IBHRE CEPS ACTUAL EXAM STUDY
QUESTIONS WITH 100% CORRECT
ANSWERS | GUARANTEE PASS!
1. Ohm's law equation - ANSWER V=IR
2. Sources of EMI in PPM's/ICD's that should be avoided - ANSWER -MRI
-electrocautery
-radiation therapy
-arc welding
-diathermy
***Cardioversion is safe as long as patches are far enough away from the
generator
3. Pacemaker implantation in patients with pre-existing LBBB - ANSWER -at
risk for developing CHB when placing the RV lead (could cause RBBB
along with LBBB = CHB)
-because of this, should always place the RV lead first for backup pacing if
necessary
4. In some CRT patients, the EKG can show - ANSWER 2 pacer spikes
preceding the QRS
5. Types of Rate Response in PPM's - ANSWER 1. Evoked QT interval
-senses shortening of QT during exercise
2. Minute ventilation
,-BSX / measures transthoracic impedance to gauge respiratory rate to increase
rate
3. Piezoelectric crystal accelerometer
-"shaker can"
4. Intracardiac impedance
-Biotronik / senses increased ventricular stroke volume and paces faster
5. Velocity of ventricular shortening
-closed loop sensor
-velocity of RV shortening increases during exercise and thus paces faster
6. accelerometer - ANSWER -only senses movement in the AP direction
(advantage)
-this is good because it prevents things like bumpy car rides from increasing the
rate
7. most common reason for lead extraction - ANSWER Device infection,
usually from staph
8. most effective method of lead extraction - ANSWER laser sheath
9. NBG code - ANSWER 1. Chamber paced
2. Chamber sensed
3. Response to sensing: Triggered or inhibited activity (O: none, D: T + I, T:
Triggered, I: inhibit)
4. Rate response (R)
5. Multisite pacing (A, V which is BiV, or D which is A and V)
,10.why is VOO primitive and not used much anymore / what is used instead -
ANSWER Because it can pace on T of intrinsic beats -> VF
-use VVI instead
11.Patient with chronic AF pacemaker vs paroxysmal - ANSWER will usually
do VVI for chronic and dual chamber for paroxysmal
12.Primary vs secondary prevention - ANSWER -primary: ICD implanted
before SCA has occurred
-secondary: ICD implanted after SCA has occurred
13.asynchronous pacing - ANSWER Pacemaker delivers a pacing stimulus at a
set rate regardless of intrinsic cardiac activity (i.e. VOO)
14.what mode of pacing reduces risk of AF in patients with SND - ANSWER -
AAI pacing
-permanent pacing in patients with SND has been shown to reduce AF
-in book: patients with persistent/chronic AF may benefit from permanent
pacing (AAI or dual chamber) to prevent AF
15.Unipolar vs bipolar pacing spike - ANSWER Unipolar pacing spike is
larger
16.threshold in bipolar vs unipolar leads - ANSWER the threshold in bipolar
leads tends to be slightly higher than in unipolar leads
17.anode - ANSWER positive pole
, 18.cathode - ANSWER negative pole
19.bipolar lead anode cathode - ANSWER -current flows from the device to
the cathode, to the myocardium, then to the anode
20.unipolar current flow - ANSWER -current travels to the cathode, then to
myocardium, then to the can (anode)
21.unipolar anode - ANSWER -anode is the can
-metal wall of PPM is attached to positive pole of battery
-if not making contact with chest, there is no more positive pole so pacing stops
22.danger of unipolar leads - ANSWER -if can not making contact with tissue,
pacing stops because no more positive pole
-this is why bipolar leads are favorable in PPM dependent patients
23.temporary pacers vs PPM threshold units - ANSWER -temp: mA
-perm: V
24.cause of most brad arrhythmias - ANSWER Sinus node disease (SSS)
25.EOL/ERI/BOL/POR - ANSWER -EOL: end of life: will die soon
-ERI: elective replacement indicator: consider replacement (will die soon)
-BOL: beginning of life: nominal settings out of box
-POR: power on reset: near death with loss of volatile memory, backup pacing
starts
QUESTIONS WITH 100% CORRECT
ANSWERS | GUARANTEE PASS!
1. Ohm's law equation - ANSWER V=IR
2. Sources of EMI in PPM's/ICD's that should be avoided - ANSWER -MRI
-electrocautery
-radiation therapy
-arc welding
-diathermy
***Cardioversion is safe as long as patches are far enough away from the
generator
3. Pacemaker implantation in patients with pre-existing LBBB - ANSWER -at
risk for developing CHB when placing the RV lead (could cause RBBB
along with LBBB = CHB)
-because of this, should always place the RV lead first for backup pacing if
necessary
4. In some CRT patients, the EKG can show - ANSWER 2 pacer spikes
preceding the QRS
5. Types of Rate Response in PPM's - ANSWER 1. Evoked QT interval
-senses shortening of QT during exercise
2. Minute ventilation
,-BSX / measures transthoracic impedance to gauge respiratory rate to increase
rate
3. Piezoelectric crystal accelerometer
-"shaker can"
4. Intracardiac impedance
-Biotronik / senses increased ventricular stroke volume and paces faster
5. Velocity of ventricular shortening
-closed loop sensor
-velocity of RV shortening increases during exercise and thus paces faster
6. accelerometer - ANSWER -only senses movement in the AP direction
(advantage)
-this is good because it prevents things like bumpy car rides from increasing the
rate
7. most common reason for lead extraction - ANSWER Device infection,
usually from staph
8. most effective method of lead extraction - ANSWER laser sheath
9. NBG code - ANSWER 1. Chamber paced
2. Chamber sensed
3. Response to sensing: Triggered or inhibited activity (O: none, D: T + I, T:
Triggered, I: inhibit)
4. Rate response (R)
5. Multisite pacing (A, V which is BiV, or D which is A and V)
,10.why is VOO primitive and not used much anymore / what is used instead -
ANSWER Because it can pace on T of intrinsic beats -> VF
-use VVI instead
11.Patient with chronic AF pacemaker vs paroxysmal - ANSWER will usually
do VVI for chronic and dual chamber for paroxysmal
12.Primary vs secondary prevention - ANSWER -primary: ICD implanted
before SCA has occurred
-secondary: ICD implanted after SCA has occurred
13.asynchronous pacing - ANSWER Pacemaker delivers a pacing stimulus at a
set rate regardless of intrinsic cardiac activity (i.e. VOO)
14.what mode of pacing reduces risk of AF in patients with SND - ANSWER -
AAI pacing
-permanent pacing in patients with SND has been shown to reduce AF
-in book: patients with persistent/chronic AF may benefit from permanent
pacing (AAI or dual chamber) to prevent AF
15.Unipolar vs bipolar pacing spike - ANSWER Unipolar pacing spike is
larger
16.threshold in bipolar vs unipolar leads - ANSWER the threshold in bipolar
leads tends to be slightly higher than in unipolar leads
17.anode - ANSWER positive pole
, 18.cathode - ANSWER negative pole
19.bipolar lead anode cathode - ANSWER -current flows from the device to
the cathode, to the myocardium, then to the anode
20.unipolar current flow - ANSWER -current travels to the cathode, then to
myocardium, then to the can (anode)
21.unipolar anode - ANSWER -anode is the can
-metal wall of PPM is attached to positive pole of battery
-if not making contact with chest, there is no more positive pole so pacing stops
22.danger of unipolar leads - ANSWER -if can not making contact with tissue,
pacing stops because no more positive pole
-this is why bipolar leads are favorable in PPM dependent patients
23.temporary pacers vs PPM threshold units - ANSWER -temp: mA
-perm: V
24.cause of most brad arrhythmias - ANSWER Sinus node disease (SSS)
25.EOL/ERI/BOL/POR - ANSWER -EOL: end of life: will die soon
-ERI: elective replacement indicator: consider replacement (will die soon)
-BOL: beginning of life: nominal settings out of box
-POR: power on reset: near death with loss of volatile memory, backup pacing
starts
