,1. Q: When assessing a patient with WCT, which of the following is the
most important initial step?
A. Administering antiarrhythmic medication
B. Identifying the presence of AV dissociation
C. Checking for structural heart disease
D. Obtaining a 12-lead ECG
Answer: D. Obtaining a 12-lead ECG
Rationale: The 12-lead ECG is crucial for diagnosing WCT as it helps in
identifying the rhythm, determining the origin of the tachycardia, and
guiding subsequent management steps.
2. Q: A regular WCT with a monomorphic appearance suggests which of
the following etiologies?
A. Atrial fibrillation with aberrancy
B. Ventricular tachycardia
C. Supraventricular tachycardia with aberrant conduction
D. Sinus tachycardia with bundle branch block
Answer: B. Ventricular tachycardia
Rationale: A regular, monomorphic WCT is more likely to be
ventricular tachycardia, especially if the patient has a history of structural
heart disease or previous myocardial infarction.
3. Q: In the context of WCT, a history of structural heart disease primarily
increases the likelihood of which diagnosis?
A. Atrial flutter
B. Ventricular fibrillation
C. Ventricular tachycardia
D. Pre-excited atrial arrhythmias
Answer: C. Ventricular tachycardia
Rationale: Patients with structural heart disease are at a higher risk for
ventricular tachycardia due to scarred or damaged myocardial tissue that
can serve as a substrate for reentrant circuits.
4. Q: Which of the following ECG findings is most suggestive of
ventricular tachycardia in WCT?
A. P wave preceding each QRS complex
B. Absence of an RS complex in all precordial leads
, C. Narrow QRS complexes
D. Fusion beats
Answer: D. Fusion beats
Rationale: Fusion beats occur when a supraventricular and a ventricular
beat occur simultaneously, which is a hallmark sign of ventricular
tachycardia.
5. Q: Capture beats on an ECG are indicative of which type of WCT?
A. Atrial tachycardia
B. Ventricular tachycardia
C. Supraventricular tachycardia
D. Junctional tachycardia
Answer: B. Ventricular tachycardia
Rationale: Capture beats are occasional normal beats that 'capture' the
ventricles during ventricular tachycardia, indicating that the ventricles can
still be depolarized by the normal conduction system.
6. Q: What is the significance of a Brugada sign in diagnosing WCT?
A. It indicates a supraventricular origin with aberrant conduction.
B. It suggests the presence of an accessory pathway.
C. It is a specific sign for ventricular tachycardia.
D. It confirms sinus rhythm with a bundle branch block.
Answer: C. It is a specific sign for ventricular tachycardia.
Rationale: The Brugada sign refers to an RS interval of >100ms in one
or more of the right precordial leads (V1-V3), which is highly specific for
ventricular tachycardia.
7. Q: A patient with WCT and evidence of AV dissociation on ECG is
most likely experiencing which of the following?
A. Atrial fibrillation
B. Ventricular tachycardia
C. Supraventricular tachycardia with bundle branch block
D. Multifocal atrial tachycardia
Answer: B. Ventricular tachycardia
Rationale: AV dissociation, where the atria and ventricles beat
independently of each other, is a classic feature of ventricular tachycardia.
8. Q: Concordance in precordial leads on an ECG is diagnostic of which
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