Home > Chapter 16 > Self Assessment Quiz

Chapter 16
Self Assessment Quiz
Quizzes (See related pages)
Self Assessment Quiz
More Resources
Related Readings

Results Reporter
Out of 15 questions, you answered 15 correctly, for a final grade of 100%.

15 correct (100%)
0 incorrect (0%)
0 unanswered (0%)

Your Results:
The correct answer for each question is indicated by a .
You are following a patient who is receiving chronic oral
1 CORRECT amiodarone. Because of the toxicities of amiodarone, which of
the following tests would you monitor?
A)Chest x-ray
B)Thyroid function tests
C)Liver function tests
D)Ophthalmic examinations
E)All the above
F)a, b, and c only
G)a and b only
H)b and c only

2 CORRECT Which of the following properties does propafenone possess?

A)Vaughan-Williams type Ib only
B)Vaughan-Williams types Ic and II
C)Vaughan-Williams type III
D)Vaughan-Williams types Ia and IV

Intravenous verapamil is much more effective in terminating

reentrant PSVT than oral verapamil is in preventing recurrences
3 CORRECT
of this tachycardia. This can be explained by which of the
following?
A)
Oral verapamil is metabolized by CYP2D6, which is
polymorphic.
B)
Oral verapamil is eliminated primarily by the kidneys as
unchanged drug.
C)
Oral verapamil undergoes extensive first-pass metabolism,
particularly the more active L-isomer.
D)
Oral verapamil has an active metabolite that increases
conduction through the AV node.
Of the Vaughan-Williams type I agents, the Ics such as flecainide
4 CORRECT slow conduction velocity through sodium-dependent tissue the
most at normal heart rates. The reason for this is
A)flecainide has slow on/off kinetics for the sodium channel.
B)flecainide has fast on/off kinetics for the sodium channel.
C)
flecainde has rate-dependant effects in blocking the sodium
channel.
D)
flecainide blocks the sodium channel primarily in the
inactivated state.
You are asked to see a patient with new-onset atrial fibrillation, a
rapid ventricular response (179 beats/min), and thyrotoxicosis.
5 CORRECT
Currently, his only symptoms are weakness and palpitations.
Which of the following do you suggest as initial therapy?
A)Intravenous digoxin to decrease ventricular rate
B)Intravenous ibutilide to restore sinus rhythm
C)Intravenous esmolol to decrease ventricular rate
D)Intravenous amiodarone to control ventricular rate

You see a patient in clinic with atrial fibrillation receiving the

following medications: digoxin 0.25 mg/day (last digoxin level
6 CORRECT 1.3 ng/mL) and warfarin 6mg/day (INR 2-3 for the past 4
weeks). Now the physician would like to restore sinus rhythm
with oral amiodarone. You suggest
A)
avoiding the drug interactions by trying quinidine instead of
amiodarone.
B)decreasing the warfarin dose to 3 mg/day.
C)decreasing the dose of digoxin to 0.125 mg/day.
D)discontinuing the warfarin 1 day after restoring sinus rhythm.
E)a and d only.
F)c only.
G)b and c only.
H)c and d only.

What is the drug of choice to restore sinus rhythm in a patient

7 CORRECT
with AV nodal reentry or orthodromic AV reentry?
A)Adenosine
B)Procainamide
C)Lidocaine
D)Digoxin

A 19-year-old woman is seen in the emergency room with a

history of Wolff-Parkinson-White syndrome. She has no other
problems or known heart disease. Now she has a wide QRS
8 CORRECT tachycardia and irregular in rhythm (rate 178 beats/min). At
present, her blood pressure is stable, and she does not feel
syncopal. Which of the following agents best represents an
effective form of therapy prior to cardioversion?
A)Intravenous adenosine
B)Intravenous verapamil
C)Intravenous amiodarone
D)Intravenous lidocaine

For the patient in Question 8, which of the following represents

9 CORRECT
the best form of chronic therapy to prevent recurrences?
A)Oral flecainide
B)Radiofrequency ablation of the Kent bundle
C)Radiofrequency modification of the AV node
D)Automatic internal defibrillator

Type Ic agents such as flecainide can cause a highly lethal form

of proarrhythmia sometimes called sinusoidal or incessant
10 CORRECT ventricular tachycardia. Which of the following are risk factors for
its occurrence and should be considered contraindications to
flecainide treatment?
A)Wolff-Parkinson-White syndrome
B)Coronary artery disease
C)Preexisting long QT intervals
D)Congestive heart failure
E)a and b only
F)c only
G)b and d only
H)c and d only

The CAST was one of the most important studies ever completed.
11 CORRECT
Which of the following did not result from the CAST?
A)
We learned that we should not treat complex PVCs with the
type III agents such as D-sotalol.
B)
We learned that we should not treat complex PVCs with the
type Ic agents such as flecainide or moricizine.
C)
Drug companies stopped their efforts to find new type Ic
agents.
D)
Some agents such as encainide and indecainide were pulled
from the market or never marketed at all.
You are asked to see a patient who suffered a cardiac arrest and
was resuscitated successfully at O'Hare airport by paramedic
electrical defibrillation. He was transported to your hospital and
12 CORRECT
admitted to the CCU. Initial enzymes show that he has had a
myocardial infarction (MI). For long-term antiarrhythmic therapy,
you suggest
A)consideration for an internal defibrillator.
B)empirical amiodarone.
C)no specific therapy except beta blockers.
D)
electrophysiologic testing to see if the patient has sustained
ventricular tachycardia or fibrillation.
You are at a cardiac arrest of a patient with an MI and ventricular
fibrillation. The patient has had four defibrillations and 40 U of
13 CORRECT vasopressin with no response. Since you are attending the drug
cart, you anticipate what the physician will call for next and draw
up
A)300 mg amiodarone diluted in 20 cc of saline.
B)100 mg of lidocaine.
C)1 mg of epinephrine.
D)300 mg of bretylium.

During rounds, the following patient is presented: a 65-year-old

man with an MI 6 months ago and a history of recurrent
sustained ventricular tachycardia. During electrophysiologic
14 CORRECT studies, he had easily inducible sustained ventricular tachycardia
(rate 240 beats/min) that caused him to pass out. Which of the
following probably will be the treatment of choice for this
patient's arrhythmia?
A)Radiofrequency ablation of the Kent bundle
B)Internal defibrillator
C)Electrophysiologic drug testing
D)No therapy at present, close follow-up only

You are confronted with a patient with a history of atrial

fibrillation who is admitted for the restoration of sinus rhythm. In
the CCU he is given 2 mg of intravenous ibutilide that terminates
15 CORRECT
atrial fibrillation, but shortly thereafter he suffers several long
episodes of polymorphic ventricular tachycardia with a prolonged
QT interval during sinus rhythm. You suggest
A)intravenous epinephrine 1.0 mg.
B)intravenous amiodarone 300 mg.
C)intravenous lidocaine 100 mg.
D)intravenous magnesium 2 g.

Routing Information
Date: Wed Mar 11 08:25:25 EDT 2020

My name:

Section ID:

Email these results to:

Email address: Format:

Me: HTML

My Instructor: HTML

My TA: HTML

Other: HTML

E-Mail The Results

We welcome your feedback. Please send comments and questions to:

medical_education@mcgraw-hill.com.
To learn more about the book this website supports, please visit its Information Center.

Copyright 2020 McGraw-Hill Global Education Holdings, LLC. All rights reserved.
Any use is subject to the Terms of Use and Privacy Center | Report Piracy