[MCQ] The Tachyarrhythmias- Part 6

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The Tachyarrhythmias- Part 6

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Question 1

Which of the following can terminate the idiopathic outflow tract ventricular tachycardia ?

A	IV lidocaine
B	IV procainamide
C	IV amiodarone
D	IV beta blockers

Question 1 Explanation:

Intravenous beta blockers frequently terminate idiopathic outflow tract ventricular tachycardia

Question 2

Verapamil is least effective / contraindicated in which of the following ?

A	Idiopathic LV septal VT
B	Ventricular tachycardia
C	Accessory pathway mediated tachycardias
D	Atrial fibrillation

Question 2 Explanation:

Most VTs do not respond to carotid sinus massage, Valsalva maneuver or adenosine administration. IV administration of verapamil and/or adenosine is not recommended as a diagnostic test. Verapamil is associated with hemodynamic collapse when administered to patients with structural heart disease and VT

Question 3

Which of the following is unique in its suppression with verapamil ?

A	Idiopathic LV septal VT
B	VT associated with LV dilated cardiomyopathy
C	Bundle Branch Reentrant VT
D	All of the above

Question 3 Explanation:

Idiopathic LV septal VT responds uniquely to IV verapamil

Question 4

Most uniform sustained VT associated with LV dilated cardiomyopathy can be mapped to ?

A	Mitral valvular region
B	Tricuspid valvular region
C	Pulmonary valvular region
D	All of the above

Question 4 Explanation:

VT associated with LV dilated cardiomyopathy may be mono- or polymorphic. Myopathic process has a predilection for fibrosis around mitral & aortic valvular regions. Most uniform sustained VT are mapped to these regions

Question 5

In ECG, bundle branch reentrant VT presents as ?

A	Incomplete right bundle block
B	Incomplete left bundle block
C	Complete right bundle block
D	Complete left bundle block

Question 5 Explanation:

In sinus rhythm, bundle branch reentrant VT presents as an incomplete left bundle block

Question 6

WPW syndrome is observed in patients with hypertrophic cardiomyopathy associated with which mutation ?

A	ACTN2
B	S135L mutation
C	PRKAG2 mutation
D	CRYAB

Question 6 Explanation:

WPW syndrome is seen in patients with hypertrophic cardiomyopathy associated with PRKAG2 mutations

Question 7

Infiltrative / Inflammatory & neuromuscular disorders associated with increased ventricular arrhythmia risk include ?

A	Sarcoidosis
B	Myotonic muscular dystrophy
C	Kearn-Sayre syndrome
D	All of the above

Question 8

Infiltrative / Inflammatory & neuromuscular disorders associated with increased ventricular arrhythmia risk include ?

A	Chagas disease
B	Fabry disease
C	Amyloidosis
D	All of the above

Question 9

Infiltrative / Inflammatory & neuromuscular disorders associated with increased ventricular arrhythmia risk include ?

A	Chagas disease
B	Fabry disease
C	Amyloidosis
D	All of the above

Question 10

Infiltrative / Inflammatory & neuromuscular disorders associated with increased ventricular arrhythmia risk include ?

A	Becker’s muscular dystrophy
B	Hemochromatosis
C	Friedreich’s ataxia
D	All of the above

Question 11

Neuromuscular disorders associated with increased ventricular arrhythmia risk include all except ?

A	Facioscapulohumeral muscular dystrophy
B	Emery-Dreyfuss muscular dystrophy
C	Limb-girdle muscular dystrophy
D	Duchenne’s muscular dystrophy

Question 11 Explanation:

Characteristically, FSH muscular dystrophy does not involve other organ systems. Labile hypertension & nerve deafness is common. Coats’ disease (telangiectasia, exudation & retinal detachment) also occurs

Question 12

Ventricular fibrillation can occur due to ?

A	Antiarrhythmic drugs
B	Torsades de pointes
C	WPW syndrome with AF
D	All of the above

Question 12 Explanation:

IHD is mostly responsible for VF which also occur with antiarrhythmic drugs, TDP and WPW syndrome who develop AF with an extremely rapid ventricular response.

Question 13

Ventricular fibrillation can occur due to ?

A	Antiarrhythmic drugs
B	Torsades de pointes
C	WPW syndrome with AF
D	All of the above

Question 13 Explanation:

IHD is mostly responsible for VF which also occur with antiarrhythmic drugs, TDP and WPW syndrome who develop AF with an extremely rapid ventricular response.

Question 14

Patients who have primary VF within first 48 hours of onset of acute infarction have ?

A	Good short-term prognosis
B	Good long-term prognosis
C	Poor long-term prognosis
D	None of the above

Question 14 Explanation:

Most patients who have primary VF within the first 48 hours of the onset of acute myocardial infarction have a good long-term prognosis, with a very low rate of recurrence or sudden cardiac death.

Question 15

Which of the following is related to arrhythmogenic RV cardiomyopathy/dysplasia (ARVCM/D) ?

A	Genetically determined
B	After viral myocarditis
C	Sporadic
D	Any of the above

Question 15 Explanation:

ARVCM/D due to a genetically determined dysplastic process or after a suspected viral myocarditis is also associated with VT/VF. Sporadic nonfamilial/nondysplastic form of RV cardiomyopathy is also seen

Question 16

Epsilon wave is characteristic ECG finding of ?

A	Arrhythmogenic RV cardiomyopathy / dysplasia
B	Brugada Syndrome
C	Long QT syndrome (LQTS)
D	Digoxin toxicity

Question 16 Explanation:

Epsilon wave is the terminal notching of QRS complex & is separated from the QRS complex. It is seen in ARVCM/D. Epsilon waves are due to marked delay in ventricular activation in RV free wall near the base of tricuspid & pulmonic valves which undergo extensive fibrosis

Question 17

In arrhythmogenic RV cardiomyopathy/dysplasia (ARVCM/D), ventricles have an excess of ?

A	Fat
B	Glycogen
C	Mucopolysaccharide
D	All of the above

Question 17 Explanation:

MRI in arrhythmogenic RV cardiomyopathy/dysplasia (ARVCM/D) shows fatty replacement of the ventricle, thinning of the RV free wall with increased fibrosis, and associated wall motion abnormalities

Question 18

Echocardiographic finding in arrhythmogenic RV cardiomyopathy/dysplasia (ARVCM/D) is ?

A	RV enlargement
B	RV wall motion abnormalities
C	RV apical aneurysm formation
D	All of the above

Question 18 Explanation:

In patients with ARVCM/D, echocardiography shows RV enlargement with RV wall motion abnormalities and RV apical aneurysm formation.

Question 19

Which of the following about Naxos disease is false ?

A	Arrhythmogenic RV dysplasia
B	Palmar-plantar keratosis
C	Parapsoriasis
D	Woolly hair

Question 19 Explanation:

Naxos disease consists of arrhythmogenic RV dysplasia with palmar-plantar keratosis & woolly hair with a high risk of SCD in adolescents & young adults.

Question 20

Which of the following about digoxin toxicity is false ?

A	Myocardial cell calcium overload
B	Bidirectional VT from left anterior & posterior fascicles
C	Narrow QRS right bundle branch configuration
D	None of the above

Question 20 Explanation:

The signature VT associated with digoxin toxicity is bidirectional VT due to triggered activity associated with calcium overload resulting from inhibition of Na +/K + ATPase by digoxin. Bidirectional VT originates from left anterior & posterior fascicles creating a relatively narrow QRS right bundle branch configuration with beat-to-beat alternating right & left frontal plane QRS axis

Question 21

Bazett’s formula for the calculation of QTc is ?

A	QT / Square root of PR
B	QT / Square root of RR
C	QT x Square root of PR
D	QT x Square root of RR

Question 21 Explanation:

QT interval is from the onset of QRS complex to the end of the T wave. Bazett’s formula (QT interval is adjusted for heart rate) for the calculation of QTc is QT interval (in seconds) divided by the square root of the RR interval (in seconds).

Question 22

Long QT syndrome (LQTS) was first described by ?

A	Romano and Ward
B	Levine and Woodworth
C	Jervell and Lange-Nielsen
D	Moss and Schwartz

Question 22 Explanation:

In 1957, Jervell and Lange-Nielsen first described a family with long QT syndrome (LQTS). The family consisted of unrelated parents and their six children, four of whom were deaf with frequent fainting attacks precipitated by acute emotional arousal and exercise. Three of the four deaf children died suddenly while playing at the ages of 4, 5, and 9 years. In 1963 and 1964, Romano and Ward respectively, reported separate families with QT prolongation in one parent and several children, all of whom possessed normal hearing but experienced recurrent syncope and sudden death (autosomal dominant mode of inheritance). In 1979 Moss and Schwartz established the prospective International LQTS Registry for enrollment and follow-up of proband-identified LQTS families

Question 23

Syncope in long-QT syndrome is attributed to ?

A	Emotional or physical stress
B	Electrolyte disturbances
C	Torsades de pointes
D	Lack of sleep

Question 23 Explanation:

Syncope in patients with the long-QT syndrome is generally attributed to the form of polymorphic ventricular tachycardia called torsades de pointes. Death is usually due to ventricular fibrillation.

Question 24

LQT1-specific trigger is ?

A	Emotional stress
B	Physical stress
C	Diving and swimming
D	All of the above

Question 25

Schwartz scoring system for diagnosis of LQTS includes all except ?

A	Genetic information
B	ECG features
C	Personal history
D	Family history

Question 25 Explanation:

Schwartz scoring system for LQTS includes ECG features, personal & family history, but does not take into account genetic information.

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See all quizzes of the The Tachyarrhythmias at here:

1.Which of the following can terminate the idiopathic outflow tract ventricular tachycardia ?
A. IV lidocaine
B. IV procainamide
C. IV amiodarone
D. IV beta blockers

2. Verapamil is least effective / contraindicated in which of the following ?
A. Idiopathic LV septal VT
B. Ventricular tachycardia
C. Accessory pathway mediated tachycardias
D. Atrial fibrillation
\
3. Which of the following is unique in its suppression with verapamil ?
A. Idiopathic LV septal VT
B. VT associated with LV dilated cardiomyopathy
C. Bundle Branch Reentrant VT
D. All of the above

4. Most uniform sustained VT associated with LV dilated cardiomyopathy can be mapped to ?
A. Mitral valvular region
B. Tricuspid valvular region
C. Pulmonary valvular region
D. All of the above

5. In ECG, bundle branch reentrant VT presents as ?
A. Incomplete right bundle block
B. Incomplete left bundle block
C. Complete right bundle block
D. Complete left bundle block

6. WPW syndrome is observed in patients with hypertrophic cardiomyopathy associated with which mutation ?
A. ACTN2

B. S135L mutation
C. PRKAG2 mutation
D. CRYAB

7. Infiltrative / Inflammatory & neuromuscular disorders associated with increased ventricular arrhythmia risk include ?
A. Sarcoidosis
B. Myotonic muscular dystrophy
C. Kearn-Sayre syndrome
D. All of the above

8. Infiltrative / Inflammatory & neuromuscular disorders associated with increased ventricular arrhythmia risk include ?
A. Chagas disease
B. Fabry disease
C. Amyloidosis
D. All of the above

9. Infiltrative / Inflammatory & neuromuscular disorders associated with increased ventricular arrhythmia risk include ?
A. Becker’s muscular dystrophy
B. Hemochromatosis
C. Friedreich’s ataxia
D. All of the above

10. Neuromuscular disorders associated with increased ventricular arrhythmia risk include all except ?
A. Facioscapulohumeral muscular dystrophy
B. Emery-Dreyfuss muscular dystrophy
C. Limb-girdle muscular dystrophy
D. Duchenne’s muscular dystrophy

11. Ventricular fibrillation can occur due to ?
A. Antiarrhythmic drugs
B. Torsades de pointes
C. WPW syndrome with AF
D. All of the above

12. Patients who have primary VF within first 48 hours of onset of acute infarction have ?
A. Good short-term prognosis
B. Good long-term prognosis
C. Poor long-term prognosis
D. None of the above

13. Which of the following is related to arrhythmogenic RV cardiomyopathy/dysplasia (ARVCM/D) ?

A. Genetically determined
B. After viral myocarditis
C. Sporadic
D. Any of the above

14. Epsilon wave is characteristic ECG finding of ?
A. Arrhythmogenic RV cardiomyopathy / dysplasia
B. Brugada Syndrome
C. Long QT syndrome (LQTS)
D. Digoxin toxicity

15. In arrhythmogenic RV cardiomyopathy/dysplasia (ARVCM/D), ventricles have an excess of ?
A. Fat
B. Glycogen
C. Mucopolysaccharide
D. All of the above

16. Echocardiographic finding in arrhythmogenic RV cardiomyopathy/dysplasia (ARVCM/D) is ?
A. RV enlargement
B. RV wall motion abnormalities
C. RV apical aneurysm formation
D. All of the above

17. Which of the following about Naxos disease is false ?
A. Arrhythmogenic RV dysplasia
B. Palmar-plantar keratosis
C. Parapsoriasis
D. Woolly hair

18. Which of the following about digoxin toxicity is false ?
A. Myocardial cell calcium overload

B. Bidirectional VT from left anterior & posterior fascicles
C. Narrow QRS right bundle branch configuration
D. None of the above

19. Bazett’s formula for the calculation of QTc is ?
A. QT / Square root of PR
B. QT / Square root of RR
C. QT x Square root of PR
D. QT x Square root of RR

20. Long QT syndrome (LQTS) was first described by ?
A. Romano and Ward
B. Levine and Woodworth
C. Jervell and Lange-Nielsen
D. Moss and Schwartz

21. Syncope in long-QT syndrome is attributed to ?
A. Emotional or physical stress
B. Electrolyte disturbances
C. Torsades de pointes
D. Lack of sleep

22. LQT1-specific trigger is ?
A. Emotional stress
B. Physical stress
C. Diving and swimming
D. All of the above

23. Schwartz scoring system for diagnosis of LQTS includes all except ?
A. Genetic information
B. ECG features
C. Personal history
D. Family history

The Tachyarrhythmias

[MCQ] The Tachyarrhythmias- Part 6

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

The Tachyarrhythmias- Part 6

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