IBHRE PREP EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
PVARP....after a _____ event, refractory for the ______ - ANSWERventricle, atrium
what is most likely the cause of the under detection of atrial flutter? - ANSWERp waves
falling into PVAB
Which two studies showed that RV pacing in patients could lead to more
hospitalizations? - ANSWERDAVID and MOST
when are the wedensky effects the greatest - ANSWERat narrow pulse widths
First degree AV block with symptoms of ppm syndrome is what class of indication for
pacing - ANSWERClass IIa
Calculation of the wenkbach interval - ANSWERMTR-TARP
What did the ADEPT study show - ANSWERrate modulation was ineffective in
improving the QoL for patients with a brady indication
Lead perf percentages in ICD placements - ANSWER0.6-5%
Class IA drugs that increase pacing thresholds (3) - ANSWERquinidine, dysopyramid,
procainamid
class IC drugs that increase pacing thresholds - ANSWERflecanide, propaferone
class 3 drugs that increase pacing thresholds (3) - ANSWERpropaferone, amio, sotalol
Osborn or J waves indicate what three things - ANSWERhypothermia, hypercalcemia,
brugada syndrome
Sign of WPW syndrome within the QRS - ANSWERdelta wave in the PR interval
lead type with the highest rate of perforation - ANSWERatrial active fix leads
MADIT study - ANSWERicd vs drug therapy. icd reduced mortality by 54%
MADITII study - ANSWERicd VS. no ICD. no need for prior arrythmias. No EP study
needed. ICD decreased mortality by 31%
,SCDHEFT study - ANSWERICD decreased mortality in both ICM (21%) and NICM (27),
amio had little to no effect on mortality
PMOP algorithm - ANSWERhelps reduce reoccurring atrial tach episodes from
reoccurring shortly after previous episode has ended
rheobase is measured in _____ while chronaxie is measured in _____ -
ANSWERvoltage, ms
charge is measured in _______. the formula is ______ - ANSWERmicrocoloumbs,
I(current) x T (pulse duration)
constant current = ____ load and ____ impedance - ANSWERsmall, low
constant voltage= ____ load and ____ impedence - ANSWERlarge, high
Which is better polyurethane 80A or 55D? - ANSWER55D
what programming change can you make to help combat PPM syndrome -
ANSWERlower the rate to decrease the RV pacing
Clinical manifestations of brugada (2) - ANSWERST elevation in V1-V3, RbBB
Drugs that increase DFT (4) - ANSWERlidocaine, quinidine, flecanide, dyapherihydation
underlying reasons for Torsades (4) - ANSWERhypomagnesia, hypokalemia, hypoxia,
acidosis
most common inherited long QT syndrome - ANSWERRomano ward
upper limit vulnerability - ANSWERweakest shock strength where VF not induced
capacitance is measured in ____ and is the _______ - ANSWERfarads, charge/voltage,
measurement of amount of electrical charge stored for given electrical current
smaller capacitor = _______ voltage required to deliver an equal charge to the tissue -
ANSWERgreater
primary endpoint of companion study - ANSWERrisk reduction of CRTD was 36%
mortality in ICD group
main type of acute infection - ANSWERstaph aureous
main type of chronic infection - ANSWERstaph epidermis
,microvolt t wave alternates - ANSWERfluctuations in the t wave morphology liked to
arrhythmia, you cannot detect on the surface because of such small changes
what type of conductor provides the low resistance needed - ANSWERDFT
what type of capacitor provides a high energy density and does not require a reform -
ANSWERwet tantalum hybrid
voltage of lithium iodine battery - ANSWER2.8V
smaller surface area = ______ current density = ______ threshold and ______
impedence - ANSWERhigher, lower, higher
hyperkalemia. what type of QT, what happens to threshold, which chamber more
sensitive - ANSWERshort QT, peaked T wave, threshold usually starts to decrease than
increase, atrium more sensitive
Hypokalemia. what type of QT, changes on EKG (3), causes what - ANSWERlong QT,
ST depression, flattening T wave, U wave, can cause torsades
normal potassium - ANSWER3.7-5.2mEq/L,
isometric time from electrical deploy of heart to the mechanical systole - ANSWERpre
ejection interval
heart rate turbulence - ANSWERvariation of sinus cycle length following a PVC
best way to decrease current drain and stim threshold - ANSWERreduce electrode
surface area
which compoenent is much susceptible to X-ray and radiation damage in a pacemaker -
ANSWERCMOS
benefit of bachman bundle pacing - ANSWERreduce p wave widths, can benefit
patients with interatrial cunduction delays
increasing the surface area will have what effect on polarization - ANSWERdecrease
the polarization
definition of charge - ANSWERquantity of electricity that has flowed
slew raet definition - ANSWERchange in voltage amplitude over time
What does CLS measure? - ANSWERit translates cardiac contractility to heart rate by
using CO and mean arterial BP
, what is modified atrial based timing - ANSWERwill function in atrial based timing. If a
PVC, will function as ventricular based timing
what is the definition of a near field ICD sensing circuit - ANSWERtip to ring or tip to RV
coil
part of a capacitor that decays over time if no high voltage applied to it and causes
increased charge times - ANSWERdielectric oxide
preload - ANSWERdegree of stretch of the cardiac muscle fibers at the end of diastole
Afterload - ANSWERresistance to left ventricular ejection
Frank-Starling Law - ANSWERThe greater the stretch, the stronger is the heart's
contraction. This increased contractility results in an increased volume of blood ejected
(Increased SV)
how does optivol work - ANSWERmeasures impedance from ICD to RV coil every 20
minutes from 12-5 pm
effective refractory period - ANSWERlongest coupling interval which a premature
interval will fail to propogate
newest type of capacitor - ANSWERtantium electrolytic
what is the job of a rectifier - ANSWERconverts signals to all positive or all negative
what percent of surgeries result in congenital heart block - ANSWER1-3%
does impedance increase or decrease with polarization - ANSWERincreases
what is the design of most leads - ANSWERcoaxial with multifil conductors
capacitors are charged in ______ and discharge in ______ - ANSWERparellel, series
compressions for adult basic life support - ANSWER30:2 at 100/min
which drug will increase a DFT but has a loading time? - ANSWERamio
which drug will lower a DFT if given through IV? - ANSWERisopoternol
which drug will lower pacing threshold (given through IV) - ANSWERisoprternol
MOST STUDY - ANSWERVVIR vs DDDR for SND patients, unneccesaray RV pacing is
bad
COMPLETE SOLUTIONS
PVARP....after a _____ event, refractory for the ______ - ANSWERventricle, atrium
what is most likely the cause of the under detection of atrial flutter? - ANSWERp waves
falling into PVAB
Which two studies showed that RV pacing in patients could lead to more
hospitalizations? - ANSWERDAVID and MOST
when are the wedensky effects the greatest - ANSWERat narrow pulse widths
First degree AV block with symptoms of ppm syndrome is what class of indication for
pacing - ANSWERClass IIa
Calculation of the wenkbach interval - ANSWERMTR-TARP
What did the ADEPT study show - ANSWERrate modulation was ineffective in
improving the QoL for patients with a brady indication
Lead perf percentages in ICD placements - ANSWER0.6-5%
Class IA drugs that increase pacing thresholds (3) - ANSWERquinidine, dysopyramid,
procainamid
class IC drugs that increase pacing thresholds - ANSWERflecanide, propaferone
class 3 drugs that increase pacing thresholds (3) - ANSWERpropaferone, amio, sotalol
Osborn or J waves indicate what three things - ANSWERhypothermia, hypercalcemia,
brugada syndrome
Sign of WPW syndrome within the QRS - ANSWERdelta wave in the PR interval
lead type with the highest rate of perforation - ANSWERatrial active fix leads
MADIT study - ANSWERicd vs drug therapy. icd reduced mortality by 54%
MADITII study - ANSWERicd VS. no ICD. no need for prior arrythmias. No EP study
needed. ICD decreased mortality by 31%
,SCDHEFT study - ANSWERICD decreased mortality in both ICM (21%) and NICM (27),
amio had little to no effect on mortality
PMOP algorithm - ANSWERhelps reduce reoccurring atrial tach episodes from
reoccurring shortly after previous episode has ended
rheobase is measured in _____ while chronaxie is measured in _____ -
ANSWERvoltage, ms
charge is measured in _______. the formula is ______ - ANSWERmicrocoloumbs,
I(current) x T (pulse duration)
constant current = ____ load and ____ impedance - ANSWERsmall, low
constant voltage= ____ load and ____ impedence - ANSWERlarge, high
Which is better polyurethane 80A or 55D? - ANSWER55D
what programming change can you make to help combat PPM syndrome -
ANSWERlower the rate to decrease the RV pacing
Clinical manifestations of brugada (2) - ANSWERST elevation in V1-V3, RbBB
Drugs that increase DFT (4) - ANSWERlidocaine, quinidine, flecanide, dyapherihydation
underlying reasons for Torsades (4) - ANSWERhypomagnesia, hypokalemia, hypoxia,
acidosis
most common inherited long QT syndrome - ANSWERRomano ward
upper limit vulnerability - ANSWERweakest shock strength where VF not induced
capacitance is measured in ____ and is the _______ - ANSWERfarads, charge/voltage,
measurement of amount of electrical charge stored for given electrical current
smaller capacitor = _______ voltage required to deliver an equal charge to the tissue -
ANSWERgreater
primary endpoint of companion study - ANSWERrisk reduction of CRTD was 36%
mortality in ICD group
main type of acute infection - ANSWERstaph aureous
main type of chronic infection - ANSWERstaph epidermis
,microvolt t wave alternates - ANSWERfluctuations in the t wave morphology liked to
arrhythmia, you cannot detect on the surface because of such small changes
what type of conductor provides the low resistance needed - ANSWERDFT
what type of capacitor provides a high energy density and does not require a reform -
ANSWERwet tantalum hybrid
voltage of lithium iodine battery - ANSWER2.8V
smaller surface area = ______ current density = ______ threshold and ______
impedence - ANSWERhigher, lower, higher
hyperkalemia. what type of QT, what happens to threshold, which chamber more
sensitive - ANSWERshort QT, peaked T wave, threshold usually starts to decrease than
increase, atrium more sensitive
Hypokalemia. what type of QT, changes on EKG (3), causes what - ANSWERlong QT,
ST depression, flattening T wave, U wave, can cause torsades
normal potassium - ANSWER3.7-5.2mEq/L,
isometric time from electrical deploy of heart to the mechanical systole - ANSWERpre
ejection interval
heart rate turbulence - ANSWERvariation of sinus cycle length following a PVC
best way to decrease current drain and stim threshold - ANSWERreduce electrode
surface area
which compoenent is much susceptible to X-ray and radiation damage in a pacemaker -
ANSWERCMOS
benefit of bachman bundle pacing - ANSWERreduce p wave widths, can benefit
patients with interatrial cunduction delays
increasing the surface area will have what effect on polarization - ANSWERdecrease
the polarization
definition of charge - ANSWERquantity of electricity that has flowed
slew raet definition - ANSWERchange in voltage amplitude over time
What does CLS measure? - ANSWERit translates cardiac contractility to heart rate by
using CO and mean arterial BP
, what is modified atrial based timing - ANSWERwill function in atrial based timing. If a
PVC, will function as ventricular based timing
what is the definition of a near field ICD sensing circuit - ANSWERtip to ring or tip to RV
coil
part of a capacitor that decays over time if no high voltage applied to it and causes
increased charge times - ANSWERdielectric oxide
preload - ANSWERdegree of stretch of the cardiac muscle fibers at the end of diastole
Afterload - ANSWERresistance to left ventricular ejection
Frank-Starling Law - ANSWERThe greater the stretch, the stronger is the heart's
contraction. This increased contractility results in an increased volume of blood ejected
(Increased SV)
how does optivol work - ANSWERmeasures impedance from ICD to RV coil every 20
minutes from 12-5 pm
effective refractory period - ANSWERlongest coupling interval which a premature
interval will fail to propogate
newest type of capacitor - ANSWERtantium electrolytic
what is the job of a rectifier - ANSWERconverts signals to all positive or all negative
what percent of surgeries result in congenital heart block - ANSWER1-3%
does impedance increase or decrease with polarization - ANSWERincreases
what is the design of most leads - ANSWERcoaxial with multifil conductors
capacitors are charged in ______ and discharge in ______ - ANSWERparellel, series
compressions for adult basic life support - ANSWER30:2 at 100/min
which drug will increase a DFT but has a loading time? - ANSWERamio
which drug will lower a DFT if given through IV? - ANSWERisopoternol
which drug will lower pacing threshold (given through IV) - ANSWERisoprternol
MOST STUDY - ANSWERVVIR vs DDDR for SND patients, unneccesaray RV pacing is
bad
