Multiple Choice Questions (MCQ)

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Category: Cardiology--->Arrythmias
Page: 5

Question 21# Print Question

A 75-year-old diabetic woman with a history of previous MI and an LVEF of 35% has been on amiodarone for paroxysmal AF for several years. On examination she is breathless at rest and has signs of congestive cardiac failure. She has heard about dronedarone and is wondering whether she can have it instead of amiodarone.
What do you advise her about dronedarone?

A. It is more effective than amiodarone in maintaining sinus rhythm
B. It has no effect on heart (ventricular) rate during AF episodes
C. It is contraindicated in NYHA class IV heart failure patients
D. It is suitable for her as she is diabetic and aged over 70
E. It is associated with more ocular side effects than amiodarone

Question 22# Print Question

A 66-year-old woman with a past medical history of hypertension undergoes DC cardioversion for atrial fibrillation. Immediately following the procedure, transient ST elevation is seen. The patient is asymptomatic post-procedure but cardiac enzymes are taken 12 hours later. These show a normal troponin I but a raised CK. The SHO calls you to advise him on the significance of the ECG and blood tests.
What do you advise?

A. The ST elevation and raised CK are probably not abnormal
B. A rise in troponin I, but not in troponin T, is sometimes seen following AF cardioversion
C. A rise in troponin T, but not in troponin I, is sometimes seen following AF cardioversion
D. Both troponin I and T are usually raised post-cardioversion
E. The raised CK suggests likely myocardial damage

Question 23# Print Question

A 40-year-old man presents to A&E with a 12-hour history of sudden-onset palpitations. He has no previous medical history of note and the clinical examination is unremarkable. His troponin is negative. His ECG shows atrial fibrillation with a ventricular rate of 130 bpm, his BP is 110/70 mmHg, and his oxygen saturation is 98%. He has no symptoms associated with his palpitations.
What is the best management?

A. Amiodarone 300 mg IV loading followed by 900 mg over 24 hours
B. Flecainide 2 mg/kg over 0 minutes followed by oral dose
C. Digoxin 500 micrograms IV followed by 500 micrograms after 6 hours
D. Anticoagulate, rate control, and perform DC cardioversion in 6 weeks
E. Aspirin, atenolol 50 mg od, and review in clinic in 6 weeks

Question 24# Print Question

A 72 year old man with symptomatic persistent atrial fibrillation is admitted for pulmonary vein isolation.
Which one of the following statements is most likely to be true?

A. The risk of stroke is around 5%
B. The chance of successful ablation of the arrhythmia is around 90% at 1 year
C. The chance of successful ablation is higher for persistent AF than for paroxysmal AF
D. The risk of cardiac tamponade is around 5%
E. The risk of pulmonary vein stenosis is around 5%

Question 25# Print Question

A patient is admitted for a DC cardioversion for their persistent atrial fibrillation.
Which one of the following statements is true?

A. Monophasic waveforms are more effective than biphasic waveforms at cardioverting patients
B. IV flecainide pre-procedure does not increase the chances of electrical cardioversion
C. The initial success rate is around 50%
D. Patients do not require anticoagulation prior to cardioversion if their CHADS2 score is ≤1
E. Increased left atrial size is associated with an increased risk of AF recurrence

Category: Cardiology--->Arrythmias
Page: 5 of 17