CMT CMT Pharmacology and Cardiac Medications 2 — Questions and Answers
Question 1: Which medication prolongs the QT interval and can predispose a patient to torsades de pointes?
- Metoprolol
- Sotalol (Correct answer)
- Atropine
- Adenosine
Correct answer: Sotalol
Sotalol, a Class III antiarrhythmic, prolongs the QT interval and carries a risk of inducing torsades de pointes.
Question 2: A patient on heparin infusion shows a new rhythm change. What primary concern related to heparin should the CMT be aware of that affects cardiac risk?
- Heparin causes direct arrhythmias
- Heparin-induced thrombocytopenia (HIT) can cause thrombotic events (Correct answer)
- Heparin prolongs the QT interval
- Heparin slows sinus node automaticity
Correct answer: Heparin-induced thrombocytopenia (HIT) can cause thrombotic events
HIT is a serious complication where heparin causes platelet aggregation, leading to potentially fatal thrombosis including coronary events.
Question 3: Beta-blockers such as metoprolol affect the cardiac monitor tracing by:
- Shortening the PR interval
- Prolonging the PR interval and decreasing heart rate (Correct answer)
- Widening the QRS complex
- Elevating the ST segment
Correct answer: Prolonging the PR interval and decreasing heart rate
Beta-blockers slow AV nodal conduction, prolonging the PR interval and reducing heart rate on the ECG tracing.
Question 4: Which antiarrhythmic drug is typically used for acute management of stable wide-complex ventricular tachycardia?
- Adenosine
- Amiodarone (Correct answer)
- Digoxin
- Calcium gluconate
Correct answer: Amiodarone
Amiodarone IV is a first-line agent for stable ventricular tachycardia due to its broad spectrum of antiarrhythmic activity.
Question 5: A patient receiving IV potassium replacement is on continuous cardiac monitoring. The CMT should monitor for:
- Peaked T waves and widened QRS (Correct answer)
- ST depression and shortened PR
- Delta waves and short QT
- Notched P waves and long QU
Correct answer: Peaked T waves and widened QRS
Hyperkalemia produces peaked (tall, narrow, tent-shaped) T waves and QRS widening, which can progress to fatal arrhythmias.
Question 6: Calcium channel blockers like diltiazem are used to control ventricular rate in atrial fibrillation primarily by:
- Converting AF to sinus rhythm
- Slowing AV nodal conduction (Correct answer)
- Blocking sodium channels in the ventricle
- Increasing the refractory period of atrial tissue
Correct answer: Slowing AV nodal conduction
Diltiazem blocks calcium channels in the AV node, slowing conduction and reducing the number of atrial impulses conducted to the ventricles.
CMT CMT Pharmacology and Cardiac Medications 2
Which medication prolongs the QT interval and can predispose a patient to torsades de pointes?