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  • Question 1 - Which of the following is true with AV nodal delay? ...

    Incorrect

    • Which of the following is true with AV nodal delay?

      Your Answer: The delay is about 0.01s

      Correct Answer: Shortened by sympathetic stimulation

      Explanation:

      AV nodal delay Is about 0.1s before the action potential spreads to the ventricles. It is shortened by stimulation of the sympathetic nervous system and lengthened by stimulation of the parasympathetic system.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      15.7
      Seconds

  • Question 2 - Which of the following does not lower ventricular rate in atrial fibrillation? ...

    Correct

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

      Your 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
      11.2
      Seconds

  • Question 3 - Blood flow to the subendocardial portions of the left ventricular muscle occurs mainly...

    Correct

    • Blood flow to the subendocardial portions of the left ventricular muscle occurs mainly during:

      Your Answer: Diastole

      Explanation:

      The sub endocardium receives the least amount of blood from the coronary arteries. During systole the coronary arteries collapse as a result of the pressure from contraction that is exerted on them. During diastole the heart muscle relaxes and the pressure on the coronary vessels is relieved allowing blood to flow through them to the sub endocardium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      20.6
      Seconds

  • Question 4 - Which of the following is a method for measurement of cardiac output? ...

    Incorrect

    • Which of the following is a method for measurement of cardiac output?

      Your Answer: Starling method

      Correct Answer: Indicator dilution method

      Explanation:

      There are two methods of calculating the cardiac output in humans other than doppler with echocardiography: The direct Fick’s method and the indicator dilution method. In the indicator dilution technique, a known amount of a substance such as a dye or, more commonly, a radioactive isotope is injected into an arm vein and the concentration of the indicator in serial samples of arterial blood is determined. The output of the heart is equal to the amount of indicator injected divided by its average concentration in arterial blood after a single circulation through the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.1
      Seconds

  • Question 5 - Which is the commonest cardiovascular abnormality seen in an adult patient with Marfan’s...

    Incorrect

    • Which is the commonest cardiovascular abnormality seen in an adult patient with Marfan’s syndrome?

      Your Answer: Aortic dissection

      Correct Answer: Aortic aneurysm

      Explanation:

      Marfan syndrome (MFS) is a genetic disorder of connective tissue. The degree to which people are affected varies. People with Marfan’s tend to be tall, and thin, with long arms, legs, fingers and toes. They also typically have flexible joints and scoliosis. The most serious complications involve the heart and aorta with an increased risk of mitral valve prolapse and aortic aneurysm.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.3
      Seconds

  • Question 6 - What is the function of the BK channel on the vascular smooth muscle...

    Correct

    • What is the function of the BK channel on the vascular smooth muscle membrane?

      Your Answer: Massive K+ efflux, increasing membrane potential, and shutting off the voltage gated Ca2+ channel

      Explanation:

      BK channels, also known as large-conductance calcium-activated potassium channels, play a critical role in regulating vascular smooth muscle tone. When BK channels open, they allow a large efflux of potassium ions (K+) out of the cell. This efflux of K+ causes the membrane potential to become more negative (hyperpolarization), which in turn leads to the closure of voltage-gated calcium channels. The closure of these calcium channels reduces the influx of calcium ions (Ca2+) into the smooth muscle cells, resulting in decreased intracellular calcium levels and subsequent relaxation of the smooth muscle.

      Thus, BK channels promote smooth muscle relaxation by hyperpolarizing the membrane and reducing the activity of voltage-gated Ca2+ channels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      38.3
      Seconds

  • Question 7 - Where on the surface of the chest is the normal site of auscultation...

    Incorrect

    • Where on the surface of the chest is the normal site of auscultation for the mitral area?

      Your Answer: 6th intercostal space mid-clavicular line

      Correct Answer: 4th left intercostal space in the mid-clavicular line

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      24.4
      Seconds

  • Question 8 - According to Starling's law of the heart: ...

    Incorrect

    • According to Starling's law of the heart:

      Your Answer: Energy of contraction is proportional to the pressure in the left ventricle

      Correct Answer: The extent of the preload is proportional to the end-diastolic volume

      Explanation:

      Frank starlings law describes that an increase in the venous return or the end diastolic volume will cause an increase in the stroke volume/ preload and also cardiac output. It stems from the fact that increased venous return will increase the stretch on the ventricular muscle fibers. The sarcomere will stretch a considerable length that is needed for maximum contraction and the development of tension in the muscle fiber. The greater the venous return the greater the cardiac output. This relationship is directly proportional.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      25.3
      Seconds

  • Question 9 - All of the following are consistent with the indicator dilution method except--- ...

    Incorrect

    • All of the following are consistent with the indicator dilution method except---

      Your Answer: The indicator must have no haemodynamic effects

      Correct Answer: In thermodilution, the indicator used is warm saline

      Explanation:

      In thermodilution, the indicator used is cold saline.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      54.6
      Seconds

  • Question 10 - Why is the sub-endocardial portion of the left ventricle the most common site...

    Incorrect

    • Why is the sub-endocardial portion of the left ventricle the most common site for ischaemic damage and myocardial infarction?

      Your Answer: Ventricular pressure decreases often on this portion

      Correct Answer: No blood flow occurs during systole

      Explanation:

      The subendocardium receives the least amount of blood from the coronary arteries. During systole the coronary arteries collapse as a result of the pressure due to contraction that is exerted on them. During diastole the heart muscle relaxes and the pressure on the coronary vessels is relieved allowing blood to flow through them to the subendocardium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      38.3
      Seconds

  • Question 11 - Vasodilatation in skeletal muscle can be caused by: ...

    Incorrect

    • Vasodilatation in skeletal muscle can be caused by:

      Your Answer: Endothelin-1

      Correct Answer: Sympathetic cholinergic nerves

      Explanation:

      In skeletal muscles some fibers that cause vasodilation run with the nerves of the sympathetic system but are cholinergic in nature. These nerves are not active during rest but become active during exercise and stress.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      23.9
      Seconds

  • Question 12 - The ability of the SA node cells to allow ionic flow through channels...

    Correct

    • The ability of the SA node cells to allow ionic flow through channels activated in a hyperpolarized state is known as:

      Your Answer: Pace maker potential

      Explanation:

      Rhythmically discharging cells have a membrane potential that, after each impulse, declines to the firing level. Thus this prepotential or Pacemaker potential triggers the next impulse. The inherent leakiness of the sinus nodal fibers to Na+ and Ca2+ causes their self excitation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      53.1
      Seconds

  • Question 13 - Catecholamines… ...

    Incorrect

    • Catecholamines…

      Your Answer: Are both positive ionotropic and negative chronotropic

      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
      11.9
      Seconds

  • Question 14 - Where does the SA node develop? ...

    Incorrect

    • Where does the SA node develop?

      Your Answer: At the same place as the AV node.

      Correct Answer: From structures on the right side of the embryo.

      Explanation:

      The SA node develops from the right side of the embryo and the AV node from the left. This is the reason why in adults the right vagus supplies the SA node and the left vagus supplies the AV node.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.8
      Seconds

  • Question 15 - In ventricular fibrillation (VF), the first defibrillation attempt (with a biphasic defibrillator) should...

    Incorrect

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

      Your Answer: 360 J

      Correct 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
      12.7
      Seconds

  • Question 16 - The coronary arteries supply which part of the heart’s subendocardial region exclusively in...

    Incorrect

    • The coronary arteries supply which part of the heart’s subendocardial region exclusively in diastole?

      Your Answer: All chambers of the heart ( all of the above if you want )

      Correct Answer: Left ventricle

      Explanation:

      It is only during diastole that the blood flows to the subendocardial portion of the left ventricle, as the heart muscle relaxes and the coronary arteries regain their patency.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      15.9
      Seconds

  • Question 17 - Which of the following normally has a slow depolarizing “prepotential”? ...

    Incorrect

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

      Your Answer: Ventricular muscle cells

      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
      14.6
      Seconds

  • Question 18 - The Plateau phase in myocyte action potentials does all of the following except:...

    Incorrect

    • The Plateau phase in myocyte action potentials does all of the following except:

      Your Answer: It is a refractory phase

      Correct Answer: It allows early reactivation of the myocytes

      Explanation:

      The presence of the plateau in the action potential causes ventricular contraction to last as much as 15 times longer in cardiac muscle as in skeletal muscle. The plateau phase which follows is unique to myocytes and results from a small, but sustained inward calcium current through L-type calcium channels lasting 200-400 ms. This calcium influx is caused by a combined increase in permeability of the cell and especially the sarcolemmal membranes to calcium. This plateau (refractory) phase prevents early reactivation of the myocytes and directly determines the strength of contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      47.1
      Seconds

  • Question 19 - What is a characteristic findings on ECG in hyperkalaemia? ...

    Correct

    • What is a characteristic findings on ECG in hyperkalaemia?

      Your Answer: Tall, tented T waves

      Explanation:

      Hyperkalaemia leads to:

      – Prolonged PR interval

      – Small P waves

      – Tall, tented T waves

      – Widened QRS complexes and eventually asystole.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.2
      Seconds

  • Question 20 - Most of the venous blood returns to the heart through the: ...

    Correct

    • Most of the venous blood returns to the heart through the:

      Your Answer: Coronary sinus and anterior cardiac veins

      Explanation:

      Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins which drain into the right atrium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      24.7
      Seconds

  • Question 21 - The following products of the vascular endothelium produce vasodilation except: ...

    Incorrect

    • The following products of the vascular endothelium produce vasodilation except:

      Your Answer: Nitrous oxide

      Correct Answer: Endothelin

      Explanation:

      Endothelin: This is incorrect in the context of vasodilation. Endothelin is actually a potent vasoconstrictor produced by the endothelium, leading to the narrowing of blood vessels and increased blood pressure.

      Nitrous oxide (Nitric oxide): This is correct for vasodilation. Nitric oxide is a powerful vasodilator produced by the endothelium, which helps relax and widen blood vessels.

      Prostacyclin: This is correct for vasodilation. Prostacyclin (PGI2) is a vasodilator and inhibits platelet aggregation, helping to maintain blood flow and reduce clot formation.

      Endothelial-derived hyperpolarizing factor (EDHF): This is correct for vasodilation. EDHF causes vasodilation by hyperpolarizing the smooth muscle cells of blood vessels.

      Vascular endothelial growth factor (VEGF): This is correct for vasodilation. VEGF primarily promotes the growth of new blood vessels but also has vasodilatory effects through nitric oxide production.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.6
      Seconds

  • Question 22 - Which of the following is NOT associated with the development of aortic regurgitation?...

    Incorrect

    • Which of the following is NOT associated with the development of aortic regurgitation?

      Your Answer: Syphilis

      Correct Answer: Dilated cardiomyopathy

      Explanation:

      Aortic insufficiency, is often due to the aortic root dilation, which is idiopathic in over 80% of cases, but otherwise may result from aging, syphilitic aortitis, osteogenesis imperfecta, aortic dissection, Bechet’s disease, reactive arthritis and systemic hypertension. Additionally, aortic insufficiency has been linked to the use of some medications and other potential causes that affect the valve directly including Marfan’s syndrome, Ehlers–Danlos syndrome, ankylosing spondylitis, and systemic lupus erythematosus. In acute cases of aortic insufficiency, the main causes are infective endocarditis, aortic dissection or trauma. Dilated cardiomyopathy is associated with the development of mitral regurgitation, not aortic regurgitation

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.7
      Seconds

  • Question 23 - Which of the following would be a contraindication to thrombolysis? ...

    Incorrect

    • Which of the following would be a contraindication to thrombolysis?

      Your Answer: Menstruation

      Correct Answer: Intracranial neoplasm

      Explanation:

      Absolute contraindications to thrombolysis include:

      • Previous intracranial bleeding at any time
      • Stroke in less than 6 months
      • Closed head or facial trauma within 3 months
      • Suspected aortic dissection
      • Ischemic stroke within 3 months (except in ischemic stroke within 3 hours time)
      • Active bleeding diathesis
      • Uncontrolled high blood pressure (>180 systolic or >100 diastolic)
      • Known structural cerebral vascular lesion
      • Arterio-venous malformations
      • Thrombocytopenia
      • Known coagulation disorders
      • Aneurysm
      • Brain tumours
      • Pericardial effusion
      • Septic embolus

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      28.8
      Seconds

  • Question 24 - Regarding the surface anatomy of the orifices of the heart, where is the...

    Incorrect

    • Regarding the surface anatomy of the orifices of the heart, where is the aortic valve located?

      Your Answer: Opposite the left upper sternal border in the 2nd intercostal space

      Correct Answer: Opposite the left 3rd intercostal space to the left of 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
      25.7
      Seconds

  • Question 25 - Which coronary artery supplies the right atria? ...

    Correct

    • Which coronary artery supplies the right atria?

      Your Answer: Right coronary

      Explanation:

      The left coronary artery distributes blood to the left side of the heart, the left atrium and ventricle, and the interventricular septum. The circumflex artery arises from the left coronary artery and follows the coronary sulcus to the left. Eventually, it will fuse with the small branches of the right coronary artery. The right coronary artery proceeds along the coronary sulcus and distributes blood to the right atrium, portions of both ventricles, and the heart conduction system.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.5
      Seconds

  • Question 26 - In Starling’s law of the heart, the decrease in tension developed by muscle...

    Incorrect

    • In Starling’s law of the heart, the decrease in tension developed by muscle contraction at high degrees of stretch is due to:

      Your Answer: Leak of calcium from cell membranes of overstretched cardiac muscle

      Correct Answer: Disruption of myocardial fibers

      Explanation:

      Starling law states that the force of contraction is directly proportional to the preload. When the heart muscle is stretched beyond its limit the tension that is developed decreases, this is not due to loss of formation of effective myosin and actin cross bridges. The heart muscles despite being fully stretched is never stretched to this point. The reason for this decreased tension is physical disruption of the myocardial fibers.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      40.8
      Seconds

  • Question 27 - Dicrotic notch is produced by which valves? ...

    Incorrect

    • Dicrotic notch is produced by which valves?

      Your Answer: Mitral

      Correct Answer: Aortic

      Explanation:

      The graph of aortic pressure throughout the cardiac cycle displays a small dip (the incisure or dicrotic notch) which coincides with the aortic valve closure. The dip in the graph is immediately followed by a brief rise (the dicrotic wave) then gradual decline.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.7
      Seconds

  • Question 28 - Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms ...

    Incorrect

    • Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms

      Your Answer: Decreased the number of sarcomeres

      Correct Answer: Increased phosphorylation of phosholamban

      Explanation:

      Phosphorylation of phospholamban, which increases calcium ATPase activity and sequestration of calcium in the sarcoplasmic reticulum. An increased rate of relaxation is explained because cAMP also activates the protein phospholamban, situated on the membrane of the SR, that controls the rate of uptake of calcium into the SR. The latter effect explains enhanced relaxation (lusitropic effect).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      52.6
      Seconds

  • Question 29 - Myocardium requires more oxygen to expel blood in: ...

    Incorrect

    • Myocardium requires more oxygen to expel blood in:

      Your Answer: A stenotic pulmonary valve

      Correct Answer: A stenotic aortic valve

      Explanation:

      In aortic valve stenosis, increased ventricular pressure Is needed to expel the blood into the aorta. Increased pressure means increased contractility hence increase O2 consumption by the heart muscles.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      24.6
      Seconds

  • Question 30 - What is the main reason for checking the urea and electrolytes prior to...

    Incorrect

    • What is the main reason for checking the urea and electrolytes prior to commencing a patient on amiodarone?

      Your Answer: To detect hyperkalaemia

      Correct Answer: To detect hypokalaemia

      Explanation:

      All antiarrhythmic drugs have the potential to cause arrhythmias. Coexistent hypokalaemia significantly increases this risk.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (7/30) 23%
Medicine (7/30) 23%
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