PCOL Anti arrhythmic Drugs

Question 1

Which of these tissues generates slow action potentials? (select all)

A. His-Purkinje Fibers

B. AV node

C. Atria

D. Ventricles

E. SA node

Answer 1

B,E

Question 2

Which of these tissues conducts a fast action potential. (select all)

A. His-Purkinje Fibers

B. AV Node

C. Ventricles

D. SA Node

E. Atria

Answer 2

A, C, E

Question 3

Which of these tissues can generate this type of action potential? (Select All)

A. His-Purkinje Fibers

B. SA Node

C. Atria

D. AV Node

E. Ventricles

Answer 3

A,C,E

The cart represents a fast action potential (hence the large initial spike in depolarization) and the only tissues that produce fast action potentials such as this include the Atria, Ventricles and His-Purkinje FIbers

Question 4

What ion channel and ion is responsible for this circled slope?

A. Potassium channel, Potassium

B. Sodium channel, Sodium

C. Calcium channel, Calcium

D. Chloride channel, Chloride

Answer 4

B

Question 5

What phase does this circled portion represent?

A. Phase 1

B. Phase 2

C. Phase 3

D. Phase 4

E. Phase 0

Answer 5

E

Question 6

What phase does this cicled portion represent?

A. Phase 1

B. Phase 2

C. Phase 3

D. Phase 4

E. Phase 0

Answer 6

D

Question 7

What phase does this circled portion of the graph represent?

A. Phase 1

B. Phase 2

C. Phase 3

D. Phase 4

E. Phase 5

Answer 7

A

Question 8

What phase does this circled portion on the graph represent?

A. Phase 1

B. Phase 2

C. Phase 3

D. Phase 4

E. Phase 0

Answer 8

B

Question 9

What does the circled portion of this graph represent?

A. Phase 1

B. Phase 2

C. Phase 3

D. Phase 4

E. Phase 0

Answer 9

C

Question 10

What is the main conformational state of sodium channels in this portion of the graph?

A. Resting (closed)

B. Active

C. Inactive

Answer 10

A

Question 11

What is the main conformational state of sodium channels on this portion of the graph?

A. Resting (closed)

B. Active

C. Inactive

Answer 11

B

Question 12

What is the conformational state of the sodium channels on this portion of the graph?

A. Resting (closed)

B. Active

C. Inactive

Answer 12

C

Question 13

The circled sodium channel represents the _____ conformation and sodium/drug ____ enter the binding sites.

A. Open, Can

B. Resting, Cannot

C. Inactive , Can

D. Inactive Cannot

Answer 13

C

Question 14

Which of these statements is true?

A. In Phase 4 of a Fast action potential the majority of the sodium channels are in the inactive state

B. In Phase 0 the majority of the sodium channels are in the resting state

C. In Phase 1-2 the majority of the sodium channels are in the inactive state

D. In Phase 3-4 the majority of the sodium channels are in the active state

Answer 14

C

Question 15

Which of the following statements is true? (select all)

A. In phase 1 and 2 of the fast action potential calcium channels open and calcium enters the cell.

B. In Phase 0 of the fast action potential potassium channels open and potassium flows out of the cell

C. In Phase 3 of the fast action potential calcium channels will close and potassium efflux is still occuring

D. In Phase 1 and 2 of the fast action potential potassium efflux is occuring while calcium influx is occuring.

E. In Phase 1 and 2 of the fast action potential potassium influx is occuring while calcium influx is occuring.

Answer 15

A,C,D

Question 16

Which of the following statements is true?

A. In phase 1 of the fast action potential the majority of sodium channels are in the inactive state

B. When the majority of the sodium channels are in the inactive state you are more likely to be in the absolute refractory period

C. When the majority of the sodium channels are in the resting state you are more likeley to be in the realtive refractory period.

D. All of the above

Answer 16

D

Question 17

The image here represents the Q-T interval which is a measure of the____

A. Action Potential Duration (APD)

B. Diastolic fill volume

C. The strength of contraction of the ventrciles

D. The strength of contraction of the atria

Answer 17

A

It is not C because ECGs do not measure contraction strength. They only measure electical activity.

Question 18

When you increase your QT interval you will ____ your Action Potential Duration (APD)

A. Increase

B. Decrease

Answer 18

A

Question 19

The QRS interval is a measure of the :

A. Atrial conduction

B. Atrial contraction strength

C. Ventricle conduction

D. Ventricle contraction strength

Answer 19

C

Question 20

QRS complex is formed how?

A. Electrical impuse spreading into the atria

B. Electrical impulse spreading into the ventricle

Answer 20

B

Question 21

An elongated QRS interval is a result of a ____ ventricle conduction.

A. Increased (faster)

B. Decreased (slower)

Answer 21

B

It is elongated because the action potential is taking longer to move through the venticle muscle (slow conduction). As a result the QRS complex will look wider.

Question 22

T/F In an absolute refractory period another action potential can be elicited

Answer 22

F.

In the ABSOLUTE refractory period more action potentials cannot be generated because the sodium channels are in the INACTIVE state.

Question 23

T/F In the Relative refractory period another action potential can be generated

Answer 23

T.

In the RELAVTIVE refractory period the majority of sodium channels are in the RESTING (closed) state and can become activated again (action potential) with a strong enough stimulus.

Question 24

Based on this picture which of these statements is true? (select all)

A, The green line is taking a longer period of time to reach threshold in comparison to the red line.

B. The red line is taking a longer period of time to reach the threshold in comparison to the green line.

C. The red line can be a result of PNS activation

D. The Green line can be a result of SNS activation

Answer 24

B,C,D

Question 25

Based on this graph what can be inferred? (Select all) A. Green line can be a result from giving a B1 agonist B. Red line can be a result of giving an Muscarinic antagonist C. Green line can be a result from giving a Muscarinic agonist D. Red line can ge a result from giving a muscarinic agonist E. Green line can be a result from giving a muscarinic antagonist

Answer 25

A,D,E

Question 26

Picture A is known as a ____ and picture B is known as a \_\_\_\_\_. A. Delayed After Depolarization (DAD), Early After Depolarization (EAD) B. Early After Depolarization (EAD), Delayed After Depolarization (DAD)

Answer 26

A

Question 27

Which of the following factors can lead to a Delayed After Depolarization (DAD)? A. Intracellular Ca overload B. Hypokalemia C. Low Heart Rate

Answer 27

A

Question 28

Which of the following can lead to an Early After Depolarization (EAD)? A. Hypokalemia B. Intracellular Ca overload C. Adrenergic stress

Answer 28

A

Question 29

How many classes of sodium channel blockers are there? A. I B. I, II C. I, II, III D. I, II, III, IV

Answer 29

D

Question 30

Which class of Na Channel Blockers is subdivided into classes 1A, 1B and 1C? A. Class I B. Class II C. Class III D. Class IV

Answer 30

A

Question 31

Which of these is in the Class IA Na Channel Blockers? (select all) A. Quinidine B. Lidocaine C. Procainamide D. Flecainide E. Disopyramide

Answer 31

A, C, E

Question 32

Which of these drugs are in the class 1B Na Channel blockers? (Select All) A. Lidocaine B. Quinidine C. Procainamide D. Mexiletine E. Flecainide

Answer 32

A, D

Question 33

Which of these drugs are class 1C Na Channel Blockers? A. Flecainide B. Disopyramide C. Flecainide D. Moricizine E. Lidocaine

Answer 33

A,C,D

Question 34

What class of drugs consists of Class II Antiarrhythmics? A. Na Channel Blockers B. Beta blockers C. Calcium channel blockers D. Miscellaneous

Answer 34

B

Question 35

All of the following Beta blockers are part of Class II antiarrhythmics EXCEPT: A. Atenolol B. Metoprolol C. Sotalol D. Propranolol

Answer 35

C Sotalol is part of the class III antiarrhythmics due to its Potassium-channel blocking activity.

Question 36

What class of drugs belongs is part of the class III antiarrhythmic agents? A. Na Channel blockers B. Beta Blockers C. Potassium channel blockers D. Calcium channel blockers E. Miscellaneous

Answer 36

C

Question 37

Which of the following drugs are part of the Class III potassium channel blockers? A. Amiodarone B. Dronedarone C. Dofetalide D. Ibutilide E. Sotalol F. All of the above

Answer 37

F Remember: Amio**_darone_** Drone**_darone_** Dofeta**_lide_** Ibuti**_lide_** Sotalol

Question 38

Which class of drugs are the class IV antiarrhythmic agents composed of? A. Na channel blockers B. Beta blockers C. Calcium channel blockers D. Potassium channel blockers E. Miscellaneous

Answer 38

C

Question 39

Class IV Ca channel blockers consist of Non-dihydropyradines. Which of these drugs belongs to this class of antiarrhythmics? (select all) A. Diltiazem B. Nifedipine C. Amlodpine D. Verapamil E. Nicardipine

Answer 39

A, D

Question 40

All of the following drugs are considered Miscellaneous-class antiarrhythmics EXCEPT: A. Digoxin B. Adenosine C. Mg²⁺ D. K+ E. ibutilide

Answer 40

E

Question 41

Which of the follwing are effects of sodium channel blockers? (select all) A. Local anesthetics B. Increase QT interval C. Increase threshold D. WIden QRS E. Decrease conduction velocity

Answer 41

A, C, D, E Remember: When you WIDEN the QRS you decrease the conduction velocity of muscle tissue such as the ventricles.