Medical MCQs

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Patients who are diagnosed with Wolff-Parkinson-White (WPW) syndrome have an ECG with a short PR interval, delta wave, and a history of which of the following?

  • A. Paroxysmal supraventricular tachycardia (PSVT)
  • B. Orthodromic circus movement tachycardia (CMT)
  • C. Antidromic circus movement tachycardia (CMT)
  • D. Any of the above
  • Correct Answer: Option D

A supraventricular arrhythmia is any arrhythmia that arises above what level?

  • A. Purkinje fibers
  • B. Either left or right bundle branch
  • C. Atrioventricular bundle (of His)
  • D. Atrioventricular (AV) node
  • Correct Answer: Option C

Which of the following describes non-sustained tachyarrhythmia?

  • A. Arrhythmia with rate >60 for 3 beats or more for less than 1 minute
  • B. Arrhythmia with rate >150 for 3 beats or more for less than 30 seconds
  • C. Arrhythmia with rate >150 for 6 beats or more for less than 1 minute
  • D. Arrhythmia with rate >100 for 3 beats or more for less than 30 seconds
  • Correct Answer: Option D

An event monitor would be indicated instead of a Holter monitor for which of the following cases?

  • A. Elderly patient with suspected atrial fibrillation found during pulse palpation
  • B. To determine ST segment changes after an acute myocardial infarction (MI)
  • C. Medical student with intermittent caffeine-induced supraventricular tachycardia
  • D. To identify and quantify an asymptomatic bradyarrhythmia or tachyarrhythmia
  • Correct Answer: Option C

For patients presenting with palpitations, dizziness, or syncope, what is the recommended diagnostic test after a history and physical exam have been performed?

  • A. External or implanted event monitor
  • B. Tilt table test
  • C. ENT, neurologic, or psychiatric consult
  • D. Exercise stress test
  • Correct Answer: Option A

Which of the following would NOT be a useful diagnostic tool for a patient presenting with syncope?

  • A. Signal averaged ECG (SAECG)
  • B. External or implanted event monitor
  • C. Electrophysiology study
  • D. Cryoablation or laser catheter ablation
  • Correct Answer: Option D

Which of the following would NOT be a useful diagnostic tool for a patient presenting with dizziness?

  • A. History and physical exam
  • B. Implanted event monitor (loop recorder)
  • C. ENT or neurologic consult
  • D. Tilt table test
  • Correct Answer: Option B

Which of the following would NOT be a useful diagnostic tool for a patient presenting with palpitations?

  • A. External event monitor (Holter)
  • B. Electrophysiology study
  • C. Exercise stress test
  • D. Tilt table test
  • Correct Answer: Option D

A patient with a known unidirectional ventricular accessory pathway is implanted with an implantable cardioverter defibrillator (ICD). During a ventricular tachycardia episode, the device will determine the ventricular rate and then pace several times at a higher rate in order to painlessly terminate the episode. What type of cardiac arrhythmia mechanism is this device treating?

  • A. Later after-depolarization
  • B. Circus movement re-entry
  • C. Reflection re-entry
  • D. Phase 2 re-entry
  • Correct Answer: Option D

During which phase of the cardiac action potential do late after-depolarizations arise?

  • A. Phase 0
  • B. Phase 1
  • C. Phase 2
  • D. Phase 3
  • Correct Answer: Option C