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Category: Cardiology--->Arrythmias
Page: 16

Question 76# Print Question

A 55-year-old man had a pacemaker initially implanted 8 years ago over the left prepectoral area. Two months earlier, his old pacemaker reached end-oflife, and he underwent replacement of the pacemaker using the existing leads. He is presenting now with dull pain, swelling, and mild erythema over the pacemaker pocket site that started 1 week earlier, together with lowgrade fever. He reports some purulent drainage from the incision site. Blood cultures were drawn.

The best course of action is:

A. To prescribe PO antibiotics for 2 weeks
B. To admit the patient for IV antibiotics and pacemaker-system extraction
C. To prescribe long-term suppressive PO antibiotics, as the pacemaker and leads system are too old to be extracted
D. To remove the recently implanted pulse generator on the left, leaving the old leads in place, and implant a new pacemaker system on the right prepectoral area
E. To incise and drain the pacemaker pocket and allow it to heal with secondary intention with daily change of dressing


Question 77# Print Question

Which of the following is a correct statement concerning external cardioversion of AFib?

A. Acute MI is a contraindication to cardioversion, as it results in further myocardial damage
B. A nonsynchronized shock should be delivered because the rhythm is irregular
C. Inadequate synchronization may occur with peaked T waves, lowamplitude signal, and malfunctioning pacemakers
D. Digoxin therapy should be discontinued for 48 hours before elective cardioversion
E. Patients with pacemakers should not undergo cardioversion because of the risk of pacemaker damage


Question 78# Print Question

In patients with Wolff-Parkinson-White syndrome, with which of the following is acute pharmacologic treatment of AFib best achieved?

A. Diltiazem
B. Lidocaine
C. Verapamil
D. Procainamide
E. Adenosine


Question 79# Print Question

A 75-year-old patient with a history of ischemic cardiomyopathy develops worsening heart failure symptoms during episodes of AFib despite a controlled ventricular rate.

Which of the following is included in a reasonable trial of pharmacologic therapy?

A. Flecainide
B. Sotalol
C. Verapamil
D. Disopyramide
E. Amiodarone


Question 80# Print Question

Which of the following is true regarding the use of digoxin in AFib?

A. It is superior to placebo for the acute conversion of AFib
B. It controls ventricular rate during exercise in most patients
C. It can control ventricular rate at rest in many patients
D. It effectively maintains sinus rhythm after cardioversion
E. Because of its hepatic clearance, it is safe to use in patients with renal insufficiency




Category: Cardiology--->Arrythmias
Page: 16 of 17