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WorksheetsCardio Exam 4 - Part 1
Total questions: 95
Worksheet time: 48mins
Name
Class
Date
1.
What are the determining factors of a net dipole?
a)
magnitude of depol (how many cells depol at once)
b)
orientation of dipoles
c)
initial depol on the left side of septum
d)
large net depol in one direction
e)
small final wave of depol
2.
What does the Q waves represent in an ECG?
a)
magnitude of depol (how many cells depol at once)
b)
orientation of dipoles
c)
initial depol on the left side of septum
d)
large net depol in one direction
e)
small final wave of depol
3.
What does the R wave represent in an ECG?
a)
magnitude of depol (how many cells depol at once)
b)
orientation of dipoles
c)
initial depol on the left side of septum
d)
large net depol in one direction
e)
small final wave of depol
4.
What does the S wave represent in an ECG?
a)
magnitude of depol (how many cells depol at once)
b)
orientation of dipoles
c)
initial depol on the left side of septum
d)
large net depol in one direction
e)
small final wave of depol
5.
What are common causes of left axis deviation
a)
left ventricular hypertrophy (LVH)
b)
right MI
c)
right ventricular hypertrophy (RVH)
d)
left MI
6.
What are common causes of right axis deviation
a)
left ventricular hypertrophy (LVH)
b)
right MI
c)
right ventricular hypertrophy (RVH)
d)
left MI
7.
ST segment should be flat on the isoelectric line
a)
true
b)
false
8.
What are examples of supraventricular tachycardia
a)
atrial fibrillation
b)
atrial flutter
c)
ventricular fibrillation
d)
Torsades de Pointes<br />
e)
ventricular tachycardia
9.
What are the main causes of supraventricular tachycardia
a)
SA node overactivity
b)
ectopic focus
c)
reentry phenomenon
d)
angina
e)
electrolyte imbalance
10.
What is it called when cells in another part of the heart is firing off signals to the SA node
a)
SA node overactivity
b)
ectopic focus
c)
reentry phenomenon
d)
angina
e)
electrolyte imbalance
11.
What are symptoms of supraventricular tachycardia
a)
dizziness
b)
low BP
c)
high BP
d)
high BG
12.
Which disorder shows an overlap of P and T waves on an ECG and a narrower RR interval?
a)
atrial fibrillation
b)
sinus tachycardia
c)
ventricular fibrillation
d)
Torsades de Pointes<br />
e)
ventricular tachycardia
13.
What is the main cause of atrial flutter
a)
SA node overactivity
b)
ectopic focus
c)
reentry phenomenon
d)
Torsades de Pointes<br />
e)
electrolyte imbalance
14.
What is occuring when not all of a signal is conducted through the AV node due to the refractory period in the AV node
a)
atrial fibrillation
b)
atrial flutter
c)
ventricular fibrillation
d)
Torsades de Pointes<br />
e)
ventricular tachycardia
15.
How does atrial flutter present on an ECG
a)
ST elevation
b)
PT waves merge into a sawtooth pattern
c)
QRS elongation
d)
T inversion
e)
promonent U wave
16.
What is the main cause of atrial fibrillation
a)
SA node overactivity
b)
ectopic focus
c)
reentry phenomenon
d)
Torsades de Pointes<br />
e)
electrolyte imbalance
17.
Rate of firing in atrial flutter is much faster than in A-fib
a)
true
b)
FALSE (A-fib faster)
18.
How does a-fib present on an ECG?
a)
ST elevation
b)
PT waves merge into a sawtooth pattern
c)
QRS elongation
d)
T inversion
e)
undistinguishable waves
19.
What is the cause and effect of the heart block
a)
cause: conduction block at the AV node
b)
cause: conduction block at the SA node
c)
effect: decreased depol of ventricles -> bradycardia
d)
effect: decreased repol of venctricles
20.
What type of heart block is associated with a slowing of a signal, but still gets through reaching the bundle branches
a)
1st degree
b)
2nd degree
c)
3rd degree
d)
complete heart block
21.
Looking at an ECG, what is determinant of 1st degree heart block
a)
longer PR interval
b)
P-waves not followed by QRS complex (2:1, 3:1, 4:1)
c)
longer QRS
d)
double R
e)
prolonged RR interval
22.
What type of heart block is associated with a complete block of signal transmission through the AV node, the ectopic cells are what come into play and the P-wave QRS complex are independent of each other
a)
1st degree
b)
2nd degree
c)
3rd degree
d)
complete heart block
23.
What determines a 3rd degree heart block
a)
longer PR interval
b)
P-waves not followed by QRS complex (2:1, 3:1, 4:1)
c)
longer QRS
d)
double R
e)
prolonged RR interval
24.
What type of heart block is when some but not all signals are transmitted through the AV node
a)
1st degree
b)
2nd degree
c)
3rd degree
d)
complete heart block
25.
What can be seen on an ECG for a pt with 2nd degree heart block?
a)
longer PR interval
b)
P-waves not followed by QRS complex (2:1, 3:1, 4:1)
c)
longer QRS
d)
double R
e)
prolonged RR interval
26.
What is a bundle branch block
a)
longer PR interval
b)
P-waves not followed by QRS complex (2:1, 3:1, 4:1)
c)
longer QRS
d)
an embolism in the coronary arteries
e)
a conduction block in the branches
27.
What is a typical cause of a bunch branch block
a)
MI
b)
PE
c)
A-fib
d)
Ventricular tachycardia
28.
What is different in an ECG for a pt with a bundle branch block
a)
longer PR interval
b)
P-waves not followed by QRS complex (2:1, 3:1, 4:1)
c)
longer QRS
d)
double R
e)
prolonged RR interval
29.
What are the main causes of premature ventricular contractions (PVC)
a)
SA node overactivity
b)
ectopic cells in the ventricle
c)
reentry phenomenon
d)
complete heart block<br />
e)
ectopic cells due to ischemia or infarction
30.
How can PVC be determined by an ECG
a)
large deflection followed by a pause
b)
sawtooth pattern
c)
wide QRS
d)
double R
e)
elongated Q
31.
What is the cause of ventricular tachycardia
a)
SA node overactivity
b)
ectopic cells in the ventricle
c)
reentry phenomenon
d)
complete heart block<br />
e)
ectopic cells due to ischemia or infarction
32.
What can be seen on an ECG for a patient with ventricular tachycardia
a)
large deflection followed by a pause
b)
sawtooth pattern
c)
wide QRS
d)
double R
e)
elongated Q
33.
What can ventricular tachycardia progress into
a)
atrial fibrillation
b)
atrial flutter
c)
ventricular fibrillation
d)
complete heart block
34.
What is the difference between ventricular tachycardia and ventricular fibrillation
a)
tachycardia: ventricles are firing in a uniform manner
b)
fibrillation: there is complete disorder and no uniformity in firing
c)
tachycardia: there is complete disorder and no uniformity of firing<br />
d)
fibrillation: ventricles are firing in a uniform manner
35.
What is the cause of long QT syndrome
a)
inappropriate opening of Na channels
b)
prolonged closure of K channels
c)
inappropriate opening of Ca channels
36.
What is seen on an ECG for a pt with a long QT syndrome
a)
longer PR interval
b)
P-waves not followed by QRS complex (2:1, 3:1, 4:1)
c)
longer QRS
d)
double R
e)
prolonged or abnormal QT interval
37.
What is an MI?
a)
when blood supply to the myocardium is interuppted having an effect on ventricular repolarization
b)
when blood supply to the myocardium is interrupted having an effect on atrial repolarization
c)
when blood supply to the myocardium is completely blocked
38.
What is seen on an ECG for pt with an acute MI
a)
ST elevation
b)
ST depression
c)
inverted T wave
d)
deep Q wave
39.
A pt's ECG shows ST elevation, smaller R wave, and a slight Q wave. How long ago did the pt suffer an MI
a)
current acute MI
b)
hours ago
c)
1-2 days ago
d)
a few days ago
e)
weeks ago
40.
A pt's ECG shows an inverted T wave and a deep Q wave. How long ago did the pt suffer an MI
a)
current acute MI
b)
hours ago
c)
1-2 days ago
d)
a few days ago
e)
weeks ago
41.
A pt's ECG shows a normal ST but has an inverted T wave. How long ago did the pt suffer an MI
a)
current acute MI
b)
hours ago
c)
1-2 days ago
d)
a few days ago
e)
weeks ago
42.
A pt's ECG shows a normal ST and T wave but has a persistent Q wave. How long ago did the pt suffer an MI
a)
current acute MI
b)
hours ago
c)
1-2 days ago
d)
a few days ago
e)
weeks ago
43.
What features can be seen on a ECG with a pt who had a non-STEMI
a)
ST elevation
b)
ST depression
c)
inverted T wave
d)
deep Q wave
44.
What eletrolyte distrubance is associated with a tall peaked T wave on an ECG
a)
hyperkalemia
b)
hypokalemia
c)
hypercalcemia/hypermagnesemia
d)
hypocalcemia/hypomagnesemia
e)
severe hyperkalemia
45.
How does severe hyperkalemia present itself on an ECG
a)
flattened P wave
b)
widened QRS
c)
shortened QT interval
d)
prominent U wave
e)
prolonged QT interval
46.
A pt's ECG shows an ST depression, flattened T wave, and prominent U wave. What electrolyte distrubance is the pt experiencing
a)
hyperkalemia
b)
hypokalemia
c)
hypercalcemia/hypermagnesemia
d)
hypocalcemia/hypomagnesemia
e)
severe hyperkalemia
47.
Hypercalcemia/hypermagnesemia have what presentation on an ECG
a)
flattened P wave
b)
widened QRS
c)
shortened QT interval
d)
prominent U wave
e)
prolonged QT interval
48.
A prolonged QT interval can be indicative of what electrolyte disturbance
a)
hyperkalemia
b)
hypokalemia
c)
hypercalcemia/hypermagnesemia
d)
hypocalcemia/hypomagnesemia
e)
severe hyperkalemia
49.
The atria and ventricles contract at the same time<br />
a)
true
b)
FALSE (contract independently)
50.
How do signals travel into the ventricles
a)
through AV node
b)
through SA node
c)
through ectopic cells
d)
through Purkinje fibers
51.
What is the pacemaker of the haert
a)
AV node
b)
SA node
c)
ectopic cells
d)
Purkinje fibers
52.
What happens when Na/Ca influx into a cell
a)
repolarization
b)
depolarization
c)
electrolyte imbalance
53.
What causes repolarizaton of cells
a)
Na influx
b)
Ca influx
c)
K efflux
54.
What are abnormalities in formation/conduction of the heart
a)
arrhythmias
b)
when blood supply to the myocardium is interrupted
c)
heart block
55.
What are some causes of arrhythmias
a)
anatomical defects
b)
electrolyte imbalance
c)
ischemia
d)
stress
e)
drugs (non-Rx & Rx)
56.
What are some common non-Rx drugs that can cause arrhythmias
a)
sudafed
b)
caffeine
c)
nicotine
d)
melatonin
e)
lavendar
57.
What are symptoms of arrhythmias
a)
palpitations, angina
b)
fatigue
c)
syncope
d)
dizziness
e)
dyspnea, SOB
58.
Tachycardia is defined as<br />
a)
> 100 bpm
b)
> 150 bpm
c)
> 80 bpm
d)
< 60 bpm
e)
<40 bpm
59.
Bradycardia is defined as
a)
> 100 bpm
b)
> 150 bpm
c)
> 80 bpm
d)
< 60 bpm
e)
<40 bpm
60.
Why is the QT interval significant
a)
it is the time it takes to depol and repol the heart
b)
it is the time it takes to depol the heart
c)
it is the time it takes to repol the heart
d)
it is the time it takes to breathe
61.
Why is a prolonged QT interval troublesome
a)
can be indicative of a longer depol and repol
b)
it can be indicative of a longer depol
c)
it can be indicative of a longer repol
62.
What drug classes are found to prolong the QT interval and pts must take caution with them
a)
antipsychotics
b)
antidepressants
c)
antibacterials
d)
antiarrhythmic
e)
antilipidemic
63.
What drug class belongs to class II antiarrhythmics
a)
Na channel blocker
b)
beta blocker
c)
K channel blocker
d)
Ca channel blocker
64.
What are the MOA of class II antiarrhythmics
a)
inhibit sympathetic input to pacing regions of the heart
b)
inhibit phase 4 depol in SA and AV nodes
c)
block open or inactivated Ca channels to slow conduction
d)
decrease automaticity of SA nodal cells
e)
blocks K channels
65.
What beta blockers should be used in a pt with LVEF <40% and A-fib
a)
metoprolol succinate
b)
bisprolol
c)
carvedilol
d)
metoprolol tartate
e)
amiodarone
66.
A decrease in the slope of phase 4 depol can lead to
a)
decrease rate of firing -> decrease automaticity
b)
increase rate of firing -> increase automaticity
c)
decrease effective refractory period
d)
increase reentry
67.
Prolonged repolarization of the AV node can lead to
a)
decrease rate of firing -> decrease automaticity
b)
increase rate of firing -> increase automaticity
c)
increase effective refractory period -> decrease reentry
d)
decrease refractory period -> decrease reentry
68.
Beta blockers are useful for arrhythmias caused by
a)
stress
b)
exercise
c)
post MI
d)
relaxation
69.
What are common ADRs a patient may experience with beta blockers
a)
hypotension
b)
bradycardia
c)
fatigue
d)
insomnia
e)
sexual dysfunction
70.
What drug class belongs to class IV antiarrhythmics
a)
Na channel blocker
b)
beta blocker
c)
K channel blocker
d)
nDHP CCBs
71.
What is the MOA of class IV antiarrhythmics
a)
inhibit sympathetic input to pacing regions of the heart
b)
inhibit phase 4 depol in SA and AV nodes
c)
block K channels
d)
decrease automaticity of SA nodal cells
e)
block open L-type Ca channels to slow conduction in SA and AV nodes
72.
Non-DHP CCBs are preferred over beta blockers in patients with what comorbidities
a)
COPD
b)
asthma
c)
heart failure
d)
CAD
e)
PVD
73.
What are some common ADRs of nDHP CCBs
a)
AV nodal block
b)
HA, dizziness, fatigue
c)
nausea, constipation
d)
edema
e)
gingival hyperplasia
74.
Why should non-DHP CCBs and beta blockers not be combined
a)
synergistic effect on each other
b)
increase the risk of HF (LV<40%)
c)
one drug will cancel out the other drug
d)
increase the risk of bleeding
75.
Why should a lower dose of Simvastatin/Lovastatin be used in pts on nDHP CCBs
a)
nDHP CCBs are substrates of P-GP and CYP3A4
b)
nDHP CCBs are substrates of P-GP and CYP2C8
c)
nDHP CCBs are substrates of CYP3A4 and CYP2C8
76.
What drink should be avoided in pts taking nDHP CCBs due to its CYP3A4 inhibition actions
a)
grapefruit juice
b)
apple juice
c)
orange juice
d)
fruit punch
77.
What drug class belongs to class I antiarrhythmics
a)
Na channel blocker
b)
beta blocker
c)
K channel blocker
d)
Ca channel blocker
78.
Class I antiarrhythmics only affect pacemaker cells
a)
true
b)
FALSE (pacemaker and myocyte)
c)
FALSE (myocyte only)
79.
Why is class I antiarrhythmic use not as common
a)
risk of pro-arrhythmic effects
b)
risk of HF
c)
other classes are more effective
80.
What is the MOA of class I antiarrhythmics on pacemaker cells
a)
inhibit sympathetic input to pacing regions of the heart
b)
slow phase 0 depol and prolonged repol -> decrease reentry
c)
increase threshold potential and decrease phase 4 slope -> decreasing firing rate and automaticity
d)
decrease automaticity of SA nodal cells
e)
block open L-type Ca channels to slow conduction in SA and AV nodes
81.
What is the MOA of class I antiarrhythmics on ventricular myocytes
a)
inhibit sympathetic input to pacing regions of the heart
b)
slow phase 0 depol and prolonged repol -> decrease reentry
c)
increase threshold potential and decrease phase 4 slope -> decreasing firing rate and automaticity
d)
decrease automaticity of SA nodal cells
e)
block open L-type Ca channels to slow conduction in SA and AV nodes
82.
Which subclass of class I antiarrhythmics has a moderate effect in blocking fast Na channels
a)
1a
b)
1b
c)
1c
83.
How do class 1a antiarrhythmics affect repol
a)
prolong
b)
shortens
c)
inverts
d)
skips
84.
What are common ADRs of class 1a antiarrhythmics
a)
anticholinergic effects
b)
arrhythmias
c)
GI (N/D)
d)
dizziness
e)
rash
85.
What are common C/I of class 1a antiarrthymics
a)
QT syndrome
b)
hypersensitivity
c)
heart block
d)
ST elevation
e)
ventricular tachycardia
86.
What are examples of class 1a antiarrhythmics
a)
Quinidine
b)
Procainamide
c)
Disopyramide
d)
Dofetilide
e)
Propafenone
87.
What class 1a antiarrhythmic agent can cause cinchonism
a)
Quinidine
b)
Procainamide
c)
Disopyramide
d)
Dofetilide
e)
Propafenone
88.
What are signs of cinchonism
a)
tinnitus
b)
flush
c)
excessive sweating
d)
N/V/D
e)
confusion
89.
What are some counseling points for Quinidine
a)
take with food to decrease GI upset
b)
carries hemolysis risk
c)
can cause DILE
d)
can cause cinchonism when OD
e)
only available as IV
90.
What are some counseling points for Procainamide
a)
may cause CNS ADRs
b)
long term use can lead to DILE
c)
long term use leads to ANA
d)
is renally cleared
e)
only available as IV
91.
Procainamide has an inactive metabolite
a)
true
b)
FALSE (active)
92.
What is the BBW associated with procainamide
a)
arganulocytosis
b)
DILE
c)
cinchonism
d)
ANA
93.
What is the therapeutic level of procainamide
a)
4-10 mcg/mL
b)
5-12 mcg/mL
c)
1-5 mcg/mL
d)
10-20 mcg/mL
94.
What are some counseling points for disopyramidine
a)
take with food to decrease GI upset
b)
take on an empty stomach
c)
has anticholinergic effects
d)
long term use can lead to DILE
95.
Which subclass of class I antiarrhythmics has a mild effect in blocking fast Na channels
a)
1a
b)
1b
c)
1c
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