Cardiology: Mobitz type I block: practice question

A General Medicine 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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General Medicine · Cardiology: Mobitz type I block

Sample item

A 19-year-old athlete is asymptomatic at a routine check. His resting ECG shows progressive lengthening of the PR interval until one P wave is not conducted, after which the cycle repeats. The QRS is narrow. What is the most appropriate management?

AReassurance and observationBIsoprenaline infusion at homeCPermanent pacemaker insertionDTemporary transvenous pacing

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

The answer and the reasoning

A. Reassurance and observation

Progressive PR prolongation with a dropped beat and a narrow QRS indicates block within the AV node, often from high vagal tone in athletes. It is usually benign and needs no treatment when asymptomatic. Pacing is reserved for symptomatic block or block below the AV node.

Option by option

A. Reassurance and observation (correct)
Correct. Nodal block with a narrow QRS in an asymptomatic athlete is benign and needs only observation.
B. Isoprenaline infusion at home
Isoprenaline is a short-term emergency measure and has no place in an asymptomatic patient.
C. Permanent pacemaker insertion
A permanent pacemaker is indicated for infranodal or symptomatic block, not for an asymptomatic nodal pattern.
D. Temporary transvenous pacing
Temporary pacing is for unstable or symptomatic bradyarrhythmia, which he does not have.

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.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Reassurance and observation. Progressive PR prolongation with a dropped beat and a narrow QRS indicates block within the AV node, often from high vagal tone in athletes.

Why is "Isoprenaline infusion at home" not the answer?

Isoprenaline is a short-term emergency measure and has no place in an asymptomatic patient.

Why is "Permanent pacemaker insertion" not the answer?

A permanent pacemaker is indicated for infranodal or symptomatic block, not for an asymptomatic nodal pattern.

Why is "Temporary transvenous pacing" not the answer?

Temporary pacing is for unstable or symptomatic bradyarrhythmia, which he does not have.

What concept does this question test?

It tests Cardiology: Mobitz type I block in General Medicine. It is usually benign and needs no treatment when asymptomatic. Pacing is reserved for symptomatic block or block below the AV node.

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 Cardiology: Mobitz type I block?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.