Frequently Missed Practice Questions – July 2016
On our Facebook page, we frequently post sample practice questions and invite our community to submit their answers. Most of the time, followers of our AMRI page do quite well, but occasionally, we post a question resulting in several incorrect responses. These difficult questions provide a valuable learning opportunity and we would like to share some with you now.
QUESTION 1:
In most patients, which are the easier arrhythmias to electrically convert?
A. SVT with regular R-R intervals
B. 2:1 or 1:1 atrial flutter
C. Ventricular tachycardia
D. All of the above
The best answer is D: All of the above.
Here's Why: Arrhythmias caused by anomolous circuitry (e.g., regular R-R SVTs, VT and atrial flutter) typically respond to low energy. Atrial fibrillation and ventricular fibrillation most often require much higher levels in order to electrically depolarize a critical mass of fibrillating muscle.
QUESTION 2:
When adenosine fails to convert a patient with a stable narrow QRS SVT, what drugs may be considered as second line agents?
A. Digoxin
B. Calcium channel blockers (verapamil, diltiazem, etc.)
C. Beta blockers (metoprolol, atenolol, etc.)
D. Both B and C
The best answer is D: Both B and C.
Here's Why: Vagal maneuvers and adenosine are the recommended first interventions when treating stable PSVT. The most recent guidelines state that vagal maneuvers convert about 25% of patients with PSVT. If adenosine fails, the use of beta blockers or calcium channel blockers is recommended. While amiodarone may be indicated, its use should be employed by expert practitioners rather than as a routine consideration.
QUESTION 3:
Which specialist is trained to do intra-chamber electrograms used to identify the source of cardiac arrhythmias?
A. Gastroenterologist
B. Cardiovascular surgeon
C. Invasive cardiologist
D. Cardiologist electrophysiologist
The best answer is D: Cardiologist electrophysiologist.
Here's Why: The cardiology sub-speciality trained to conduct cardiac electrophysiology studies such as intra-chamber electrograms is the Electro-Physiologist (EP). Most practice in a specialty EP lab.
Like us on Facebook for more questions like these, every Tuesday and Thursday.
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Frequently Missed Practice Questions –2016 Quarterly Recap
On our Facebook page, we frequently post sample practice questions and invite our community to submit their answers. Most of the time, followers of our AMRI page do quite well, but occasionally, we post a question resulting in several incorrect responses. These difficult questions provide a valuable learning opportunity. Here is a recap of the most challenging questions during the second quarter of 2016. Take the quiz to see how well you do.
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