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  • Question 1 - Which of the following describes the pulse pressure: ...

    Correct

    • Which of the following describes the pulse pressure:

      Your Answer: Systolic - diastolic pressure

      Explanation:

      During systole, the pressure in the left ventricle increases and blood is ejected into the aorta. The rise in pressure stretches the elastic walls of the aorta and large arteries and drives blood flow. Systolic pressure is the maximum arterial pressure during systole. During diastole, arterial blood flow is partly maintained by elastic recoil of the walls of large arteries. The minimum pressure reached before the next systole is the diastolic pressure. The difference between the systolic and diastolic pressure is the pulse pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      35.2
      Seconds

  • Question 2 - A 60-year-old patient had a sudden onset of palpitations and shortness of breath....

    Incorrect

    • A 60-year-old patient had a sudden onset of palpitations and shortness of breath. He had a history of poorly controlled hypertension and ischemic heart disease. His ECG also shows atrial fibrillation. Based on the patient’s condition, which pharmacologic cardioversion would be best to use?

      Your Answer: Adenosine

      Correct Answer: Amiodarone

      Explanation:

      Chemical cardioversion, or pharmacologic cardioversion, is the treatment of abnormal heart rhythms using drugs.

      Flecainide and propafenone are examples of drugs used as chemical cardioverters.

      However, given the situation of the patient, these drugs are contraindicated for his ischaemic heart disease. Amiodarone is also an antiarrhythmic drug and is the best choice for this situation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      24.1
      Seconds

  • Question 3 - Nitric oxide release from endothelium is stimulated by all of the following EXCEPT...

    Correct

    • Nitric oxide release from endothelium is stimulated by all of the following EXCEPT for:

      Your Answer: Noradrenaline

      Explanation:

      Nitric oxide (NO) production by the endothelium is increased by factors that elevate intracellular Ca2+, including local mediators such as bradykinin, histamine and serotonin, and some neurotransmitters (e.g. substance P). Increased flow (shear stress) also stimulates NO production and additionally activates prostacyclin synthesis. The basal production of NO continuously modulates vascular resistance; increased production of nitric oxide acts to cause vasodilation. Nitric oxide also inhibits platelet activation and thrombosis.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      27
      Seconds

  • Question 4 - The risk of renal impairment in a patient on ACE inhibitor therapy is...

    Correct

    • The risk of renal impairment in a patient on ACE inhibitor therapy is increased by concomitant treatment with which of the following drug classes:

      Your Answer: NSAIDs

      Explanation:

      Concomitant treatment with NSAIDs increases the risk of renal damage, and with potassium-sparing diuretics (or potassium-containing salt substitutes) increases the risk of hyperkalaemia. Hyperkalaemia and other side effects of ACE inhibitors are more common in the elderly and in those with impaired renal function and the dose may need to be reduced.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      26
      Seconds

  • Question 5 - When an elderly dehydrated patient is moved from a supine to a standing...

    Incorrect

    • When an elderly dehydrated patient is moved from a supine to a standing position, her heart rate increases. Which of the following accounts for the increase in heart rate upon standing:

      Your Answer: Increased venoconstriction

      Correct Answer: Decreased venous return

      Explanation:

      On standing from a prone position, gravity causes blood to pool in veins in the legs. Central venous pressure (CVP) falls, causing a fall in stroke volume and cardiac output (due to Starling’s law) and thus a fall in blood pressure. Normally this fall in BP is rapidly corrected by the baroreceptor reflex which causes venoconstriction (partially restoring CVP), and an increase in heart rate and contractility, so restoring cardiac output and blood pressure. Impaired autonomic nervous activity in the elderly accounts for the greater likelihood of postural hypotension. Any symptoms of dizziness, blurred vision or syncope is due to a transient fall in cerebral perfusion that occurs before cardiac output and mean arterial pressure (MAP) can be corrected.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      266
      Seconds

  • Question 6 - Which of the following is NOT an adverse effect associated with warfarin therapy:...

    Incorrect

    • Which of the following is NOT an adverse effect associated with warfarin therapy:

      Your Answer: Calciphylaxis

      Correct Answer: Neutropenia

      Explanation:

      Adverse effects of warfarin:
      The most common adverse effect of warfarin is bleeding

      Other common adverse effects of warfarin include nausea, vomiting, diarrhoea, jaundice, hepatic dysfunction, pancreatitis, pyrexia, alopecia, purpura, and rash

      Skin necrosis is a rare but serious adverse effect of warfarin; treatment with warfarin should be stopped if warfarin related skin necrosis is suspected

      Calciphylaxis is a rare, but a very serious condition that causes vascular calcification and cutaneous necrosis

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      16.9
      Seconds

  • Question 7 - Which of the following is NOT a pharmacological effect of beta-blockers: ...

    Incorrect

    • Which of the following is NOT a pharmacological effect of beta-blockers:

      Your Answer: Reduced heart rate

      Correct Answer: Reduced AV conduction time

      Explanation:

      Effects of beta-blockers:
      Cardiovascular system:
      Reduce blood pressure
      Reduce heart rate, contractility and cardiac output
      Increase AV conduction time, refractoriness and suppress automaticity

      Eye:
      Reduce intraocular pressure

      Respiratory system:
      Cause bronchoconstriction

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      128.5
      Seconds

  • Question 8 - A patient has a cardiac output of 4.8 L/min and a heart rate...

    Incorrect

    • A patient has a cardiac output of 4.8 L/min and a heart rate of 80 bpm, therefore their stroke volume is:

      Your Answer: 40 mL

      Correct Answer: 60 mL

      Explanation:

      Cardiac output (CO) = Stroke volume (SV) x Heart rate (HR).
      Therefore SV = CO/HR
      = 4.8/80
      = 0.06 L = 60 mL.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      65.3
      Seconds

  • Question 9 - Digoxin is contraindicated in all of the following EXCEPT for: ...

    Incorrect

    • Digoxin is contraindicated in all of the following EXCEPT for:

      Your Answer: Ventricular tachycardia

      Correct Answer: Asthma

      Explanation:

      Digoxin is contraindicated in:Supraventricular arrhythmias associated with accessory conduction pathways e.g. Wolff-Parkinson-White syndromeVentricular tachycardia or fibrillationHeart conduction problems e.g. second degree or intermittent complete heart blockHypertrophic cardiomyopathy (unless concomitant atrial fibrillation and heart failure but should be used with caution)

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      43.9
      Seconds

  • Question 10 - Regarding ACE inhibitors, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding ACE inhibitors, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Angiotensin-II receptor blockers are a useful alternative in patients who cannot tolerate ACE-inhibitors due a persistent cough.

      Explanation:

      ACE inhibitors should be used with caution in patients of Afro-Caribbean descent who may respond less well; calcium channel blockers are first line for hypertension in these patients. ACE inhibitors have a role in the management of diabetic nephropathy. ACE inhibitors are contraindicated in pregnant women. ACE inhibitors inhibit the breakdown of bradykinin; this is the cause of the persistent dry cough. Blocking ACE also diminishes the breakdown of the potent vasodilator bradykinin which is the cause of the persistent dry cough. Angiotensin-II receptor blockers do not have this effect, therefore they are useful alternative for patients who have to discontinue an ACE inhibitor because of persistent cough.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (4/9) 44%
Physiology (2/4) 50%
Pharmacology (2/5) 40%
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