ACLS: torsades de pointes: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · ACLS: torsades de pointes

Sample item

Pulseless polymorphic ventricular tachycardia of torsades type in a patient with long QT should be treated with defibrillation and which drug?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Magnesium sulphate 1 to 2 g intravenously

Magnesium stabilises the myocardium in torsades, and drugs that prolong the QT interval such as amiodarone, procainamide and sotalol worsen it. The causative drug should be stopped and electrolytes corrected.

Option by option

  • A. Procainamide

    Procainamide prolongs QT.

  • B. Magnesium sulphate 1 to 2 g intravenously (correct)

    Correct. Magnesium is the specific treatment.

  • C. Sotalol

    Sotalol prolongs QT.

  • D. Amiodarone

    Amiodarone prolongs QT.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Magnesium sulphate 1 to 2 g intravenously. Magnesium stabilises the myocardium in torsades, and drugs that prolong the QT interval such as amiodarone, procainamide and sotalol worsen it.

Why is "Procainamide" not the answer?

Procainamide prolongs QT.

Why is "Sotalol" not the answer?

Sotalol prolongs QT.

Why is "Amiodarone" not the answer?

Amiodarone prolongs QT.

What concept does this question test?

It tests ACLS: torsades de pointes in Anaesthesia. The causative drug should be stopped and electrolytes corrected.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study ACLS: torsades de pointes?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.