IBHRE CEPS LATEST EXAMS SCRIPT QUESTIONS
AND ANSWERS SURE A+
✔✔1b drug used in pts with MI w/ frequent PVCs - ✔✔Lidocaine
✔✔Drug effective for VTs caused by digitalis toxicity - ✔✔Phenytoid
✔✔Drug class that significantly slows conduction velocity by does not prolong AP or
refractory periods - ✔✔1c
✔✔Effect of 1c on DFT - ✔✔increases
✔✔Affects catecholamines, mainly affects SA & AV nodes, blocks epinephrine which
slows HR - ✔✔Beta blockers
✔✔Beta blockers effect on DFT - ✔✔reduces DFT
✔✔Reduces VF after MI
Avoid use in WPW
Contraindicated in pts w/ asthma - ✔✔Beta blockers
✔✔Only class III that only prolong AP (not ERP) - ✔✔Dofetilide
,✔✔Class III affects which phase of the AP - ✔✔prolongs phase 2
✔✔Class that increases ERP and prolong AP - ✔✔III
✔✔Most effective drug for VF and unstable VT - ✔✔Amiodarone
✔✔Preferred drug for AFib pts in renal failure - ✔✔amiodarone
✔✔Drug used in cardioversion which may lower energy required and allow for rapid
carioversion - ✔✔Ibutilide
✔✔Slows HR and increases force of contraction in pts in heart failure - ✔✔Digoxin
✔✔Effective on monomorphic VT involving abnormal purkinje and exercise VT -
✔✔Verapamil
✔✔Caution of class IV drug in WPW - ✔✔can enhance antegrade conduction through
AP
✔✔Class that decreases automaticity, conduction, and refractory - ✔✔IV
✔✔(+) response to CSM - ✔✔PPM
✔✔Normal LV pressure - ✔✔120/5
✔✔First line drug for malignant vasovagal syncope - ✔✔Metoprolol
✔✔Most common cause of R sided heart failure - ✔✔L sided heart failure
✔✔Genetic basis and has significant rate of SCD w/ exertion - ✔✔Hypertrophic
cardiomyopathy
✔✔Positive predictor for_____
heart rate variability/baroreflex sensitivity (low)
T wave alternans
Signal Average EG - ✔✔SCD
✔✔Vigorous squeezing of a relatively empty ventricle cause stimulation of cardiac C
fibers in pts exhibiting - ✔✔Vasodepressor syncope
✔✔When checking pacing threshold w/ stimulator, what should the pacing voltage be
set at - ✔✔2x threshold
,✔✔Chest compression/ventilation ratio for infant - ✔✔15:2
✔✔Ways to lower DFT w/ external defibrilator - ✔✔Gel
Biphasic waveform
Scapula-apical patch placement
✔✔ATTEST - ✔✔Catheter ablation delays progression of AFib
✔✔Progression from paroxysmal to persistent AF results in increased risk of - ✔✔MI,
Thromboembolism, Heart failure, stroke
✔✔Accumulation of abnormal protein - ✔✔Amyloidosis
✔✔Long-standing inflammatory process - ✔✔Sarcoidosis
✔✔Drug treatment for amyloidosis - ✔✔Calcium channel blockers
✔✔Drug treatment for Sarcoidosis - ✔✔Corticosteroids
✔✔Early PVC transition - ✔✔LVOT
✔✔ICD primary prevention - ✔✔prevention of SCD in pts who have not had VA or SCA
but increased risk
✔✔ICD secondary prevention - ✔✔2nd chance- survivors of SCA/ Prior VA
✔✔VANISH Study - ✔✔superiority of ablation over escalating medication therapy for pts
w/ recurrent VT despite antiarrhythmic medication
✔✔Most common cause of SCD in individuals under 40 - ✔✔HCM
✔✔exertion related polymorphic (bi-directional) VT - ✔✔Catecholaminergic polymorphic
VT
✔✔Coved ST elevation in leads V1/2 - ✔✔Brugada
✔✔Treatment of SQTS - ✔✔Quinidine & ICD
✔✔Outflow tract more likely occurring in men - ✔✔LVOT
✔✔Outflow tract more likely occurring in women - ✔✔RVOT
✔✔# of paps in RV - ✔✔3
, ✔✔# of paps in LV - ✔✔2
✔✔BBB and axis of Fasicular VT - ✔✔RBBB & superior axis
✔✔retrograde leg in Fasicular VT - ✔✔Left posterior fascicle
✔✔Drug choice in IST - ✔✔Ivabradine
✔✔Charge (Q) formula - ✔✔Q=It
✔✔Unit of absorbed dose - ✔✔RAD (gray)
✔✔Unit of does equivalent or occupational exposure - ✔✔REM
✔✔Normal function in dual chamber pacing. Occurs when sensed P rate is fast than the
programed maximum tracking rate (or URL) - ✔✔Pacemaker wenkebach
✔✔When might automatic mode switching fail - ✔✔A flutter
✔✔When pacing mode switches from atrial tracking to non tracking mode upon tach
detection - ✔✔automatic mode switching
✔✔SCD-HeFT trial - ✔✔* NYHA II/III, CM, EF 35%
* Endpoint - mortality placebo vs. amnio vs. ICD
*23% risk of death for ICD therapy
✔✔CASH trial - ✔✔randomized patients to ICD, amiodarone, and metoprolol.
Mortality in the metoprolol group was similar to amiodarone. The benefit of ICD therapy
is more evident during the first five years after the index event
✔✔CIDS trial - ✔✔randomized patients with VF or VT to treatment with an ICD or
amiodarone . mean follow up 3 years
in a subset a CIDS, the benefit of ICD over amiodarone increased over time
✔✔Most common infection agents - ✔✔Staphylococcus areus & epidermis
✔✔All factors that cause an increase in contractility cause an increase in what
intracellular concentration - ✔✔Calcium
✔✔Determinates of myocardial performance - ✔✔HR
AND ANSWERS SURE A+
✔✔1b drug used in pts with MI w/ frequent PVCs - ✔✔Lidocaine
✔✔Drug effective for VTs caused by digitalis toxicity - ✔✔Phenytoid
✔✔Drug class that significantly slows conduction velocity by does not prolong AP or
refractory periods - ✔✔1c
✔✔Effect of 1c on DFT - ✔✔increases
✔✔Affects catecholamines, mainly affects SA & AV nodes, blocks epinephrine which
slows HR - ✔✔Beta blockers
✔✔Beta blockers effect on DFT - ✔✔reduces DFT
✔✔Reduces VF after MI
Avoid use in WPW
Contraindicated in pts w/ asthma - ✔✔Beta blockers
✔✔Only class III that only prolong AP (not ERP) - ✔✔Dofetilide
,✔✔Class III affects which phase of the AP - ✔✔prolongs phase 2
✔✔Class that increases ERP and prolong AP - ✔✔III
✔✔Most effective drug for VF and unstable VT - ✔✔Amiodarone
✔✔Preferred drug for AFib pts in renal failure - ✔✔amiodarone
✔✔Drug used in cardioversion which may lower energy required and allow for rapid
carioversion - ✔✔Ibutilide
✔✔Slows HR and increases force of contraction in pts in heart failure - ✔✔Digoxin
✔✔Effective on monomorphic VT involving abnormal purkinje and exercise VT -
✔✔Verapamil
✔✔Caution of class IV drug in WPW - ✔✔can enhance antegrade conduction through
AP
✔✔Class that decreases automaticity, conduction, and refractory - ✔✔IV
✔✔(+) response to CSM - ✔✔PPM
✔✔Normal LV pressure - ✔✔120/5
✔✔First line drug for malignant vasovagal syncope - ✔✔Metoprolol
✔✔Most common cause of R sided heart failure - ✔✔L sided heart failure
✔✔Genetic basis and has significant rate of SCD w/ exertion - ✔✔Hypertrophic
cardiomyopathy
✔✔Positive predictor for_____
heart rate variability/baroreflex sensitivity (low)
T wave alternans
Signal Average EG - ✔✔SCD
✔✔Vigorous squeezing of a relatively empty ventricle cause stimulation of cardiac C
fibers in pts exhibiting - ✔✔Vasodepressor syncope
✔✔When checking pacing threshold w/ stimulator, what should the pacing voltage be
set at - ✔✔2x threshold
,✔✔Chest compression/ventilation ratio for infant - ✔✔15:2
✔✔Ways to lower DFT w/ external defibrilator - ✔✔Gel
Biphasic waveform
Scapula-apical patch placement
✔✔ATTEST - ✔✔Catheter ablation delays progression of AFib
✔✔Progression from paroxysmal to persistent AF results in increased risk of - ✔✔MI,
Thromboembolism, Heart failure, stroke
✔✔Accumulation of abnormal protein - ✔✔Amyloidosis
✔✔Long-standing inflammatory process - ✔✔Sarcoidosis
✔✔Drug treatment for amyloidosis - ✔✔Calcium channel blockers
✔✔Drug treatment for Sarcoidosis - ✔✔Corticosteroids
✔✔Early PVC transition - ✔✔LVOT
✔✔ICD primary prevention - ✔✔prevention of SCD in pts who have not had VA or SCA
but increased risk
✔✔ICD secondary prevention - ✔✔2nd chance- survivors of SCA/ Prior VA
✔✔VANISH Study - ✔✔superiority of ablation over escalating medication therapy for pts
w/ recurrent VT despite antiarrhythmic medication
✔✔Most common cause of SCD in individuals under 40 - ✔✔HCM
✔✔exertion related polymorphic (bi-directional) VT - ✔✔Catecholaminergic polymorphic
VT
✔✔Coved ST elevation in leads V1/2 - ✔✔Brugada
✔✔Treatment of SQTS - ✔✔Quinidine & ICD
✔✔Outflow tract more likely occurring in men - ✔✔LVOT
✔✔Outflow tract more likely occurring in women - ✔✔RVOT
✔✔# of paps in RV - ✔✔3
, ✔✔# of paps in LV - ✔✔2
✔✔BBB and axis of Fasicular VT - ✔✔RBBB & superior axis
✔✔retrograde leg in Fasicular VT - ✔✔Left posterior fascicle
✔✔Drug choice in IST - ✔✔Ivabradine
✔✔Charge (Q) formula - ✔✔Q=It
✔✔Unit of absorbed dose - ✔✔RAD (gray)
✔✔Unit of does equivalent or occupational exposure - ✔✔REM
✔✔Normal function in dual chamber pacing. Occurs when sensed P rate is fast than the
programed maximum tracking rate (or URL) - ✔✔Pacemaker wenkebach
✔✔When might automatic mode switching fail - ✔✔A flutter
✔✔When pacing mode switches from atrial tracking to non tracking mode upon tach
detection - ✔✔automatic mode switching
✔✔SCD-HeFT trial - ✔✔* NYHA II/III, CM, EF 35%
* Endpoint - mortality placebo vs. amnio vs. ICD
*23% risk of death for ICD therapy
✔✔CASH trial - ✔✔randomized patients to ICD, amiodarone, and metoprolol.
Mortality in the metoprolol group was similar to amiodarone. The benefit of ICD therapy
is more evident during the first five years after the index event
✔✔CIDS trial - ✔✔randomized patients with VF or VT to treatment with an ICD or
amiodarone . mean follow up 3 years
in a subset a CIDS, the benefit of ICD over amiodarone increased over time
✔✔Most common infection agents - ✔✔Staphylococcus areus & epidermis
✔✔All factors that cause an increase in contractility cause an increase in what
intracellular concentration - ✔✔Calcium
✔✔Determinates of myocardial performance - ✔✔HR
