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  • Question 1 - A sarcomere is the area between: ...

    Correct

    • A sarcomere is the area between:

      Your 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
      10.4
      Seconds

  • Question 2 - The branche(s) of the left coronary artery include: ...

    Correct

    • The branche(s) of the left coronary artery include:

      Your Answer: Left circumflex artery & anterior interventricular artery

      Explanation:

      The left main coronary divides into branches:

      1. The left anterior descending artery branches off the left coronary artery and supplies blood to the front of the left side of the heart.

      2. The circumflex artery branches off the left coronary artery and encircles the heart muscle.

      The anterior interventricular artery is otherwise known as the anterior descending branch. The posterior descending artery comes from Right coronary artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11
      Seconds

  • Question 3 - Relaxation of the cardiac muscle at the actin-myosin cross bridges is initiated by...

    Incorrect

    • Relaxation of the cardiac muscle at the actin-myosin cross bridges is initiated by binding of which molecule to the exposed site on the myosin.

      Your Answer: Calcium ATPase

      Correct Answer: ATP

      Explanation:

      A crossbridge is a myosin projection, consisting of two myosin heads, that extends from the thick filaments. Each myosin head has two binding sites: one for ATP and another for actin. The binding of ATP to a myosin head detaches myosin from actin, thereby allowing myosin to bind to another actin molecule. Once attached, the ATP is hydrolysed by myosin, which uses the released energy to move into the cocked position whereby it binds weakly to a part of the actin binding site.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      35.4
      Seconds

  • Question 4 - Where would one find pericytes around endothelial cells? ...

    Incorrect

    • Where would one find pericytes around endothelial cells?

      Your Answer: Larger arteries

      Correct Answer: Post-capillary venules

      Explanation:

      Pericytes release a wide variety of vasoactive agents which regulate the flow through the junction between endothelial cells.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      29.4
      Seconds

  • Question 5 - 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
      56.2
      Seconds

  • Question 6 - Where are the baroreceptors of the great arteries located? ...

    Correct

    • Where are the baroreceptors of the great arteries located?

      Your 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
      12.7
      Seconds

  • Question 7 - 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
      25.2
      Seconds

  • Question 8 - The basic unit of contraction in myocytes is: ...

    Correct

    • The basic unit of contraction in myocytes is:

      Your Answer: Sarcomere

      Explanation:

      Sarcomere is the organelle where calcium is stored to be released during contraction of the muscle. It is the basic unit of contraction in striated muscle fibers. As myocytes are also striated muscles, sarcomeres also forms the basic unit of contraction. The impulses travel along the membrane and via its interaction with the dihydropyridine receptors it releases the stored calcium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6
      Seconds

  • Question 9 - 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
      34.4
      Seconds

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

    Incorrect

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

      Your Answer: P cells

      Correct Answer: Gap junctions

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      15.3
      Seconds

  • Question 11 - With regard to the endothelial structure, the epithelium constitute: ...

    Correct

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

      Your 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
      10.8
      Seconds

  • Question 12 - 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: Nitric oxide

      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
      33
      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
      10.9
      Seconds

  • Question 14 - Water hammer pulse is found in: ...

    Correct

    • Water hammer pulse is found in:

      Your Answer: Aortic insufficiency

      Explanation:

      Watson’s water hammer pulse is the medical sign which describes a pulse that is bounding and forceful, rapidly increasing and subsequently collapsing, as if it were the sound of a water hammer that was causing the pulse. A water hammer was a Victorian toy in which a tube was half filled with fluid, the remainder being a vacuum. The child would invert and reinvert the tube; each time the impact of the fluid at each end would sound like a hammer blow. This is associated with increased stroke volume of the left ventricle and decrease in the peripheral resistance leading to the widened pulse pressure of aortic regurgitation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.9
      Seconds

  • Question 15 - The isoforms of nitric oxide synthase which are found in the nervous system...

    Correct

    • The isoforms of nitric oxide synthase which are found in the nervous system (NOS1) and endothelial cells (NOS3) are activated by agents that increase which of the following intracellular electrolytes?

      Your Answer: Ca

      Explanation:

      Synthesis of nitric oxide is stimulated by activation of the NMDA receptors by certain agents. This leads to opening of the Calcium channels and an influx of calcium into the cell. This will activate the nitric oxide synthase. Nitric oxide is produced on demand.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.6
      Seconds

  • Question 16 - Angina pectoris develops when blood through the coronary artery becomes: ...

    Correct

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

      Your 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
      11.4
      Seconds

  • Question 17 - In a 30 year old male with hypertrophic obstructive cardiomyopathy (HOCM), which of...

    Incorrect

    • In a 30 year old male with hypertrophic obstructive cardiomyopathy (HOCM), which of the following is not associated with increased risk of sudden death?

      Your Answer: Family history of sudden death

      Correct Answer: Age

      Explanation:

      Hypertrophic cardiomyopathy (HCM) is a disease in which a portion of the myocardium (heart muscle) is enlarged without any obvious cause, creating functional impairment of the heart. It is the leading cause of sudden death in young athletes. The major risk factors for sudden death (SD) are recent unexplained syncope unlikely to be neurocardiogenic; HCM-related SD in first-degree or other close relatives; repetitive and/or prolonged nonsustained ventricular tachycardia (NSVT) episodes on Holter or extended ambulatory monitoring; massive left ventricular hypertrophy (LVH) (wall thickness ≥30 mm); extensive/diffuse late gadolinium enhancement (LGE); end-stage heart failure usually with systolic dysfunction; and thin-walled akinetic LV apical aneurysm with regional scarring.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.9
      Seconds

  • Question 18 - The right border of the heart corresponds to which line on the surface...

    Incorrect

    • The right border of the heart corresponds to which line on the surface of the chest?

      Your Answer: Line drawn from the 3rd left costal cartilage to the 6th left costal cartilage

      Correct Answer: Line drawn from the 3rd right costal cartilage to the 6th right costal cartilage

      Explanation:

      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
      12.2
      Seconds

  • Question 19 - The direct determinants of cardiac output are ...

    Correct

    • The direct determinants of cardiac output are

      Your 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
      18.1
      Seconds

  • Question 20 - Sinus bradycardia may be caused by disease of which of the following: ...

    Incorrect

    • Sinus bradycardia may be caused by disease of which of the following:

      Your Answer: Left marginal artery

      Correct Answer: Right coronary artery

      Explanation:

      Disease of the right coronary artery may cause sinus bradycardia and AV nodal block.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      30.6
      Seconds

  • Question 21 - Which ion channel does not contribute to the myocardial action potential? ...

    Incorrect

    • Which ion channel does not contribute to the myocardial action potential?

      Your Answer: Transient outward potassium channel

      Correct Answer: Chloride channel

      Explanation:

      The upstroke in the cardiac action potential is due to opening of the sodium channels and an influx of sodium into the cell. The initial repolarization phase is due to transient opening of the potassium channels along with calcium channels. Influx of calcium causes the prolonged plateau phase of the action potential. Delayed opening of the rectifier potassium channel and delayed closure of the calcium channel leads to the repolarization phase of cardiac action potential.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11
      Seconds

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

    Correct

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

      Your 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
      4.5
      Seconds

  • Question 23 - Which of the following pairs are correct concerning arteriolar tone? ...

    Incorrect

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

      Your Answer: Myogenic control: vascular smooth muscle responds to changes in pressure

      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
      11.6
      Seconds

  • Question 24 - Coronary flow is reduced during ...

    Correct

    • Coronary flow is reduced during

      Your Answer: Tachycardia

      Explanation:

      Maximum amount of blood flow in the coronary arteries occur during diastole. When the heart rate increases which is also called tachycardia the duration of diastole decreases. Hence the amount of blood flow to the cardiac muscle also decreases.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.9
      Seconds

  • Question 25 - Which factors increase the end-diastolic volume? ...

    Incorrect

    • Which factors increase the end-diastolic volume?

      Your Answer: Infiltrative disease

      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
      13.9
      Seconds

  • Question 26 - Which of the following causes the closure of the ductus arteriosus during birth?...

    Correct

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

      Your 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
      9.5
      Seconds

  • Question 27 - A 27-year-old man presents with a regular tachycardia of 190 bpm. He is...

    Incorrect

    • A 27-year-old man presents with a regular tachycardia of 190 bpm. He is healthy and has no past medical history. Blood pressure and blood tests are all within normal parameters however the ECG confirms a narrow complex tachycardia. The tachycardia persists after giving IV adenosine 6mg. What should be the next step in management of this patient?

      Your Answer: IV amiodarone 900mg

      Correct Answer: IV 12mg adenosine

      Explanation:

      For narrow complex tachycardias with no compromise then vagal manoeuvres should be trialled first. The Valsalva manoeuvre should be the first vagal manoeuvre tried and works by increasing intra-thoracic pressure and affecting baroreceptors (pressure sensors) within the arch of the aorta. It is carried out by asking the patient to hold his/her breath while trying to exhale forcibly as if straining during a bowel movement. Adenosine, an ultra-short-acting AV nodal blocking agent, is indicated if vagal manoeuvres are not effective. Adenosine may be safely used during pregnancy. In adults the recommended first dose of intravenous adenosine is 6 mg. The dose is administered rapidly and then followed by a saline flush. Adenosine is only present in the circulation for about 5 seconds, so it is an excellent drug for diagnosis and treatment. If there was a response to adenosine but it was not long lasting, an additional dose of 12 mg of adenosine intravenously can be attempted. Doses greater than 12 mg are not recommended. If adenosine fails then Verapamil or a beta blocker can be used as alternatives. If the patient is hemodynamically unstable or other treatments have not been effective, synchronized electrical cardioversion may be used.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.3
      Seconds

  • Question 28 - The most resistant area in the brain to hypoxia is: ...

    Incorrect

    • The most resistant area in the brain to hypoxia is:

      Your Answer: Thalamus

      Correct Answer: Brain stem

      Explanation:

      The structures in the brainstem are more resistant to hypoxia than the cerebral cortex and the rest of the brain structures.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.5
      Seconds

  • Question 29 - All valves are closed in which phase of the cardiac cycle? ...

    Incorrect

    • All valves are closed in which phase of the cardiac cycle?

      Your Answer: Atrial contraction

      Correct Answer: Isovolumetric relaxation

      Explanation:

      The cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat, and so includes the diastole, the systole, and the intervening pause.The first stage, diastole, is when the semilunar valves (the pulmonary valve and the aortic valve) close, the atrioventricular (AV) valves (the mitral valve and the tricuspid valve) open, and the whole heart is relaxed. The second stage, atrial systole, is when the atrium contracts, and blood flows from atrium to the ventricle.The third stage, isovolumic contraction is when the ventricles begin to contract, the AV and semilunar valves close, and there is no change in volume. The fourth stage, ventricular ejection, is when the ventricles are contracting and emptying, and the semilunar valves are open. During the fifth stage, isovolumic relaxation time, pressure decreases, no blood enters the ventricles, the ventricles stop contracting and begin to relax, and the semilunar valves close due to the pressure of blood in the aorta.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.2
      Seconds

  • Question 30 - 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: 5th left intercostal space mid-axillary 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
      17
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (16/30) 53%
Medicine (16/30) 53%
Passmed
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