[MCQ] The Tachyarrhythmias- Part 7

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The Tachyarrhythmias- Part 7

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Question 1

Which of the following is not useful in diagnosis of LQTS ?

A	Echocardiography
B	Holter monitoring
C	Electrophysiological testing
D	All of the above

Question 1 Explanation:

Physical examination, echocardiography, MRI, Holter monitoring and electrophysiological testing show no abnormalities in LQTS

Question 2

Most powerful predictor of risk in LQTS is ?

A	QTc duration
B	Family history
C	History of syncope
D	Gender

Question 2 Explanation:

The most powerful predictor of risk is the QTc duration. Marked lengthening of the QT interval to > 500 ms is clearly associated with a greater arrhythmia risk in patients with the LQTS. In LQT2, females fared worse than their males, while opposite was true in LQT3, and no sex bias occurs in LQT1. Syncope and sudden death are most frequent in childhood and adolescence. The risk of cardiac events is higher in males before puberty and higher in females during adulthood

Question 3

Which of the following is false about LQT1 ?

A	Most common genotypic abnormality in LQTS
B	QT interval fails to shorten with exercise
C	T wave is broad
D	None of the above

Question 4

Which of the following is false about LQT1 ?

A	Exercise is the most common trigger for arrhythmias
B	Respond to beta blocker therapy
C	Due to mutation in potassium-channel gene (KCNQ1) on chromosome 11
D	None of the above

Question 5

Which of the following is false about LQT2 ?

A	T wave is low amplitude, notched and bifid
B	Emotional stress /startle triggers arrhythmias
C	Sleep or auditory stimulation triggers arrhythmias
D	None of the above

Question 6

Which of the following is false about LQT2 ?

A	Risk of syncope & sudden death increased in postpartum period
B	Respond to beta blocker therapy
C	Due to a mutation in a potassium-channel gene on chromosome 7 (KCNH2 or HERG)
D	None of the above

Question 7

Which of the following is false about LQT3 ?

A	Due to a mutation in cardiac sodium channel gene on chromosome 3
B	. Late-onset peaked biphasic/asymmetric T waves
C	Prognosis for LQT3 is the poorest of all LQTs
D	None of the above

Question 8

Which of the following is false about LQT3 ?

A	Beta blockers are not recommended
B	Exercise is not restricted in LQT3
C	QT shortening occurs with mexiletine
D	None of the above

Question 9

Which of the following is false about LQT3 ?

A	Most events in LQT3 patients occur during sleep
B	LQT3 is caused by a mutation in sodium channel gene on chromosome 3 (SCN5A)
C	Male patients have worst prognosis in LQT3
D	None of the above

Question 10

Which of the following do not cause QT prolongation ?

A	Ibutilide
B	Sotalol
C	Lidocaine
D	Disopyramide

Question 10 Explanation:

Class IB antiarrhythmic agents (lidocaine) do not cause QT prolongation. Disopyramide, Dofetilide, Ibutilide, Procainamide, Quinidine, Sotalol prolong QT interval prolong QT and may precipitate torsades des pointes

Question 11

Which of the following prolongs QT interval ?

A	Hypocalcemia
B	Hypothyroidism
C	Hypokalemia
D	All of the above

Question 12

Which of the following is a repolarization abnormality ?

A	Brugada syndrome
B	Arrhythmogenic right ventricular cardiomyopathy
C	Short QT syndrome
D	All of the above

Question 12 Explanation:

Besides LQTS, other repolarization abnormalities are Brugada syndrome (opposite of LQT3), arrhythmogenic right ventricular cardiomyopathy, & short QT syndrome.

Question 13

In short QT syndrome, QT interval is ?

A	< 320 ms
B	< 340 ms
C	< 360 ms
D	< 380 ms

Question 13 Explanation:

A QT interval < 320 ms is required to establish the diagnosis of Short QT syndrome

Question 14

Mutations in which of the following gene is the cause of short QT syndrome ?

A	HERG
B	KvLQT1
C	KCNJ2
D	Any of the above

Question 14 Explanation:

Mutations in the HERG, KvLQT1 & KCNJ2 genes cause of Short QT syndrome

Question 15

Which of the following is a feature of Short QT syndrome ?

A	Short PR interval
B	Flat P waves
C	Tall and peaked T waves
D	Prominent U waves

Question 15 Explanation:

In Short QT syndrome, T waves tends to be tall and peaked especially in leads V2 to V4 and may be interpreted as R waves by an implantable cardioverter-defibrillator. Patients with the syndrome are predisposed to both AF and VF

Question 16

Which of the following can shorten QT interval ?

A	Hypercalcemia
B	Hyperkalemia
C	Acidosis
D	All of the above

Question 16 Explanation:

Conditions that can shorten QT interval include hypercalcemia (with an accompanying prolonged PR interval and a wide QRS complex), hyperkalemia, acidosis, increased vagal tone, after ventricular fibrillation (due to increased intracellular calcium), digitalis use, androgen use. Interestingly, a shorter-than-expected QT interval was noted in patients with chronic fatigue syndrome. Quinidine is helpful.

Question 17

In Brugada syndrome, ST segment elevation in V1 - V3 may be ?

A	Manifest
B	Transient
C	Concealed
D	Any of the above

Question 18

ECG manifestations of Brugada syndrome are provoked with ?

A	Ajmaline
B	Flecainide
C	Procainamide
D	All of the above

Question 18 Explanation:

The major clinical features of autosomal dominant Brugada syndrome include manifest, transient, or concealed ST segment elevation in V1 to V3 that can typically be provoked with sodium channel-blocking drugs ajmaline, flecainide, cocaine and procainamide and a risk of polymorphic ventricular arrhythmias

Question 19

Which of the following is false about Brugada syndrome ?

A	Left bundle branch block pattern
B	Left bundle branch block pattern
C	Terminal T-wave inversion in leads V 1 – V3
D	Due to mutation in cardiac sodium channel SCN 5A

Question 19 Explanation:

In ECG, right bundle-branch block (rSR’) and downsloping ST-segment elevation in lead V1 is typical of Brugada syndrome. It is syndrome of RBBB & nonischemic ST-segment elevations.

Question 20

Which of the following is false about Brugada syndrome ?

A	Most common in young Asian male
B	Affected region is RV outflow tract epicardium
C	Patients do not benefit from beta blocker therapy
D	Procainamide & flecainide are beneficial

Question 20 Explanation:

Procainamide & flecainide exacerbate Brugada syndrome

Question 21

Which of the following is the cause of ST-segment elevation ?

A	Acute pericarditis
B	Hyperkalemia
C	Pulmonary embolism
D	All of the above

Question 22

ST-segment elevation in normal healthy young men (male pattern) is seen in ?

A	V1
B	V2
C	V3
D	V4

Question 22 Explanation:

Concave ST-segment elevation of 1 - 3 mm seen in ~90 % of healthy young men (male pattern) is most marked in V2

Question 23

ST-segment elevation in early repolarization is seen in ?

A	V1
B	V2
C	V3
D	V4

Question 23 Explanation:

ST-segment elevation due to early repolarization is most marked in V4, with notching at J point, tall, upright T waves, reciprocal ST depression in aVR, not in aVL, when limb leads are involved

Question 24

Which of the following is an ECG feature of acute pericarditis ?

A	Diffuse ST-segment elevation
B	Reciprocal ST-segment depression in aVR, not in aVL
C	PR-segment depression
D	All of the above

Question 24 Explanation:

In acute pericarditis, ECG shows diffuse ST-segment elevation (seldom >5 mm), reciprocal STsegment depression in aVR, not in aVL and PR-segment depression.

Question 25

Which of the following is not an ECG feature of hyperkalemia ?

A	Widened QRS
B	Tall, peaked, tented T waves
C	Low-amplitude or absent P waves
D	ST segment usually upsloping

Question 25 Explanation:

In Hyperkalemia, ECG shows widened QRS, tall, peaked, tented T waves, low-amplitude or absent P waves, with ST segment usually downsloping

Question 26

Which of the following “Channelopathies” can cause Ventricular Fibrillation–Induced Cardiac Arrest ?

A	Long-QT syndrome
B	Short-QT syndrome
C	Brugada syndrome
D	All of the above

Question 27

Noncardiac causes of Ventricular Fibrillation Induced Cardiac Arrest include ?

A	Bronchospasm
B	Sleep apnea
C	Seizure
D	All of the above

Question 27 Explanation:

All of the above

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See all quizzes of the The Tachyarrhythmias at here:

1.Which of the following is not useful in diagnosis of LQTS ?
A. Echocardiography
B. Holter monitoring
C. Electrophysiological testing
D. All of the above

2. Most powerful predictor of risk in LQTS is ?
A. QTc duration
B. Family history
C. History of syncope
D. Gender

3. Which of the following is false about LQT1 ?
A. Most common genotypic abnormality in LQTS
B. QT interval fails to shorten with exercise
C. T wave is broad
D. None of the above

4. Which of the following is false about LQT1 ?
A. Exercise is the most common trigger for arrhythmias
B. Respond to beta blocker therapy
C. Due to mutation in potassium-channel gene (KCNQ1) on chromosome 11
D. None of the above

5. Which of the following is false about LQT2 ?
A. T wave is low amplitude, notched and bifid
B. Emotional stress /startle triggers arrhythmias
C. Sleep or auditory stimulation triggers arrhythmias
D. None of the above

6. Which of the following is false about LQT2 ?
A. Risk of syncope & sudden death increased in postpartum period
B. Respond to beta blocker therapy
C. Due to a mutation in a potassium-channel gene on chromosome 7 (KCNH2 or HERG)
D. None of the above

7. Which of the following is false about LQT3 ?
A. Due to a mutation in cardiac sodium channel gene on chromosome 3
B. Late-onset peaked biphasic/asymmetric T waves

C. Prognosis for LQT3 is the poorest of all LQTs
D. None of the above

8. Which of the following is false about LQT3 ?
A. Beta blockers are not recommended
B. Exercise is not restricted in LQT3
C. QT shortening occurs with mexiletine
D. None of the above

9. Which of the following is false about LQT3 ?
A. Most events in LQT3 patients occur during sleep
B. LQT3 is caused by a mutation in sodium channel gene on chromosome 3 (SCN5A)
C. Male patients have worst prognosis in LQT3
D. None of the above

10. Which of the following do not cause QT prolongation ?
A. Ibutilide
B. Sotalol
C. Lidocaine
D. Disopyramide

11. Which of the following prolongs QT interval ?
A. Hypocalcemia
B. Hypothyroidism
C. Hypokalemia
D. All of the above

12. Which of the following is a repolarization abnormality ?
A. Brugada syndrome
B. Arrhythmogenic right ventricular cardiomyopathy
C. Short QT syndrome
D. All of the above

13. In short QT syndrome, QT interval is ?
A. < 320 ms
B. < 340 ms
C. < 360 ms
D. < 380 ms

14. Mutations in which of the following gene is the cause of short QT syndrome ?
A. HERG
B. KvLQT1

C. KCNJ2
D. Any of the above

15. Which of the following is a feature of Short QT syndrome ?
A. Short PR interval
B. Flat P waves
C. Tall and peaked T waves
D. Prominent U waves

16. Which of the following can shorten QT interval ?
A. Hypercalcemia
B. Hyperkalemia
C. Acidosis
D. All of the above

17. In Brugada syndrome, ST segment elevation in V1 – V3 may be ?
A. Manifest
B. Transient
C. Concealed
D. Any of the above

18. ECG manifestations of Brugada syndrome are provoked with ?
A. Ajmaline
B. Flecainide
C. Procainamide
D. All of the above

19. Which of the following is false about Brugada syndrome ?
A. Left bundle branch block pattern
B. ST elevation leads V1 – V3
C. Terminal T-wave inversion in leads V1 – V3
D. Due to mutation in cardiac sodium channel SCN 5A

20. Which of the following is false about Brugada syndrome ?
A. Most common in young Asian male
B. Affected region is RV outflow tract epicardium
C. Patients do not benefit from beta blocker therapy
D. Procainamide & flecainide are beneficial

21. Which of the following is the cause of ST-segment elevation ?
A. Acute pericarditis
B. Hyperkalemia
C. Pulmonary embolism
D. All of the above

22. ST-segment elevation in normal healthy young men (male pattern) is seen in ?
A. V1
B. V2
C. V3
D. V4

23. ST-segment elevation in early repolarization is seen in ?
A. V1
B. V2
C. V3
D. V4

24. Which of the following is an ECG feature of acute pericarditis ?
A. Diffuse ST-segment elevation
B. Reciprocal ST-segment depression in aVR, not in aVL
C. PR-segment depression
D. All of the above

25. Which of the following is not an ECG feature of hyperkalemia ?
A. Widened QRS
B. Tall, peaked, tented T waves
C. Low-amplitude or absent P waves
D. ST segment usually upsloping

26. Which of the following “Channelopathies” can cause Ventricular Fibrillation–Induced Cardiac Arrest ?
A. Long-QT syndrome
B. Short-QT syndrome
C. Brugada syndrome
D. All of the above

27. Noncardiac causes of Ventricular Fibrillation Induced Cardiac Arrest include ?
A. Bronchospasm
B. Sleep apnea
C. Seizure
D. All of the above

The Tachyarrhythmias

[MCQ] The Tachyarrhythmias- Part 7

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The Tachyarrhythmias- Part 7

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