FPGEE Review Exam Questions with Correct Answers

FPGEE Review Exam Questions with Correct Answers In FAST response fibers - Electrolyte involved in phase 0 - Answer-Na+ influx In FAST response fibers - Electrolyte involved in phase 2 - Answer-Ca+ influx, K+ outflux plateau In FAST response fibers - Electrolyte involved in phase 3 - Answer-K+ outflux (Ca+ drops off) rapid repolarization In SLOW response fibers - Electrolyte involved in phase 0 - Answer-Ca+(few Na+ channels in Nodal fibers) In SLOW response fibers - Electrolyte involved in phase 3 - Answer-K+ outflux repolarization In SLOW response fibers - Electrolyte involved in phase 4 - Answer-"Mainly Na+ (This is the pacemaker current) aarapim. " Ectopic rhythm can result from - Answer-ischemia, electrolyte abnormalities, or heightened sympathetic tone If an early afterdepolarization is sustained - Answer-torades de pointes (QRS complexes of varying amplitudes) ECG of a patient with an accessory pathway (bundle of Kent) - Answer-"Wide QRS complexes, early ventricular upstroke (also predisposed to re-entry loops) (Wolff Parkinson White (WPW) syndrome) wolff-parkinson-white-accessory-bundle-bundle-ofKent " MOA of quinidine - Answer-Blocks (open-activated) Na+ channels: In SA Nodal tissue - Shift to a more positive threshold and decrease the pacemaker slope (phase 4), In Ventricular tissue - Decreases the phase 0 slope (depolarization) and block K+ channels prolongs repolarization (longer refractory period protected from reentry currents): Anticholanergic (vagolytic effect faster conduction through AV node) Indications of quinidine - Answer-"atrial flutter or fibrillation maintain normal sinus rhythm,Paroxysmal supraventricular tachycardia, Premature atrial or ventricular contractions, paroxysmal AV junctional rhythm 9" When taking this drug patients must be monitored for lupus (with ANA) - AnswerProcainamide Take with quinidine to prevent rapid ventricular response in patient with atrial flutter - Answer-β-blocker or Ca2+ channel blocker Which 1A antiarrhythmic for a patient on digoxin - Answer-Procainamide (doesn't alter digoxin levels) MOA of Lidocaine and Phenytoin - Answer-( 1B) block of voltage-gated Na+ in ventricular myocytes (decrease phase 0 upstroke) MOA of Encainide, Flecainide, Moricizine, Propafenone - Answer-( 1C) block of voltagegated Na+ channelsin ventricular myocytes MOA of Propranolol, Atenolol, Metoprolol... - Answer-( ) block β1-adrenergic receptors SLOW SA and AV nodal activity,(decreases phase 4 slope) MOA of Ibutilide, Dofetilide, Sotalol, Amiodarone - Answer-( I) Block K+ channels longer action potential plateau and prolonged repolarization MOA of Verapamil, Diltiazem - Answer-( IV) Ca2+ channel blocker slows action potential upstroke in SA and AV nodes This 1A drug is associated with the development of Lupus, hematotoxicity, but less likely to cause torsades - Answer-procainamide Antiarrhythmics of choice for post ischemic insults - Answer-1B Drug used for Supraventricular tachycardias, and post-MI prophylaxis - Answerantiarrhythmics (β-blockers) What does Quinidine do to AV node - Answer-increases conduction velocity (via anticholinergic effects) This 1A drug is meolized to a meolite with a pure I effect (prolonging refractory, lengthening QT interval) - Answer-Procainamide DOC or ventricular arrhythmias in ER situations (like in MI) - Answer-Lidocaine LidocaineMexiletine should be (increased or decreased) in patients with drug inducible P0 - Answer-increased Moderate Na+ channel block decrease phase 0, and prolonged repolarization ( 1A, 1B or 1C) - Answer-1A Mild Na+ channel block slight pahse 0 slope decrease, shortened repolarization( 1A, 1B or 1C) - Answer-1B