IBHRE CEPS Prep Questions and Answers 2024, Exams of Advanced Education

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IBHRE CEPS Prep Questions and

Answers 2024 Graded A+

An adult in VF/VT should initially be defibrillated with how much energy? - ANSWER- 200 J An emergency drug given for bradycardia or AV nodal Block - ANSWER-Atropine An isolation transformer allows - ANSWER-AC signals (used for ablation energy) to pass from one circuit to another without allowing the transmission of DC signals. This effectively reduces direct current leakage and acts as a surge preotector. Beta blockers do what? - ANSWER-slow the upstoke velocity of the SA & AV Node cells, therefore slowing conduction in these fibers. Beta Blockers slow down the - ANSWER-AV Node by reducing automaticity Calcium channel blockers also help to increase - ANSWER-vagal tone Calcium channel blockers will _________ automaticity and _________________________ conduction velocity or action potential duration - ANSWER-decrease; not change Cardiac perforation results in - ANSWER-shoulder pain, dyspnea, and pleuritic chest pain Class 1 guidelines for permanent pacing - ANSWER-Conditions where there is evidence that a pacemaker is beneficial and has greater benefits than risks. For example, symptomatic sinus node dysfunction, such as sinus bradycardia or sinus pauses, is a class I indication. Class 1A antiarrhythmic drugs like Quinidine, Procainamide, and Class 3 antiarrhythmic drugs like dofetilide and sotalol do what? - ANSWER-Prolong action potential duration and cause QT prolongation. Class 1B antiarrhythmics block what channels? - ANSWER-sodium channels Class 1B antiarrhythmics mostly affect what chamber? - ANSWER-Ventricles (good for VT) Class 1B drugs ________________ the duration of the action potential and _______________ refractoriness - ANSWER-shorten; decrease

Class 1C agents including flecainide and propafenone do not: - ANSWER-prolong the action potential or increase refractoriness Class 1C antiarrhythmics block what? - ANSWER-Fast Sodium channels Class 2 guidelines for permanent pacing - ANSWER-Conditions where there is conflicting evidence or different opinions about the usefulness of a pacemaker. Class IIa conditions have evidence that favors the pacemaker's efficacy, while Class IIb conditions have less clear evidence. For example, asymptomatic third-degree AV block is a class IIa indication. Class 3 guidelines for permanent pacing - ANSWER-Conditions where there is evidence that a pacemaker is not useful or effective, and may even be harmful. Permanent pacing is not recommended for these conditions Class I Antiarrhythmic drugs are - ANSWER-Sodium channel blockers Class IA antiarrhythmics block what channels? - ANSWER-Sodium and Potassium Class II Antiarrhythmic drugs are - ANSWER-Beta Blockers Class III Antiarrhythmic drugs are - ANSWER-Potassium channel blockers Class III antiarrhythmic drugs block what? - ANSWER-Potassium channels Class III antiarrhythmic drugs will _______ action potential duration and __________ conduction velocity or automaticity - ANSWER-increase; not change Class IV Antiarrhythmic drugs are - ANSWER-calcium channel blockers Class IV antiarrhythmics block what? - ANSWER-Calcium channels Electrophysiologic recorder filters should be able to process signals filtered between - ANSWER-30-40 Hz and 400-500 Hz Examples of Class 1A antiarrhythmics - ANSWER-Quinidine Procainamide Disopyramide Examples of Class 1B antiarrhythmics - ANSWER-Lidocaine Mexiletine Phenytoin

Lead fracture causes - ANSWER-High impendance Lidocaine does what to sodium current? - ANSWER-Selectively blocks the slow component of the sodium current, can block sodium transport across the cell membrane in high concentrations. Ohm's Law - ANSWER-Voltage (V) = Current (I) x Resistance (R) Pain at the pocket in the early post-implant period is most likely related to - ANSWER- device edge irritation of subcuticular structures due to the location of the pulse generator Phase 0 of action potential represents - ANSWER-rapid depolarization Phase 4 of the action potential most directly determines - ANSWER-automaticity Propranolol, atenolol, metropolol, inderal, and acetabulol are all: - ANSWER-beta blockers Radiofrequency energy has a frequency range of: - ANSWER-100 kHz to 1.5 MHz Sotalol tends to _______ the QT interval, which may give rise to _____________ - ANSWER-prolong; Torsade de Pointes The conduction velocity of an electrical impulse through cardiac tissue is most directly determined by - ANSWER-The slope of phase 0 of the action potential The first drug of choice for ventricular fibrillation is - ANSWER-epinephrine The longest coupling interval for which a premature impulse fails to propagate through cardiac tissue is: - ANSWER-The Effective Refractory Period The longest coupling interval for which a premature impulse results in slowed conduction through cardiac tissue is: - ANSWER-The Relative Refractory Period The primary effect of Class 1C antiarrhythmic drugs is to - ANSWER-Block sodium channel and slow conduction The primary effect of class III antiarrhythmic drugs is to - ANSWER-Increase the action potential duration and prolong the refractory period The refractory period of a myocardial cell is most directly determined by - ANSWER-The duration of the plateau phase of the action potential The right coronary artery travels along the course of the - ANSWER-tricuspid annulus

The shortest coupling period in which successive impulses can conduct through a tissue is: - ANSWER-The Functional Refractory period The Vaughn Williams classification of antiarrhythmic drugs is based on the - ANSWER- effect of the cardiac action potential This type of lead is contraindicated when a pacemaker is necessary in a patient with a transvenous ICD - ANSWER-Unipolar Lead Triggered activity involves abnormal behavior in which phases of the action potential? - ANSWER-Phases 3 and 4 What action potential phases are affected in Class IA antiarrhythmics? - ANSWER- Phases 0- What class Drug is Lidocaine? - ANSWER-Class 1B What class drug is Propanolol? - ANSWER-Class 2C What class drug is Verapamil? - ANSWER-Class 4, Calcium Channel Blocker What do calcium channel blockers do? - ANSWER-Block the slow calcium channels that primarily regulate the SA and AV Nodes and tend to slow conduction What does digoxin do? - ANSWER-Stops the Na-K pump Increases heart contraction because there is a lot of Na+ inside the cell Affects the parasympathetic nervous system and nodal tissues What drug can be used for rate control with AF or AFL? - ANSWER-Amiodarone What drug has Class II and III antiarrhythmic properties, and is used in the treatment of Atrial Fibrillation, atrial flutter, and ventricular tachycardia? - ANSWER-Sotalol What drug slows AV Node conduction time? - ANSWER-Adenosine What drugs are indicated in the treatment of stable, wide-complex tachycardia? - ANSWER-Amiodarone and procainamide What happens in Phase 0? - ANSWER-Sodium channels open, allowing sodium to rapidly move into the cells in response to the less negative potential gradient across the cell membrane What is the morphology during right ventricular apex pacing? - ANSWER-LBBB with superior axis.