arrhythmia

Question 1

In a 75 years old male patient with passed time acute inferior myocardial infarction after 48 hours of the onset of chest pain, the patient developed complete heart block. Which of the following must be avoided in the management of such patient?

1. Temporary pacemaker
2. Coronary intervention
3. Alteplase
4. Enoxaparin

Answer: c. Alteplase

Explanation: Alteplase is a thrombolytic agent. In cases of complete heart block following myocardial infarction, thrombolytic therapy is generally contraindicated due to the risk of further complications.

Question 2

In a 65 years old male patient with persistent anginal attacks despite taking bisoprolol and long-acting isosorbide mononitrate. The patient resting heart rate is 55 beat per minute. Which of the following is the appropriate add on anti-anginal drug?

1. Verapamil
2. Nicorandil
3. Trimetazidine
4. Ivabradine

Answer: d. Ivabradine

Explanation: Ivabradine is a heart rate-lowering agent that can be used in patients with persistent angina who are already on beta-blockers and have a resting heart rate above 50-60 bpm.

Question 3

A 75 years old patient with recurrent syncopal attack and Complete heart block, what is the emergency management?

1. IV atropine
2. Permanent pacemaker
3. Temporary pacemaker
4. DC shock

Answer: c. Temporary pacemaker

Explanation: In cases of complete heart block with recurrent syncope, a temporary pacemaker is often used as an emergency measure to stabilize the patient's heart rhythm.

Question 4

In a 58 years old male patient presented with non-ST elevation myocardial infarction with recurrent attacks of non-sustained ventricular tachycardia that last for less than 15 seconds, which of the following is the appropriate management?

1. DC shock
2. Streptokinase
3. Verapamil
4. Coronary intervention

Answer: d. Coronary intervention

Explanation: Coronary intervention is appropriate for managing non-ST elevation myocardial infarction, especially when accompanied by recurrent ventricular tachycardia.

Question 5

Which of the following is not a line of treatment of supraventricular tachycardia?

1. IV heparin
2. IV verapamil
3. IV adenosine
4. IV metoprolol

Answer: a. IV heparin

Explanation: IV heparin is not typically used in the treatment of supraventricular tachycardia. Common treatments include adenosine, verapamil, and metoprolol.

Question 6

Which of the following is not used in treatment of cyanotic spells of Fallot's tetralogy?

1. Oxygen
2. Sod. Bicarbonate
3. Morphine sulfate
4. Hydrocortisone

Answer: d. Hydrocortisone

Explanation: Hydrocortisone is not typically used in the treatment of cyanotic spells in Fallot's tetralogy. Common treatments include oxygen, sodium bicarbonate, and morphine sulfate.