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Old 07-04-2011
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Heart Cardiology- MCQ

A 69-year-old woman with a history of severe coronary artery disease and a permanent pacemaker for tachybrady syndrome is admitted for dyspnea secondary to congestive heart failure. Her medications include digoxin, amiodarone, metoprolol, and furosemide. While in the telemetry unit, she develops torsades de pointes. She is initially treated with magnesium, atropine, and potassium. Her resting heart rate now is in the 40s. However, she continues having intermittent runs of torsade. The QT interval is 610 milliseconds. What is the next step in treating this dysrhythmia?

(A) Increase the atrial rate of the pacemaker
(B) Isoproterenol
(C) Procainamide
(D) Change oral amiodarone to intravenous
(E) Defibrillation at 200 Joules (J)
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Old 01-26-2012
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i thnk ans is B,
Isoproterenol can be used in bradycardia-dependent torsade that usually is associated with acquired long QT syndrome (pause-dependent). It should be administered as a continuous IV infusion to keep the heart rate above 90 bpm.
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Old 01-29-2012
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(B) Isoproterenol
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Old 07-08-2012
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Correct Answer

Originally Posted by bebix View Post
(B) Isoproterenol
Yes, B is correct,

Hemodynamically stable bradycardias that are resistant to atropine.
Heart blocks with palpable pulse
Management of torsades de pointes

Ventricular tachycardia
Ventricular fibrillation
Pulseless idioventricular rhythm
Ischemic heart disease
Cardiac arrest
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Cardiology-, Step-3-Questions

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