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  • Question 1 - Which of the following is NOT associated with the development of aortic regurgitation?...

    Correct

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

      Your 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
      3.9
      Seconds

  • Question 2 - The ‘c’ wave in JVP corresponds more closely with: ...

    Correct

    • The ‘c’ wave in JVP corresponds more closely with:

      Your Answer: Isovolumetric contraction

      Explanation:

      The jugular venous pressure (JVP, sometimes referred to as jugular venous pulse) is the indirectly observed pressure over the venous system via visualization of the internal jugular vein. It can be useful in the differentiation of different forms of heart and lung disease. Classically three upward deflections (peaks) and two downward deflections (troughs) have been described:The upward deflections are the a (atrial contraction), c (ventricular contraction and resulting bulging of tricuspid into the right atrium during isovolumetric systole) and v = venous filling.The downward deflections of the wave are the x (the atrium relaxes and the tricuspid valve moves downward) and the y descent (filling of ventricle after tricuspid opening).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.8
      Seconds

  • Question 3 - 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
      6.6
      Seconds

  • Question 4 - The T-tubular system in cardiac muscle is: ...

    Correct

    • The T-tubular system in cardiac muscle is:

      Your Answer: Transmits action potential from sarcolemma to the SR to allow for Ca2+ release into the cytoplasm

      Explanation:

      Action potentials are transmitted to the fibrils of a fiber through the T tubule system. It triggers the release of Ca 2+ from the terminal cisterns. Depolarization of the T tubules activates the sarcoplasmic reticulum through the dihydropyridine receptors, which are voltage gated calcium channels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.7
      Seconds

  • Question 5 - How does pregnancy affect the cardiac output of a patient? ...

    Correct

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

      Your 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
      7.1
      Seconds

  • Question 6 - Excitation-contraction coupling in cardiac muscle involves all of the following except: ...

    Correct

    • Excitation-contraction coupling in cardiac muscle involves all of the following except:

      Your Answer: Binding of Ca2+ to calmodulin

      Explanation:

      In the excitation contraction coupling model, an action potential is transmitted to the fibrils of a fiber through the T tubule system. It triggers the release of Ca 2+ from the terminal cisterns. Depolarization of the T tubules activates the sarcoplasmic reticulum through the dihydropyridine receptors. These are voltage gates calcium channels. Calcium binds to calmodulin during contraction of the smooth muscle and not the cardiac muscles.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.6
      Seconds

  • Question 7 - When is the blood pressure at its lowest during pregnancy? ...

    Correct

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

      Your 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
      2.4
      Seconds

  • Question 8 - The Sinoatrial node in the majority of people is supplied by the? ...

    Correct

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

      Your 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
      6
      Seconds

  • Question 9 - Regarding cardiac output, an increased ejection fraction results from increases in which of...

    Correct

    • Regarding cardiac output, an increased ejection fraction results from increases in which of the following?

      Your Answer: Strength of contraction without increase in muscle fiber length

      Explanation:

      When the strength of contraction increases without an increase in fiber length, the EF increases.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      460.9
      Seconds

  • Question 10 - Which of the following are responsible for the 4th heart sound? ...

    Correct

    • Which of the following are responsible for the 4th heart sound?

      Your Answer: Ventricular hypertrophy

      Explanation:

      The fourth heart sound is not normally audible in a normal adult. It occurs as a consequence of ventricular hypertrophy. It is caused by filling of the ventricle in atrial systole.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.3
      Seconds

  • Question 11 - Isovolumetric ventricular contraction lasts for? ...

    Correct

    • Isovolumetric ventricular contraction lasts for?

      Your Answer: 0,05 s

      Explanation:

      Isovolumetric contraction lasts for about 0.05 seconds.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      2.6
      Seconds

  • Question 12 - Myocyte action potentials – Choose the false statement: ...

    Correct

    • Myocyte action potentials – Choose the false statement:

      Your Answer: Repolarisation is due to net k+ influx

      Explanation:

      Final repolarization (phase 3) to the resting membrane potential (phase 4) is due to closure of the Ca2+ channels and a slow, delayed increase of K+ efflux through various types of K+ channels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.6
      Seconds

  • Question 13 - Regarding the cardiac muscle striations as viewed under the microscope, which areas are...

    Correct

    • Regarding the cardiac muscle striations as viewed under the microscope, which areas are dark?

      Your Answer: A band and z line

      Explanation:

      Dark bands: a, h. Dark line: z. Clear band: i, m

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.8
      Seconds

  • Question 14 - Which of the following occurs during a Valsalva manoeuvre? ...

    Incorrect

    • Which of the following occurs during a Valsalva manoeuvre?

      Your Answer: No change

      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
      2.1
      Seconds

  • Question 15 - Which part of the ECG represents ventricular repolarisation? ...

    Correct

    • Which part of the ECG represents ventricular repolarisation?

      Your Answer: T wave

      Explanation:

      Ventricular repolarisation is denoted by the T wave.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.2
      Seconds

  • Question 16 - The interventricular septum is supplied anteriorly by the? ...

    Incorrect

    • The interventricular septum is supplied anteriorly by the?

      Your Answer: Circumflex artery

      Correct Answer: Left anterior descending artery

      Explanation:

      The anterior interventricular artery or left anterior descending artery supplies the anterior 2/3rds of the interventricular septum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3
      Seconds

  • Question 17 - The coronary arteries fill during? ...

    Incorrect

    • The coronary arteries fill during?

      Your Answer: Occlusion by valve cusps

      Correct Answer: Diastole

      Explanation:

      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
      49.1
      Seconds

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

    Correct

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

      Your 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
      12.8
      Seconds

  • Question 19 - Which of the following structures of the cardiac conduction system is located in...

    Incorrect

    • Which of the following structures of the cardiac conduction system is located in the right posterior portion of the interatrial septum?

      Your Answer: Bundle of his

      Correct Answer: AV node

      Explanation:

      AV node is located at the right posterior portion of the interatrial septum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      1.9
      Seconds

  • Question 20 - Generalized vasoconstrictors include: ...

    Incorrect

    • Generalized vasoconstrictors include:

      Your Answer: Nitric oxide, carbon monoxide, natriuretic peptide

      Correct Answer: Norepinephrine, endothelin, angiotensin ii

      Explanation:

      Vasopressin, angiotensin II, adrenaline and endothelin are generalized vasoconstrictors.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      2
      Seconds

  • Question 21 - What is pulse pressure? ...

    Correct

    • What is pulse pressure?

      Your Answer: Difference between systolic and diastolic pressure

      Explanation:

      The pulse pressure is the difference between the measured systolic and diastolic pressures.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      2.2
      Seconds

  • Question 22 - What type of intercellular connection found between cardiac muscle fibers allow for the...

    Incorrect

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

      Your Answer: Hemidesmosomes

      Correct 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
      4.7
      Seconds

  • Question 23 - Myocardial oxygen consumption is increased by: ...

    Incorrect

    • Myocardial oxygen consumption is increased by:

      Your Answer: Aortic regurgitation

      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
      2.3
      Seconds

  • Question 24 - The celiac trunk consists of which arteries? ...

    Incorrect

    • The celiac trunk consists of which arteries?

      Your Answer: Superior mesenteric and inferior mesenteric

      Correct Answer: Left gastric, common hepatic, splenic

      Explanation:

      The celiac trunk is the first major branch of the abdominal aorta. It is 1.25 cm in length. Branching from the aorta at thoracic vertebra 12 (T12). There are three main divisions of the celiac artery:- left gastric artery- common hepatic artery- splenic artery

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      1.9
      Seconds

  • Question 25 - What is the function of the BK channel on the vascular smooth muscle...

    Incorrect

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

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

      Correct 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
      3.3
      Seconds

  • Question 26 - 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
      14.5
      Seconds

  • Question 27 - The rate of depolarization of the SA node membrane potential is modulated by...

    Incorrect

    • The rate of depolarization of the SA node membrane potential is modulated by the following:

      Your Answer: None of the above

      Correct Answer: All of the above

      Explanation:

      Rate of depolarization of the SA node is modulated by all of these.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9
      Seconds

  • Question 28 - The effects of β1 stimulation include the following ...

    Incorrect

    • The effects of β1 stimulation include the following

      Your Answer: Only a and b are correct

      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
      5
      Seconds

  • Question 29 - Which of the following statements is true regarding pulsus alternans? ...

    Incorrect

    • Which of the following statements is true regarding pulsus alternans?

      Your Answer: It is diagnosed electrocardiographically

      Correct Answer: It is found in association with a third heart sound

      Explanation:

      Pulsus alternans is a physical finding with arterial pulse waveform showing alternating strong and weak beats. It is almost always indicative of left ventricular systolic impairment, and carries a poor prognosis. A pathological third heart sound is usually associated.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.3
      Seconds

  • Question 30 - 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: Intermodal pathways

      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
      3.5
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (29/30) 97%
Medicine (29/30) 97%
Passmed
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