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  • Question 1 - How does pregnancy affect the cardiac output of a patient? ...

    Incorrect

    • How does pregnancy affect the cardiac output of a patient?

      Your Answer: Decreased cardiac output due to decrease in stroke volume

      Correct Answer: Increased cardiac output due to increase in heart rate and stroke volume

      Explanation:

      Cardiac Output increases to a similar degree as the blood volume. During the first trimester cardiac output is 30-40% higher than in the non-pregnant state. Steady rises are shown on Doppler echocardiography, from an average of 6.7 litres/minute at 8-11 weeks to about 8.7 litres/minute flow at 36-39 weeks; they are due, primarily, to an increase in stroke volume (35%) and, to a lesser extent, to a more rapid heart rate (15%). There is a steady reduction in systemic vascular resistance (SVR) which contributes towards the hyperdynamic circulation observed in pregnancy

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.7
      Seconds

  • Question 2 - A 55 year old cardiac patient is comfortable at rest but heavy housework...

    Incorrect

    • A 55 year old cardiac patient is comfortable at rest but heavy housework results in fatigue, palpitations or dyspnoea. What New York Heart Association class best describes the severity of their disease?

      Your Answer: NYHA Class III

      Correct Answer: NYHA Class II

      Explanation:

      New York Heart Association functional classification:

      Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities.

      Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.

      Class III: marked limitation of any activity; the patient is comfortable only at rest.

      Class IV: any physical activity brings on discomfort and symptoms occur at rest.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.2
      Seconds

  • Question 3 - Which statement about the 2nd heart sound is true? ...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 4 - Afferent fibers from the baroreceptors of the great arteries form branches of which...

    Incorrect

    • Afferent fibers from the baroreceptors of the great arteries form branches of which cranial nerves?

      Your Answer:

      Correct Answer: Glossopharyngeal and vagus nerves

      Explanation:

      The receptors of the carotid sinus are innervated by the carotid sinus nerve, a branch of the glossopharyngeal nerve. The aortic arch receptors located in the arch of the aorta are innervated by the aortic depressor nerve, a branch of the vagus nerve.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 5 - Which of the following occurs during a Valsalva manoeuvre? ...

    Incorrect

    • Which of the following occurs during a Valsalva manoeuvre?

      Your Answer:

      Correct Answer: An initial rise in blood pressure

      Explanation:

      The Valsalva maneuver involves forced expiration against a closed glottis. It has several phases, each affecting the cardiovascular system differently:

      1. Phase I: During the initial forced expiration against the closed glottis, there is a transient rise in intrathoracic pressure, which compresses the thoracic aorta and causes a brief increase in blood pressure.
      2. Phase II: Continued straining leads to decreased venous return to the heart, reducing cardiac output and causing a drop in blood pressure. This phase is characterized by a compensatory increase in heart rate.
      3. Phase III: Upon releasing the strain, there is a sudden drop in intrathoracic pressure, which momentarily decreases blood pressure.
      4. Phase IV: Blood pressure then rises rapidly as venous return to the heart is restored, leading to increased cardiac output. This is often followed by a reflex bradycardia (slow heart rate).

      Given these phases, the most accurate statement about what occurs during the Valsalva maneuver is the initial rise in blood pressure (Phase I).

      Other options explained:

      • Forced inspiration against a closed glottis: Incorrect. The Valsalva maneuver involves forced expiration, not inspiration, against a closed glottis.
      • Low intrathoracic pressures throughout: Incorrect. The Valsalva maneuver involves high intrathoracic pressures due to forced expiration.
      • Disruption of autonomic function: Incorrect. The Valsalva maneuver affects autonomic function but does not disrupt it. Instead, it triggers autonomic responses to changes in blood pressure and heart rate.
      • No change: Incorrect. The Valsalva maneuver causes significant changes in blood pressure and heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 6 - Which of the following concerning PR interval is INCORRECT? ...

    Incorrect

    • Which of the following concerning PR interval is INCORRECT?

      Your Answer:

      Correct Answer: Always measured from the beginning of p wave to the beginning of r wave

      Explanation:

      The PR interval measures the time from the start of atrial depolarization to the start of ventricular depolarization. The PR interval is only measured from the beginning of P wave to beginning of R wave if the Q wave is absent.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 7 - The effects of β1 stimulation include the following ...

    Incorrect

    • The effects of β1 stimulation include the following

      Your Answer:

      Correct Answer: Increased strength of contraction

      Explanation:

      β1 stimulation include the phosphorylation of L type Ca++ channels and phospholamban and increased Ca++ influx from myocytes.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 8 - The initial rapid depolarization in the action potential of cardiac muscle cells is...

    Incorrect

    • The initial rapid depolarization in the action potential of cardiac muscle cells is due to:

      Your Answer:

      Correct Answer: Opening of voltage-gated Na+ channels

      Explanation:

      The initial depolarization of the action potential in a cardiac muscle cell is due to the sodium current generated by opening of the voltage gated sodium channels leading to an influx of sodium ions into the cell and raising the membrane potential towards threshold.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 9 - Catecholamines… ...

    Incorrect

    • Catecholamines…

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 10 - Pacemaker cells in the SA node and the AV node are connected by?...

    Incorrect

    • Pacemaker cells in the SA node and the AV node are connected by?

      Your Answer:

      Correct Answer: Gap junctions

      Explanation:

      Gap junctions allows for rapid propagation of the action potential from one cell to the other. The cells of the heart are connected by gap junctions.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 11 - In the blood supply of the heart, ‘dominance’ refers to the coronary artery...

    Incorrect

    • In the blood supply of the heart, ‘dominance’ refers to the coronary artery which supplies the?

      Your Answer:

      Correct Answer: Posterior interventricular artery

      Explanation:

      Dominance of the coronary artery system is defined by the artery that gives rise to the posterior interventricular artery. Dominance of the right coronary artery is more common (68%). It gives rise to the large posterior interventricular branch which goes down to the apex of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 12 - Although variable, branches of which artery most often supply the SA and AV...

    Incorrect

    • Although variable, branches of which artery most often supply the SA and AV nodes?

      Your Answer:

      Correct Answer: Right coronary artery

      Explanation:

      The RCA (right coronary artery) supplies the SA and the AV nodes along with the postero-basal wall of the left ventricle, posterior one third of the inferior vena cava, right ventricle and the posteromedial papillary muscle in the left ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 13 - The process by which depolarization of the muscle fiber initiates contraction is called?...

    Incorrect

    • The process by which depolarization of the muscle fiber initiates contraction is called?

      Your Answer:

      Correct Answer: Action potential

      Explanation:

      This process is known as an action potential. Upon generation of an action potential when depolarization reaches threshold, it spreads throughout the muscle fiber, resulting in generation of an excitation-contraction coupling leading to contraction of the muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 14 - The AV Node: ...

    Incorrect

    • The AV Node:

      Your Answer:

      Correct Answer: It decelerates impulses passing to the ventricles

      Explanation:

      The action potentials in the sinoatrial (SA) and atrioventricular (AV) nodes are largely due to Ca2+, with no contribution by Na+ influx. The depolarization continues to conduct slowly through the atrioventricular (AV) node. The AV node is located in the right posterior portion of the interatrial septum. This is small and bean-shaped. The atrial conductive system is organized so that the cardiac impulse does not travel from the atria into the ventricles too rapidly; this delay allows the atria to empty before ventricular contraction begins. It is the AV node and its adjacent conductive fibers that delay this transmission into the ventricles. Conduction through the AV Node is represented on the ECG by the PR interval.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 15 - Direct conduction from the atrium to the ventricles is prevented by: ...

    Incorrect

    • Direct conduction from the atrium to the ventricles is prevented by:

      Your Answer:

      Correct Answer: Annulus fibrosus

      Explanation:

      The annulus fibrosus disconnects the syncytium complex. The atria are rapidly activated however the activation peters out when the insulating layer-the annulus fibrosus-is reached.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 16 - The approximate incidence of deep venous thrombosis (DVT) in the general population each...

    Incorrect

    • The approximate incidence of deep venous thrombosis (DVT) in the general population each year is:

      Your Answer:

      Correct Answer: 1 per 1000

      Explanation:

      About 1 in 1000 adults per year has DVT, but as of 2011, available data is dominated by North American and European populations. DVT is rare in children, with an incidence of about 1 in 100,000 a year. From childhood to old age, incidence increases by a factor of about 1000, with almost 1% of the elderly experiencing DVTs yearly.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 17 - Which of the following does not lower ventricular rate in atrial fibrillation? ...

    Incorrect

    • Which of the following does not lower ventricular rate in atrial fibrillation?

      Your Answer:

      Correct Answer: Adrenaline

      Explanation:

      Adrenaline is a sympathetic neurotransmitter which increases the heart rate. During atrial fibrillation the atria is contracting at more than 200 beats/min. Acetylcholine is a parasympathetic neurotransmitter decreasing the heart rate. Digital also depresses the conduction at the AV conduction. Vagal discharge and occulocardiac reflux decrease the heart rate and convert the tachycardia into normal sinus rhythm.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 18 - The following is true in relation to coronary venous drainage? ...

    Incorrect

    • The following is true in relation to coronary venous drainage?

      Your Answer:

      Correct Answer: Most venous return ultimately drains into right atrium via the coronary sinus

      Explanation:

      Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins. Apart from these there are other vessels that drain directly into the heart chambers

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 19 - The internodal tract of Bachman: ...

    Incorrect

    • The internodal tract of Bachman:

      Your Answer:

      Correct Answer: Connects the SA node to the AV node

      Explanation:

      Internodal tract of Bachman connects the SA node to the AV node conducting the electrical impulses generated from the SA node to the AV node and from the AV node to the rest of the electrical complex of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 20 - The posterior aspect of the interventricular septum is supplied by: ...

    Incorrect

    • The posterior aspect of the interventricular septum is supplied by:

      Your Answer:

      Correct Answer: A branch of the right coronary artery

      Explanation:

      The posterior aspect of the heart is supplied by the posterior interventricular artery which is a branch of the right coronary artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 21 - Which of the following does not contribute to increased stroke volume during exercise?...

    Incorrect

    • Which of the following does not contribute to increased stroke volume during exercise?

      Your Answer:

      Correct Answer: Increased length of filling time during diastole

      Explanation:

      Prolonged aerobic exercise training may also increase stroke volume, which frequently results in a lower (resting) heart rate. Reduced heart rate prolongs ventricular diastole (filling), increasing end-diastolic volume, and ultimately allowing more blood to be ejected.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 22 - The a-wave is created by: ...

    Incorrect

    • The a-wave is created by:

      Your Answer:

      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
      0
      Seconds

  • Question 23 - The coronary sinus drains into the: ...

    Incorrect

    • The coronary sinus drains into the:

      Your Answer:

      Correct Answer: Right atrium

      Explanation:

      The coronary sinus drains into the right atrium. Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins. Apart from these there are other vessels that drain directly into the heart chambers.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 24 - The amount of a substance taken up by an organ (or whole body)...

    Incorrect

    • The amount of a substance taken up by an organ (or whole body) per unit time is = (the arterial level - the venous level) * the blood flow. This statement describes?

      Your Answer:

      Correct Answer: The Fick principle

      Explanation:

      The essence of the Fick principle is that blood flow to an organ can be calculated using a marker substance if the following information is known:- Amount of marker substance taken up by the organ per unit time- Concentration of marker substance in arterial blood supplying the organ- Concentration of marker substance in venous blood leaving the organ

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 25 - Which of the following normally has a slow depolarizing “prepotential”? ...

    Incorrect

    • Which of the following normally has a slow depolarizing “prepotential”?

      Your Answer:

      Correct Answer: Sinoatrial node

      Explanation:

      There are 2 main types of action potentials (AP) in the heart, the slow response and the fast response:The slow response is initiated by the slow calcium-sodium channels, found in the SA node (which is the natural pacemaker of the heart) and the conduction fibers of the AV node.The fast response occurs in the atrial and ventricles muscle cells and the purkinje fibers.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 26 - Which of the following conditions does not influence the cardiac output? ...

    Incorrect

    • Which of the following conditions does not influence the cardiac output?

      Your Answer:

      Correct Answer: Sleep

      Explanation:

      Sleep has no effect on the cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 27 - The Sinoatrial node in the majority of people is supplied by the? ...

    Incorrect

    • The Sinoatrial node in the majority of people is supplied by the?

      Your Answer:

      Correct Answer: Right coronary artery

      Explanation:

      In 60% of people, the SA node is supplied by the right coronary artery branch and in 40% of the people by the left coronary artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 28 - 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:

      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
      0
      Seconds

  • Question 29 - Preload: ...

    Incorrect

    • Preload:

      Your Answer:

      Correct Answer: Is the degree to which the myocardium is stretched before is contracts

      Explanation:

      Preload is end diastolic volume. It is the degree to which the heart muscle fiber is stretched when it fills up completely just before the heart contracts.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 30 - Which of the following is the most common causative organism in infective endocarditis?...

    Incorrect

    • Which of the following is the most common causative organism in infective endocarditis?

      Your Answer:

      Correct Answer: Streptococcus viridans

      Explanation:

      Viridans Alpha-haemolytic streptococci, that are present in the mouth are the most frequently isolated microorganisms when the infection is acquired in a community setting. In contrast, Staphylococcus blood stream infections are frequently acquired in a health care setting where they can enter the blood stream through procedures that cause break in the integrity of skin like surgery, catheterisation or during access of long term indwelling catheters or secondary to intravenous injection of recreational drugs.Prosthetic valve endocarditis is commonly caused by Staphylococcus epidermidis as it is capable of growing as a biofilm on plastic surfaces

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

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Medicine (0/2) 0%
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