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  • Question 1 - When looking at the JVP what does the c wave signify: ...

    Incorrect

    • When looking at the JVP what does the c wave signify:

      Your Answer: Atrial systole

      Correct Answer: Isovolumetric ventricular contraction

      Explanation:

      The C wave signifies a rise in the atrial pressure during isovolumetric contraction due to the tricuspid valve bulging into the atria.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      19.6
      Seconds

  • Question 2 - Endothelial cells are attached to adjacent cells by adherent junctions via: ...

    Incorrect

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

      Your Answer: Integrins

      Correct 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
      14.9
      Seconds

  • Question 3 - 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: Left ventricle

      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
      11.5
      Seconds

  • Question 4 - Describe the location of the SA node: ...

    Incorrect

    • Describe the location of the SA node:

      Your Answer: Base of the right atrium

      Correct Answer: Junction of the SVC and right atrium

      Explanation:

      Anatomically the SA node is located at the junction of the superior vena cava and the right atrium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.2
      Seconds

  • Question 5 - Which membrane bound protein in the sarcoplasmic reticulum regulates calcium return from the...

    Incorrect

    • Which membrane bound protein in the sarcoplasmic reticulum regulates calcium return from the cytosol to the sarcoplasmic reticulum?

      Your Answer: Actin

      Correct Answer: Phospholamban

      Explanation:

      Phosphorylation of phospholamban 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 sarcoplasmic reticulum (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
      15.3
      Seconds

  • Question 6 - With regards to the cardiac cycle which of the following is true ...

    Incorrect

    • With regards to the cardiac cycle which of the following is true

      Your Answer: Left ventricular ejection begins before right ventricular ejection

      Correct Answer: Right atrial systole occurs before left atrial systole: as below

      Explanation:

      Cardiac cycle: The first event in the cycle is atrial depolarization (a P wave on the surface ECG) follows by RIGHT ATRIAL and then LEFT ATRIAL contraction. Ventricular activation (QRS) follows after a short interval (the PR interval). LEFT VENTRICULAR contraction starts shortly thereafter RIGHT VENTRICULAR contraction begins. At the end, the aortic valve closure is followed by pulmonary valve closure.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      16.5
      Seconds

  • Question 7 - How does pregnancy affect the cardiac output of a patient? ...

    Incorrect

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

      Your Answer:

      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
      0
      Seconds

  • Question 8 - 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 9 - Which of the following isoforms of Nitric oxide synthase (NOS) is found in...

    Incorrect

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

      Your Answer:

      Correct Answer: Nos 3

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 10 - Which of the following regulates the calcium release channels? ...

    Incorrect

    • Which of the following regulates the calcium release channels?

      Your Answer:

      Correct Answer: Calstabin 2

      Explanation:

      Ca2+ is released from the SR through a Ca2+ release channel, a cardiac isoform of the ryanodine receptor (RyR2), which controls intracytoplasmic [Ca2+] and, as in vascular smooth-muscle cells, leads to the local changes in intracellular [Ca2+] called calcium sparks. A number of regulatory proteins, including calstabin 2, inhibit RyR2 and, thereby, the release of Ca2+ from the SR.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 11 - 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:

      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
      0
      Seconds

  • Question 12 - Which of the following is true of the Natriuretic hormones? ...

    Incorrect

    • Which of the following is true of the Natriuretic hormones?

      Your Answer:

      Correct Answer: They are released in response to hypervolemia

      Explanation:

      Natriuretic hormones are vasodilators released in response to hypervolemia.

      Natriuretic hormones (NH) include three groups of compounds: the natriuretic peptides NPs (ANP, BNP and CNP), the gastrointestinal peptides (guanylin and uroguanylin), and endogenous cardiac steroids. These substances induce the kidney to excrete sodium and therefore participate in the regulation of sodium and water homeostasis, blood volume, and blood pressure (BP). In addition to their peripheral functions, these hormones act as neurotransmitters or neuromodulators in the brain.

      Atrial natriuretic peptide (ANP) plays a crucial role in blood pressure regulation by inducing natriuresis and diuresis in the kidney, inhibiting renin secretion, aldosterone production, and promoting vasorelaxation.  Two paracrine factors derived from endothelial cells play important roles in modulating ANP secretion. Endothelin, a potent vasoconstrictor, stimulates ANP secretion and augments stretch induced ANP secretion. The dramatic increase in ANP release produced by cardiac ischemia appears to be mediated in part by endothelin. Nitric oxide (NO), an important vasodilator, is also produced by endothelial cells and inhibits ANP secretion.

      Brain natriuretic peptide (BNP) shares ANP’s receptor but is primarily associated with antifibrotic effects in ventricular remodeling, serving as a biomarker for heart failure and myocardial infarction.

      C-type natriuretic peptide (CNP) acts locally in an autocrine/paracrine manner, exerting potent cardiovascular effects, including vasorelaxation and vascular remodeling post-injury. NPs also demonstrate diverse effects beyond cardiovascular and renal systems, such as bronchodilation, anti-inflammatory actions, and metabolic effects on adipose tissue and long bones.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 13 - Vasodilatation in skeletal muscle can be caused by: ...

    Incorrect

    • Vasodilatation in skeletal muscle can be caused by:

      Your Answer:

      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
      0
      Seconds

  • Question 14 - 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 15 - 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:

      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
      0
      Seconds

  • Question 16 - Why does arterial blood pressure drop during pregnancy? ...

    Incorrect

    • Why does arterial blood pressure drop during pregnancy?

      Your Answer:

      Correct Answer: Progesterone relaxes vascular smooth muscle

      Explanation:

      Progesterone relaxes vascular smooth muscle thus resulting In a decrease in total peripheral resistance. This accounts for the increase in the cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 17 - 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 18 - The function of ATP in cardiac muscle contraction includes: ...

    Incorrect

    • The function of ATP in cardiac muscle contraction includes:

      Your Answer:

      Correct Answer: Binding to myosin after the power stroke to allow uncoupling of actin and myosin

      Explanation:

      After calcium binds to the troponin C, there is a conformational change in the structure of troponin I and tropomyosin, which moves out of the way and frees the site where myosin can bind to actin. This results in the formation of the cross linkage of the actin and myosin giving rise to the power stroke in the contraction phase. This occurs with the release of ADP. When ATP combines to this complex it breaks and the cycle repeats itself.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 19 - Closure of the tricuspid valve is marked by which of the following features...

    Incorrect

    • Closure of the tricuspid valve is marked by which of the following features of the jugular venous waveform?

      Your Answer:

      Correct Answer: c wave

      Explanation:

      The jugular venous pressure (JVP) classically has three upward deflections and two downward deflections. 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
      0
      Seconds

  • Question 20 - Which factors increase the end-diastolic volume? ...

    Incorrect

    • Which factors increase the end-diastolic volume?

      Your Answer:

      Correct Answer: Constriction of veins

      Explanation:

      End diastolic volume is also known as preload. It is the amount of blood the heart contracts against. Constriction of veins will decrease venous pooling and increase venous return, hence increasing the end diastolic volume. Standing will increase venous pooling hence decreasing venous return and end diastolic volume. Raised intrapericardial pressure will also decrease venous return and hence end diastolic volume.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 21 - Concerning surface anatomy, where is the apex beat found? ...

    Incorrect

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

      Your Answer:

      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
      0
      Seconds

  • Question 22 - Concerning coronary arteries, what is the net effect of B2 stimulation on the...

    Incorrect

    • Concerning coronary arteries, what is the net effect of B2 stimulation on the heart (e.g. Running athlete)?

      Your Answer:

      Correct Answer: Vasodilation via production of metabolites

      Explanation:

      The coronary arterioles contain α-adrenergic receptors, which cause vasoconstriction, and β-adrenergic receptors, which cause vasodilation. Activity in the noradrenergic nerves to the heart and injections of norepinephrine cause coronary vasodilation. However, norepinephrine also increases the heart rate and the force of cardiac contraction, and the vasodilation is due to production of vasodilator metabolites in the myocardium secondary to the increase in its activity. As exercise has the same effect as sympathetic stimulation, it will result in vasodilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 23 - Which of the following structures is not part of the conducting system of...

    Incorrect

    • Which of the following structures is not part of the conducting system of the heart?

      Your Answer:

      Correct Answer: Ventricular wall

      Explanation:

      The conduction system of the heart consists of the SA node, AV node, internodal pathway between these two nodes, Bundle of His and the purkinje fibers

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 24 - With regard to the endothelial structure, the epithelium constitute: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Simple squamous

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 25 - Absolute refractory period in a cardiac action potential graph occurs during. ...

    Incorrect

    • Absolute refractory period in a cardiac action potential graph occurs during.

      Your Answer:

      Correct Answer: All of the above

      Explanation:

      Absolute refractory period (ARP): the cell is completely unexcitable to a new stimulus and occurs from phase 0 – 2 i.e. depolarisation, early repolarisation and plateau phase.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 26 - Myocardial oxygen consumption is increased by: ...

    Incorrect

    • Myocardial oxygen consumption is increased by:

      Your Answer:

      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
      0
      Seconds

  • Question 27 - Most of the venous blood returns to the heart through the: ...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 28 - Regarding cardiac muscle contractility, the afterload refers to: ...

    Incorrect

    • Regarding cardiac muscle contractility, the afterload refers to:

      Your Answer:

      Correct Answer: The resistance against which blood is expected

      Explanation:

      The afterload for the left ventricle is the aortic pressure. Hence it is this pressure that offers resistance against which the blood is to be expelled from the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 29 - 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:

      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
      0
      Seconds

  • Question 30 - The hyperpolarization phase of pacemaker cells is dominated by ____ current. ...

    Incorrect

    • The hyperpolarization phase of pacemaker cells is dominated by ____ current.

      Your Answer:

      Correct Answer: K+

      Explanation:

      The hyperpolarization phase is a continuation of the repolarization phase but the membrane potential dips below the resting membrane potential. This results due to the fact that the K+ channels take a longer time to close than the Na+ channels. Hence efflux of the K+ will result in hyperpolarization.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 31 - Where are the baroreceptors of the great arteries located? ...

    Incorrect

    • Where are the baroreceptors of the great arteries located?

      Your Answer:

      Correct Answer: In the adventitia

      Explanation:

      Arterial baroreceptors are located in the aortic arch and carotid sinuses, and are formed by small nerve endings present in the adventitia of these vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 32 - Coronary arteries arise from? ...

    Incorrect

    • Coronary arteries arise from?

      Your Answer:

      Correct Answer: None of the above

      Explanation:

      Coronary arteries arise from the sinuses behind 2 of the cusps of the aortic valve at the root of aorta.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 33 - Which vaso metabolite decreases coronary blood flow? ...

    Incorrect

    • Which vaso metabolite decreases coronary blood flow?

      Your Answer:

      Correct Answer: Endothelin

      Explanation:

      Decreased O2, increased CO2, lactate, prostaglandins, adenine nucleotides, adenosine, H+, K+ and cyanide produce vasodilation and thus an increase in coronary blood flow.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 34 - According to Poiseuille’s formula, which 1 of the following will lead to increased...

    Incorrect

    • According to Poiseuille’s formula, which 1 of the following will lead to increased flow?

      Your Answer:

      Correct Answer: Shorter tube

      Explanation:

      V = π p r4 / 8 η lwhere V = discharge volume flow (m3/s)p = pressure difference between the ends of the pipe (N/m2, Pa)r = internal radius of pipe (m)l = length of pipe (m)η = viscosity of fluid

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 35 - The average end diastolic volume in a healthy individual’s ventricle is? ...

    Incorrect

    • The average end diastolic volume in a healthy individual’s ventricle is?

      Your Answer:

      Correct Answer: 130 ml

      Explanation:

      The end diastolic volume in a healthy individual is about 130 ml.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 36 - Angina pectoris develops when blood through the coronary artery becomes: ...

    Incorrect

    • Angina pectoris develops when blood through the coronary artery becomes:

      Your Answer:

      Correct Answer: Restricted, limiting blood blow

      Explanation:

      Angina pectoris develops when stenosis ( >70%) of the artery occurs as a result of formation of an atherosclerotic plaque. This leads to a decrease in the O2 carried to the thickened heart muscle by the blood, leading to the characteristic chest pain associated with angina pectoris.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 37 - 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 38 - Which coronary artery supplies the right atria? ...

    Incorrect

    • Which coronary artery supplies the right atria?

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 39 - 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:

      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
      0
      Seconds

  • Question 40 - Xanthines (for example Caffeine), exhibit their positive inotropic effect by: ...

    Incorrect

    • Xanthines (for example Caffeine), exhibit their positive inotropic effect by:

      Your Answer:

      Correct Answer: Inhibiting the breakdown cAMP

      Explanation:

      Xanthines exert their positive inotropic effect by inhibiting the breakdown of the cAMP resulting in stronger and sustained contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 41 - Regarding the length of systole and diastole which of the following is true?...

    Incorrect

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

      Your Answer:

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

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 42 - 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 43 - 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:

      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
      0
      Seconds

  • Question 44 - A sarcomere is the area between: ...

    Incorrect

    • A sarcomere is the area between:

      Your Answer:

      Correct Answer: Two adjacent z lines

      Explanation:

      The area that lies between the two adjacent Z lines is known as a sarcomere and is the contractile unit of the muscle. The line passing in the middle of the myosin filaments is the M line. It also passes through the middle of the sarcomere.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 45 - Which of the following causes the closure of the ductus arteriosus during birth?...

    Incorrect

    • Which of the following causes the closure of the ductus arteriosus during birth?

      Your Answer:

      Correct Answer: Reduced levels of prostaglandins

      Explanation:

      Ductus arteriosus is kept open by the prostaglandin E2 which is a vasodilator. At birth the high levels of cyclooxygenase blocks the production of prostaglandins which results in the closure of the ductus arteriosus.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 46 - 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:

      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
      0
      Seconds

  • Question 47 - What is a characteristic findings on ECG in hyperkalaemia? ...

    Incorrect

    • What is a characteristic findings on ECG in hyperkalaemia?

      Your Answer:

      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
      0
      Seconds

  • Question 48 - Currents caused by opening of which of the following channels contribute to the...

    Incorrect

    • Currents caused by opening of which of the following channels contribute to the repolarization phase of the action potential of the ventricular muscle fibers?

      Your Answer:

      Correct Answer: Potassium channels

      Explanation:

      Depolarization occurs due to opening of the voltage gated sodium channels. Repolarization occurs due to opening of the voltage gates potassium channels causing an out flux of potassium ions, decreasing the membrane potential towards resting potential.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 49 - The ability of the SA node cells to allow ionic flow through channels...

    Incorrect

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

      Your Answer:

      Correct 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
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      Seconds

  • Question 50 - 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:

      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
      0
      Seconds

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