IBHRE CEPS 2023:
Type of pause seen after PVC - ANSWER Compensatory pause
Type of pause seen after PAC - ANSWER Non-compensatory pause
What would lead I look like in BiV pacing - ANSWER small or isoelectric because
activating both V at the same time
Inferior STEMI best seen in which leads - ANSWER inferiors
Large (+) p wave in II - ANSWER Right Atrial enlargement (RAE)
Notched P in II; biphasic late (-) p in V1 - ANSWER Left Atrial Enlargement (LAE)
Elevated R in V1 - ANSWER Right Ventricle hypertrophy
electrolyte imbalance associate with SQTS - ANSWER hypercalcemia
electrolyte imbalance associate with LQTS - ANSWER hypocalcemia
Which 2 leads are usually similar in configuration because they measure along the
same horizontal axis - ANSWER I & v6
PVC location: (-) II, III, avF - ANSWER low, apex
PVC location: (+) II, III, avF - ANSWER high, outflow tract
PVC location: transition before v3 - ANSWER Left sided
PVC location: transition after v3 - ANSWER Right sided
Delta waves: (-) v1 - ANSWER Right sided
Delta waves: (+) v1 - ANSWER Left sided
Delta waves: (-) II, III, avF - ANSWER posterior
Delta waves: (+) II, III, avF - ANSWER anterior
Delta waves: (+) v2-6 - ANSWER posterior septal
Delta waves: transition v1-2 - ANSWER septal
Indication for ablation of AP in pt w/ no SVT - ANSWER shortest pre-excited R-R
<220 in AF
increased risk of AP through pathway leading to VF
,Conduction through the AV node with delay or block, resulting in a broader QRS -
ANSWER Aberrancy
Electrical impulses trigger cardiac muscle contraction by controlling the flux of which
ion across membrane - ANSWER Calcium
Ventricle activation time measurement - ANSWER Beginning of Q to peak of R
cSNRT= - ANSWER cSNRT=SNRT-SCL
AVNRT response to adenosine - ANSWER SVT terminates with an A
AVRT response to adenosine - ANSWER Ruled out, if SVT continues with AV block
VA<AV - ANSWER AVRT
Ashman's phenomenon - ANSWER aberration occurring when a short cycle follows
a long one in AF
RBBB morphology in v6 - ANSWER wide S wave
LBBB morphology in v6 - ANSWER opposite of v1
Heart block type: A, H, no V - ANSWER 2nd type 2 - infranodal block
Heart block that resolves during exercise is located in - ANSWER AVN
Most rare hemiblock - ANSWER Left posterior Hemiblock
Does antidromic AVRT have a delta wave? - ANSWER Yes
Does orthodromic AVRT have a delta wave? - ANSWER No (AP conducts
retrograde)
When would you use precordial thump - ANSWER in pulseless VT when defib is not
nearby
Typical BBRVT - ANSWER LBBB morphology: down RB; up HIS
VA conduction times different between RVA & RVT pacing in pt w/ AP - ANSWER
slanted pathway
alpha-adrenergic - ANSWER vasoconstriction
Beta 1 adrenergic - ANSWER Cardiac stimulation
Cholinergic - ANSWER Cardiac depression
Contraindications for Isuprel - ANSWER pts w/ MI - increases MVO2 demand
,Beta adrenergic agonist - ANSWER Isoproterenol
Average t 1/2 of Amiodarone - ANSWER ~58 days
Heparin blocks what during a clot formation - ANSWER prothrombin to thrombin
Normal INR - ANSWER 1.0
Complications of high INR - ANSWER bleeding
Anticoagulant, Direct Thrombin Inhibitor - ANSWER Dabigatran (Pradaxa)
Anticoagulant, direct factor XA inhibitor - ANSWER Rivaroxaban & Apixaban
Factor Xa inhibitors - ANSWER Rivaroxaban
Apixaban
Edoxaban
Recommended therapy for asymptomatic pt w/ LQTS - ANSWER Avoid exercise &
stress; take beta blockers
Best drug class for ischemic hearts - ANSWER beta blockers
drugs to convert AF to NSR - ANSWER Ibutilide & dofetilide
Drug to give in drug acquired Torsades - ANSWER Isuprel
Ventricular antiarrhythmic that acts on ischemic tissue by blocking conduction,
interrupting reentry circuits; used in MI pts w/ frequent PVCs that depress
hemodynamics - ANSWER Lidocaine
Oral drug most similar to Lidocaine - ANSWER Mexiletine
Drug that decreases theophylline levels - ANSWER Mexiletine
Most common toxic effect of antiarrhythmic drugs - ANSWER proarrhythmic
1st line class 1c drug on symptomatic AF pts w/ recent onset w/ no structural or
ischemic heart disease - ANSWER Flecainide
1st line action for pt w/ narrow complex SVT - ANSWER Vagal maneuvers
Side effects of amiodarone - ANSWER Acute - AV block, hypotension, bradycardia
Chronic - pulmonary fibrosis, peripheral deposition leading to bluish discoloration,
arrhythmias, hypo/hyperthyroidism, photosensitivity (corneal deposition)
Drugs to avoid in WPW - ANSWER Any drug that blocks the AVN can increase the
risk of rapid bypass
Adenosine
Beta Blockers
, Calcium Channel Blockers
Digoxin
Drugs that may be beneficial in WPW - ANSWER Flecainide & Procainamide
Rhythm control for AF & AFL - ANSWER 1c & III
Rate control for AF & AFL - ANSWER II & IV
Cardiac Active Sympathetic catecholamines - ANSWER DINED
Dopamine
Isuprel
Norepinephrine
Epinephrine
Dobutamine
Beta Blocker Contraindications - ANSWER Asthma
Heart block
COPD
Diabetes
Extremities PVD
Benefits of Vasopressin over Epinephrine in VF/pulseless VT - ANSWER Reduced
cardiac ischemia & irritability
one-time does to simplify administration
reduced propensity for VF
ACE inhibitors reduce - ANSWER vasoconstriction & hypertension
Medical therapies indicated for pt in anaphylactic shock - ANSWER IV fluid &
epinephrine
Cardiotonic drugs like Digitalis - ANSWER Slow HR & increase force of contraction
Contrast is filtered out via - ANSWER Kidneys
Deg and time of tilt table test - ANSWER 60-90 degrees
20-45 min
SA node conduction time (SACT) - ANSWER SACT=(return interval-BCL)/2
Echo beat - ANSWER impulse travels down to V via slow pathway & back up to A
via fast pathway
Tach happenings in DDD pacing when the paced V wave passes retrograde up to
the AVN which is sensed as an A then the V is paced too soon - ANSWER PMT
Type of AP that can conduct both ways - ANSWER manifest
Type of AP that can only conduct retrograde - ANSWER Concealed
Type of pause seen after PVC - ANSWER Compensatory pause
Type of pause seen after PAC - ANSWER Non-compensatory pause
What would lead I look like in BiV pacing - ANSWER small or isoelectric because
activating both V at the same time
Inferior STEMI best seen in which leads - ANSWER inferiors
Large (+) p wave in II - ANSWER Right Atrial enlargement (RAE)
Notched P in II; biphasic late (-) p in V1 - ANSWER Left Atrial Enlargement (LAE)
Elevated R in V1 - ANSWER Right Ventricle hypertrophy
electrolyte imbalance associate with SQTS - ANSWER hypercalcemia
electrolyte imbalance associate with LQTS - ANSWER hypocalcemia
Which 2 leads are usually similar in configuration because they measure along the
same horizontal axis - ANSWER I & v6
PVC location: (-) II, III, avF - ANSWER low, apex
PVC location: (+) II, III, avF - ANSWER high, outflow tract
PVC location: transition before v3 - ANSWER Left sided
PVC location: transition after v3 - ANSWER Right sided
Delta waves: (-) v1 - ANSWER Right sided
Delta waves: (+) v1 - ANSWER Left sided
Delta waves: (-) II, III, avF - ANSWER posterior
Delta waves: (+) II, III, avF - ANSWER anterior
Delta waves: (+) v2-6 - ANSWER posterior septal
Delta waves: transition v1-2 - ANSWER septal
Indication for ablation of AP in pt w/ no SVT - ANSWER shortest pre-excited R-R
<220 in AF
increased risk of AP through pathway leading to VF
,Conduction through the AV node with delay or block, resulting in a broader QRS -
ANSWER Aberrancy
Electrical impulses trigger cardiac muscle contraction by controlling the flux of which
ion across membrane - ANSWER Calcium
Ventricle activation time measurement - ANSWER Beginning of Q to peak of R
cSNRT= - ANSWER cSNRT=SNRT-SCL
AVNRT response to adenosine - ANSWER SVT terminates with an A
AVRT response to adenosine - ANSWER Ruled out, if SVT continues with AV block
VA<AV - ANSWER AVRT
Ashman's phenomenon - ANSWER aberration occurring when a short cycle follows
a long one in AF
RBBB morphology in v6 - ANSWER wide S wave
LBBB morphology in v6 - ANSWER opposite of v1
Heart block type: A, H, no V - ANSWER 2nd type 2 - infranodal block
Heart block that resolves during exercise is located in - ANSWER AVN
Most rare hemiblock - ANSWER Left posterior Hemiblock
Does antidromic AVRT have a delta wave? - ANSWER Yes
Does orthodromic AVRT have a delta wave? - ANSWER No (AP conducts
retrograde)
When would you use precordial thump - ANSWER in pulseless VT when defib is not
nearby
Typical BBRVT - ANSWER LBBB morphology: down RB; up HIS
VA conduction times different between RVA & RVT pacing in pt w/ AP - ANSWER
slanted pathway
alpha-adrenergic - ANSWER vasoconstriction
Beta 1 adrenergic - ANSWER Cardiac stimulation
Cholinergic - ANSWER Cardiac depression
Contraindications for Isuprel - ANSWER pts w/ MI - increases MVO2 demand
,Beta adrenergic agonist - ANSWER Isoproterenol
Average t 1/2 of Amiodarone - ANSWER ~58 days
Heparin blocks what during a clot formation - ANSWER prothrombin to thrombin
Normal INR - ANSWER 1.0
Complications of high INR - ANSWER bleeding
Anticoagulant, Direct Thrombin Inhibitor - ANSWER Dabigatran (Pradaxa)
Anticoagulant, direct factor XA inhibitor - ANSWER Rivaroxaban & Apixaban
Factor Xa inhibitors - ANSWER Rivaroxaban
Apixaban
Edoxaban
Recommended therapy for asymptomatic pt w/ LQTS - ANSWER Avoid exercise &
stress; take beta blockers
Best drug class for ischemic hearts - ANSWER beta blockers
drugs to convert AF to NSR - ANSWER Ibutilide & dofetilide
Drug to give in drug acquired Torsades - ANSWER Isuprel
Ventricular antiarrhythmic that acts on ischemic tissue by blocking conduction,
interrupting reentry circuits; used in MI pts w/ frequent PVCs that depress
hemodynamics - ANSWER Lidocaine
Oral drug most similar to Lidocaine - ANSWER Mexiletine
Drug that decreases theophylline levels - ANSWER Mexiletine
Most common toxic effect of antiarrhythmic drugs - ANSWER proarrhythmic
1st line class 1c drug on symptomatic AF pts w/ recent onset w/ no structural or
ischemic heart disease - ANSWER Flecainide
1st line action for pt w/ narrow complex SVT - ANSWER Vagal maneuvers
Side effects of amiodarone - ANSWER Acute - AV block, hypotension, bradycardia
Chronic - pulmonary fibrosis, peripheral deposition leading to bluish discoloration,
arrhythmias, hypo/hyperthyroidism, photosensitivity (corneal deposition)
Drugs to avoid in WPW - ANSWER Any drug that blocks the AVN can increase the
risk of rapid bypass
Adenosine
Beta Blockers
, Calcium Channel Blockers
Digoxin
Drugs that may be beneficial in WPW - ANSWER Flecainide & Procainamide
Rhythm control for AF & AFL - ANSWER 1c & III
Rate control for AF & AFL - ANSWER II & IV
Cardiac Active Sympathetic catecholamines - ANSWER DINED
Dopamine
Isuprel
Norepinephrine
Epinephrine
Dobutamine
Beta Blocker Contraindications - ANSWER Asthma
Heart block
COPD
Diabetes
Extremities PVD
Benefits of Vasopressin over Epinephrine in VF/pulseless VT - ANSWER Reduced
cardiac ischemia & irritability
one-time does to simplify administration
reduced propensity for VF
ACE inhibitors reduce - ANSWER vasoconstriction & hypertension
Medical therapies indicated for pt in anaphylactic shock - ANSWER IV fluid &
epinephrine
Cardiotonic drugs like Digitalis - ANSWER Slow HR & increase force of contraction
Contrast is filtered out via - ANSWER Kidneys
Deg and time of tilt table test - ANSWER 60-90 degrees
20-45 min
SA node conduction time (SACT) - ANSWER SACT=(return interval-BCL)/2
Echo beat - ANSWER impulse travels down to V via slow pathway & back up to A
via fast pathway
Tach happenings in DDD pacing when the paced V wave passes retrograde up to
the AVN which is sensed as an A then the V is paced too soon - ANSWER PMT
Type of AP that can conduct both ways - ANSWER manifest
Type of AP that can only conduct retrograde - ANSWER Concealed
