Atrial Fibrillation (Exam Mode) By Rnpedia.Com
Choose the letter of the correct answer. You have 20 mins to answer the questions.
Questions and Answers
- 1.
Which of these is not a type of atrial fibrillation?
- A.
Paroxysmal atrial fibrillation
- B.
Lone atrial fibrillation
- C.
Persistent atrial fibrillation
- D.
Combined atrial fibrillation
Correct Answer
B. Lone atrial fibrillationExplanation
Lone atrial fibrillation is not a type of atrial fibrillation. This term is used to describe atrial fibrillation that occurs in individuals who are otherwise healthy and have no underlying heart disease or risk factors. It is considered a benign form of atrial fibrillation and typically has a better prognosis compared to other types.Rate this question:
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- 2.
Which of these is a feature of atrial fibrillation?
- A.
Presence of “p” wave on electrocardiogram
- B.
Absence of “p” wave on electrocardiogram
- C.
“p” wave of differing morphology on electrocardiogram
- D.
None of the above
Correct Answer
B. Absence of “p” wave on electrocardiogramExplanation
Atrial fibrillation is a type of arrhythmia where the atria of the heart quiver instead of contracting normally. This results in an irregular heart rhythm. One of the key features of atrial fibrillation is the absence of the "p" wave on an electrocardiogram (ECG). The "p" wave represents the electrical signal that is generated when the atria contract. In atrial fibrillation, the atria are not contracting in a coordinated manner, so the "p" wave is either absent or not clearly visible on the ECG.Rate this question:
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- 3.
Which of these is not a risk factor for atrial fibrillation?
- A.
Hypertension
- B.
Diabetes
- C.
Hypothyroidism
- D.
Congestive cardiac failure
Correct Answer
C. HypothyroidismExplanation
Hypothyroidism is not a risk factor for atrial fibrillation. Atrial fibrillation is commonly associated with conditions such as hypertension, diabetes, and congestive cardiac failure. However, hypothyroidism, which is an underactive thyroid gland, is not directly linked to an increased risk of developing atrial fibrillation. While thyroid disorders can affect heart function, hypothyroidism itself does not specifically contribute to the development of atrial fibrillation.Rate this question:
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- 4.
The management of atrial fibrillation involves which of the following objectives?
- A.
Rate control
- B.
Correction of rhythm disturbance
- C.
Prevention of thromboembolism
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
The management of atrial fibrillation involves three main objectives: rate control, correction of rhythm disturbance, and prevention of thromboembolism. Rate control aims to control the heart rate in order to improve symptoms and prevent complications. Correction of rhythm disturbance involves restoring normal sinus rhythm or maintaining a controlled atrial fibrillation rhythm. Prevention of thromboembolism focuses on reducing the risk of blood clots and stroke by using anticoagulant medications. Therefore, all of the given options are correct objectives in the management of atrial fibrillation.Rate this question:
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- 5.
Strongest risk factor for stroke in patients with atrial fibrillation is:
- A.
Irregular atrial rhythm
- B.
Increased ventricular rate
- C.
Lack of anticoagulation
- D.
None of the above
Correct Answer
C. Lack of anticoagulationExplanation
The strongest risk factor for stroke in patients with atrial fibrillation is lack of anticoagulation. Anticoagulation therapy, such as the use of blood thinners, is crucial in preventing blood clots from forming in the atria of the heart and traveling to the brain, causing a stroke. Atrial fibrillation already increases the risk of blood clots due to the irregular and inefficient pumping of blood, and without anticoagulation, this risk is further heightened. Therefore, the lack of anticoagulation is the most significant risk factor for stroke in these patients.Rate this question:
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- 6.
In patients who have self-limited episodes of atrial fibrillation (AF), antiarrhythmic drugs are unnecessary to prevent recurrence unless AF is associated with severe symptoms related to:
- A.
Hypotension
- B.
Myocardial Ischemia
- C.
Heart failure
- D.
Any of the above
Correct Answer
D. Any of the aboveExplanation
Patients who have self-limited episodes of atrial fibrillation (AF) do not necessarily require antiarrhythmic drugs to prevent recurrence, unless AF is associated with severe symptoms related to hypotension, myocardial ischemia, or heart failure. In such cases, antiarrhythmic drugs may be necessary to manage these symptoms and prevent further complications.Rate this question:
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- 7.
Which of these drugs should be used unless contraindicated in all patients to prevent postoperative atrial fibrillation during cardiac surgery?
- A.
Flecainide
- B.
Procainanide
- C.
Propafenone
- D.
Beta blockers
Correct Answer
D. Beta blockersExplanation
Beta blockers should be used unless contraindicated in all patients to prevent postoperative atrial fibrillation during cardiac surgery. Beta blockers are commonly used in cardiac surgery to prevent atrial fibrillation due to their ability to decrease heart rate and suppress abnormal electrical activity in the heart. They work by blocking the effects of adrenaline on the heart, which reduces the risk of arrhythmias. Other drugs listed, such as Flecainide, Procainamide, and Propafenone, may be used in specific cases or if beta blockers are contraindicated.Rate this question:
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- 8.
Which of the following drugs should not be used in patients with atrial fibrillation with acute myocardial infarction?
- A.
Amiodarone
- B.
Propanolol
- C.
Propafenone
- D.
None of the above
Correct Answer
C. PropafenoneExplanation
Propafenone should not be used in patients with atrial fibrillation with acute myocardial infarction. This is because propafenone is a class IC antiarrhythmic drug that can have proarrhythmic effects, meaning it can potentially worsen existing arrhythmias or cause new ones. In patients with acute myocardial infarction, there is already a risk of arrhythmias, and using propafenone can increase this risk. Therefore, it is contraindicated in this patient population. Amiodarone and propanolol are alternative drugs that can be used in these patients.Rate this question:
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- 9.
Antiarrhythmic drug that can be used in patients of atrial fibrillation with heart failure is:
- A.
Amiodarone
- B.
Flecainide
- C.
Propafenone
- D.
Sotalol
Correct Answer
A. AmiodaroneExplanation
Amiodarone is an antiarrhythmic drug that can be used in patients with atrial fibrillation and heart failure. It is effective in controlling irregular heart rhythms and has been shown to improve symptoms and reduce hospitalizations in these patients. Amiodarone works by blocking certain electrical signals in the heart, helping to restore a normal rhythm. It has a long half-life and can be given orally or intravenously. However, it should be used with caution due to its potential for serious side effects, such as lung toxicity and liver damage. Close monitoring is necessary while using amiodarone.Rate this question:
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- 10.
For patients with recurrent paroxysmal atrial fibrillation, with no or minimal heart disease, the recommended initial antiarrhythmic therapy is:
- A.
Flecainide
- B.
Propafenone
- C.
Sotalol
- D.
Any of the above
Correct Answer
D. Any of the aboveExplanation
The recommended initial antiarrhythmic therapy for patients with recurrent paroxysmal atrial fibrillation, with no or minimal heart disease, is any of the above options (Flecainide, Propafenone, or Sotalol). This means that all three medications can be considered as suitable choices for treatment in these patients.Rate this question:
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- 11.
The recommended antithrombotic therapy for high-risk patients with atrial fibrillation is:
- A.
Warfarin
- B.
Aspirin
- C.
Warfarin + Aspirin
- D.
Clopidogrel + Aspirin
Correct Answer
A. WarfarinExplanation
Warfarin is the recommended antithrombotic therapy for high-risk patients with atrial fibrillation. Atrial fibrillation increases the risk of blood clots, which can lead to stroke. Warfarin is an anticoagulant that helps to prevent the formation of blood clots by inhibiting the production of certain clotting factors in the liver. It is more effective than aspirin alone in reducing the risk of stroke in high-risk patients. Warfarin + Aspirin or Clopidogrel + Aspirin may be considered in certain cases, but the first-line therapy for high-risk patients is warfarin.Rate this question:
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- 12.
Which of the following are the non-pharmacological treatments for atrial fibrillation?
- A.
Maze surgery
- B.
Radiofrequency catheter ablation
- C.
Implantable cardioverter defibrillators
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
The correct answer is "All of the above". Maze surgery, radiofrequency catheter ablation, and implantable cardioverter defibrillators are all non-pharmacological treatments for atrial fibrillation. Maze surgery is a surgical procedure that creates scar tissue in the heart to redirect electrical signals and restore normal heart rhythm. Radiofrequency catheter ablation uses heat energy to destroy abnormal heart tissue causing the irregular rhythm. Implantable cardioverter defibrillators are devices that monitor the heart's rhythm and deliver electric shocks to restore normal rhythm when necessary. All three treatments aim to correct atrial fibrillation without the use of medication.Rate this question:
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- 13.
The recommended INR range for warfarin therapy in atrial fibrillation is:
- A.
2-3
- B.
1.5-3
- C.
2-4
- D.
1.5-4
Correct Answer
A. 2-3Explanation
The recommended INR range for warfarin therapy in atrial fibrillation is 2-3. This range is considered ideal to prevent blood clots while minimizing the risk of bleeding. Warfarin is a medication that helps to thin the blood and prevent clotting, and maintaining the INR within this range ensures that the medication is effective in preventing clots without increasing the risk of bleeding complications.Rate this question:
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- 14.
Electrical cardioversion is contraindicated in patients of atrial fibrillation with:
- A.
Heart failure
- B.
Myocardial ischemia
- C.
Digitalis toxicity
- D.
All the above
Correct Answer
C. Digitalis toxicityExplanation
Electrical cardioversion is contraindicated in patients with digitalis toxicity because it can lead to life-threatening arrhythmias. Digitalis toxicity is characterized by an excessive level of digitalis in the blood, which can cause abnormal electrical activity in the heart. Electrical cardioversion involves delivering a controlled electric shock to the heart to restore a normal heart rhythm. However, in patients with digitalis toxicity, this procedure can further disrupt the electrical activity of the heart and worsen the arrhythmia. Therefore, it is important to correct digitalis toxicity before considering electrical cardioversion in these patients.Rate this question:
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- 15.
Which of the following patients can undergo cardioversion without prior anticoagulation?
- A.
Atrial fibrillation less than 48 hours with haemodynamic instability
- B.
Atrial fibrillation
- C.
Atrial fibrillation
- D.
Atrial fibrillation
Correct Answer
A. Atrial fibrillation less than 48 hours with haemodynamic instabilityExplanation
Patients with atrial fibrillation less than 48 hours with hemodynamic instability can undergo cardioversion without prior anticoagulation. This is because the risk of thromboembolism is low in these patients due to the short duration of atrial fibrillation. Anticoagulation is typically recommended for patients with atrial fibrillation lasting longer than 48 hours or of unknown duration, as these patients have a higher risk of thrombus formation in the atria. However, in the case of hemodynamic instability, immediate cardioversion is necessary to restore normal heart rhythm and stabilize the patient, outweighing the potential risk of thromboembolism.Rate this question:
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