IBHRE Study Guide: Syndromes UPDATED
ACTUAL Exam Questions and CORRECT
Answers
Brugada Syndrome - CORRECT ANSWER - Common in SE Asia. Major cause of death
in young, Asian males. ST elevation in leads V1-V3. Appears like RBBB in pericardial leads.
VT appears more like Torsades than Polymorphic VT (the latter of which is often proceeded by
long-short intervals or rate acceleration)
Ashman's Phenomon - CORRECT ANSWER - Long, short beats. Often in AF but not
exclusively.
A predisposition to extort and aberration. A long interval precedes a short one, and the ventricles
are caught off guard, repolarizing as if they were preparing for another long interval.
Wendesky Effect - CORRECT ANSWER - A prolonged lower threshold of excitability
induced by a strong stimulus. Explains why thresholds may appear lower while decrementing
opposed to incrementing
Wolf Parkinson White Syndrome - CORRECT ANSWER - This is caused by the presence
of an abnormal accessory electrical conduction pathway between the atria and the ventricles.
Electrical signals traveling down this abnormal pathway (known as the bundle of Kent) may
stimulate the ventricles to contract prematurely, resulting in a unique type of supraventricular
tachycardia referred to as an atrioventricular re-entrant tachycardia.
May present with a delta wave (extra wave at start of qrs)
Long QT Syndrome - CORRECT ANSWER - QTc > 500ms, or a 25 % increase in QT
over baseline. Can be causes by Class I or III antiarrhythmics, or by low Potassium. Cause of
death in 10-15% of SIDS cases. ICD recommended. Propensity for syncope, Torsades, and SCD.
Treat with beta blockers, Rate Smoothing to control EADs
ACTUAL Exam Questions and CORRECT
Answers
Brugada Syndrome - CORRECT ANSWER - Common in SE Asia. Major cause of death
in young, Asian males. ST elevation in leads V1-V3. Appears like RBBB in pericardial leads.
VT appears more like Torsades than Polymorphic VT (the latter of which is often proceeded by
long-short intervals or rate acceleration)
Ashman's Phenomon - CORRECT ANSWER - Long, short beats. Often in AF but not
exclusively.
A predisposition to extort and aberration. A long interval precedes a short one, and the ventricles
are caught off guard, repolarizing as if they were preparing for another long interval.
Wendesky Effect - CORRECT ANSWER - A prolonged lower threshold of excitability
induced by a strong stimulus. Explains why thresholds may appear lower while decrementing
opposed to incrementing
Wolf Parkinson White Syndrome - CORRECT ANSWER - This is caused by the presence
of an abnormal accessory electrical conduction pathway between the atria and the ventricles.
Electrical signals traveling down this abnormal pathway (known as the bundle of Kent) may
stimulate the ventricles to contract prematurely, resulting in a unique type of supraventricular
tachycardia referred to as an atrioventricular re-entrant tachycardia.
May present with a delta wave (extra wave at start of qrs)
Long QT Syndrome - CORRECT ANSWER - QTc > 500ms, or a 25 % increase in QT
over baseline. Can be causes by Class I or III antiarrhythmics, or by low Potassium. Cause of
death in 10-15% of SIDS cases. ICD recommended. Propensity for syncope, Torsades, and SCD.
Treat with beta blockers, Rate Smoothing to control EADs
