00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Mins)
Retry this test Dashboard

  • Question 1 - A 55 year old cardiac patient is comfortable at rest but heavy housework...

    Correct

    • A 55 year old cardiac patient is comfortable at rest but heavy housework results in fatigue, palpitations or dyspnoea. What New York Heart Association class best describes the severity of their disease?

      Your Answer: NYHA Class II

      Explanation:

      New York Heart Association functional classification:

      Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities.

      Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.

      Class III: marked limitation of any activity; the patient is comfortable only at rest.

      Class IV: any physical activity brings on discomfort and symptoms occur at rest.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      24.3
      Seconds

  • Question 2 - 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
      107.2
      Seconds

  • Question 3 - Where is the carotid sinus located? ...

    Correct

    • Where is the carotid sinus located?

      Your Answer: After the bifurcation of the carotid artery, on the internal carotid

      Explanation:

      The carotid sinus is a small dilation in the internal carotid artery just above its bifurcation into the external and internal carotid branch. Baroreceptors are present at this dilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.1
      Seconds

  • Question 4 - Coronary arteries fill up during ...

    Correct

    • Coronary arteries fill up during

      Your 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
      14.9
      Seconds

  • Question 5 - Calcium is mobilized from the sarcoplasmic reticulum through: ...

    Correct

    • Calcium is mobilized from the sarcoplasmic reticulum through:

      Your Answer: Ryanodine receptor (RyR2) calcium release channels

      Explanation:

      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. As a result intracellular calcium increases binding to troponin C resulting in contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17.5
      Seconds

  • Question 6 - Which of the following causes an increase in venous return? ...

    Incorrect

    • Which of the following causes an increase in venous return?

      Your Answer: A decrease in the normal negative intra-thoracic pressure

      Correct Answer: An increase in the negative intra-thoracic pressure

      Explanation:

      During inspiration, intrathoracic pressure becomes more negative and intra-abdominal pressure more positive. This increases the venous pressure gradient from abdomen to thorax and promotes filling of the central veins.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.8
      Seconds

  • Question 7 - Regarding the cardiac muscle striations as viewed under the microscope, which areas are...

    Incorrect

    • Regarding the cardiac muscle striations as viewed under the microscope, which areas are dark?

      Your Answer: H band and m line

      Correct 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
      20.4
      Seconds

  • Question 8 - The triangle with the heart at its centre, using limb leads is called:...

    Correct

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

      Your 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
      5.5
      Seconds

  • Question 9 - Direct conduction from the atrium to the ventricles is prevented by: ...

    Correct

    • Direct conduction from the atrium to the ventricles is prevented by:

      Your Answer: Annulus fibrosus

      Explanation:

      The annulus fibrosus disconnects the syncytium complex. The atria are rapidly activated however the activation peters out when the insulating layer-the annulus fibrosus-is reached.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.5
      Seconds

  • Question 10 - The initial rapid depolarization in the action potential of cardiac muscle cells is...

    Correct

    • The initial rapid depolarization in the action potential of cardiac muscle cells is due to:

      Your Answer: Opening of voltage-gated Na+ channels

      Explanation:

      The initial depolarization of the action potential in a cardiac muscle cell is due to the sodium current generated by opening of the voltage gated sodium channels leading to an influx of sodium ions into the cell and raising the membrane potential towards threshold.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.1
      Seconds

  • Question 11 - 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
      7.5
      Seconds

  • Question 12 - Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms ...

    Correct

    • Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms

      Your 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
      19.3
      Seconds

  • Question 13 - 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
      77.1
      Seconds

  • Question 14 - Coronary arteries arise from? ...

    Incorrect

    • Coronary arteries arise from?

      Your Answer: Ascending aorta

      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
      75.9
      Seconds

  • Question 15 - If both the noradrenergic and the cholinergic systems are blocked in the heart,...

    Correct

    • If both the noradrenergic and the cholinergic systems are blocked in the heart, the rate will be approximately:

      Your Answer: 100/min

      Explanation:

      The normal heart beat is about 70/min. This is due to a predominant parasympathetic activity. If sympathetic activity was unopposed the heart rate would have been 150/min. When both the noradrenergic and cholinergic systems are blocked the heart rate is 100/min. This is the normal firing rate of the SA node.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.4
      Seconds

  • Question 16 - Pacemaker cells in the SA node and the AV node are connected by?...

    Correct

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

      Your 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
      4.2
      Seconds

  • Question 17 - Currents caused by opening of which of the following channels contribute to the...

    Correct

    • 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: 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
      30
      Seconds

  • Question 18 - 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: Vasoconstriction via production of metabolites

      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
      31.9
      Seconds

  • Question 19 - Normal stroke volume is about: ...

    Correct

    • Normal stroke volume is about:

      Your Answer: 70 ml

      Explanation:

      Stroke volume is the amount of blood that is pumped from the heart into the aorta. It is typically 70 ml.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      24.4
      Seconds

  • Question 20 - 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
      268.7
      Seconds

  • Question 21 - What is the most common cardiac defect seen in patients with Down’s syndrome?...

    Correct

    • What is the most common cardiac defect seen in patients with Down’s syndrome?

      Your Answer: Atrioventricular septal defect

      Explanation:

      The rate of congenital heart disease in new-borns with Down syndrome is around 40%. Of those with heart disease, about 80% have an atrioventricular septal defect or ventricular septal defect with the former being more common. Mitral valve problems become common as people age, even in those without heart problems at birth.[3] Other problems that may occur include tetralogy of Fallot and patent ductus arteriosus.[38] People with Down syndrome have a lower risk of hardening of the arteries

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      49.2
      Seconds

  • Question 22 - Which is the most common site for primary cardiac tumours to occur in...

    Correct

    • Which is the most common site for primary cardiac tumours to occur in adults?

      Your Answer: Left atrium

      Explanation:

      Myxomas are the most common type of primary heart tumour. The tumour is derived from multipotential mesenchymal cells and may cause a ball valve-type obstruction. About 75% of myxomas occur in the left atrium of the heart, usually beginning in the wall that divides the two upper chambers of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      31
      Seconds

  • Question 23 - Which of the following statements is true regarding pulsus alternans? ...

    Correct

    • Which of the following statements is true regarding pulsus alternans?

      Your Answer: It is found in association with a third heart sound

      Explanation:

      Pulsus alternans is a physical finding with arterial pulse waveform showing alternating strong and weak beats. It is almost always indicative of left ventricular systolic impairment, and carries a poor prognosis. A pathological third heart sound is usually associated.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.2
      Seconds

  • Question 24 - Which of the following affects the magnitude of the action potential? ...

    Correct

    • Which of the following affects the magnitude of the action potential?

      Your Answer: Changes in the external Na+ concentration

      Explanation:

      The magnitude of the action potential is determined by the sodium current. Increase in external sodium will result in increased influx of sodium and hence generation of a stronger action potential.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      23
      Seconds

  • Question 25 - 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: Opposite the left upper sternal border in the 2nd intercostal space

      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
      26.5
      Seconds

  • Question 26 - What is the isolated effect of B2 stimulation on the coronaries? ...

    Correct

    • What is the isolated effect of B2 stimulation on the coronaries?

      Your Answer: Vasodilatation

      Explanation:

      Norepinephrine and epinephrine are agonists for all adrenergic receptor subtypes, although with varying affinities. Based on their physiology and pharmacology, adrenergic receptors have been divided into two principal types: alpha and beta. These types have been further differentiated into alpha-1, alpha-2, b1, and b2 receptors.

      Alpha-1 Receptors are located on postsynaptic cells in smooth muscle and elicit vasoconstriction.

      Alpha-2 receptors are localized on presynaptic membranes of postganglionic nerve terminals that synthesize norepinephrine. When activated by catecholamines, alpha-2 receptors act as negative feedback controllers, inhibiting further norepinephrine release.

      Activation of myocardial b1 receptors stimulates the rate and strength of cardiac contraction, and consequently increases cardiac output. b1 Receptor activation also stimulates renin release from the kidney. Another class of antihypertensive agents acts by inhibiting b1 receptors.

      Activation of b2 receptors by epinephrine relaxes vascular smooth muscle and results in vasodilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      59.1
      Seconds

  • Question 27 - Concerning surface anatomy, where is the aortic valve found? ...

    Correct

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

      Your 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
      18.4
      Seconds

  • Question 28 - Which statement about the 2nd heart sound is true? ...

    Correct

    • Which statement about the 2nd heart sound is true?

      Your 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
      57.4
      Seconds

  • Question 29 - Troponin I is inhibited by calcium binding to: ...

    Correct

    • Troponin I is inhibited by calcium binding to:

      Your Answer: Troponin c

      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
      19.9
      Seconds

  • Question 30 - The following is true in relation to coronary venous drainage? ...

    Correct

    • The following is true in relation to coronary venous drainage?

      Your Answer: Most venous return ultimately drains into right atrium via the coronary sinus

      Explanation:

      Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins. Apart from these there are other vessels that drain directly into the heart chambers

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      21.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (23/30) 77%
Medicine (23/30) 77%
Passmed
Retry this test Dashboard