ISHNE Sudden Cardiac Death World Wide Internet SymposiumISHNE Sudden Cardiac Death World Wide Internet Symposium
 
CME Testing
Questions Related to Lecture, "Drug-Proarrhythmic Sudden Cardiac Death," Michael H. Lehmann, M.D.

1) Which of the following non-cardiac conditions predisposes to baseline QTc prolongation and, thereby, confers an increased risk for Torsade de Pointes upon exposure to QT-prolonging drugs?
1.0) Don't know.
1.A) Chronic obstructive pulmonary disease
1.B) End-stage renal disease
1.C) Hyperthyroidism
1.D) Hepatic cirrhosis

2) If a patient with a history of myocardial infarction develops atrial fibrillation, which of the following medications should NOT be administered because of concern regarding ventricular proarrhythmia?
2.0) Don't know.
2.A) Digoxin
2.B) Propafenone
2.C) Diltiazem
2.D) Metoprolol

3) For drug treatment of atrial flutter with a 2:1 ventricular response, which of the following drugs - used as the sole initial agent - is most likely to cause life-threatening tachycardia acceleration by conversion to a 1:1 ventricular response?
3.0) Don't know.
3.A) Mexiletine
3.B) Verapamil
3.C) Quinidine
3.D) Digoxin


Questions Related to Lecture, "ARVD" - Frank Markus, M.D.

4) The diagnosis of ARVD/C can be established:

4.0) Don't know.
4.A) By ECG criteria alone
4.B) By ECG criteria plus inducible ventricular tachycardia
4.C) By family history of ARVD/C plus ECG criteria
4.D) By meeting Task Force Criteria

5) T wave inversion in V1-V3 is seen in what percentage of otherwise healthy men age 19-45 years?
5.0) Don't know.
5.A) 10%
5.B) 50%
5.C) 1%
5.D) 25%

6) The genetic defect in ARVD/C is due to:
6.0) Don't know.
6.A) Defect in coupling of myocardial cells
6.B) Defect in sarcomeres
6.C) Defect in ion channels
6.D) None of the above

7) Risk stratification for sudden cardiac death in ARVD/C includes:
7.0) Don't know.
7.A) Young age
7.B) Syncope
7.C) LV involvement
7.D) All of the above

 

Questions Related to Lecture, "Genetic and Acquired Causes of Sudden Death" Jeffrey Towbin, M.D

8) Which disorder is the most cause of sudden cardiac death in young, healthy, athletic persons?
8.0) Don't know.
8.A) Myocarditis
8.B) Long QT syndrome
8.C) Hypertrophic cardiomyopathy
8.D) Brugada syndrome

9) Arrhythmias, a significant cause of SCD, are caused by mutations in genes encoding
9.0) Don't know.
9.A) Ion channels
9.B) Sarcomere proteins
9.C) Inflammatory mediators
9.D) Apoptosis

10) Sudden death associated with dilated cardiomyopathy and conduction system disease may result from mutations in
10.0) Don't know.
10.A) Cadherin E
10.B) Lamin A/C
10.C) TGF-beta receptor
10.D) Fibrillin


Questions Related to Lecture "Polymorphic ventricular tachycardia in patients with vasospastic angina" - Masayasu Hiraoka / Mitsuhiro Nishizaki, MD

11) How much percentage of patients with vasospastic angina (VSA) develop PVT?
11.0) Don't know.
11.A) Nearly 100% of patients with VSA
11.B) Over 50% of patients with VSA
11.C) 20-30% of patients with VSA
11.D) 1-10% of patients with VSA

12) Development of PVT in patients with VSA is likely to indicate the following conditions. Select one that is not a correct statement.
12.0) Don't know.
12.A) Patients show silent coronary vasospasm associated with PVT
12.B) Patients must have severe organic stenotic lesions in their coronary arteries
12.C) This is a preceding sign for the development of acute myocardial infarction
12.D) This is an important sign for patients having severe LVH

13) PVT in patients with VSA demonstrates the following characteristics:
(1)   prolonged QT intervals
(2)   torsades de pointes
(3)   PVT starts with long-short sequence
(4)   Association of ST-T alternans
Which combination is a correct statement?

13.0) Don't know.
13.A) (1), (2)
13.B) (1, (3), (4)
13.C) (2), (3), (4)
13.D) (1), (2), (3), (4)

14) Which statement is not correct for PVT in patients with VSA?
14.0) Don't know.
14.A) Ventricular vulnerability is increased during symptom free period
14.B) PVT is not inducible by programmed ventricular stimulation
14.C) Atrial fibrillation (Af) as a basal rhythm is a sign of high risk for sudden cardiac death
14.D) ST elevation precedes development of PVT

 

Questions Related to Lecture, "Ankyrin-B Syndrome and Ankyrin-G Brugada Syndrome: Two Arrhythmogenic Fatal Cardiac Arrhythmic Entities ¨ - Andres Perez Riera, M.D.

15) Ankyrins are intracellular polypeptides required for the biogenesis and maintenance of membrane domains:
15.0) Don't know.
15.A) Only in excitable cells.
15.B) In both excitable and non-excitable cells;
15.C) Are important in erythrocyte, kidney, lung and brain.
15.D) Answer b and c are correct.

16) In reference to Ankyrin-B is true:
16.0) Don't know.
16.A) Mutations of ankyrin-B cause a newly defined cardiac arrhythmia syndrome associated with abnormal calcium homeostasis in a mouse model.
16.B) Mutations of ankyrin-B cause LQT4 syndrome.
16.C) ankyrin-B syndrome is a cardiac disease with a spectrum of clinical presentations that include: Bradycardia with sinus node dysfunction; VT, CPVT
16.D) Answer a and c are correct

17) In reference to Brugada syndrome  is not true
17.0) Don't know.
17.A) The principal voltage-gated Na+ channel in heart, Nav1.5, is directly associated with ankyrin-G, which is encoded by a distinct gene from ankyrin-B.
17.B) The principal voltage-gated Na+ channel in heart, Nav1.5, is directly associated with ankyrin-B.
17.C) Nav1.5 causing loss of binding to ankyrin-G results in Brugada syndrome and loss of targeting of Nav1.5 to the cell surface of cardiomyocytes.
17.D) Human variants in SCN5A (encodes Na(v)1.5) that block Na(v)1.5 interaction with ankyrin-G lead to loss of Na(v)1.5 membrane expression and Brugada syndrome.

 

Questions Related to Lecture Left cardiac sympathectomy to manage beta-blocker resistant LQT patients - Lexin Wang, MD

18) Which of the following ion channels on the myocyte membrane are involved in the pathogenesis of congenital long QT syndrome?
18.0) Don't know.
18.A) Potassium
18.B) Calcium
18.C) Sodium
18.D) a, b, and c

19) The surgical technique that provides adequate cardiac sympathectomy in drug-resistant congenital long QT syndrome and is LEAST likely to cause Horner's syndrome is:
19.0) Don't know.
19.A) Left stellectomy
19.B) Left cervicothoracic sympathectomy
19.C) High thoracic left sympathectomy
19.D) Right stellectomy

20) Which of the following statements on left cardiac sympathectomy in the management of long QT syndrome is INCORRECT?
20.0) Don't know.
20.A) Prolonged QT interval on body surface ECG is always shortened after the surgery
20.B) The surgery has no significant effect on resting heart rate
20.C) Left ventricular ejection fraction remains unchanged after the surgery
20.D) When used in combination with ICDs, it reduces the number of shocks from ICDs and improves quality of life of patients

 

Questions Related to Lecture The Role of Spatial Dispersion of Repolarization in Sudden Cardiac Death - Ch Charles Antzelevitch / Alejandra Guerchicoff / Guido D. Pollevick

21) Prolongation of the action potential duration of the M cells usually underlies the prolongation of the QT interval on the surface ECG as consequence of
21.0) Don't know.
21.A) A reduction of the potassium currents or an increase in calcium current or late sodium current.
21.B) A reduction of the potassium currents or an increase of late sodium current.
21.C) A reduction of the potassium currents or a reduction of late sodium current.
21.D) An increase of the potassium currents or a reduction in calcium current or late sodium current

22) Beta blockers are considered the first line of therapy in
22.0) Don't know.
22.A) LQT1, LQT2 and LQT3
22.B) LQT1 and LQT3
22.C) LQT1 and LQT2
22.D) LQT2 and LQT3

23) The short QT syndrome is a clinical entity characterized by
23.0) Don't know.
23.A) QTc <= 330 msec
23.B) QTc <= 420 msec, high incidence of VT/VF and familial inheritance
23.C) QTc <= 330 msec, high incidence of VT/VF and familial inheritance
23.D) QTc <= 330 msec and a distinct J wave

24) The accentuation of the right ventricular notch in Brugada syndrome produces:
24.0) Don't know.
24.A) St segment reduction
24.B) Accentuation of the J wave
24.C) Qtc<300
24.D) QTC>500

 

Questions Related to Lecture Lessons from the DEFINITE Trial - Kenneth A. Ellenbogen, M.D, Alan Kadish, M.D.

25) The DEFINITE trial was a prospective, randomized multicenter trial to evaluate
25.0) Don't know.
25.A) ICD therapy in Non-Ischemic dilated Cardiomyopathy
25.B) ICD therapy in Ischemic dilated Cardiomyopathy
25.C) CRT therapy in Non-Ischemic dilated Cardiomyopathy
25.D) CRT therapy in Ischemic dilated Cardiomyopathy

26) In the DEFINITE trial, ICD therapy showed that
26.0) Don't know.
26.A) The risk of sudden death from arrhythmias was statistically significantly reduced by ICD therapy.    
26.B) The risk of death from any cause was reduced by borderline statistical significance by ICD therapy
26.C) a and b are correct
26.D) none

27) Benefit is similar in patients with recently diagnosed cardiomyopathy vs. patients with cardiomyopathy of longer duration
27.0) Don't know.
27.A) The ICD group was associated with a reduced risk of death for patients who were recently diagnosed within 3 months
27.B) The ICD insertion was not significantly related to survival for patients who had been diagnosed with cardiomyopathy for longer than 9 months
27.C) a and b are correct
27.D) none

 

Questions Related to Lecture Genetic of Arrhythmogenic Diseases - Silvia Priori

28) Which is the most common variant in the LQTS
28.0) Don't know.
28.A) LQTS 1
28.B) LQTS 1
28.C) LQTS 1
28.D) JLN1

29) The ion current affected in the HERG is
29.0) Don't know.
29.A) IKs
29.B) sodium current
29.C) IKr
29.D) Na-Ca exchange

30) In the LQTS1 patients, symptoms are most frequent to presented during
30.0) Don't know.
30.A) sleep
30.B) emotion
30.C) exercise
30.D) no relation

 

Questions Related to Lecture Syncope in a 29 year old male - Martin Borggrefe

To answer the following 3 questions, please go to http://www.scd-symposium.org/clinicalcases.php

31) What is the most likely the underlying diagnosis based on the ECG
31.0) Don't know.
31.A) Brugada syndrome
31.B) LQTS
31.C) Short QT
31.D) Hypertrophic cardiomyopathy

32) Which additional technical examination is not necessary helpful to assure the diagnosis
32.0) Don't know.
32.A) echocardiography
32.B) left heart catheterization
32.C) programmed ventricular stimulation
32.D) cardiac MRI

33) What of the following is not a major risk factor for SCD in hypertrophic cardiomyopathy
33.0) Don't know.
33.A) family story of premature SCD
33.B) unexplained syncope
33.C) right ventricular involvement
33.D) LV thickness greater than or equal to 30 mm

 

Questions Related to Lecture Sudden Cardiac Death in Patients with Left Ventricular Dysfunction: Focus on Primary Prevention with ICDs - Andrew Epstein

34) The Sudden Cardiac Death in Heart Failure Trial compare
34.0) Don't know.
34.A) conventional Rx and placebo
34.B) conventional Rx and amiodarone
34.C) conventional Rx and ICD
34.D) a against b against c

35) The Care-HF compare
35.0) Don't know.
35.A) conventional Rx and placebo
35.B) conventional Rx and CRT
35.C) conventional Rx and ICD
35.D) none of above

36) Which one is NO a common indication for CRT device
36.0) Don't know.
36.A) LBBB
36.B) EF < 35%
36.C) NYHA III-IV
36.D) QRS < 120 mseg

 

Questions Related to Lecture Community-Wide Analysis of Sudden Cardiac Death: Clinical and Research Implications - Sumeet Chugh

37) Approximately what percentage of patients who suffer sudden cardiac death have associated coronary artery disease?
37.0) Don't know.
37.A) 75-80%
37.B) 0-5%
37.C) 15-20%
37.D) 20-25%

38) Which one or more of the following conditions have been associated with increased risk of sudden cardiac death?
38.0) Don't know.
38.A) Diabetes
38.B) Socioeconomic status
38.C) Prolonged QT interval
38.D) All of the above

39) Approximately what percentage of patients who suffer sudden cardiac death have evidence of severe LV dysfunction?
39.0) Don't know.
39.A) Over 90%
39.B) Less than 10%
39.C) Over 80%
39.D) 30-40%


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