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  • Question 1 - The triangle with the heart at its centre, using limb leads is called:...

    Incorrect

    • The triangle with the heart at its centre, using limb leads is called:

      Your Answer: Bornholm

      Correct Answer: Einthoven

      Explanation:

      The Einthoven triangle is formed by placing the limb leads on both the arms and on the left leg with the heart in the centre.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      19.1
      Seconds

  • Question 2 - Regarding cardiac contractility, catecholamines exert their inotropic effect via: ...

    Incorrect

    • Regarding cardiac contractility, catecholamines exert their inotropic effect via:

      Your Answer: Reduced intracellular Ca2+

      Correct Answer: Β1-adrenergic receptors and gs

      Explanation:

      Catecholamines exert their inotropic effect on the heart via the B1 adrenergic receptors and Gs, stimulating adenyl cyclase and increasing the production of cAMP.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      22.2
      Seconds

  • Question 3 - Which of the following pairs are correct concerning arteriolar tone? ...

    Incorrect

    • Which of the following pairs are correct concerning arteriolar tone?

      Your Answer: Neural control: vasoconstriction activated by sympathetic nerves

      Correct Answer: Hormonal control: catecholamines affect the adrenergic receptors of the vascular smooth muscle

      Explanation:

      Catecholamines released from the adrenal medulla act on the noradrenergic receptors of the vascular smooth muscles. In the skeletal muscles and liver it causes vasodilation whilst it causes vasoconstriction in the rest of the blood vessels of the body.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.9
      Seconds

  • Question 4 - Endothelial cells are attached to adjacent cells by adherent junctions via: ...

    Correct

    • Endothelial cells are attached to adjacent cells by adherent junctions via:

      Your Answer: Cadherins

      Explanation:

      Cadherins are calcium dependant molecules that mediate cell to cell adhesions in epithelial and endothelial cells among others.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.2
      Seconds

  • Question 5 - Activation of nitric oxide synthesis by endothelial cells is triggered by: ...

    Incorrect

    • Activation of nitric oxide synthesis by endothelial cells is triggered by:

      Your Answer: Acetylcholine

      Correct Answer: All of the above

      Explanation:

      Acetylcholine, histamine, bradykinin, vasoactive intestinal peptide (VIP) and shear stress on the endothelial cells causing the release of NO. NO is formed from arginine and causes vasodilatation of the blood vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.9
      Seconds

  • Question 6 - Which factor produced by the endothelium is responsible for the regulation of vascular...

    Incorrect

    • Which factor produced by the endothelium is responsible for the regulation of vascular cell growth?

      Your Answer: Endothelial-derived hyperpolarizing factor

      Correct Answer: Vascular endothelial growth factor (VEGF)

      Explanation:

      VEGF is produced by the endothelial cells and is the major growth factor responsible for causing vasculogenesis. Some isoforms of this growth factor also have a prominent role in formation of lymphatic vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.5
      Seconds

  • Question 7 - The direct determinants of cardiac output are ...

    Incorrect

    • The direct determinants of cardiac output are

      Your Answer: Stroke volume and peripheral resistance

      Correct Answer: Stroke volume and heart rate

      Explanation:

      Cardiac output is classically defined alongside stroke volume (SV) and the heart rate (HR) as:Cardiac Output [L/min] = Stroke Volume [L/beat] x Heart Rate [beats/min]

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      15.1
      Seconds

  • Question 8 - Which heart sounds are matched correctly? ...

    Correct

    • Which heart sounds are matched correctly?

      Your Answer: All of the above

      Explanation:

      In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the atrioventricular valves and semilunar valves, respectively. In addition to these normal sounds, a variety of other sounds may be present including heart murmurs, adventitious sounds, and gallop rhythms S3 and S4. S3 is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by blood rushing in from the atria. The reason the third heart sound does not occur until the middle third of diastole is probably that during the early part of diastole, the ventricles are not filled sufficiently to create enough tension for reverberation. S4 when audible in an adult is called a presystolic gallop or atrial gallop. This gallop is produced by the sound of blood being forced into a stiff or hypertrophic ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.4
      Seconds

  • Question 9 - Where would one normally find venous valves? ...

    Correct

    • Where would one normally find venous valves?

      Your Answer: Saphenous vein

      Explanation:

      The intima of the limb veins is folded at intervals to form venous valves that prevent retrograde flow. There are no valves present in the very small veins, the great veins, or the veins in the brain and viscera.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      21.7
      Seconds

  • Question 10 - Following an action potential, cytosolic Ca2+ is increased. The binding of free Ca2+...

    Incorrect

    • Following an action potential, cytosolic Ca2+ is increased. The binding of free Ca2+ to troponin C results in all of the following except:

      Your Answer: Induction of a conformational change in tropomyosin

      Correct Answer: Weakening of the troponin i interaction with actin

      Explanation:

      At rest, troponin i is bound to actin and tropomyosin and covers the site where the myosin head interacts with actin. When Calcium enters into the muscle, it binds with troponin C and cause a structural change in troponin i which moves out of the myosin binding site and causes the cross bridges between the actin and myosin filaments to occur.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.7
      Seconds

  • Question 11 - Which of the following corresponds to an oblique line drawn from the sternal...

    Incorrect

    • Which of the following corresponds to an oblique line drawn from the sternal end of the left 3rd costal cartilage to the sternal end of the right 6th costal cartilage?

      Your Answer: Ascending aorta

      Correct Answer: Atrio-ventricular (coronary) groove

      Explanation:

      The AV groove corresponds to the right border of the heart. 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
      24.4
      Seconds

  • Question 12 - The T-tubular system in cardiac muscle is: ...

    Incorrect

    • The T-tubular system in cardiac muscle is:

      Your Answer: Integral to the maintenance of cytoskeletal integrity of the cell

      Correct 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
      3.5
      Seconds

  • Question 13 - Coronary arteries fill up during ...

    Incorrect

    • Coronary arteries fill up during

      Your Answer: Atrial systole

      Correct Answer: Diastole

      Explanation:

      During contraction of the ventricular myocardium (systole), the subendocardial coronary vessels (the vessels that enter the myocardium) are compressed due to the high ventricular pressures. This compression results in momentary retrograde blood flow (i.e., blood flows backward toward the aorta) which further inhibits perfusion of myocardium during systole. However, the epicardial coronary vessels (the vessels that run along the outer surface of the heart) remain open. Because of this, blood flow in the sub endocardium stops during ventricular contraction. As a result, most myocardial perfusion occurs during heart relaxation (diastole) when the subendocardial coronary vessels are open and under lower pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7
      Seconds

  • Question 14 - In the Fick‘s method of measuring cardiac output, the arterial oxygen content can...

    Incorrect

    • In the Fick‘s method of measuring cardiac output, the arterial oxygen content can be measured in a sample obtained from

      Your Answer: The aorta

      Correct Answer: The pulmonary vein

      Explanation:

      In Fick’s original method, the following variables are measured:VO2, oxygen consumption in ml of pure gaseous oxygen per minute. This may be measured using a spirometer within a closed rebreathing circuit incorporating a CO2 absorberCa, the oxygen concentration of blood taken from the pulmonary vein (representing oxygenated blood)Cv, the oxygen concentration of blood from an intravenous cannula (representing deoxygenated blood)From these values, we know that:VO2 = (CO x Ca) – (CO x Cv)where CO = Cardiac Output, Ca = Oxygen concentration of arterial blood and Cv = Oxygen concentration of mixed venous blood.This allows us to sayCO = VO2/{Ca – Cv}and hence calculate cardiac output.Note that (Ca – Cv) is also known as the arteriovenous oxygen difference.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.1
      Seconds

  • Question 15 - Cholinergic vagal supply to the SA and AV nodes results in slowing of...

    Incorrect

    • Cholinergic vagal supply to the SA and AV nodes results in slowing of the heart rate via:

      Your Answer: B2 receptors

      Correct Answer: M2 muscarinic receptors

      Explanation:

      M2 muscarinic receptors are the receptors for the parasympathetic system to the SA and the AV node.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14
      Seconds

  • Question 16 - Which of the following occurs during a Valsalva manoeuvre? ...

    Incorrect

    • Which of the following occurs during a Valsalva manoeuvre?

      Your Answer: Forced inspiration against a closed glottis: no: forced expiration rather

      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
      27.4
      Seconds

  • Question 17 - Calcium needed for cardiac muscle contraction is made available during which phase of...

    Incorrect

    • Calcium needed for cardiac muscle contraction is made available during which phase of the action potential?

      Your Answer: 4

      Correct Answer: 2

      Explanation:

      It is made available during the plateau phase of the action potential i.e. phase 2. During the plateau phase of the action potential, Calcium from the extracellular fluid enters through the L type of calcium channels. This entry triggers the release of more calcium from the sarcoplasmic reticulum via the ryanodine receptors.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      16.6
      Seconds

  • Question 18 - How many molecules of myosin attach to actin at any given time? ...

    Incorrect

    • How many molecules of myosin attach to actin at any given time?

      Your Answer: 3

      Correct Answer: 1

      Explanation:

      1 molecule of myosin binds to actin at any give time.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.2
      Seconds

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

    Incorrect

    • What is a characteristic findings on ECG in hyperkalaemia?

      Your Answer: Bifid P waves

      Correct 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
      10.4
      Seconds

  • Question 20 - 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
      13.6
      Seconds

  • Question 21 - Which one of the following ECG findings is least associated with digoxin use?...

    Incorrect

    • Which one of the following ECG findings is least associated with digoxin use?

      Your Answer: Flattened T waves

      Correct Answer: Prolonged QT interval

      Explanation:

      Digoxin ECG features:•    ST depression (‘reverse tick’)•    flattened/inverted T waves•  Prolonged PR interval•    short QT interval•    arrhythmias e.g. AV block, bradycardia, ventricular tachycardia or fibrillation (for example paroxysmal atrial tachycardia with A-V block – so-called PAT with block) is said to be pathognomonic (i.e. diagnostic) of digoxin toxicity.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.7
      Seconds

  • Question 22 - Vasodilatation in skeletal muscle can be caused by: ...

    Incorrect

    • Vasodilatation in skeletal muscle can be caused by:

      Your Answer: AVP

      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
      9.5
      Seconds

  • Question 23 - Which one of the following is a risk factor for torsade de pointes?...

    Incorrect

    • Which one of the following is a risk factor for torsade de pointes?

      Your Answer: Hyperkalaemia

      Correct Answer: Hypothermia

      Explanation:

      The following is a list of factors associated with an increased tendency toward torsades de pointes:- Hypokalaemia (low blood potassium)- Hypomagnesemia (low blood magnesium)- Hypocalcaemia (low blood calcium)- Bradycardia (slow heartbeat)- Heart failure- Left ventricular hypertrophy- Hypothermia- Subarachnoid haemorrhage- Hypothyroidism

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.6
      Seconds

  • Question 24 - Cholinergic nerves from the vagus innervate the SA and AV nodes via which...

    Incorrect

    • Cholinergic nerves from the vagus innervate the SA and AV nodes via which receptor in the heart?

      Your Answer: B1 receptor

      Correct Answer: M2 receptor

      Explanation:

      M2 receptor is found in the heart. M3 and M4 are associated with smooth muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      20.3
      Seconds

  • Question 25 - Transport of Ca2+ into the reticulum to initiate cardiac muscle relaxation in via:...

    Incorrect

    • Transport of Ca2+ into the reticulum to initiate cardiac muscle relaxation in via:

      Your Answer: Calmodulin

      Correct Answer: Serca (sarcoplasmic or endoplasmic reticulum Ca2+ ATPase)

      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
      51.8
      Seconds

  • Question 26 - The principle by which the energy of contraction is proportional to the initial...

    Incorrect

    • The principle by which the energy of contraction is proportional to the initial length of cardiac muscle fiber is known as:

      Your Answer: Thermodilution

      Correct Answer: Starling’s law

      Explanation:

      The Frank starling relationship 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 increase 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 increased development of tension in the muscle fiber. The greater the venous return the greater the cardiac output. This relation is directly proportional.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      20.3
      Seconds

  • Question 27 - According to Starling's law of the heart: ...

    Incorrect

    • According to Starling's law of the heart:

      Your Answer: Stroke volume is not affected during diastolic dysfunction

      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
      24.8
      Seconds

  • Question 28 - The function of Troponin T in cardiac muscle is? ...

    Incorrect

    • The function of Troponin T in cardiac muscle is?

      Your Answer: Generation of ATP which is passed on to the contractile mechanism

      Correct Answer: Allows attachment of troponin components to tropomyosin

      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
      10
      Seconds

  • Question 29 - Concerning surface anatomy, where is the apex beat found? ...

    Incorrect

    • Concerning surface anatomy, where is the apex beat found?

      Your Answer: 6th intercostal space mid clavicular line

      Correct Answer: 5th intercostal space mid clavicular line

      Explanation:

      The location of the apex beat may vary but it is mostly found in the left 5th intercostal space 6 cm from the anterior median line or in the mid clavicular line.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.3
      Seconds

  • Question 30 - Which of the following conditions has no effect on cardiac output? ...

    Incorrect

    • Which of the following conditions has no effect on cardiac output?

      Your Answer:

      Correct Answer: Sleep

      Explanation:

      Sleep has no effect on the cardiac output. Anxiety, excitement 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
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (22/29) 76%
Medicine (22/29) 76%
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