[MCQ] The Tachyarrhythmias- Part 8

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The Tachyarrhythmias- Part 8

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Question 1

Which of the following is an ECG marker of abnormality in repolarization ?

A	PR-interval dispersion
B	QT-interval dispersion
C	J-point dispersion
D	All of the above

Question 1 Explanation:

Two ECG markers of abnormalities in repolarization are QT-interval dispersion & T-wave alternans. They identify patients who are at risk for sudden death from arrhythmia. QT-interval dispersion refers to difference between maximal & minimal QT intervals from various leads on standard ECG. T-wave alternans is defined as alternating T-wave amplitude from beat to beat on special ECG recording techniques.

Question 2

Catecholaminergic polymorphic VT is best related to ?

A	Ang II type I receptor
B	B2-Bradykinin receptor
C	Ryanodine receptor
D	All of the above

Question 2 Explanation:

In catecholaminergic polymorphic VT there occurs a mutation of myocardial ryanodine release channel, which creates a “leak” in calcium from sarcoplasmic reticulum (SR). Accumulation of intracellular calcium potentiates delayed afterdepolarizations and triggered activity. Ca2+ is released from SR through a Ca2+ release channel - ryanodine receptor (RyR2), which controls intracytoplasmic [Ca2+] and leads to local changes in intracellular [Ca2+] called calcium sparks. Regulatory protein, calstabin 2 inhibit RyR2 and thereby release of Ca2+ from SR. PKA dissociates calstabin from RyR2, enhancing Ca2+ release and thereby myocardial contractility. Excessive plasma catecholamine levels and cardiac sympathetic neuronal release of norepinephrine cause hyperphosphorylation of PKA, leading to calstabin 2–depleted RyR2. The latter depletes SR Ca2+ stores and thereby impairs cardiac contraction, leading to heart failure, and also triggers ventricular arrhythmias.

Question 3

Patients of catecholaminergic polymorphic VT may present with ?

A	Bidirectional VT
B	Nonsustained polymorphic VT
C	Recurrent VF
D	Any of the above

Question 3 Explanation:

Patients of catecholaminergic polymorphic VT can manifest bidirectional VT, nonsustained polymorphic VT, or recurrent VF. The arrhythmias are precipitated by exercise & emotional stress. Treatment with beta blockers & ICD implantation is recommended.

Question 4

Which of the following is useful for patients with congenital prolonged QT interval syndrome ?

A	 adrenergic blocking agents
B	Phenytoin
C	Cervicothoracic sympathectomy
D	All of the above

Question 5

Vaughan-Williams classification is used to classify ?

A	Cardiotonic drugs
B	Antiarrhythmic drugs
C	Vasodilator drugs
D	Vasopressor drugs

Question 6

Which of the following drug does not fit in Vaughan-Williams classification of antiarrhythmic drugs ?

A	Ibutilide
B	Adenosine
C	Bretylium
D	Propafenone

Question 6 Explanation:

Adenosine does not fit into VW classification

Question 7

Class III antiarrhythmics exert their action through ?

A	Cardiac cellular excitatory current
B	Action potential duration
C	Automaticity
D	All of the above

Question 8

Class I and IV antiarrhythmics exert their action through ?

A	Cardiac cellular excitatory current
B	Action potential duration
C	Automaticity
D	All of the above

Question 9

Which of the following drug exhibits properties consistent with multiple classes in Vaughan-Williams classification ?

A	Quinidine
B	Amiodarone
C	Mexiletine
D	Propafenone

Question 9 Explanation:

Amiodarone is consistent with multiple classes.

Question 10

Which of the following is included in ‘Genetically determined arrhythmia syndrome’ ?

A	LQTS
B	Brugada syndrome
C	Hypertrophic cardiomyopathy
D	All of the above

Question 11

Which of the following ‘Genetically determined arrhythmia syndromes’ have autosomal dominant inheritance ?

A	LQTS
B	Brugada syndrome
C	Hypertrophic cardiomyopathy
D	All of the above

Question 12

Torsades de pointes occurs most often in the setting of ?

A	Slow heart rate
B	QT prolongation
C	Hypokalemia
D	All of the above

Question 12 Explanation:

TDP occurs most often with slow heart rates, QT prolongation & hypokalemia or hypomagnesemia and at the time of conversion from atrial fibrillation to sinus rhythm

Question 13

Which of the following antiarrhythmic drugs is least likely to produce bradycardia ?

A	Mexiletine
B	Flecainide
C	Propafenone
D	Amiodarone

Question 14

Which of the following is not an adverse effect of amiodarone ?

A	Pulmonary infiltrates
B	Hepatitis
C	Photosensitivity
D	Bronchospasm

Question 15

Which of the following antiarrhythmic drugs can cause ‘Lupus erythematosus like syndrome’ ?

A	Procainamide
B	Disopyramide
C	Lidocaine
D	Mexiletine

Question 16

Which of the following antiarrhythmic drugs can cause seizures ?

A	Procainamide
B	Disopyramide
C	Lidocaine
D	Mexiletine

Question 17

Which of the following antiarrhythmic drugs can cause congestive heart failure ?

A	Procainamide
B	Disopyramide
C	Lidocaine
D	Mexiletine

Question 18

Which of the following antiarrhythmic drugs can cause taste disturbance ?

A	Procainamide
B	Disopyramide
C	Propafenone
D	Sotalol

Question 19

Who, from the following, was one of the inventors of cardiac defibrillator ?

A	Mickey Isenberg
B	Bardy GH
C	Claude Beck
D	Terry Mengert

Question 19 Explanation:

Claude Beck is one of the inventors of cardiac defibrillation.

Question 20

The first intervention in the “chain of survival” is ?

A	Rapid access
B	Rapid cardiopulmonary resuscitation
C	Rapid defibrillation
D	Rapid advanced care

Question 20 Explanation:

The sequence of rapid access, rapid cardiopulmonary resuscitation, rapid defibrillation, and rapid advanced care is termed the chain of survival.

Question 21

In cardiopulmonary resuscitation, chest compression should be administered in the center of the chest on the ?

A	Upper half of the sternum
B	Middle of the sternum
C	Lower half of the sternum
D	Any of the above

Question 21 Explanation:

In cardiopulmonary resuscitation, chest compression should be administered in the center of the chest on the lower half of the sternum.

Question 22

In cardiopulmonary resuscitation in adults, the depth of chest compression should be ?

A	2 to 3 cm
B	3 to 4 cm
C	4 to 5 cm
D	5 to 6 cm

Question 22 Explanation:

In CPR in adults, the depth of chest compression should be 4 to 5 cm in adults.

Question 23

In cardiopulmonary resuscitation in adults, the rate of chest compression should be approximately ?

A	30 per minute
B	50 per minute
C	75 per minute
D	100 per minute

Question 24

In cardiopulmonary resuscitation performed by two persons, the ratio of compressions to breaths is ?

A	10 : 1
B	10 : 2
C	15 : 1
D	15 : 2

Question 24 Explanation:

When cardiopulmonary resuscitation is performed by two persons, the ratio of chest compressions to breaths remains 15:2 with pause during ventilations. After endotracheal intubation, the ratio should be five compressions to one ventilation, and there should be no pause in chest compressions for the ventilatory breath.

Question 25

In ventricular fibrillation, initial shock with a monophasic wave form defibrillator should be ?

A	100 J
B	200 J
C	300 J
D	360 J

Question 25 Explanation:

When a monophasic wave-form defibrillator is used for ventricular fibrillation, the initial shock should be 200 J. If the arrhythmia persists, a second shock of 200 to 300 J should be given, followed by a third shock of 360 J if still necessary. All three shocks should be given in quick succession

Question 26

Paddle diameter for external cardioversion is ?

A	10 cm
B	12 cm
C	18 cm
D	24 cm

Question 27

One paddle during external cardioversion is placed at ?

A	Fourth ICS, midclavicular line
B	Fifth ICS, midclavicular line
C	Fourth ICS, left anterior axillary line
D	Fifth ICS, left anterior axillary line

Question 28

One paddle during external cardioversion is placed at ?

A	Right parasternally at the level of first rib
B	Right parasternally at the level of second rib
C	Right parasternally at the level of third rib
D	Right parasternally at the level of fourth rib

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See all quizzes of the The Tachyarrhythmias at here:

1.Which of the following is an ECG marker of abnormality in repolarization ?
A. PR-interval dispersion
B. QT-interval dispersion
C. J-point dispersion
D. All of the above

2. Catecholaminergic polymorphic VT is best related to ?
A. Ang II type I receptor
B. B2-Bradykinin receptor
C. Ryanodine receptor
D. All of the above

3. Patients of catecholaminergic polymorphic VT may present with ?
A. Bidirectional VT
B. Nonsustained polymorphic VT
C. Recurrent VF
D. Any of the above

4. Which of the following is useful for patients with congenital prolonged QT interval syndrome ?
A.  adrenergic blocking agents
B. Phenytoin
C. Cervicothoracic sympathectomy
D. All of the above

5. Vaughan-Williams classification is used to classify ?
Harrison’s 16th Ed. 1355
A. Cardiotonic drugs
B. Antiarrhythmic drugs
C. Vasodilator drugs
D. Vasopressor drugs

6. Which of the following drug does not fit in Vaughan-Williams classification of antiarrhythmic drugs ?
A. Ibutilide
B. Adenosine
C. Bretylium
D. Propafenone

7. Class III antiarrhythmics exert their action through ?
A. Cardiac cellular excitatory current
B. Action potential duration
C. Automaticity
D. All of the above

8. Class I and IV antiarrhythmics exert their action through ?
A. Cardiac cellular excitatory current
B. Action potential duration
C. Automaticity
D. All of the above

9. Which of the following drug exhibits properties consistent with multiple classes in Vaughan-Williams classification ?
A. Quinidine
B. Amiodarone
C. Mexiletine
D. Propafenone

10. Which of the following is included in ‘Genetically determined arrhythmia syndrome’ ?
A. LQTS
B. Brugada syndrome
C. Hypertrophic cardiomyopathy
D. All of the above

11. Which of the following ‘Genetically determined arrhythmia syndromes’ have autosomal dominant inheritance ?
A. LQTS
B. Brugada syndrome
C. Hypertrophic cardiomyopathy
D. All of the above

12. Torsades de pointes occurs most often in the setting of ?
A. Slow heart rate
B. QT prolongation
C. Hypokalemia
D. All of the above

13. Which of the following antiarrhythmic drugs is least likely to produce bradycardia ?
A. Mexiletine
B. Flecainide
C. Propafenone
D. Amiodarone

14. Which of the following is not an adverse effect of amiodarone ?
A. Pulmonary infiltrates
B. Hepatitis
C. Photosensitivity
D. Bronchospasm

15. Which of the following antiarrhythmic drugs can cause ‘Lupus erythematosus like syndrome’ ?
A. Procainamide
B. Disopyramide
C. Lidocaine
D. Mexiletine

16. Which of the following antiarrhythmic drugs can cause seizures ?
A. Procainamide
B. Disopyramide
C. Lidocaine
D. Mexiletine

17. Which of the following antiarrhythmic drugs can cause congestive heart failure ?
A. Procainamide
B. Disopyramide
C. Lidocaine
D. Mexiletine

18. Which of the following antiarrhythmic drugs can cause taste disturbance ?
A. Procainamide
B. Disopyramide
C. Propafenone
D. Sotalol

19. Who, from the following, was one of the inventors of cardiac defibrillator ?
A. Mickey Isenberg
B. Bardy GH
C. Claude Beck
D. Terry Mengert

20. The first intervention in the “chain of survival” is ?
A. Rapid access
B. Rapid cardiopulmonary resuscitation
C. Rapid defibrillation
D. Rapid advanced care

21. In cardiopulmonary resuscitation, chest compression should be administered in the center of the chest on the ?
A. Upper half of the sternum
B. Middle of the sternum
C. Lower half of the sternum
D. Any of the above

22. In cardiopulmonary resuscitation in adults, the depth of chest compression should be ?
A. 2 to 3 cm
B. 3 to 4 cm
C. 4 to 5 cm
D. 5 to 6 cm

23. In cardiopulmonary resuscitation in adults, the rate of chest compression should be approximately ?
A. 30 per minute
B. 50 per minute
C. 75 per minute
D. 100 per minute

24. In cardiopulmonary resuscitation performed by two persons, the ratio of compressions to breaths is ?
A. 10 : 1
B. 10 : 2
C. 15 : 1
D. 15 : 2

25. In ventricular fibrillation, initial shock with a monophasic wave form defibrillator should be ?
A. 100 J
B. 200 J
C. 300 J
D. 360 J

26. Paddle diameter for external cardioversion is ?
A. 10 cm
B. 12 cm
C. 18 cm
D. 24 cm

27. One paddle during external cardioversion is placed at ?
A. Fourth ICS, midclavicular line
B. Fifth ICS, midclavicular line
C. Fourth ICS, left anterior axillary line
D. Fifth ICS, left anterior axillary line

28. One paddle during external cardioversion is placed at ?
A. Right parasternally at the level of first rib
B. Right parasternally at the level of second rib
C. Right parasternally at the level of third rib
D. Right parasternally at the level of fourth rib

The Tachyarrhythmias

[MCQ] The Tachyarrhythmias- Part 8

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The Tachyarrhythmias- Part 8

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