Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Review Question - QID 100635

In scope icon M 1 E
QID 100635 (Type "100635" in App Search)
A 48-year-old female comes into the ER with chest pain. An electrocardiogram (EKG) shows a heart beat of this individual in Image A. The QR segment best correlates with what part of the action potential of the ventricular myocyte shown in Image B?
  • A
  • B

Phase 0, which is primarily characterized by sodium influx

83%

275/331

Phase 0, which is primarily characterized by potassium efflux

1%

3/331

Phase 1, which is primarily characterized by potassium and chloride efflux

4%

12/331

Phase 1, which is primarily characterized by calcium efflux

6%

20/331

Phase 3, which is primarily characterized by potassium efflux

5%

15/331

  • A
  • B

Select Answer to see Preferred Response

bookmode logo Review TC In New Tab

The QR segment corresponds to ventricular depolarization, which is Phase 0 of the myocyte action potential and is characterized by sodium influx.

The QR segment of an EKG tracing represents synchronized ventricular depolarization and contraction. This coordinated action of ventricular myocytes is caused by the opening of the fast Na+ channels that allow influx of Na+ ions into the cell in Phase 0 of the action potential, leading to rapid depolarization. This portion of the action potential is affected by Class I antiarrhythmics, such as propafenone and flecainide.

Siddoway discusses the use of amiodarone, a potent class III antiarrhythmic that prolongs the QT interval, slows heart rate and AV node conduction (via Ca++ channel and beta blockade), increases refractoriness (K+ and Na+ channel blockade), and slows intracardiac conduction (via Na+ blockade).

Roy et al. performed a randomized controlled trial comparing amiodarone to propafenone (a class I drug) and sotalol (a class III drug) in maintaining sinus rhythm in patients with atrial fibrillation. They found that 35% of patients on amiodarone had recurrence of atrial fibrillation, while 63% on sotalol or propafenone had recurrence of their atrial fibrillation.

Image A shows a labeled beat with a P wave, QRS complex, and T wave.
Image B shows a cardiac action potential with the phases labelled.

Illustration A demonstrates the movement of ions through the ventricular action potential.
Illustration B demonstrates the appearance of the action potential in different parts of the heart, and the correlation with the QRS complex.

Incorrect Answers:
Answer 2: Phase 0 is primarily driven by Na+ influx through the fast Na+ channels.
Answer 3-4: Phase 1 follows the closure of the fast Na+ channels, and the downward deflection is driven by a net outward current driven by potassium efflux from the cell.
Answer 5: Phase 3 is the repolarization phase that is driven by potassium efflux, and corresponds to the T wave on a typical EKG tracing.

ILLUSTRATIONS:
REFERENCES (2)
Authors
Rating
Please Rate Question Quality

4.8

  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon

(6)

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options