and does not have significant proarrhythmia risk.

Question 15

The Cox-MAZE procedure is a surgical approach to cure ?

A	AF
B	VT
C	PSVT
D	All of the above

Question 15 Explanation:

Most ablation strategies isolate atrial muscle sleeves entering the pulmonary veins which are a source of triggers responsible for initiation of AF. Risks include pulmonary vein stenosis, atrioesophageal fistula, systemic embolic events & perforation/tamponade. The Cox-Maze procedure is designed to interrupt all macroreentrant circuits that might potentially develop in the atria, thereby precluding the ability of the atria to fibrillate.

Question 16

Which of the following statements is false about macroreentrant arrhythmias ?

A	Macroreentrant arrhythmias involving atrial myocardium are called AFL
B	Nonfocal source of an atrial arrhythmia
C	AFL is poorly tolerated than AF
D	None of the above

Question 16 Explanation:

Macroreentrant nonfocal arrhythmias involving the atrial myocardium are referred to collectively as AFL

Question 17

Atrial flutter is a form of atrial reentry localized to the ?

A	Right atrium
B	Left atrium
C	Both atria
D	Both atria and AV node

Question 18

Typical AFL circuit rotates around ?

A	Mitral valve annulus
B	Tricuspid valve annulus
C	Aortic valve annulus
D	Pulmonary valve annulus

Question 19

In ECG, flutter waves of atrial flutter are most prominent in ?

A	Inferior leads
B	Anterior leads
C	Posterior leads
D	Lateral leads

Question 19 Explanation:

Typical AFL circuit rotates in right atrium around tricuspid valve annulus. Counterclockwise right AFL with superiorly directed activation of interatrial septum produces saw-toothed appearance of P waves in ECG leads II, III and aVF. Clockwise rotation of right atrial circuit produces predominantly positive P waves in leads II, III, and aVF

Question 20

In atrial flutter, the atrial rate is ?

A	150 and 250 bpm
B	260 and 300 bpm
C	300 and 400 bpm
D	400 and 550 bpm

Question 20 Explanation:

Classic or typical right AFL has an atrial rate of 260 - 300 beats/minute with a ventricular response at 2:1 or 130 - 150 beats/minute.

Question 21

Which of the following drugs is particularly effective for conversion of atrial flutter to sinus rhythm ?

A	Ibutilide
B	Beta blocker
C	Calcium antagonist
D	Digitalis

Question 21 Explanation:

In AFL, rate control with calcium antagonists (diltiazem, verapamil), beta blockers, and/or digoxin is difficult. In patients with high anesthestic risk, pharmacologic cardioversion with procainamide, amiodarone or ibultilide is appropriate. Antiarrhythmic drug therapy may enhance efficacy of direct current cardioversion & maintenance of sinus rhythm after cardioversion

Question 22

Which of the following drugs is useful in preventing recurrences of atrial flutter ?

A	Quinidine
B	Sotalol
C	Amiodarone
D	All of the above

Question 23

Which of the following statements about multifocal atrial tachycardia (MAT) is false ?

A	Defined as >= 3 consecutive P waves of different morphologies at rates >100 beats/minute
B	Common following theophylline administration
C	Irregular ventricular rate
D	High incidence of VF

Question 23 Explanation:

There is a high incidence of AF in patients with MAT.

Question 24

Which of the following is the signature tachycardia of significant pulmonary disease ?

A	Atrial flutter
B	Atrial fibrillation
C	Multifocal atrial tachycardia
D	AV Nodal reentrant tachycardia

Question 25

Which of the following about multifocal atrial tachycardia is false ?

A	Signature tachycardia of significant pulmonary disease
B	Isoelectric baseline on ECG
C	Absence of any intervening sinus rhythm
D	None of the above

Question 25 Explanation:

Macroreentrant ATs represent continuous atrial activation and isoelectric baseline between P waves is frequently absent.

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See all quizzes of the The Tachyarrhythmias at here:

1. ‘Tachycardia-induced cardiomyopathy’ is cause by ?
A. Digitalis
B. Atrial Fibrillation
C. Thyrotoxicosis
D. Acute alcoholic intoxication
2. Which of the following is a precipitating factor for acute AF ?
A. Pulmonary emboli
B. CHF
C. Pericarditis
D. All of the above

3. In AF, if a patient’s clinical status is severely compromised, which of the following is the treatment of choice ?
A.  adrenergic blocker
B. Calcium channel antagonist
C. Digitalis
D. Electrical cardioversion

4. It is difficult to convert AF to sinus rhythm and/or maintain it, despite therapy, when the left atrial diameter exceeds ?

A. 2.5 cm
B. 3.5 cm
C. 4.5 cm
D. 5.5 cm

5. IV heparin treatment is begun, if the duration of AF is ?
A. > 3 hours
B. > 6 hours
C. > 9 hours
D. > 12 hours

6. Ventricular rate control for acute AF is best established with ?
A. Adenosine
B. Beta blockers
C. Amiodarone
D. Digoxin

7. In AF, conversion to sinus rhythm by cardioversion should be done after proper anticoagulation for ?
A. 1 week
B. 2 weeks
C. 3 weeks
D. 4 weeks

8. In AF, following cardioversion, anticoagulation must be maintained for ?
A. 1 week
B. 2 weeks
C. 3 weeks
D. 4 weeks

9. Electrical cardioversion for AF is accomplished through delivery of ?
A. At least 40 J
B. At least 100 J
C. At least 200 J
D. At least 400 J

10. Electrical cardioversion for atrial flutter is accomplished through delivery of ?
A. 20 – 40 J

B. 50 – 100 J
C. 100 – 150 J
D. 150 – 300 J

11. Electrical cardioversion for atrioventricular nodal reentrant tachycardia (AVNRT) is accomplished through delivery of ?
A. 20 – 40 J
B. 50 – 100 J
C. 100 – 200 J
D. 200 – 300 J

12. What energy should be used for initial attempts at terminating VF ?
A. At least 100 W
B. At least 200 W
C. At least 300 W
D. At least 400 W

13. In AF, pretreatment with which of the following drugs facilitates cardioversion ?
A. Ibutilide
B. Beta blocker
C. Calcium antagonist
D. Digitalis

14. Which drug is preferred in AF to maintain sinus rhythm in patients without evidence of structural heart disease ?
A. Sotalol
B. Flecainide
C. Amiodarone
D. Dofetilide

15. The Cox-MAZE procedure is a surgical approach to cure ?
A. AF
B. VT
C. PSVT
D. All of the above

16. Which of the following statements is false about macroreentrant arrhythmias ?
A. Macroreentrant arrhythmias involving atrial myocardium are
called AFL

B. Nonfocal source of an atrial arrhythmia
C. AFL is poorly tolerated than AF
D. None of the above

17. Atrial flutter is a form of atrial reentry localized to the ?
A. Right atrium
B. Left atrium
C. Both atria
D. Both atria and AV node

18. Typical AFL circuit rotates around ?
A. Mitral valve annulus
B. Tricuspid valve annulus
C. Aortic valve annulus
D. Pulmonary valve annulus

19. In ECG, flutter waves of atrial flutter are most prominent in ?
A. Inferior leads
B. Anterior leads
C. Posterior leads
D. Lateral leads

20. In atrial flutter, the atrial rate is ?
A. 150 and 250 bpm
B. 260 and 300 bpm
C. 300 and 400 bpm
D. 400 and 550 bpm

21. Which of the following drugs is particularly effective for conversion of atrial flutter to sinus rhythm ?
A. Ibutilide
B. Beta blocker
C. Calcium antagonist
D. Digitalis

22. Which of the following drugs is useful in preventing recurrences of atrial flutter ?
A. Quinidine
B. Sotalol

C. Amiodarone
D. All of the above

23. Which of the following statements about multifocal atrial tachycardia (MAT) is false ?
A. Defined as >= 3 consecutive P waves of different morphologies at rates >100 beats/minute
B. Common following theophylline administration
C. Irregular ventricular rate
D. High incidence of VF

24. Which of the following is the signature tachycardia of significant pulmonary disease ?
A. Atrial flutter
B. Atrial fibrillation
C. Multifocal atrial tachycardia
D. AV Nodal reentrant tachycardia

25. Which of the following about multifocal atrial tachycardia is false ?
A. Signature tachycardia of significant pulmonary disease
B. Isoelectric baseline on ECG
C. Absence of any intervening sinus rhythm
D. None of the above

The Tachyarrhythmias

[MCQ] The Tachyarrhythmias- Part 2

I. Start the exam by click the “Start” button

The Tachyarrhythmias- Part 2

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