IBHRE 2026 EXAMINERS UPDATED QUESTIONS
AND ANSWERS SURE A+
✔✔drug absorption - ✔✔-entrance of a drug into the bloodstream from its site of
administration
-affected by gut flora (especially if on antibiotics, and interactions with other drugs)
✔✔-when pts have rapid transit times through the gut (colostomy pts)
-acutely ill pts where absorption is impaired - ✔✔When can't you use a drug that has a
sustained release formula?
✔✔drug distribution - ✔✔-volume distribution is the difference between the dose and
the plasma concentration
-volume of distribution reduced by HF and elderly, so for these pts lower the drugs that
are rapidly reduced (best on drugs with slow reduction)
✔✔-intermittant/complete LOC
-Change in morphology of captured beats
-change in dipole (???) spike polarity
-change in lead position
-lead impedance does not change drastically - ✔✔what are common signs of lead
dislodgment?
, ✔✔-adequate heel on lead
-2-3 mV current of injury on ecg
-fixation of lead sleeve to prevent pullback - ✔✔What are signs of good lead
placement?
✔✔Twiddler's Syndrome - ✔✔a malfunction of a pacemaker due to manipulation of the
device and the subsequent dislodging of the leads from their intended location
(most common cause of "late dislodgment")
✔✔exit block - ✔✔failure of an impulse to excite the surrounding tissue when falling
outside of the refractory period of the heart
✔✔TARP - ✔✔-PAV delay + PVARP
-if RR is on use shortest AV delay in calculation
-the BPM conversion is the 2:1 block point
✔✔wenkebach window - ✔✔max tracking interval-TARP
✔✔nonionizing radiation - ✔✔-not harmful, most common, doesnt have enough energy
to ionize atoms
-UV light, visible light, infrared radiation, RF radiation, microwaves
✔✔Ionizing radiation - ✔✔-harmful causes atoms to lose electrons and become charged
atoms
-alpha and beta particles, gamma rays and xrays
✔✔photons - ✔✔energy packets with no charge that travel at the speed of light
✔✔rad - ✔✔radiation absorbed dose
=0.01 J absorbed/kg of any material (Gy)
=1/100 of a gray (Gy)
✔✔REM - ✔✔roentgen equivalent man, quantity of radiation received by radiation
workers
✔✔AV delay - ✔✔begins when the atrial escape interval times out and causes a V pace
(ApVp)
✔✔PV delay - ✔✔P tracking interval that is started by a sensed event in the atrial
channel (AsVp)
✔✔Pacemaker Wenckebach - ✔✔occurs when the p rate is faster than the max tracking
rate
AND ANSWERS SURE A+
✔✔drug absorption - ✔✔-entrance of a drug into the bloodstream from its site of
administration
-affected by gut flora (especially if on antibiotics, and interactions with other drugs)
✔✔-when pts have rapid transit times through the gut (colostomy pts)
-acutely ill pts where absorption is impaired - ✔✔When can't you use a drug that has a
sustained release formula?
✔✔drug distribution - ✔✔-volume distribution is the difference between the dose and
the plasma concentration
-volume of distribution reduced by HF and elderly, so for these pts lower the drugs that
are rapidly reduced (best on drugs with slow reduction)
✔✔-intermittant/complete LOC
-Change in morphology of captured beats
-change in dipole (???) spike polarity
-change in lead position
-lead impedance does not change drastically - ✔✔what are common signs of lead
dislodgment?
, ✔✔-adequate heel on lead
-2-3 mV current of injury on ecg
-fixation of lead sleeve to prevent pullback - ✔✔What are signs of good lead
placement?
✔✔Twiddler's Syndrome - ✔✔a malfunction of a pacemaker due to manipulation of the
device and the subsequent dislodging of the leads from their intended location
(most common cause of "late dislodgment")
✔✔exit block - ✔✔failure of an impulse to excite the surrounding tissue when falling
outside of the refractory period of the heart
✔✔TARP - ✔✔-PAV delay + PVARP
-if RR is on use shortest AV delay in calculation
-the BPM conversion is the 2:1 block point
✔✔wenkebach window - ✔✔max tracking interval-TARP
✔✔nonionizing radiation - ✔✔-not harmful, most common, doesnt have enough energy
to ionize atoms
-UV light, visible light, infrared radiation, RF radiation, microwaves
✔✔Ionizing radiation - ✔✔-harmful causes atoms to lose electrons and become charged
atoms
-alpha and beta particles, gamma rays and xrays
✔✔photons - ✔✔energy packets with no charge that travel at the speed of light
✔✔rad - ✔✔radiation absorbed dose
=0.01 J absorbed/kg of any material (Gy)
=1/100 of a gray (Gy)
✔✔REM - ✔✔roentgen equivalent man, quantity of radiation received by radiation
workers
✔✔AV delay - ✔✔begins when the atrial escape interval times out and causes a V pace
(ApVp)
✔✔PV delay - ✔✔P tracking interval that is started by a sensed event in the atrial
channel (AsVp)
✔✔Pacemaker Wenckebach - ✔✔occurs when the p rate is faster than the max tracking
rate
