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  • Question 1 - 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: Shear stress

      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
      20.9
      Seconds

  • Question 2 - Which of the following occurs during a Valsalva manoeuvre? ...

    Incorrect

    • Which of the following occurs during a Valsalva manoeuvre?

      Your Answer: Disruption of autonomic function

      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
      17.9
      Seconds

  • Question 3 - The branche(s) of the left coronary artery include: ...

    Incorrect

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

      Your Answer: Left circumflex artery

      Correct 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
      19.3
      Seconds

  • Question 4 - Vasodilatation of coronary arteries is caused by: ...

    Correct

    • Vasodilatation of coronary arteries is caused by:

      Your Answer: Hypoxia

      Explanation:

      The heart is highly metabolically active and boasts the highest oxygen consumption by mass of any organ. This demand for oxygen is met by the coronary circulation, which is responsible for delivering blood to the myocardium and represents approximately 5% of cardiac output. Vasodilation may be due to the local effect of hypoxia on coronary vessels, or local metabolic vasodilation, or the activation of β-adrenoceptors or some combination of these mechanisms.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.3
      Seconds

  • Question 5 - 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
      32.5
      Seconds

  • Question 6 - The isoforms of nitric oxide synthase which are found in the nervous system...

    Incorrect

    • 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: Na

      Correct 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
      19.4
      Seconds

  • Question 7 - Concerning S3, which of the following statements is INCORRECT? ...

    Correct

    • Concerning S3, which of the following statements is INCORRECT?

      Your Answer: Coincide with atrial contraction

      Explanation:

      A third heart sound also called a ventricular gallop occurs at the beginning of diastole after S2 and is lower in pitch than S1 or S2 as it is not of valvular origin. The third heart sound is benign in youth, some trained athletes, and sometimes in pregnancy but if it re-emerges later in life it may signal cardiac problems, such as a failing left ventricle as in dilated congestive heart failure (CHF). 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. It may also be a result of tensing of the chordae tendineae during rapid filling and expansion of the ventricle. In other words, an S3 heart sound indicates increased volume of blood within the ventricle. An S3 heart sound is best heard with the bell-side of the stethoscope (used for lower frequency sounds). A left-sided S3 is best heard in the left lateral decubitus position and at the apex of the heart, which is normally located in the 5th left intercostal space at the midclavicular line. A right-sided S3 is best heard at the lower-left sternal border. The way to distinguish between a left and right-sided S3 is to observe whether it increases in intensity with inhalation or exhalation. A right-sided S3 will increase on inhalation, while a left-sided S3 will increase on exhalation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      26.4
      Seconds

  • Question 8 - 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: M1 muscarinic 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
      29.6
      Seconds

  • Question 9 - 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: AV block

      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
      36.9
      Seconds

  • Question 10 - Cholinergic nerves from the vagus innervate the SA and AV nodes via which...

    Correct

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

      Your 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
      23.2
      Seconds

  • Question 11 - Which of the following is NOT true of the parasympathetic control of the...

    Correct

    • Which of the following is NOT true of the parasympathetic control of the heart?

      Your Answer: It can be blocked by beta blockers

      Explanation:

      Parasympathetic fibers do not innervate the Beta receptors on the heart. They are innervated by the sympathetic nerve fibers. Then a beta blocker such as propranolol will block the sympathetic outflow and increase the parasympathetic tone of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      40.7
      Seconds

  • Question 12 - Concerning surface anatomy, where is the apex beat found? ...

    Incorrect

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

      Your Answer: 5th intercostal space anterior axillary 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
      17.5
      Seconds

  • Question 13 - 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
      39.4
      Seconds

  • Question 14 - Afferent fibers from the baroreceptors of the great arteries form branches of which...

    Incorrect

    • Afferent fibers from the baroreceptors of the great arteries form branches of which cranial nerves?

      Your Answer: Vestibulocochlear and glossopharyngeal nerves

      Correct Answer: Glossopharyngeal and vagus nerves

      Explanation:

      The receptors of the carotid sinus are innervated by the carotid sinus nerve, a branch of the glossopharyngeal nerve. The aortic arch receptors located in the arch of the aorta are innervated by the aortic depressor nerve, a branch of the vagus nerve.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      30.8
      Seconds

  • Question 15 - The rate of depolarization of the SA node membrane potential is modulated by...

    Correct

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

      Your 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
      12.2
      Seconds

  • Question 16 - Which structure forms the major part of the sternocostal surface of the heart?...

    Incorrect

    • Which structure forms the major part of the sternocostal surface of the heart?

      Your Answer: Right atrium

      Correct Answer: Right ventricle

      Explanation:

      The anterior (sternocostal) surface is formed mainly by the right ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      32.5
      Seconds

  • Question 17 - 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 coronary 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
      20.1
      Seconds

  • Question 18 - Concerning surface anatomy, where is the aortic valve found? ...

    Incorrect

    • Concerning surface anatomy, where is the aortic valve found?

      Your Answer: Situated in the right third intercostal space underneath the sternum

      Correct Answer: Situated in the left third intercostal space underneath 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
      19.6
      Seconds

  • Question 19 - In which organ will you find extremely porous sinusoidal capillaries, with discontinuous endothelium?...

    Incorrect

    • In which organ will you find extremely porous sinusoidal capillaries, with discontinuous endothelium?

      Your Answer: Kidneys

      Correct Answer: Liver

      Explanation:

      The liver is the organ which contains sinusoidal capillaries with discontinuous endothelium. The brain, lungs and the intestine all contain continuous capillaries, however the kidney contains fenestrated capillaries to aid in filtration.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.5
      Seconds

  • Question 20 - Initial depolarization of cardiac muscle is due to influx of: ...

    Incorrect

    • Initial depolarization of cardiac muscle is due to influx of:

      Your Answer: H+

      Correct Answer: Na+

      Explanation:

      Initial depolarization of the cardiac muscle results from opening of the sodium voltage gated channels. This results in the influx of sodium and an increase in the membrane potential towards threshold. Potassium efflux results in repolarization.

      The cardiac action potential has 5 phases:

      • Phase 0—depolarization because of the opening of fast sodium channels. Potassium flux also decreases.
      • Phase 1—partial repolarization because of a rapid decrease in sodium ion passage as fast sodium channels close.
      • Phase 2—plateau phase in which the movement of calcium ions out of the cell, maintains depolarization.
      • Phase 3—repolarization, sodium, and calcium channels all close and membrane potential returns to baseline.
      • Phase 4—resting membrane potential (−90 mV), resulting from the activity of the Na+/K+ ATPase pump which creates a negative intracellular potential because of the exchange of three sodium ions for only two potassium ions.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      27.6
      Seconds

  • Question 21 - 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
      25
      Seconds

  • Question 22 - Which of the following makes up the thick filaments in muscle fibers? ...

    Correct

    • Which of the following makes up the thick filaments in muscle fibers?

      Your Answer: Myosin

      Explanation:

      The thick filaments are made up of myosin and the thin filaments are made up of actin. The thick filaments are twice the size of the thin filaments and are aligned to form the A band. The thin filaments extending out from the A band form the less dense I bands.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      25.9
      Seconds

  • Question 23 - Which heart sounds are matched correctly? ...

    Incorrect

    • Which heart sounds are matched correctly?

      Your Answer: S3 - rapid ventricular filling

      Correct 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
      27
      Seconds

  • Question 24 - The function of Troponin T in cardiac muscle is? ...

    Incorrect

    • The function of Troponin T in cardiac muscle is?

      Your Answer: Escape into the circulation during acute coronary syndrome to allow for a diagnosis of NSTEMI

      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
      28.5
      Seconds

  • Question 25 - Which of the following normally has a slow depolarizing “prepotential”? ...

    Incorrect

    • Which of the following normally has a slow depolarizing “prepotential”?

      Your Answer: Purkinje fibers

      Correct Answer: Sinoatrial node

      Explanation:

      There are 2 main types of action potentials (AP) in the heart, the slow response and the fast response:The slow response is initiated by the slow calcium-sodium channels, found in the SA node (which is the natural pacemaker of the heart) and the conduction fibers of the AV node.The fast response occurs in the atrial and ventricles muscle cells and the purkinje fibers.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      20.9
      Seconds

  • Question 26 - With regard to the endothelial structure, the epithelium constitute: ...

    Incorrect

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

      Your Answer: Stratified squamous

      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
      10.3
      Seconds

  • Question 27 - In ventricular fibrillation (VF), the first defibrillation attempt (with a biphasic defibrillator) should...

    Correct

    • In ventricular fibrillation (VF), the first defibrillation attempt (with a biphasic defibrillator) should be made at:

      Your Answer: 200 J

      Explanation:

      Defibrillation is a common treatment for life-threatening cardiac dysrhythmias and ventricular fibrillation. If the patient is in Ventricular tachycardia (VT) or ventricular fibrillation (VF) on the monitor, immediately apply the pads and shock the patient with 120-200 Joules on a biphasic defibrillator or 360 Joules on a monophasic defibrillator.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17
      Seconds

  • Question 28 - Coronary arteries arise from? ...

    Incorrect

    • Coronary arteries arise from?

      Your Answer: Aortic arch

      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
      12.9
      Seconds

  • Question 29 - What is cardiac output? ...

    Correct

    • What is cardiac output?

      Your Answer: Product of stroke volume and heart rate

      Explanation:

      Cardiac output is the product of stroke volume and heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      31.3
      Seconds

  • Question 30 - Which of the following is NOT associated with the development of aortic regurgitation?...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (14/29) 48%
Medicine (14/29) 48%
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