EP IBHRE UPDATED ACTUAL Exam
Questions and CORRECT Answers
A blockage to which coronary artery can cause AV Block? - CORRECT ANSWER -
Posterior Descending Artery most commonly supplied by RCA but could be supplied by the
circumflex
What type of tissue has the longest refractory period? - CORRECT ANSWER -
Ventricular
Is the femoral vein medial or lateral to the femoral artery? - CORRECT ANSWER - The
femoral vein is medial to the femoral artery
At what value is something statistically significant? - CORRECT ANSWER - P<0.05
What are the normal cardiac pressures? - CORRECT ANSWER - "RA: 2-8 mmHg
LA: 5-12 mmHg
RV: 15-28 mmHg
LV: 90-140 mmHg
Aorta: 120 mmHg"
While performing a tilt test you see asystole. What is your next step? - CORRECT
ANSWER - Return patient to the supine position
What causes a ice-cream scoop like ST segment? - CORRECT ANSWER - Digitalis
Toxicity
What structure is at the base of the Triangle of Koch? - CORRECT ANSWER - CS OS
"The phenomenon of capture hysteresis is also known as:
,a. Wenckebach
b. Wedensky effect
c. Wolf-Parkinson white effect
d. Wilkoff effect" - CORRECT ANSWER - b. Wedensky effect (Threshold lower when
measured from high to low than when measured from lower to higher outpus, due to
hyperpolerization of the myocardial cell membranes because of high output stimulation)
"In a normal axis on a 12 lead ECG:
a. Lead I is negative and AVR is positive
b. Lead I is positive and V1 is positive
c. Lead I is positive and AVF is positive
d. Lead I is positive and V5 and V6 are negative
" - CORRECT ANSWER - C. Lead I is positive and AVF is positive
"What effect does Diltiazem have on the AV node?
a. Slows conduction by blocking calcium channels
b. Prolongs the refractory period by blocking the sodium channels
c. Increases the HV interval by blocking the calcium channels
d. None" - CORRECT ANSWER - a. slows conduction by blocking calcium channels
"Class II AA drugs do all of the following except:
a. Decrease sympathetic tone
b. Increase refractory period
c. Beta blockade
d. Affect SA and AV node" - CORRECT ANSWER - b. increase refractory period
"Conduction times over a conventional pathway is typically rate dependent, i.e., VA and AV
times remain constant with incremental pacing. A specific difference to this is demonstrated in
what type of pathway which demonstrate decremental property similar to the AV node:
,a. Mahaim fiber
b. James fiber
c. Nodofasicular fiber
d. Both A and C
e. None of the above
" - CORRECT ANSWER - d. Both A and C
"All of the following are located at or near the CS os EXCEPT:
a. christa terminalis
b. tricuspid annulus
c. eustachian ridge
d. thebesian valve
" - CORRECT ANSWER - a. crista terminalis
"The time from electrical depolarization to mechanical systole is:
a. evoked response interval
b. pre-ejection interval
c. Q-T interval
d. dV/dT
" - CORRECT ANSWER - a. evoked response interval
"What type of procedure would most likely be performed on a patient with HOCM
a. mustard procedure
b. blalock taussing shunt
c. septal myectomy
d. fontan procedure
" - CORRECT ANSWER - c. septal myectomy
, "A new study showed the result of a head to head comparison of DRUG A versus DRUG B
outcomes. The difference between the two drugs was shown to have P value of 0.15. Based on
these findings:
a. DRUG A showed a significant outcome based on this trial
b. DRUG B showed a significant outcome based on this trial
c. Neither showed a significant outcome based on this trial
d. DRUG A showed an inferior outcome based on this trial
" - CORRECT ANSWER - c. neither showed a significant outcome based on this trial
"A 30 year old patient with a history of paroxysmal atrial fibrillation and Ventricular tachycardia
has been seen in the device clinic. The interrogation shows an increase in the pacing threshold, as
well as 2 failed shocks for VF which broke spontaneously after the episodes. The patient states
his cardiologist changed a drug to help with his atrial fibrillation. Which drug would you suspect:
a. Amiodarone
b. Metoprolol
c. Flecainide
d. None
" - CORRECT ANSWER - c. Flecainide
"Ablation of isthmus dependent typical flutter is performed by connecting which two anatomic
structures ?
a. The eustachian ridge to the tendon of todaro
b. The tricuspid valve to the foramen ovale
c. The mitral valve to the left inferior pulmonary vein
d. The tricuspid valve to the eustachian ridge
" - CORRECT ANSWER - d. The tricuspid valve to the eustachian ridge
"The shortest coupling interval that allows impulse propagation is termed:
a. Effective refractory period (ERP)
b. Functional refractory period (FRP)
Questions and CORRECT Answers
A blockage to which coronary artery can cause AV Block? - CORRECT ANSWER -
Posterior Descending Artery most commonly supplied by RCA but could be supplied by the
circumflex
What type of tissue has the longest refractory period? - CORRECT ANSWER -
Ventricular
Is the femoral vein medial or lateral to the femoral artery? - CORRECT ANSWER - The
femoral vein is medial to the femoral artery
At what value is something statistically significant? - CORRECT ANSWER - P<0.05
What are the normal cardiac pressures? - CORRECT ANSWER - "RA: 2-8 mmHg
LA: 5-12 mmHg
RV: 15-28 mmHg
LV: 90-140 mmHg
Aorta: 120 mmHg"
While performing a tilt test you see asystole. What is your next step? - CORRECT
ANSWER - Return patient to the supine position
What causes a ice-cream scoop like ST segment? - CORRECT ANSWER - Digitalis
Toxicity
What structure is at the base of the Triangle of Koch? - CORRECT ANSWER - CS OS
"The phenomenon of capture hysteresis is also known as:
,a. Wenckebach
b. Wedensky effect
c. Wolf-Parkinson white effect
d. Wilkoff effect" - CORRECT ANSWER - b. Wedensky effect (Threshold lower when
measured from high to low than when measured from lower to higher outpus, due to
hyperpolerization of the myocardial cell membranes because of high output stimulation)
"In a normal axis on a 12 lead ECG:
a. Lead I is negative and AVR is positive
b. Lead I is positive and V1 is positive
c. Lead I is positive and AVF is positive
d. Lead I is positive and V5 and V6 are negative
" - CORRECT ANSWER - C. Lead I is positive and AVF is positive
"What effect does Diltiazem have on the AV node?
a. Slows conduction by blocking calcium channels
b. Prolongs the refractory period by blocking the sodium channels
c. Increases the HV interval by blocking the calcium channels
d. None" - CORRECT ANSWER - a. slows conduction by blocking calcium channels
"Class II AA drugs do all of the following except:
a. Decrease sympathetic tone
b. Increase refractory period
c. Beta blockade
d. Affect SA and AV node" - CORRECT ANSWER - b. increase refractory period
"Conduction times over a conventional pathway is typically rate dependent, i.e., VA and AV
times remain constant with incremental pacing. A specific difference to this is demonstrated in
what type of pathway which demonstrate decremental property similar to the AV node:
,a. Mahaim fiber
b. James fiber
c. Nodofasicular fiber
d. Both A and C
e. None of the above
" - CORRECT ANSWER - d. Both A and C
"All of the following are located at or near the CS os EXCEPT:
a. christa terminalis
b. tricuspid annulus
c. eustachian ridge
d. thebesian valve
" - CORRECT ANSWER - a. crista terminalis
"The time from electrical depolarization to mechanical systole is:
a. evoked response interval
b. pre-ejection interval
c. Q-T interval
d. dV/dT
" - CORRECT ANSWER - a. evoked response interval
"What type of procedure would most likely be performed on a patient with HOCM
a. mustard procedure
b. blalock taussing shunt
c. septal myectomy
d. fontan procedure
" - CORRECT ANSWER - c. septal myectomy
, "A new study showed the result of a head to head comparison of DRUG A versus DRUG B
outcomes. The difference between the two drugs was shown to have P value of 0.15. Based on
these findings:
a. DRUG A showed a significant outcome based on this trial
b. DRUG B showed a significant outcome based on this trial
c. Neither showed a significant outcome based on this trial
d. DRUG A showed an inferior outcome based on this trial
" - CORRECT ANSWER - c. neither showed a significant outcome based on this trial
"A 30 year old patient with a history of paroxysmal atrial fibrillation and Ventricular tachycardia
has been seen in the device clinic. The interrogation shows an increase in the pacing threshold, as
well as 2 failed shocks for VF which broke spontaneously after the episodes. The patient states
his cardiologist changed a drug to help with his atrial fibrillation. Which drug would you suspect:
a. Amiodarone
b. Metoprolol
c. Flecainide
d. None
" - CORRECT ANSWER - c. Flecainide
"Ablation of isthmus dependent typical flutter is performed by connecting which two anatomic
structures ?
a. The eustachian ridge to the tendon of todaro
b. The tricuspid valve to the foramen ovale
c. The mitral valve to the left inferior pulmonary vein
d. The tricuspid valve to the eustachian ridge
" - CORRECT ANSWER - d. The tricuspid valve to the eustachian ridge
"The shortest coupling interval that allows impulse propagation is termed:
a. Effective refractory period (ERP)
b. Functional refractory period (FRP)
