2ND BIMONTHLY Flashcards
(100 cards)
The most common form of paroxysmal supraventricular tachycardia?
a. AVNRT
b. AVRT
c. Atrial Fibrillation
d. Atrial Tachycardia
a. AVNRT
In patients with paroxysmal supraventricular tachycardia presenting with hypotension, which of the following is the next best step?
a. Defibrillation
b. Cardioversion
c. Adenosine 6mg intravenously
d. Verapamil 5mg intravenously
b. Cardioversion
These accessory _________ are abnormal connections that allow conduction between the atrium and ventricles across the AV ring. They are present from birth and are due to failure to complete partitioning of atrium and ventricles by the fibrous AV rings.
a. Bundles
b. Fibres
c. Pathways
d. Way
c. Pathways
This type of atrial fibrillation occurs continuously for >7 days but <1 year?
a. Paroxysmal
b. Persistent
c. Longstanding
d. Longstanding Persistent
b. Persistent
The following statements about atrial fibrillation is true?
a. AF is slightly more common in women and in the middle aged-groups
b. The most important consequence in AF patients is the significantly increased risk of cerebral bleed
c. There is increased risk of dementia in AF patients
d. AF is not a marker of worsened morbidity and mortality in patients with existing heart disease
c. There is increased risk of dementia in AF patients
In patients with atrial fibrillation who are anticoagulated using Warfarin, what is the target international normalized ratio (INR)?
a. 1.5
b. 2
c. >2
d. 2.3
c. >2
Treatment and management of patient with AF centers on three aims, which of the following is NOT one of the objectives?
a. Control of patient symptoms through rate and/or rhythm control
b. Electrical cardioversion to achieve sinus rhythm
c. Appropriate mitigation of thromboembolism risk
d. Addressing modifiable risk factors for progression of AF
b. Electrical cardioversion to achieve sinus rhythm
What is the pointed complex in the ECG tracing below?
a. Focal PVC
b. Multifocal PVC
c. Conducted PAC
d. Non-conducted PAC
b. Multifocal PVC
This has continuous irregular activation with no discrete QRS complexes and one of the “shockable rhythms?
A. Polymorphic VT
B. Unstable Sustained VT
C. Ventricular Fibrillation
D. Idiopathic ventricular arrhythmia
C. Ventricular Fibrillation
This drug blocks multiple cardiac ionic currents and has sympatholytic activity. It is the most effective anti-arrhythmic drug for suppressing ventricular arrhythmias. What is this drug
a. Sotalol
b. Metoprolol
c. Digoxin
d. Amiodarone
d. Amiodarone
Clinical manifestations of patients with ventricular arrhythmias may vary. Perhaps the most serious manifestation is an episode of pre-syncopal attack or outright syncope. Which of the following is a benign cause of syncope?
a. Carotid sinus syndrome
b. Primary autonomic failure
c. Drug-induced
d. Neuro-cardiogenic
d. Neuro-cardiogenic
The following statements are TRUE regarding ventricular arrhythmias, EXCEPT
a. PVCs & NSVT, with absence of structural heart disease or a genetic sudden death syndrome, no specific therapy is needed unless the patient has significant symptom
b. Avoiding stimulants, such as caffeine and alcohol is not helpful in some patients
c. Idiopathic ventricular arrhythmias frequently originate from the left or right ventricular outflow tracts near the valve annuli
d. PVCs are very common and can be due to enhance automatically triggered automaticity or entry
b. Avoiding stimulants, such as caffeine and alcohol is not helpful in some patients
Which of the following types of patients warrant an ICD implantation?
a. 56yo, male patient complaining of palpitations, shortness of breath and on 24-hour holter monitoring has 60% PVC burden.
b. 32YO female patient with symptoms of SOB on exertion and records a heart rate of 162 beats per minute on her iWatch
c. 70YO, male with atrial fibrillation, had experienced shortness of breath and palpitations with an LV ejection fraction of 35%
d. 62-year-old, male who had recent myocardial infarction 2 months ago with an LV ejection fraction of <30%
d. 62-year-old, male who had recent myocardial infarction 2 months ago with an LV ejection fraction of <30%
Ventricular tachycardia that persists beyond 30 seconds is called?
a. Non-sustained VT
b. Sustained VT
c. Polymorphic VT
d. Idiopathic VT
b. Sustained VT
The following are strong risk factors for association with atrial fibrillation, EXCEPT
a. Hypertension
b. Alcoholism
c. Sleep apnea
d. Diabetes mellitus
b. Alcoholism
This is the most common valve lesion among adult patients with chronic valvular heart disease?
a. Mitral Stenosis
b. Mitral regurgitation
c. Pulmonic stenosis
d. Aortic stenosis
d. Aortic stenosis
Which of the following best describes the pathogenesis of aortic stenosis?
a. There is commissural fusion resulting in a bicuspid-appearing valve, makes the leaflets more susceptible to trauma, fibrosis & stenosis
b. For the most part, majority of the processes leading to aortic stenosis endothelial dysfunction.
c. Upon autopsy of patients who died of aortic stenosis, majority were tricuspid and about 20% are bicuspid
d. Different processes involved in aortic stenosis is multifactorial which involves endothelial dysfunction, lipid accumulation, inflammatory cell activation among others
d. Different processes involved in aortic stenosis is multifactorial which involves endothelial dysfunction, lipid accumulation, inflammatory cell activation among others
Which of the following best describes the response of the left ventricle when there is sudden left ventricular outflow obstruction?
a. The systolic pressure gradient between and the LV is minimal
b. There is dilation and reduction of stroke volume
c. LV adapts by concentric LV hypertrophy and maintains contractile performance and thus cardiac output
d. When afterload mismatch occurs, stroke volume can be maintained adequately
b. There is dilation and reduction of stroke volume
Which of the following best describes Pulsus parvus et tardus?
a. Carotid arterial sudden peak, and then a delayed decay
b. Carotid arterial pulse rises slowly to a delayed peak
c. Carotid arterial peak systolic upstroke, then sudden decay
d. Carotid arterial pulse is biphasic, with a delayed peak
b. Carotid arterial pulse rises slowly to a delayed peak
Which of the following aortic stenosis natural history is correctly paired?
a. Angina pectoris–4 years
b. Syncope–3 years
c. Dyspnea–3 years
d. Heart failure–1.5-3 years
b. Syncope–3 years
Which of the following statements is true regarding mitral stenosis?
a. Pure or predominant MS occurs in -60% of all patients with rheumatic fever
b. Acute Inflammation leads to diffuse thickening of valve leaflets with formation of fibrous tissue often calcific deposits
c. Mitral commissures are spared, with diffuse thickening of valve leaflets with formation of fibrous tissue often calcific deposits
d. Chordae tendineae fuse and shorten, the valvular cusps become rigid and pathologic process eventually leads to narrowing
d. Chordae tendineae fuse and shorten, the valvular cusps become rigid and pathologic process eventually leads to narrowing
Which of the following best describes the hallmark of significant mitral stenosis
a. The pressure gradient gradient between the LA and LV is minimal that passive blood still flows during early diastole
b. During diastole, there is passive movement of blood from the LA to LV, but atrial contraction starts earlier & diastasis is no longer occurs
c. Blood can flow from the LA to the LV only if propelled by an abnormally elevated left atrio-ventricular pressure gradient
d. A LA pressure of ~30 mmhg is required to maintain a normal cardiac output
c. Blood can flow from the LA to the LV only if propelled by an abnormally elevated left atrio-ventricular pressure gradient
Which of the following statements best describes the earliest changes seen on Chest X-ray in patients with mitral stenosis
a. Straightening of the upper left border of the cardiac silhouette and prominence of the main pulmonary artery
b. Displacement of the LV apex to the anterior axillary line, and signs of congestion
c. Posterior displacement of the esophagus by an enlarged RA
d. Kerley A and B lines are enlarged, non-dense, radiolucent horizontal lines are commonly seen.
a. Straightening of the upper left border of the cardiac silhouette and prominence of the main pulmonary artery
Which of the following statements best definitive treatment (Class I) for a 40 year old, with no comorbidities but with severe mitral stenosis NYHA FC III-IV functional capacity?
a. Percutaneous mitral balloon commissurotomy (PMBC)
b. Mitral valve repair
c. Mitral valve replacement
d. PMBC + MV replacement
c. Mitral valve replacement
?