A 72-year-old man presents with lethargy and palpitation for the past five days. On examination, his pulse is 123/min and irregularly irregular, blood pressure is 118/70 mmHg and his chest is clear. An ECG confirms atrial fibrillation. Which of the following is the most appropriate drug to control his heart rate?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Bisoprolol
He has stable AF with a fast ventricular rate, normal BP and no heart failure, so rate control with a beta blocker (e.g. bisoprolol) is first line. Digoxin is second line (preferred mainly in acute decompensated HF or sedentary patients). Amiodarone is third line, and flecainide is a rhythm-control drug, not a rate-control agent.
ليش كل خيار صح أو غلط
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A
ليش غلط
Amiodarone is only third line for rate control, for patients in whom all other options have failed.
✓ CARDIOLOGY - ARRHYTHMIA.pdf · p. 8 -
B
ليش صح
Beta blockers (e.g. metoprolol, atenolol, propranolol) are first-line rate control in AF, avoided in COPD and acute decompensated HF; bisoprolol is a beta blocker.
✓ CARDIOLOGY - ARRHYTHMIA.pdf · p. 8 -
C
ليش غلط
Digoxin is second line for rate control; it is the preferred initial therapy mainly in acute decompensated heart failure, which he does not have.
✓ CARDIOLOGY - ARRHYTHMIA.pdf · p. 8 -
D
ليش غلط
Flecainide is a rhythm-control drug (pharmacological cardioversion), not a rate-control drug.
✓ CARDIOLOGY - ARRHYTHMIA.pdf · p. 8
- المصدر
- CARDIOLOGY - ARRHYTHMIA.pdf · p. 8
3• Atrial Fibrillation [Notes].pdf · p. 7 - المحاضرة
- Arrhythmia · Cardiology · Module B
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- Cardio bank