fpgee review Comprehensive Questions and Solutions
Graded A+
I nM oFrAe ST response fibers - Electrolyte Na+ influx
involved in phase 0
In FAST response fibers - Electrolyte Ca+ influx, K+ outflux plateau
involved in phase 2
In FAST response fibers - Electrolyte K+ outflux (Ca+ drops off) rapid repolarization
involved in phase 3
In SLOW response fibers - Electrolyte Ca+(few Na+ channels in Nodal fibers)
involved in phase 0
In SLOW response fibers - Electrolyte K+ outflux repolarization
involved in phase 3
,In SLOW response fibers - Electrolyte "Mainly Na+ (This is the pacemaker current) aarapim. "
involved in phase 4
Ectopic rhythm can result from ischemia, electrolyte abnormalities, or heightened
sympathetic tone
If an early afterdepolarization is sustained torades de pointes (QRS complexes of varying amplitudes)
ECG of a patient with an accessory pathway "Wide QRS complexes, early ventricular upstroke (also
(bundle of Kent) predisposed to re-entry loops) (Wolff Parkinson White (WPW)
syndrome) wolff-parkinson-white-accessory-bundle-bundle-
of-Kent "
MOA of quinidine 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 "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 Procainamide
monitored for lupus (with ANA)
Take with quinidine to prevent rapid β-blocker or Ca2+ channel blocker
ventricular response in patient with atrial
flutter
Which 1A antiarrhythmic for a patient on Procainamide (doesn't alter digoxin levels)
digoxin
MOA of Lidocaine and Phenytoin ( 1B) block of voltage-gated Na+ in ventricular myocytes
(decrease phase 0 upstroke)
MOA of Encainide, Flecainide, Moricizine, ( 1C) block of voltage-gated Na+ channelsin ventricular
Propafenone myocytes
MOA of Propranolol, Atenolol, Metoprolol... ( ) block β1-adrenergic receptors SLOW SA and AV nodal
activity,(decreases phase 4 slope)
MOA of Ibutilide, Dofetilide, Sotalol, ( I) Block K+ channels longer action potential plateau and
Amiodarone prolonged repolarization
MOA of Verapamil, Diltiazem ( IV) Ca2+ channel blocker slows action potential upstroke
in SA and AV nodes
Graded A+
I nM oFrAe ST response fibers - Electrolyte Na+ influx
involved in phase 0
In FAST response fibers - Electrolyte Ca+ influx, K+ outflux plateau
involved in phase 2
In FAST response fibers - Electrolyte K+ outflux (Ca+ drops off) rapid repolarization
involved in phase 3
In SLOW response fibers - Electrolyte Ca+(few Na+ channels in Nodal fibers)
involved in phase 0
In SLOW response fibers - Electrolyte K+ outflux repolarization
involved in phase 3
,In SLOW response fibers - Electrolyte "Mainly Na+ (This is the pacemaker current) aarapim. "
involved in phase 4
Ectopic rhythm can result from ischemia, electrolyte abnormalities, or heightened
sympathetic tone
If an early afterdepolarization is sustained torades de pointes (QRS complexes of varying amplitudes)
ECG of a patient with an accessory pathway "Wide QRS complexes, early ventricular upstroke (also
(bundle of Kent) predisposed to re-entry loops) (Wolff Parkinson White (WPW)
syndrome) wolff-parkinson-white-accessory-bundle-bundle-
of-Kent "
MOA of quinidine 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 "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 Procainamide
monitored for lupus (with ANA)
Take with quinidine to prevent rapid β-blocker or Ca2+ channel blocker
ventricular response in patient with atrial
flutter
Which 1A antiarrhythmic for a patient on Procainamide (doesn't alter digoxin levels)
digoxin
MOA of Lidocaine and Phenytoin ( 1B) block of voltage-gated Na+ in ventricular myocytes
(decrease phase 0 upstroke)
MOA of Encainide, Flecainide, Moricizine, ( 1C) block of voltage-gated Na+ channelsin ventricular
Propafenone myocytes
MOA of Propranolol, Atenolol, Metoprolol... ( ) block β1-adrenergic receptors SLOW SA and AV nodal
activity,(decreases phase 4 slope)
MOA of Ibutilide, Dofetilide, Sotalol, ( I) Block K+ channels longer action potential plateau and
Amiodarone prolonged repolarization
MOA of Verapamil, Diltiazem ( IV) Ca2+ channel blocker slows action potential upstroke
in SA and AV nodes
