FPGEE review questions and answers
with solutions 2025
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-of-Kent "
,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) - ANSWER
Procainamide
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 voltage-gated
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 - ANSWER antiarrhythmics
(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
, Marked Na+ channel block severe decreased in phase 0 slope, No change in repolarization ( 1A,
1B or 1C) - ANSWER 1C
This drug can worsen the arrhythmia in patients with pre-existing ventricular tachyarrythmias
and those with a history of MI - ANSWER Flecainide (a 1C)
Drug used when other measure fail to help life threatening paroxysmal supraventricular or
vventricular arrhythmias - ANSWER Flecainide (a 1C)
MOA of β1-blockers - ANSWER block sympathetic input to AV (and SA nodes) decrease the rate
of phase 4 depolarization (pacemaker current), prolong repolarization
Non-selective β1 and β2 blockers that DO NOT prolong repolarization - ANSWER First generation
β-blockers (Propranolol, Nadolol, Timolol) and carvedilol and labetalol
Β-blocker also used for glaucoma - ANSWER Timolol
This β-blocker can cause liver damage - ANSWER labetalol
These β-blockers cause vasodilationvia α1-blockage - ANSWER Carvedilol and labetalol
Selective β1-blocker with a very short half-life - ANSWER Esmolol
Used in ER treatment to block β in thyroid storm - ANSWER esmolol
A selective β1-blocker and selective β2-agonist - ANSWER celiprolol
with solutions 2025
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-of-Kent "
,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) - ANSWER
Procainamide
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 voltage-gated
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 - ANSWER antiarrhythmics
(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
, Marked Na+ channel block severe decreased in phase 0 slope, No change in repolarization ( 1A,
1B or 1C) - ANSWER 1C
This drug can worsen the arrhythmia in patients with pre-existing ventricular tachyarrythmias
and those with a history of MI - ANSWER Flecainide (a 1C)
Drug used when other measure fail to help life threatening paroxysmal supraventricular or
vventricular arrhythmias - ANSWER Flecainide (a 1C)
MOA of β1-blockers - ANSWER block sympathetic input to AV (and SA nodes) decrease the rate
of phase 4 depolarization (pacemaker current), prolong repolarization
Non-selective β1 and β2 blockers that DO NOT prolong repolarization - ANSWER First generation
β-blockers (Propranolol, Nadolol, Timolol) and carvedilol and labetalol
Β-blocker also used for glaucoma - ANSWER Timolol
This β-blocker can cause liver damage - ANSWER labetalol
These β-blockers cause vasodilationvia α1-blockage - ANSWER Carvedilol and labetalol
Selective β1-blocker with a very short half-life - ANSWER Esmolol
Used in ER treatment to block β in thyroid storm - ANSWER esmolol
A selective β1-blocker and selective β2-agonist - ANSWER celiprolol
