[MCQ] The Tachyarrhythmias- Part 4

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The Tachyarrhythmias- Part 4

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Question 1

Regular supraventricular tachycardias include all except ?

A	Atrial tachycardia (AT)
B	Atrioventricular nodal reentrant tachycardia (AVNRT)
C	Atrioventricular reciprocating tachycardia (AVRT)
D	Multifocal atrial tachycardia (MAT)

Question 1 Explanation:

Regular supraventricular tachycardias include sinus tachycardia, atrial flutter (AFL), atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reciprocating tachycardia (AVRT), and atrial tachycardia (AT). Orthodromic AVRT is more common than antidromic AVRT. Irregular supraventricular tachycardias include atrial fibrillation (AF), AFL when it occurs in a patient with variable AV block, multifocal atrial tachycardia (MAT) & sinus rhythm with multiple atrial premature beats.

Question 2

Which of the following arrhythmias are seen with bypass tracts ?

A	Orthodromic AV reentry
B	Antidromic AV reentry
C	Wide irregular QRS complex (atrial fibrillation)
D	All of the above

Question 2 Explanation:

Three arrhythmias are seen with bypass tracts: a narrow regular QRS complex (orthodromic; conduction down the atrioventricular node and retrograde conduction through the bypass tract), a wide regular QRS complex (antidromic; conduction down the bypass tract and retrograde conduction through the atrioventricular node), and a wide irregular QRS complex (atrial fibrillation).

Question 3

Heart rate regularity is defined as beat-to-beat timing variation of less than ?

A	5 %
B	10 %
C	15 %
D	20 %

Question 3 Explanation:

Regularity is defined as variation of less than 10% in beat-to-beat timing, but most regular tachycardias actually vary by less than 5%.

Question 4

P waves immediately precede the QRS complex in all except ?

A	Atrial tachycardia
B	Multifocal atrial tachycardia
C	Atrioventricular nodal reentrant tachycardia
D	Multiple atrial premature contractions

Question 4 Explanation:

P waves immediately precede the QRS complex in sinus tachycardia, atrial tachycardia, multifocal atrial tachycardia, and multiple atrial premature contractions. P waves follow the QRS complex in atrioventricular nodal reentrant tachycardia and atrioventricular reciprocating tachycardia

Question 5

Which of the following is a wide-complex tachycardia ?

A	Ventricular tachycardia
B	Ventricular fibrillation
C	Torsades de pointes
D	All of the above

Question 5 Explanation:

Wide-complex tachycardias are caused by ventricular arrhythmia (ventricular tachycardia, ventricular fibrillation, and torsades de pointes or polymorphic ventricular tachycardia) or supraventricular tachycardias with aberrant conduction resulting from disease in His–Purkinje system (left or right bundle-branch block), a bypass tract (Wolff–Parkinson–White syndrome), with depolarization of ventricle from bypass tract; and a ventricular paced rhythm from a pacemaker

Question 6

Vagomimetic maneuvers include ?

A	Carotid sinus massage
B	Valsalva maneuver
C	Immersion of face in cold water
D	All of the above

Question 6 Explanation:

Vagal maneuvers include Valsalva maneuver, carotid sinus massage, bearing down, and immersion of the face in ice water They increase vagal tone and block the atrioventricular node.

Question 7

Adenosine terminates which of the following ?

A	Atrioventricular nodal reentrant tachycardias
B	Atrioventricular reciprocating tachycardias
C	Atrial tachycardias
D	All of the above

Question 7 Explanation:

Adenosine, a very short-acting endogenous nucleotide that blocks atrioventricular nodal conduction, terminates nearly all atrioventricular nodal reentrant tachycardias and atrioventricular reciprocating tachycardias as well as up to 80% of atrial tachycardias.

Question 8

Adenosine should not be given in ?

A	Regular wide-complex tachycardias
B	Irregular wide-complex tachycardias
C	Atrioventricular nodal reentrant tachycardias
D	Atrioventricular reciprocating tachycardias

Question 8 Explanation:

Adenosine is also useful in the differential diagnosis and treatment of wide-complex tachycardias, but it should be given only when these tachycardias are regular, since irregular wide-complex tachycardias may be rendered unstable after the administration of adenosine.

Question 9

Arrhythmias that cause which of the following require urgent electrical cardioversion ?

A	Hypotension
B	Heart failure
C	Coronary ischemia
D	All of the above

Question 9 Explanation:

Arrhythmias causing hemodynamic instability (hypotension, heart failure, or coronary ischemia) require urgent electrical cardioversion.

Question 10

If hemodynamic compromise is present, which of the following is preferred to terminate atrioventricular nodal reentrant tachycardia ?

A	Intravenous adenosine
B	Intravenous beta blockade
C	Intravenous calcium channel therapy
D	R-wave synchronous DC cardioversion (100 - 200 J)

Question 10 Explanation:

If hemodynamic compromise is present, R-wave synchronous DC cardioversion using 100–200 J can terminate atrioventricular nodal reentrant tachycardia.

Question 11

Which of the following drugs slow conduction in the antegrade slow pathway in atrioventricular nodal reentrant tachycardia ?

A	DigitalisBeta blockers
B	Calcium channel blockers
C	Calcium channel blockers
D	All of the above

Question 11 Explanation:

AVNRT prevention may be achieved with drugs that slow conduction in the antegrade slow pathway, such as digitalis, beta blockers, and calcium channel blockers

Question 12

Which of the following drugs is useful in preventing exercise precipitated atrioventricular nodal reentrant tachycardia ?

A	Digitalis
B	Beta blockers
C	Calcium channel blockers
D	All of the above

Question 12 Explanation:

In patients who have a history of exercise-precipitated AVNRT, use of beta blockers frequently eliminates symptoms

Question 13

Which of the following drugs slow conduction in the antegrade slow pathway in atrioventricular nodal reentrant tachycardia ?

A	Digitalis
B	Beta blockers
C	Calcium channel blockers
D	Flecainide

Question 13 Explanation:

In patients who do not respond to drug therapy directed at antegrade slow pathway, treatment with class IA or IC agents directed at altering conduction of the fast pathway may be considered

Question 14

Which of the following about AV junctional complexes is false?

A	Site of origin is AV node
B	Associated with digitalis intoxication
C	Can conduct both antegradely and retrogradely
D	May cause cannon ‘a’ waves

Question 14 Explanation:

The site of origin of AV junctional complexes is in the bundle of His, since the normal AV node in vivo possesses no automaticity.

Question 15

Which of the following arrhythmia may be a manifestation of digoxin toxicity ?

A	Multifocal atrial tachycardia
B	Focal atrial tachycardias
C	AV junctional tachycardias
D	AV nodal reentrant tachycardia

Question 16

Junctional tachycardia due to abnormal automaticity can be treated pharmacologically with ?

A	Digitalis
B	Beta blockers
C	Calcium channel blockers
D	All of the above

Question 16 Explanation:

Junctional tachycardia due to abnormal automaticity can be treated with beta blockers

Question 17

Which of the following is false for carotid sinus massage ?

A	Not performed in patients with carotid arterial bruits
B	Not performed in patients with carotid arterial bruits
C	Performed by applying firm pressure just underneath the angle of jaw for up to 10 seconds
D	Patient should be supine with neck extended

Question 18

Which of the following statements regarding accessory pathways (APs) is correct ?

A	APs connect the atria with the ventricles
B	There may be no delta wave in the ECG of concealed APs
C	More than 50% of APs are located at the left free wall
D	All of the above

Question 19

The most common accessory pathway (AP) connects which of the following ?

A	Left atrium to left ventricle
B	Right atrium to right ventricle
C	Left atrium to right ventricle
D	Right atrium to left ventricle

Question 19 Explanation:

The most common AP connects the left atrium to the left ventricle, followed by posterior septal, right free wall, and anterior septal APs

Question 20

Which of the following about atriofascicular accessory pathways is false ?

A	Originate from the right atrium
B	Conduct more slowly
C	Have decremental antegrade conduction
D	None of the above

Question 21

Which of the following best relates to normal PR interval with a delta wave in ECG ?

A	James fibers
B	Bundle of Kent
C	Mahaim fibers
D	Brechenmacher fibers

Question 22

Wolff-Parkinson-White syndrome is best related to ?

A	James fibers
B	Bundle of Kent
C	Mahaim fibers
D	Brechenmacher fibers

Question 22 Explanation:

Preexcitation through an AV bypass tract, the bundle of Kent, produces the ECG pattern described by Wolff, Parkinson, and White in 1930. Bundle of Kent in WPW directly connects atrial & ventricular myocardium, bypassing the AV node/His-Purkinje system. AV conduction is nondecremental and more rapid through the accessory pathway than through the AV node, a difference that is increased at fast heart rates. Decremental conduction means increase in conduction time of the impulse propagating through the AV node as the cycle length shortens (heart rate increased).

Question 23

Classic electrocardiographic triad in WPW syndrome includes all except ?

A	Short PR interval
B	Slurred QRS upstroke (delta wave)
C	Prolonged QRS complex
D	Prolonged QT interval

Question 23 Explanation:

In WPW syndrome, classic electrocardiographic triad is a short PR interval, a slurred QRS upstroke (delta wave), and a prolonged QRS complex.

Question 24

Most common arrhythmia associated with WPW syndrome is ?

A	Atrioventricular reciprocating tachycardia
B	Atrioventricular nodal reentrant tachycardia
C	Atrial tachycardia
D	Multifocal atrial tachycardia

Question 24 Explanation:

Most common arrhythmia associated with WPW syndrome is atrioventricular reciprocating tachycardia

Question 25

The following are ECG features of WPW syndrome except ?

A	Presence of delta wave
B	Shortened PR interval of < 0.12 seconds
C	PR depression
D	Prolonged QRS interval of > 0.12 seconds

Question 26

Which of the following are known conditions associated with WPW syndrome ?

A	ST elevation myocardial infarction
B	ST elevation myocardial infarction
C	Acute pericarditis
D	Marfan’s syndrome

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See all quizzes of the The Tachyarrhythmias at here:

`1.Regular supraventricular tachycardias include all except ?
A. Atrial tachycardia (AT)
B. Atrioventricular nodal reentrant tachycardia (AVNRT)
C. Atrioventricular reciprocating tachycardia (AVRT)
D. Multifocal atrial tachycardia (MAT)

2. Which of the following arrhythmias are seen with bypass tracts ?
A. Orthodromic AV reentry
B. Antidromic AV reentry
C. Wide irregular QRS complex (atrial fibrillation)
D. All of the above

3. Heart rate regularity is defined as beat-to-beat timing variation of less than ?
A. 5 %
B. 10 %

C. 15 %
D. 20 %

4. P waves immediately precede the QRS complex in all except ?
A. Atrial tachycardia
B. Multifocal atrial tachycardia
C. Atrioventricular nodal reentrant tachycardia
D. Multiple atrial premature contractions

5. Which of the following is a wide-complex tachycardia ?
A. Ventricular tachycardia
B. Ventricular fibrillation
C. Torsades de pointes
D. All of the above

6. Vagomimetic maneuvers include ?
A. Carotid sinus massage
B. Valsalva maneuver
C. Immersion of face in cold water
D. All of the above

7. Adenosine terminates which of the following ?
A. Atrioventricular nodal reentrant tachycardias
B. Atrioventricular reciprocating tachycardias
C. Atrial tachycardias
D. All of the above

8. Adenosine should not be given in ?
A. Regular wide-complex tachycardias
B. Irregular wide-complex tachycardias
C. Atrioventricular nodal reentrant tachycardias
D. Atrioventricular reciprocating tachycardias

9. Arrhythmias that cause which of the following require urgent electrical cardioversion ?

A. Hypotension
B. Heart failure
C. Coronary ischemia
D. All of the above

10. If hemodynamic compromise is present, which of the following is preferred to terminate atrioventricular nodal reentrant tachycardia ?
A. Intravenous adenosine
B. Intravenous beta blockade
C. Intravenous calcium channel therapy
D. R-wave synchronous DC cardioversion (100 – 200 J)

11. Which of the following drugs slow conduction in the antegrade slow pathway in atrioventricular nodal reentrant tachycardia ?
A. Digitalis
B. Beta blockers
C. Calcium channel blockers
D. All of the above

12. Which of the following drugs is useful in preventing exercise precipitated atrioventricular nodal reentrant tachycardia ?
A. Digitalis
B. Beta blockers
C. Calcium channel blockers
D. All of the above

13. Which of the following drugs slow conduction in the antegrade slow pathway in atrioventricular nodal reentrant tachycardia ?
A. Digitalis
B. Beta blockers
C. Calcium channel blockers
D. Flecainide

14. Which of the following about AV junctional complexes is false?
A. Site of origin is AV node
B. Associated with digitalis intoxication
C. Can conduct both antegradely and retrogradely
D. May cause cannon ‘a’ waves

15. Which of the following arrhythmia may be a manifestation of digoxin toxicity ?
A. Multifocal atrial tachycardia
B. Focal atrial tachycardias
C. AV junctional tachycardias
D. AV nodal reentrant tachycardia

16. Junctional tachycardia due to abnormal automaticity can be treated pharmacologically with ?
A. Digitalis
B. Beta blockers
C. Calcium channel blockers
D. All of the above

17. Which of the following is false for carotid sinus massage ?
A. Not performed in patients with carotid arterial bruits
B. Massage one carotid bulb at a time
C. Performed by applying firm pressure just underneath the angle of jaw for up to 10 seconds
D. Patient should be supine with neck extended

18. Which of the following statements regarding accessory pathways (APs) is correct ?
A. APs connect the atria with the ventricles
B. There may be no delta wave in the ECG of concealed APs
C. More than 50% of APs are located at the left free wall
D. All of the above

19. The most common accessory pathway (AP) connects which of the following ?
A. Left atrium to left ventricle
B. Right atrium to right ventricle
C. Left atrium to right ventricle
D. Right atrium to left ventricle

20. Which of the following about atriofascicular accessory pathways is false ?
A. Originate from the right atrium
B. Conduct more slowly
C. Have decremental antegrade conduction
D. None of the above

21. Which of the following best relates to normal PR interval with a delta wave in ECG ?
A. James fibers
B. Bundle of Kent
C. Mahaim fibers
D. Brechenmacher fibers

22. Wolff-Parkinson-White syndrome is best related to ?
A. James fibers
B. Bundle of Kent
C. Mahaim fibers
D. Brechenmacher fibers

24. Classic electrocardiographic triad in WPW syndrome includes all except ?
A. Short PR interval
B. Slurred QRS upstroke (delta wave)
C. Prolonged QRS complex
D. Prolonged QT interval

25. Most common arrhythmia associated with WPW syndrome is ?
A. Atrioventricular reciprocating tachycardia
B. Atrioventricular nodal reentrant tachycardia
C. Atrial tachycardia
D. Multifocal atrial tachycardia

26. The following are ECG features of WPW syndrome except ?
A. Presence of delta wave
B. Shortened PR interval of < 0.12 seconds
C. PR depression
D. Prolonged QRS interval of > 0.12 seconds

27. Which of the following are known conditions associated with WPW syndrome ?
A. ST elevation myocardial infarction
B. Ebstein anomaly
C. Acute pericarditis
D. Marfan’s syndrome

The Tachyarrhythmias

[MCQ] The Tachyarrhythmias- Part 4

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The Tachyarrhythmias- Part 4

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