IBHRE CCDS EXAM QUESTIONS AND ANSWERS
What is the suggested type of antibiotics? - Answers-Beta-Lactam antibiotics,
vancomycin reserved for those with penicillin allerigies
What lead insulation material best reduces ingrowth? - Answers-.ePTFE
Which lead insulation material is most susceptible to metal ion oxidation (MIO) and
environmental stress cracking (ESC) - Answers-Poly 80A
ESC and MIO - Answers-Environmental Stress Cracking
Metal Ion Oxidation
Pros/Cons of Silicone Leads - Answers-Pros: Longevity, flexible, repairable
Cons: Tacky, thick, easily damaged
Most common cause of Ventricular Safety Pacing? - Answers-Ventricular Ectopy
Which electrode material is bad? - Answers-Elgiloy
Cardiac action potential:
0-4 - Answers-0 - depolarization (Ca+ and Na+ rush in)
1 - Na+ channels close
2 - Slow Ca+ channels
3 - fast K+ channels
4 - alert
Cardiac Tissue is (-) at rest and (+) at contraction
0 - Na channels are open
1 - K channels open and start repolarization
2 - Ca channels open and delay repolarization
3 - Ca channels close
4 - Rest
Cardiac cells are ______________ charged at rest - Answers-Negatively
Conductor Types - Answers-DFT (Drawn Filled Tube) and DBS (Brawn Brazed Strand)
Components of DFT and DBS conductors - Answers-Silver and MP35N
Best type of capacitor - Answers-Tantalum Electrolytic
Describe the depletion Lithium Silver Vanadium Oxide battery - Answers-Predictable, 3
plateaus in discharge curve
,Common battery type for ppm? ICD? - Answers-Ppm - Lithium Iodide
ICD - Lithium Silver vanadium oxide
1 Hz = ___________ bpm - Answers-60
100 bpm = _________ Hz - Answers-1.67
Battery components:
Capacitor -
Reed Switch -
Diode -
Resistor -
Rectifier - - Answers-Cap - stores electrical charge
Reed - switches ppm to Magnet mode
Diode - ensures one way flow of current
Resistor - restricts current flow
rectifier - creates all pos or all neg signals
Voltage of PPM battery? - Answers-2.8V
Voltage of ICD battery? - Answers-3.2V
Types of Sensors: Open Loop - Answers-Only takes in positive feedback; ex:
piezoelectric sensor senses movement -> increased rate until no more sensed
movement
Types of sensor: closed loop - Answers-More physiologic than open loop; rate changes
in response to physiologic change -> rate stays until physiologic state indicates it needs
to slow (ex: 02 sats)
Types of Sensors: Primary - Answers-Detects changes that normal effect the sinus
node (02 sats, myocardial contractilty)
Types of sensors: Secondary - Answers-Detects internal changes that result from
exercise
Types of sensors: Tertiary - Answers-Detects external changes as a result of exercise
(piezoelectric, accelerometer)
Describe acute threshold graph of steroid eluting lead VS polished platinum post implat
- Answers-Steroid: low threshold and not much change
polished platinum: bad. High threshold, acute rise, then chronic high threshold
What creates a higher current density? - Answers-Smaller pacing cathode
Anode must be atleast _____ times _______ than cathode - Answers-3x Larger
, ohms law - Answers-V=IR
Most common electrolyte abnormality to cause LOC? - Answers-Hyperkalemia
Effects of Hyperkalemia - Answers-Increase in threshold, wide paced complex, latency,
peaked T wave
Effects of Hypokalemia - Answers-Irratble foci, R on T, Torsades
Equation for current drain - Answers-Time = Battery capacity / current drain
Time = AmpHour/amperes = Hours
Micro units - Answers-10^-6
BOL
ERI
EOS - Answers-Beginning of Life
Elective Replacement Indicator
End of Service
Cardiac cell charge and electrolyte membrane potential at rest - Answers-Charge: ~(-
90mV) inside of cell
Membrane: Na+ outside;
Cardiac action potentials - Answers-0 - depolarization; Rapid Na+ influx
1 - early rapid depolarization; Na+ influx STOPS,
2 - Plateau phase; Ca+ enters
3 - Rapid depolarization; K+ outflux and Ca+ channels close
4 - alert
Preferred Peak to Peak for P and R waves - Answers-P waves: >2mV
R waves: >5mV
Preferred slew rate for P and R waves - Answers-P waves: > .5 V/s
R waves: > .75V/s
Co- Axial VS Co-radial conductor types - Answers-Co - Axial: One conductor coil inside
the other
Co - radial: Two coils overlayed around the radius of lead
S1
S2 - Answers-S1: Drive train
S2: First premature impulse
What is the suggested type of antibiotics? - Answers-Beta-Lactam antibiotics,
vancomycin reserved for those with penicillin allerigies
What lead insulation material best reduces ingrowth? - Answers-.ePTFE
Which lead insulation material is most susceptible to metal ion oxidation (MIO) and
environmental stress cracking (ESC) - Answers-Poly 80A
ESC and MIO - Answers-Environmental Stress Cracking
Metal Ion Oxidation
Pros/Cons of Silicone Leads - Answers-Pros: Longevity, flexible, repairable
Cons: Tacky, thick, easily damaged
Most common cause of Ventricular Safety Pacing? - Answers-Ventricular Ectopy
Which electrode material is bad? - Answers-Elgiloy
Cardiac action potential:
0-4 - Answers-0 - depolarization (Ca+ and Na+ rush in)
1 - Na+ channels close
2 - Slow Ca+ channels
3 - fast K+ channels
4 - alert
Cardiac Tissue is (-) at rest and (+) at contraction
0 - Na channels are open
1 - K channels open and start repolarization
2 - Ca channels open and delay repolarization
3 - Ca channels close
4 - Rest
Cardiac cells are ______________ charged at rest - Answers-Negatively
Conductor Types - Answers-DFT (Drawn Filled Tube) and DBS (Brawn Brazed Strand)
Components of DFT and DBS conductors - Answers-Silver and MP35N
Best type of capacitor - Answers-Tantalum Electrolytic
Describe the depletion Lithium Silver Vanadium Oxide battery - Answers-Predictable, 3
plateaus in discharge curve
,Common battery type for ppm? ICD? - Answers-Ppm - Lithium Iodide
ICD - Lithium Silver vanadium oxide
1 Hz = ___________ bpm - Answers-60
100 bpm = _________ Hz - Answers-1.67
Battery components:
Capacitor -
Reed Switch -
Diode -
Resistor -
Rectifier - - Answers-Cap - stores electrical charge
Reed - switches ppm to Magnet mode
Diode - ensures one way flow of current
Resistor - restricts current flow
rectifier - creates all pos or all neg signals
Voltage of PPM battery? - Answers-2.8V
Voltage of ICD battery? - Answers-3.2V
Types of Sensors: Open Loop - Answers-Only takes in positive feedback; ex:
piezoelectric sensor senses movement -> increased rate until no more sensed
movement
Types of sensor: closed loop - Answers-More physiologic than open loop; rate changes
in response to physiologic change -> rate stays until physiologic state indicates it needs
to slow (ex: 02 sats)
Types of Sensors: Primary - Answers-Detects changes that normal effect the sinus
node (02 sats, myocardial contractilty)
Types of sensors: Secondary - Answers-Detects internal changes that result from
exercise
Types of sensors: Tertiary - Answers-Detects external changes as a result of exercise
(piezoelectric, accelerometer)
Describe acute threshold graph of steroid eluting lead VS polished platinum post implat
- Answers-Steroid: low threshold and not much change
polished platinum: bad. High threshold, acute rise, then chronic high threshold
What creates a higher current density? - Answers-Smaller pacing cathode
Anode must be atleast _____ times _______ than cathode - Answers-3x Larger
, ohms law - Answers-V=IR
Most common electrolyte abnormality to cause LOC? - Answers-Hyperkalemia
Effects of Hyperkalemia - Answers-Increase in threshold, wide paced complex, latency,
peaked T wave
Effects of Hypokalemia - Answers-Irratble foci, R on T, Torsades
Equation for current drain - Answers-Time = Battery capacity / current drain
Time = AmpHour/amperes = Hours
Micro units - Answers-10^-6
BOL
ERI
EOS - Answers-Beginning of Life
Elective Replacement Indicator
End of Service
Cardiac cell charge and electrolyte membrane potential at rest - Answers-Charge: ~(-
90mV) inside of cell
Membrane: Na+ outside;
Cardiac action potentials - Answers-0 - depolarization; Rapid Na+ influx
1 - early rapid depolarization; Na+ influx STOPS,
2 - Plateau phase; Ca+ enters
3 - Rapid depolarization; K+ outflux and Ca+ channels close
4 - alert
Preferred Peak to Peak for P and R waves - Answers-P waves: >2mV
R waves: >5mV
Preferred slew rate for P and R waves - Answers-P waves: > .5 V/s
R waves: > .75V/s
Co- Axial VS Co-radial conductor types - Answers-Co - Axial: One conductor coil inside
the other
Co - radial: Two coils overlayed around the radius of lead
S1
S2 - Answers-S1: Drive train
S2: First premature impulse
