[MCQ] The Bradyarrhythmias- Part 3

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

The Bradyarrhythmias- Part 3

Please wait while the activity loads.
If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled.

If loading fails, click here to try again

Start

Congratulations - you have completed The Bradyarrhythmias- Part 3. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

Your answers are highlighted below.

Question 1

Which of the following about Type II second-degree AV block is false ?

A	Occurs in distal or infra-His conduction system
B	Associated with intraventricular conduction delays
C	May proceed to higher grades of AV block
D	None of the above

Question 1 Explanation:

Type II second-degree AV block typically occurs in distal or infra-His conduction system and is often associated with intraventricular conduction delays (bundle branch block). It is more likely to proceed to higher grades of AV block than is type I second-degree AV block.

Question 2

“Paroxysmal AV block” best relates to ?

A	Self correcting AV block
B	Series of nonconducted P waves
C	P waves buried in QRS complex
D	P waves following QRS complex

Question 2 Explanation:

Second-degree AV block (particularly type II) may be associated with a series of nonconducted P waves, referred to as paroxysmal AV block. It implies significant conduction system disease and is an indication for permanent pacing.

Question 3

AV block that is intermediate between second degree & third degree is referred to as ?

A	High-grade AV block
B	Pre third degree AV block
C	Post second degree AV block
D	Paroxysmal AV block

Question 3 Explanation:

AV block that is intermediate between second degree & third degree is referred to as high-grade AV block and like CHB implies advanced AV conduction system disease.

Question 4

Which of the following about Third-degree AV block is false ?

A	No atrial impulse propagates to ventricles
B	Congenital complete AV block is localized to AV node
C	In AV nodal block, QRS duration is prolonged
D	In His bundle block, QRS duration is prolonged

Question 4 Explanation:

Complete failure of conduction from atrium to ventricle is called complete or third-degree AV block. It is most often distal to the AV node. A wide QRS escape rhythm implies block in the distal His or bundle branches, while a narrow QRS rhythm implies block in the AV node or proximal His and an escape rhythm originating in the AV junction.

Question 5

Which of the following about Lev’s disease is false ?

A	Calcification & sclerosis of fibrous cardiac skeleton
B	Frequently involves pulmonary & tricuspid valves
C	Involves central fibrous body & summit of ventricular septum
D	Produces AV block

Question 6

Which of the following about Lenegre’s disease is false ?

A	Primary sclerodegenerative disease in conducting system
B	No involvement of myocardium
C	Involves fibrous skeleton of heart
D	Cause of isolated chronic heart block in adults

Question 7

Which of the following improve conduction through AV node & impair infranodal conduction ?

A	Atropine
B	Isoproterenol
C	Exercise
D	All of the above

Question 8

To obtain a recording from the bundle of His, the electrode catheter is positioned ?

A	Across the pulmonary valve
B	Across the tricuspid valve
C	In coronary sinus
D	In superior vena cava

Question 8 Explanation:

Recording of His bundle electrogram by a catheter positioned at superior margin of tricuspid valve annulus provides information about conduction at all levels of AV conduction axis

Question 9

AH interval in the His bundle recording represents an indirect method of assessing ?

A	AV nodal conduction time
B	Atrial conduction time
C	Sinus node activation time
D	None of the above

Question 9 Explanation:

Time from the most rapid deflection of the atrial electrogram in the His bundle recording to the His electrogram (AH interval) represents conduction through the AV node and is normally <130 ms

Question 10

HV interval in the His bundle recording represents conduction time through ?

A	AV node
B	His bundle
C	His-Purkinje system
D	Endocardium to epicardium

Question 11

Normal HV interval in the His bundle recording is ?

A	10 to 20 ms
B	15 to 35 ms
C	35 to 55 ms
D	60 to 75 ms

Question 11 Explanation:

The time from the His electrogram to the earliest onset of the QRS on the surface ECG (HV interval) represents the conduction time through the His-Purkinje system and is normally 55 ms

Question 12

Normal PA interval in the His bundle recording is ?

A	30 ms
B	40 ms
C	50 ms
D	60 ms

Question 12 Explanation:

PA interval is the time from the earliest onset of P wave on surface ECG to onset of atrial deflection on His bundle catheter. It is an index of intraatrial conduction time & should be 50 ms

Question 13

Normal AH interval in the His bundle recording is ?

A	10 to 50 ms
B	60 to 125 ms
C	125 to 180 ms
D	180 to 250 ms

Question 14

Anisotropic conduction means impulse propagation is more rapid ?

A	Parallel to fiber orientation than transverse to it
B	Transverse to fiber orientation than parallel to it
C	In a particular fiber type
D	In a particular fiber length

Question 14 Explanation:

Impulse propagation is more rapid parallel to fiber orientation than transverse to it. This property is termed anisotropic conduction.

Question 15

“Effective” refractory period is defined as that portion of action potential during which ?

A	No stimulus can evoke another response
B	Stimulus can evoke a local, nonpropagated response
C	Stronger stimulus is required to evoke a response
D	Weaker stimulus can evoke a response

Question 15 Explanation:

Effective refractory period is that part of the action potential during which a stimulus can evoke only a local, nonpropagated response.

Question 16

To obtain a recording of left atrial activity, the electrode catheter is positioned ?

A	Across the pulmonary valve
B	Across the tricuspid valve
C	In the coronary sinus
D	In the superior vena cava

Question 16 Explanation:

Left atrial activity is recorded directly via a catheter placed across a patent foramen ovale or indirectly using a catheter inserted into the coronary sinus

Question 17

Intrinsic discharge rate is highest of which of the following potential cardiac pacemakers ?

A	Sinus node
B	Specialized fibers of His-Purkinje system
C	Some specialized atrial fibers
D	None of the above

Question 17 Explanation:

SA node is normally the dominant cardiac pacemaker because its intrinsic discharge rate is the highest of all potential cardiac pacemakers.

Question 18

Which of the following conditions do not require electro physiologic tests for diagnosis in ‘symptomatic’ patients with ECG documentation of ?

A	Asystole
B	Sinoatrial block or arrest
C	Bradycardia-tachycardia syndrome
D	All of the above

Question 18 Explanation:

Symptomatic patients with ECG documentation of asystole, sinoatrial block or arrest, or the bradycardia-tachycardia syndrome do not require electrophysiologic tests for diagnosis

Question 19

Escape pacemaker following AV nodal block is usually in ?

A	His bundle
B	Bundle branches
C	Purkinje fibres
D	Ventricular myocardium

Question 20

Which of the following statements about escape pacemaker in His bundle is false ?

A	Has a rate of 40 to 60 beats per minute
B	Is associated with a QRS complex of normal duration
C	Is the escape pacemaker following AV nodal block
D	Is the escape pacemaker following AV nodal block

Question 20 Explanation:

Escape pacemaker in His bundle is stable with discharge rate of 40 to 60 beats/minute, associated with a QRS complex of normal duration.

Question 21

Which of the following statements about escape pacemaker in distal His-Purkinje system is false ?

A	Has a rate of 25 to 45 beats per minute
B	Wide QRS complex of prolonged duration
C	Is the escape pacemaker following AV nodal block
D	Is unstable

Question 22

Which of the following is false ?

A	First-degree AV block is intranodal
B	Mobitz type 1 second-degree AV block is intranodal
C	Mobitz type 2 second-degree block is infranoda
D	None of the above

Question 23

How many letter codes are used for describing pacemaker modes & function ?

A	3
B	4
C	5
D	6

Question 23 Explanation:

Pacemaker modes & function are named using a five-letter code.

Question 24

The first letter in the pacing code indicates ?

A	Chamber(s) paced
B	Chamber in which electrical activity is sensed
C	The response to a sensed electric signal
D	Programmability and rate modulation

Question 25

The second letter in the Pacing Code indicates ?

A	Chamber(s) paced
B	Chamber in which electrical activity is sensed
C	The response to a sensed electric signa
D	Programmability and rate modulation

Question 26

The third letter in the Pacing Code indicates ?

A	Chamber(s) paced
B	Chamber in which electrical activity is sensed
C	The response to a sensed electric signal
D	Programmability and rate modulation

Question 27

The fourth letter in the Pacing Code indicates ?

A	Chamber(s) paced
B	Chamber in which electrical activity is sensed
C	The response to a sensed electric signal
D	Programmability and rate modulation

Question 27 Explanation:

In pacing code , the first letter indicates the chamber(s) that is paced (O, none; A, atrium; V, ventricle; D, dual; S, single), the second letter indicates the chamber(s) in which sensing occurs (O, none; A, atrium; V, ventricle; D, dual; S, single), the third letter indicates the response to a sensed event (O, none; I, inhibition; T, triggered; D, inhibition + triggered), the fourth letter refers to the programmability or rate response (R, rate responsive), and the fifth refers to the existence of antitachycardia functions if present (O, none; P, antitachycardia pacing; S, shock; D, pace + shock)

Question 28

Twiddler’s syndrome best relates to ?

A	Failing battery of pacemaker
B	Interference by external stimuli on pacemaker
C	Rotation of pacemaker pulse generator in its pocket
D	All of the above

Question 29

Pacemaker syndrome is associated in those ?

A	Who do not maintain AV synchrony
B	Who do not have adequate cardiac output
C	Who have chronic illnesses (HTN, DM)
D	All of the above

Question 29 Explanation:

Pacemaker syndrome is a constellation of signs and symptoms associated with any mode of pacing that does not maintain or restore AV synchrony

Question 30

Class I indication for pacing in SA node dysfunction include all except ?

A	Documented symptomatic bradycardia
B	Syncope of unexplained origin with major abnormalities of SA node dysfunction
C	Sinus node dysfunction associated long-term drug therapy for which there is no alternative
D	Symptomatic chronotropic incompetence

Question 30 Explanation:

Class I indications for pacing in SA node dysfunction include documented symptomatic bradycardia, sinus node dysfunction associated long-term drug therapy for which there is no alternative, or symptomatic chronotropic incompetence

Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results

There are 30 questions to complete.

←

List

→

Return

Shaded items are complete.

1	2	3	4	5
6	7	8	9	10
11	12	13	14	15
16	17	18	19	20
21	22	23	24	25
26	27	28	29	30
End

Return

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 about Type II second-degree AV block is false ?
A. Occurs in distal or infra-His conduction system
B. Associated with intraventricular conduction delays
C. May proceed to higher grades of AV block
D. None of the above

2. “Paroxysmal AV block” best relates to ?
A. Self correcting AV block
B. Series of nonconducted P waves
C. P waves buried in QRS complex
D. P waves following QRS complex

3. AV block that is intermediate between second degree & third degree is referred to as ?
A. High-grade AV block

B. Pre third degree AV block
C. Post second degree AV block
D. Paroxysmal AV block

4. Which of the following about Third-degree AV block is false ?
A. No atrial impulse propagates to ventricles
B. Congenital complete AV block is localized to AV node
C. In AV nodal block, QRS duration is prolonged
D. In His bundle block, QRS duration is prolonged

5. Which of the following about Lev’s disease is false ?
A. Calcification & sclerosis of fibrous cardiac skeleton
B. Frequently involves pulmonary & tricuspid valves
C. Involves central fibrous body & summit of ventricular septum
D. Produces AV block

6. Which of the following about Lenegre’s disease is false ?
A. Primary sclerodegenerative disease in conducting system
B. No involvement of myocardium
C. Involves fibrous skeleton of heart
D. Cause of isolated chronic heart block in adults

7. Which of the following improve conduction through AV node & impair infranodal conduction ?
A. Atropine
B. Isoproterenol
C. Exercise
D. All of the above

8. To obtain a recording from the bundle of His, the electrode catheter is positioned ?
A. Across the pulmonary valve
B. Across the tricuspid valve
C. In coronary sinus
D. In superior vena cava

9. AH interval in the His bundle recording represents an indirect method of assessing ?
A. AV nodal conduction time
B. Atrial conduction time
C. Sinus node activation time

D. None of the above

10. HV interval in the His bundle recording represents conduction time through ?
A. AV node
B. His bundle
C. His-Purkinje system
D. Endocardium to epicardium

11. Normal HV interval in the His bundle recording is ?
A. 10 to 20 ms
B. 15 to 35 ms
C. 35 to 55 ms
D. 60 to 75 ms

12. Normal PA interval in the His bundle recording is ?
A. 30 ms
B. 40 ms
C. 50 ms
D. 60 ms

13. Normal AH interval in the His bundle recording is ?
A. 10 to 50 ms
B. 60 to 125 ms
C. 125 to 180 ms
D. 180 to 250 ms

14. Anisotropic conduction means impulse propagation is more rapid ?
A. Parallel to fiber orientation than transverse to it
B. Transverse to fiber orientation than parallel to it
C. In a particular fiber type
D. In a particular fiber length

15. “Effective” refractory period is defined as that portion of action potential during which ?
A. No stimulus can evoke another response
B. Stimulus can evoke a local, nonpropagated response
C. Stronger stimulus is required to evoke a response
D. Weaker stimulus can evoke a response

16. To obtain a recording of left atrial activity, the electrode catheter is positioned ?
A. Across the pulmonary valve
B. Across the tricuspid valve
C. In the coronary sinus
D. In the superior vena cava

17. Intrinsic discharge rate is highest of which of the following potential cardiac pacemakers ?
A. Sinus node
B. Specialized fibers of His-Purkinje system
C. Some specialized atrial fibers
D. None of the above

18. Which of the following conditions do not require electro physiologic tests for diagnosis in ‘symptomatic’ patients with
ECG documentation of ?
A. Asystole
B. Sinoatrial block or arrest
C. Bradycardia-tachycardia syndrome
D. All of the above

19. Escape pacemaker following AV nodal block is usually in ?
A. His bundle
B. Bundle branches
C. Purkinje fibres
D. Ventricular myocardium

20. Which of the following statements about escape pacemaker in His bundle is false ?
A. Has a rate of 40 to 60 beats per minute
B. Is associated with a QRS complex of normal duration
C. Is the escape pacemaker following AV nodal block
D. Is unstable

21. Which of the following statements about escape pacemaker in distal His-Purkinje system is false ?
A. Has a rate of 25 to 45 beats per minute
B. Wide QRS complex of prolonged duration
C. Is the escape pacemaker following AV nodal block
D. Is unstable

22. Which of the following is false ?
A. First-degree AV block is intranodal
B. Mobitz type 1 second-degree AV block is intranodal
C. Mobitz type 2 second-degree block is infranodal
D. None of the above

23. How many letter codes are used for describing pacemaker modes & function ?
A. 3
B. 4
C. 5
D. 6

24. The first letter in the pacing code indicates ?
A. Chamber(s) paced
B. Chamber in which electrical activity is sensed
C. The response to a sensed electric signal
D. Programmability and rate modulation

25. The second letter in the Pacing Code indicates ?
A. Chamber(s) paced
B. Chamber in which electrical activity is sensed
C. The response to a sensed electric signal
D. Programmability and rate modulation

26. The third letter in the Pacing Code indicates ?
A. Chamber(s) paced
B. Chamber in which electrical activity is sensed
C. The response to a sensed electric signal
D. Programmability and rate modulation

27. The fourth letter in the Pacing Code indicates ?
A. Chamber(s) paced
B. Chamber in which electrical activity is sensed
C. The response to a sensed electric signal
D. Programmability and rate modulation

28. Twiddler’s syndrome best relates to ?
A. Failing battery of pacemaker
B. Interference by external stimuli on pacemaker

C. Rotation of pacemaker pulse generator in its pocket
D. All of the above

29. Pacemaker syndrome is associated in those ?
A. Who do not maintain AV synchrony
B. Who do not have adequate cardiac output
C. Who have chronic illnesses (HTN, DM)
D. All of the above

30, Class I indication for pacing in SA node dysfunction include all except ?
A. Documented symptomatic bradycardia
B. Syncope of unexplained origin with major abnormalities of SA node dysfunction
C. Sinus node dysfunction associated long-term drug therapy for which there is no alternative
D. Symptomatic chronotropic incompetence

The Bradyarrhythmias

[MCQ] The Bradyarrhythmias- Part 3

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

The Bradyarrhythmias- Part 3

Share this:

Related

[MCQ] The Bradyarrhythmias- Part 2

[MCQ] The Tachyarrhythmias- Part 1

You may also like

Leave a Comment Cancel Reply