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  • Question 1 - The positive inotropic effect of digoxin is due to? ...

    Incorrect

    • The positive inotropic effect of digoxin is due to?

      Your Answer: Inhibition of breakdown of cAMP

      Correct Answer: Inhibition of the sodium potassium ATPase in the myocardium

      Explanation:

      Digitalis compounds are potent inhibitors of cellular Na+/K+-ATPase. This ion transport system moves sodium ions out of the cell and brings potassium ions into the cell. By inhibiting the Na+/K+-ATPase, cardiac glycosides cause the intracellular sodium concentration to increase. This then leads to an accumulation of intracellular calcium via the Na+/Ca++ exchange system. In the heart, increased intracellular calcium causes more calcium to be released by the sarcoplasmic reticulum, thereby making more calcium available to bind to troponin-C, which increases contractility (inotropy).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17.3
      Seconds

  • Question 2 - Concerning surface anatomy, where is the aortic valve found? ...

    Incorrect

    • Concerning surface anatomy, where is the aortic valve found?

      Your Answer: Situated in the right second intercostal space underneath the sternum

      Correct Answer: Situated in the left third intercostal space underneath the sternum

      Explanation:

      The aortic valve is situated in the left 3rd intercostal space just beneath the sternum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      21.8
      Seconds

  • Question 3 - In cardiac muscle, which of the following is directly responsible for the release...

    Correct

    • In cardiac muscle, which of the following is directly responsible for the release of Ca2+ stored in the sarcoplasmic reticulum (calcium-induced calcium release)?

      Your Answer: Ryanodine receptor (RyR)

      Explanation:

      Ryanodine receptor (RyR) is a ligand-gated Ca2+ channel with Ca2+ as its natural ligand. In skeletal muscle, Ca2+ entry from ECF by this route is not required for Ca2+ release. Instead, the DHPR that serves as the voltage sensor unlocks release of Ca2+ from the nearby SR via physical interaction with the RyR. The release is amplified through ca-induced ca release. However, in cardiac muscle, it is the influx of extracellular Ca2+ through the voltage-sensitive DHPR in the T system that triggers ca-induced ca release trough the RyR at the SR.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      21.6
      Seconds

  • Question 4 - Which of the following intercellular connections is important in endothelial barrier function? ...

    Incorrect

    • Which of the following intercellular connections is important in endothelial barrier function?

      Your Answer: Desmosomes

      Correct Answer: Tight junctions

      Explanation:

      Tight junctions surround the apical margins of the epithelial cells such as in the intestinal mucosa and the choroid plexus. They are also important to the endothelial barrier function. They are made up of ridges that adhere to each other strongly at the cell junction, obliterating the space completely between the cells.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      19.4
      Seconds

  • Question 5 - Which of the following causes an increase in venous return? ...

    Correct

    • Which of the following causes an increase in venous return?

      Your Answer: An increase in the negative intra-thoracic pressure

      Explanation:

      During inspiration, intrathoracic pressure becomes more negative and intra-abdominal pressure more positive. This increases the venous pressure gradient from abdomen to thorax and promotes filling of the central veins.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      33.9
      Seconds

  • Question 6 - Which statement about the 2nd heart sound is true? ...

    Correct

    • Which statement about the 2nd heart sound is true?

      Your Answer: It is caused by closure of the aortic and pulmonary valves.

      Explanation:

      The second heart sound is produced due to closure of the aortic and pulmonary valves. It is a high pitched dub sound.

      Normally the aortic closure sound (A2) occurs prior to the pulmonic closure sound (P2), and the interval between the two (splitting) widens on inspiration and narrows on expiration. With quiet respiration, A2 will normally precede P2 by 0.02 to 0.08 second (mean, 0.03 to 0.04 sec) with inspiration. In younger subjects inspiratory splitting averages 0.04 to 0.05 second during quiet respiration. With expiration, A2 and P2 may be superimposed and are rarely split as much as 0.04 second. If the second sound is split by greater than 0.04 second on expiration, it is usually abnormal. Therefore, the presence of audible splitting during expiration (i.e., the ability to hear two distinct sounds during expiration) is of greater significance at the bedside in identifying underlying cardiac pathology than is the absolute inspiratory increase in the A2–P2 interval.

      The respiratory variation of the second heart sound can be categorized as follows: (1) normal (physiologic) splitting; (2) persistent (audible expiratory) splitting, with normal respiratory variation; (3) persistent splitting without respiratory variation (fixed splitting); and (4) reversed (paradoxical) splitting.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      30.9
      Seconds

  • Question 7 - With regard to the endothelial structure, the epithelium constitute: ...

    Correct

    • With regard to the endothelial structure, the epithelium constitute:

      Your Answer: Simple squamous

      Explanation:

      The single layer of squamous epithelium lining the heart and blood vessels is known as the endothelium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      22.6
      Seconds

  • Question 8 - The a-wave is created by: ...

    Incorrect

    • The a-wave is created by:

      Your Answer: Bulging of the tricuspid valve into the atria during isovolumetric ventricular contraction

      Correct Answer: Regurgitation of some blood to the great veins when the atria contracts in atrial systole

      Explanation:

      The a-wave created on the venous pulse curve occurs as a result of atrial systole. Due to the pressure build-up in the atria, it causes a back pressure in the vena cava. This pressure is exerted on the valve and this back pressure is what causes a slight increase in the venous pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      44
      Seconds

  • Question 9 - Myocardial oxygen consumption is increased by: ...

    Incorrect

    • Myocardial oxygen consumption is increased by:

      Your Answer: B[ an increase in preload

      Correct Answer: An increase in after load

      Explanation:

      Cardiac oxygen consumption is directly related to the amount of tension that develops in the ventricles. It is increased by an increased size of heart, increased afterload, increased contractility and increased heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      31.6
      Seconds

  • Question 10 - The right border of the heart corresponds to which line on the surface...

    Incorrect

    • The right border of the heart corresponds to which line on the surface of the chest?

      Your Answer: Line drawn from the 4th right costal cartilage to the 5th left intercostal space

      Correct Answer: Line drawn from the 3rd right costal cartilage to the 6th right costal cartilage

      Explanation:

      The right border corresponds to a line drawn from the 3rd right costal cartilage to the 6th right costal cartilage; this border is slightly convex to the right.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      38.5
      Seconds

  • Question 11 - Catecholamines… ...

    Correct

    • Catecholamines…

      Your Answer: Activate adenylyl cyclase

      Explanation:

      Norepinephrine and epinephrine activate or deactivate adenylyl cyclase resulting in a decrease or an increase in the production of cAMP.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.1
      Seconds

  • Question 12 - When is the blood pressure at its lowest during pregnancy? ...

    Incorrect

    • When is the blood pressure at its lowest during pregnancy?

      Your Answer: Third trimester

      Correct Answer: Second trimester

      Explanation:

      It is lowest during the second trimester.

      Previous studies have reported changes in blood pressure (BP) throughout pregnancy, and it was generally accepted that in clinically healthy pregnant women, BP falls gradually at first trimester, reaching the lowest around 22–24 weeks, rising again from 28 weeks, and reaching preconception levels by 36 weeks of gestation

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12
      Seconds

  • Question 13 - What type of intercellular connection found between cardiac muscle fibers allow for the...

    Correct

    • What type of intercellular connection found between cardiac muscle fibers allow for the spread of excitation from one cell to another?

      Your Answer: Gap junctions

      Explanation:

      The cardiac muscles have gap junctions in-between the cells. They form low resistance passages, which allow ions to diffuse through every muscle fiber rapidly and result in the cardiac muscles functioning as a syncytium, without any protoplasmic bridges involved.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      18.7
      Seconds

  • Question 14 - In the cardiac cycle, all of the following are true except: ...

    Correct

    • In the cardiac cycle, all of the following are true except:

      Your Answer: Mitral valve is closed by contraction of papillary muscles

      Explanation:

      Mitral valve is closed by contraction of papillary muscles: This statement is incorrect. The mitral valve closes due to the pressure difference between the left ventricle and the left atrium at the onset of ventricular systole. The papillary muscles contract to prevent prolapse of the valve into the atrium but do not cause the valve to close.

      The left ventricular volume is maximal at the end of atrial systole: This statement is true. At the end of atrial systole, the atria have pushed the remaining blood into the ventricles, making the ventricular volume maximal (end-diastolic volume).

      The left ventricular pressure is maximal just before the aortic valve opens: This statement is true. Left ventricular pressure peaks just before the aortic valve opens, as the ventricle contracts to overcome the pressure in the aorta.

      The ejection fraction is about 55%: This statement is true. The ejection fraction, which is the percentage of blood ejected from the ventricles with each contraction, is typically around 55%.

      The ‘a’ wave is due to atrial systole: This statement is true. The ‘a’ wave on the venous pressure curve corresponds to atrial systole, reflecting the increased pressure from atrial contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      49.9
      Seconds

  • Question 15 - Concerning surface anatomy, where is the mitral valve found? ...

    Incorrect

    • Concerning surface anatomy, where is the mitral valve found?

      Your Answer: Situated in the 4th intercostal space to the right of the sternum

      Correct Answer: Situated in the 4th intercostal space to the left of the sternum

      Explanation:

      The mitral valve is situated in the left 4th intercostal space just beneath the sternum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      33
      Seconds

  • Question 16 - Regarding the length of systole and diastole which of the following is true?...

    Correct

    • Regarding the length of systole and diastole which of the following is true?

      Your Answer: The duration of systole is more fixed than diastole

      Explanation:

      The duration of systole is more fixed than the duration of diastole. When the heart rate increases the timing of systole remains more or less the same however, diastole decreases.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.8
      Seconds

  • Question 17 - Which of the following isoforms of Nitric oxide synthase (NOS) is found in...

    Incorrect

    • Which of the following isoforms of Nitric oxide synthase (NOS) is found in endothelial cells?

      Your Answer: Nos 2

      Correct Answer: Nos 3

      Explanation:

      There are only 3 isoforms:NOS 1: found in nervous systemNOS 2: in macrophages and other immune cellsNOS 3: In endothelial cells

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.3
      Seconds

  • Question 18 - In ventricular fibrillation (VF), the first defibrillation attempt (with a biphasic defibrillator) should...

    Correct

    • In ventricular fibrillation (VF), the first defibrillation attempt (with a biphasic defibrillator) should be made at:

      Your Answer: 200 J

      Explanation:

      Defibrillation is a common treatment for life-threatening cardiac dysrhythmias and ventricular fibrillation. If the patient is in Ventricular tachycardia (VT) or ventricular fibrillation (VF) on the monitor, immediately apply the pads and shock the patient with 120-200 Joules on a biphasic defibrillator or 360 Joules on a monophasic defibrillator.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.1
      Seconds

  • Question 19 - Which of the following factors serve to decrease cardiac output? ...

    Correct

    • Which of the following factors serve to decrease cardiac output?

      Your Answer: Standing from a lying position

      Explanation:

      Sleep has no effect on the cardiac output. Anxiety, excitement, increased body temperature and pregnancy will increase the cardiac output. Standing from a lying position will decrease the cardiac output transiently.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      20.1
      Seconds

  • Question 20 - Regarding the myofilament molecules, which of the following contains binding sites for calcium...

    Incorrect

    • Regarding the myofilament molecules, which of the following contains binding sites for calcium that helps to initiate contraction?

      Your Answer: Actinin

      Correct Answer: Troponin c

      Explanation:

      Troponin T binds the troponin components to tropomyosin. Troponin I inhibits the interaction of myosin with actin and troponin C contains the binding sites for the Ca2+ that helps initiate contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      15.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (10/20) 50%
Medicine (10/20) 50%
Passmed
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