NATIONAL POLICE OF ECUADOR

HOSPITAL QUITO No. 1

HOSPITAL OF THE DAY

ATRIAL FIBRILLATION

1.-Pulmonary vein ablation in atrial fibrillation is more effective in

Select one:
to. Patients with an underlying congenital heart disease
b. Heart failure
c. Valvular patients
d, Young patients without structural heart disease

2.- In a routine examination, it is detected that Lola, 72, is in atrial fibrillation, with an adequate
ventricular rate despite not taking any treatment. The echocardiogram performed is completely normal,
except for a dilated left atrium. With which statement does she agree?
to. Arrhythmia must be old
b. If you do an electrical cardioversion, the arrhythmia is likely to recur again
c. In the absence of pathology in the left ventricle or mitral valve, atrial dilation is due to remodeling
secondary to arrhythmia
d, All statements are correct

3. Aspirin in AF
Select one:
to. Associated with clopidogrel, it can replace anticoagulants
b. It is the appropriate choice in valvular patients
c. It is as effective as blood thinners
d, It is less effective than anticoagulants, with a similar bleeding rate

4.- A diabetic patient with an aortic bioprosthesis and atrial fibrillation requires
A, Anticoagulant therapy with antivitamins K or direct-acting anticoagulants
b. Double antiplatelet therapy with aspirin and ticagrelor
c. Antiplatelet therapy with aspirin
d. Anticoagulant treatment with antivitamins K

5.-In what situation can we proceed to perform an electrical cardioversion without prior
anticoagulation?

to. In patients with previous episodes of AF

b. In diabetic patients
c. In kidney failure
d, When the arrhythmia has been less than 48 hours

6.-Which of the following is a contraindication for electrical cardioversion?

to. Previous treatment with anticoagulants
b. Elevated ventricular rate
c .Not fasting.
d. Diabetes

7.-The periodic control of anticoagulated patients with direct-acting anticoagulants is based on.
to. Prothrombin activity
b. It is not necessary to do a periodic check
c. Platelet count
d., Activated partial thromboplastin time

8.- The drawback of digoxin in AF is that

Select one:
to. Thromboembolic risk increases
b, May not be effective enough to control rate during exercise
c. May depress contractility in heart failure patients
d. Increase heart rate

9.- Patient, who is taking apixaban for a permanent AF, comes very worried about a nosebleed. You
think
to. A platelet concentrate must be administered
b. You have to go to heparin, which is better controlled
c. Apixaban should be stopped immediately and treatment with vitamin K started.
d, Local measures must be applied and, if that is not enough, suspend one or two doses of the
anticoagulant

10. If in an ECG we do not detect P waves, the QRS complexes are arrhythmic, but we do not see f waves
either, we will think that

Select one:
to. That's typical of permanent atrial palsy.
b. It can't be atrial fibrillation
c. It is a nodal rhythm with retrograde conduction to the atrium
d, May be atrial fibrillation of many years

11. If a patient with heart failure falls into atrial fibrillation

to. It does not affect the state of it, unless the ventricular rate exceeds 120 per minute
b. Usually goes unnoticed from a clinical point of view
c. AF is exceptionally rare in heart failure
d, It can trigger a worsening of the clinic

12. The most worrisome complication of atrial fibrillation is

Select one:
to. Kidney failure
b, Embolic stroke
c. Syncopal bradycardia
d. Myocardial infarction

13. In relation to atrial fibrillation in young people, which statement seems correct to you?
to. It is an infrequent arrhythmia in young people
b. Athletes are more at risk of suffering from it
c. If there are several young members with the arrhythmia in the same family, it may have a genetic
basis
d, All the above answers are correct

14. In which of the following valve diseases is atrial fibrillation particularly common?

Select one:
A, Mitral stenosis
b. Aortic regurgitation
c. Triuspid regurgitation
d. Aortic stenosis

15. A 72-year-old patient, diabetic and hypertensive, has had a paroxysmal AF attack and is being
treated with apixaban. You think

Select one:
to. You can suspend it if you are now in sinus rhythm
b. You should take it only during crises
c. You can stop it, but taking aspirin
d, You must maintain the treatment

16. Which of the following drugs is a poor option to lower the ventricular rate in a patient with atrial
fibrillation and heart failure?
Select one:
to. Esmolol
b, Verapamil
c. Bisoprolol
d. Digoxin

17. In a patient with heart failure with an ejection fraction of 26% and periodic attacks of atrial
fibrillation, what drug can be prescribed to prevent further relapses?

Select one:
A, Amiodarone
b. Flecainide
c. Propafenone
d. Lidocaine

18. Patient has infrequent attacks of AF, and his doctor has recommended that he carry some pills with
him and take them when he has one of the attacks. What pills can they be?

Select one:
to. Vaium
b. Digoxin
c. Amiodarone
d . Flecainide

19. Margarita, who is a carrier of a mechanical mitral prosthesis, is fed up with Sintrom (acenocoumarin)
and wants me to prescribe one of those new drugs that do not need monitoring. You tell him that

a. It would be better to give him low doses of the sintrom along with one of the new anticoagulants.
b .We do not yet have evidence that they work in that situation.
c. No problem, but it has to be the dabigatran
d. There is no problem, as long as she also takes aspirin

20. The remodeling produced by chronic atrial fibrillation includes

a. Calcification of the atrial wall

b .Ventricular hypertrophy
c. Progressive atrial dilation
d. Mitral and tricuspid regurgitation

FIRM_
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