CMC Cardiac Arrhythmia Management 1

Question 1

A patient presents with a narrow-complex tachycardia at 160 bpm with regular rhythm and retrograde P waves. Which arrhythmia is most likely?

Accepted Answer

Atrioventricular nodal reentrant tachycardia (AVNRT)

Answer

AVNRT characteristically produces a narrow-complex regular tachycardia with retrograde P waves buried in or just after the QRS complex due to simultaneous atrial and ventricular activation.

Question 2

Which finding on a 12-lead ECG is most characteristic of Wolff-Parkinson-White (WPW) syndrome during sinus rhythm?

Accepted Answer

Short PR interval with a delta wave

Answer

WPW syndrome is characterized by a short PR interval (<120 ms) and a slurred upstroke of the QRS called a delta wave, caused by ventricular pre-excitation via the accessory pathway.

Question 3

A patient with symptomatic bradycardia due to complete heart block is hemodynamically unstable. What is the immediate treatment of choice?

Accepted Answer

Transcutaneous pacing

Answer

Transcutaneous pacing is the immediate stabilizing therapy for hemodynamically unstable complete heart block while preparing for transvenous pacing or definitive permanent pacemaker placement.

Question 4

On telemetry, you observe a regular rhythm at 75 bpm with no visible P waves and narrow QRS complexes. Which rhythm is most consistent with this pattern?

Accepted Answer

Accelerated junctional rhythm

Answer

Accelerated junctional rhythm originates in the AV junction and presents as a regular narrow-complex rhythm at 60-100 bpm with absent, retrograde, or buried P waves.

Question 5

Which medication is the first-line pharmacologic treatment for stable monomorphic ventricular tachycardia in a patient with preserved ejection fraction?

Accepted Answer

Amiodarone IV

Answer

IV amiodarone is the preferred antiarrhythmic for stable monomorphic ventricular tachycardia because it effectively terminates VT and is safe across a broad range of cardiac function.

CMC - Cardiac Medicine Certification Practice Test

CMC - Cardiac Medicine Certification Practice Test

CMC Cardiac Arrhythmia Management 1