1. 10-month-old infant suffers from febrile illness for 3 days.

He presents at ED with tachypnea, pallor, poor

feeding, and lethargy. The heart rate is about 220 per minute. ECG reveals a narrow complex tachycardia.
Which origin of ECG changes should be included in the differential diagnosis?
A. AVRT, AVNRT
B. Sinus tachycardia
C. Junctional ectopic tachycardia,
D. Atrial ectopic tachycardia
E. All mentioned
2. What is the most common origin for symptomatic SVT in children among mentioned below?
A. AVRT, AVNRT
B. Sinus tachycardia
C. Junctional ectopic tachycardia,
D. Atrial ectopic tachycardia
E. Atrial fibrillation and atrial flutter
3. The infant patient is felt to be in supraventricular tachycardia and mild congestive heart failure. What is
the appropriate first management approach in this case?
A. To give a bolus dose of lidocaine
B. To give a rapid IV bolus dose of adenosine
C. To start digitalization
D. To give amiodarone
E. To give verapamil

4. Upon conversion from SVT to a sinus rhythm, the child’s ECG revealed the upsloping of the initial
portion of the QRS complex. Which additional sign is typical for this ECG?
A. Prolonged PR interval
B. Short PR interval
C. Prolonged QT
D. Biphasic T wave
E. P superimposed on T wave

5. This 12 years old female with a history of WPW syndrome became symptomatic. The ECG reveals an
atrial fibrillation. Which medicine is of choice for the treatment in this child among the following?
A. Digoxin
B. Lidocaine
C. Propranolol
D. Procainamide
E. Verapamil

6. This is 10 years old child with the shortness of breath. His ECG revealed wide complex tachycardia.
Choose an appropriate statement about a wide complex tachycardia.
A. It is always ventricular tachycardia
B. It may be treated easily by vagal maneuvers
C. It may be in patients with SVT and a bundle branch block or antidromic WPW
D. It occurs because of complete AV block
E. Use verapamil with any wide complex tachycardia in the emergency setting
7. This toddler patient has sensorineural hearing loss. Her ECG reveals QTc duration 0,46 sec. What
diagnosis is appropriate?
A. Romano-Ward syndrome
B. Jervell and Lange-Nielsen syndrome
C. Lown-Ganong-Levine syndrome (LGL)
D. Clerc-Levy-Critesco syndrome (CLC)
E. Brugada syndrome

8. The child is diagnosed with the LQTS. Which medicine is of choice for long QT syndrome among
mentioned below?
A. Digoxin
B. Lidocaine
C. Propranolol
D. Verapamil
E. Procainamide

9. The adolescent girl suffers from anorexia nervosa. What disorder on ECG is most typical for this
condition?
A. Sinus tachycardia
B. Sinus bradycardia
C. Acquired long QT
D. AV block of 1 degree
E. Complete AV block

10. The bradycardia is diagnosed in newborn infant. ECG reveals the complete heart block. Which maternal
pathology during pregnancy is associated with a such condition in infants?
A. Lyme disease
B. Acute rheumatic fever
C. Systemic lupus erythematous
D. CHD
E. T1DM

11. The adolescent male with permanent arrhythmia has passed through the ECG, heart Echo and
Dopplerography, Holter investigation, viral immune serology, dentist and otolaryngologist observation and
endocrine investigation. What else may be helpful in design of investigation to find the cause of arrhythmia?
A. Electroencephalography, Dopplerography of head and neck and vertebral X-Ray
B. EFGDS
C. Psychologist concealing
D. Lipid profile of blood serum
E. Serum electrolyte level

12. The child is admitted to the hospital with the diagnosis of community acquired pneumonia. His history is
markable with allergy to cephalosporins, GERD and congenital LQTS. Which medicine administration can
trigger the episode of VT in this child?
A. Protected aminopenicillin
B. Expectorants
C. PPI
D. Prokinetics
E. Antihistamine

13. The adolescent girl was brought to the ED due to the episode of syncope which was occurred during
physical exercise. Her HR is normal in rest and ECG does not reveal any abnormality. Heart Echo and
Dopplerography, CBC and heart biochemistry indexes are also normal. But the irregular ventricular
arrhythmia has been occurred during ECG exercising stress test. What is the diagnosis?
A. Dysmetabolic cardiomyopathy
B. Brugada syndrome
C. Jervell and Lange-Nielsen syndrome
D. Catecholaminergic polymorphic ventricular tachycardia
E. Vagotonic type of autonomic miss regulation

14. A 13-year-old girl complains of periodic prickly pain in the heart region. Percussion revealed no changes
of cardiac borders. Auscultation revealed loud heart sounds and arrhythmia. Extrasystoles are heard after 20-
25 beats. The ECG revealed sinus rhythm, repolarization disorders, single supraventricular extrasystoles at
rest. What is the most likely cause of the arrhythmia in this patient?
A. Autonomic vascular dysfunction
B. Rheumatic fever
C. Nonrheumatic carditis
D. Cardiomyopathy
E. Intoxication syndrome

15. An 8-year-old girl periodically has sudden short-term heart pains, sensation of chest compression,
epigastric pain, dizziness, vomiting. Objectively: the patient is pale, respiratory rate - 40/min., jugular pulse
is present. Ps- 185/min., of poor volume. BP- 75/40 mm Hg. ECG taken during an attack shows ectopic P
waves, QRS wave is not deformed. At the end of an attack a compensatory pause is observed. The most
likely cause of the attack is:
A. Sinus tachycardia
B. Paroxysmal atrial tachycardia
C. Paroxysmal ventricular tachycardia
D. Complete AV-block
E. Atrial fibrillation

16. An 8-year-old girl was diagnosed with signs of Morgagni-Adams-Stokes disease that developed against
the background of the III-degree atrioventricular heart block. What drug should be introduced intravenously
for emergency aid?
A. Dobutamine
B. Prednisolone
C. Atropine
D. Digoxin
E. Potassium chloride

17. A 14-year-old boy with a history of chronic tonsillitis and sinusitis has developed a feeling of heart
irregularities and additional pulse. HR- 83/min. ECG results: regular impulses with no visible P wave that
occur every two sinus contractions, QRS complex is dramatically deformed and prolonged to over 0,11 s, T
wave is discordant followed by a complete compensatory pause. Specify the arrhythmia type:
A. Trigeminal extrasystole
B. Bigeminal extrasystole
C. Partial AV-blockade
D. Complete AV-block
E. Left bundle branch block

18. A 5-year-old child had an attack of palpitation with nausea, dizziness, generalized fatigue. On ECG:
tachycardia with the rate of 220/min. Ventricle complexes are deformed and widened. P wave is absent.
What medications should be prescribed for first aid?
A. Strophantin
B. Isoptin
C. Seduxen
D. Novocainamides
E. Lidocaine

19. The adolescent boy passed through the episode of tachycardia and describes it to the doctor. Which
anamnestic data allows to do the conclusion about paroxysmal tachycardia?
A. Pulse rate above 150 per min
B. Sudden onset of the episode
C. The duration of the episode more than 10 min
D. Dizziness
E. Effectiveness of Valsalva’s maneuver

20. A 9-year-old child recovers from carditis. The child no longer has any health complaints. However, the
ECG detects AV block of the second degree, Mobitz I. Determine the ECG characteristics of this disorder
A. The normal duration of the P-R interval and P wave is dropped occasionally
B. Prolonged PR interval
C. Progressive prolongation of the P-R interval that culminates in a non-conducted P wave
D. Progressive prolongation of the P-R interval that culminates in a non-conducted QRS complex
E. The normal duration of the P-R interval and QRS is dropped occasionally

21. The adolescent girl who suffers from SLE is present at your office with main complaint of fatigue and
dyspnea at physical activity. Examination detects bradyarrhythmia. The ECG reveals Mobitz type II block.
Determine the ECG characteristics of this disorder
A. Progressive prolongation of the P-R interval that culminates in a non-conducted P wave
B. Progressive prolongation of the P-R interval that culminates in a non-conducted QRS complex
C. The normal duration of the P-R intervals and QRS is dropped occasionally
D. Dropped QRS complexes at regular intervals (2:1 or 3:1) after normal P wave
E. Total dissociation of P waves and QRS complexes on ECG

22. This is 16 years old boy who present in your office with the heart rate of 164 beats per minute. You
decided to use the Valsalva maneuver, and it was successful. The heart rate dropped to 78 in 1 minute. What
arrhythmia occurred in the adolescent?
A. Paroxysmal supraventricular tachycardia
B. Paroxysmal ventricular tachycardia
C. Episode of sinus tachycardia
D. Paroxysmal atrial fibrillation
E. Paroxysmal atrial flutter

23. The adolescent suffers from AV block of II degree and presents with bradycardia and dyspnea. Which of
the following medications is appropriate in this case?
A. Lidocaine
B. Isoproterenol
C. Digoxin
D. Propranolol
E. Ajmaline

24. A 3-year-old child was diagnosed with WPW syndrome. What arrhythmia is most expected in this
patient?
A. Sinus tachycardia
B. Sinus bradycardia
C. Paroxysmal tachycardia
D. AV block
E. Adams-Stokes syndrome