-
Question 1
Correct
-
Which of the following is true with AV nodal delay?
Your Answer: Shortened by sympathetic stimulation
Explanation:AV nodal delay Is about 0.1s before the action potential spreads to the ventricles. It is shortened by stimulation of the sympathetic nervous system and lengthened by stimulation of the parasympathetic system.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 2
Correct
-
Question 3
Incorrect
-
Nitric oxide triggers vascular smooth muscle contraction through activation of which enzyme?
Your Answer: Protein kinase a
Correct Answer: Guanylyl cyclase
Explanation:Impaired production or excess catabolism of NO impairs this endothelium-dependent vasodilator function and may contribute to excessive vasoconstriction under various pathological situations.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 4
Incorrect
-
Although variable, branches of which artery most often supply the SA and AV nodes?
Your Answer: Left anterior descending artery
Correct Answer: Right coronary artery
Explanation:The RCA (right coronary artery) supplies the SA and the AV nodes along with the postero-basal wall of the left ventricle, posterior one third of the inferior vena cava, right ventricle and the posteromedial papillary muscle in the left ventricle.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 5
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
-
-
Question 6
Correct
-
The coronary sinus drains into the:
Your Answer: Right atrium
Explanation:The coronary sinus drains into the right atrium. 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
-
-
Question 7
Incorrect
-
The approximate incidence of deep venous thrombosis (DVT) in the general population each year is:
Your Answer: 0.1 per 1000
Correct Answer: 1 per 1000
Explanation:About 1 in 1000 adults per year has DVT, but as of 2011, available data is dominated by North American and European populations. DVT is rare in children, with an incidence of about 1 in 100,000 a year. From childhood to old age, incidence increases by a factor of about 1000, with almost 1% of the elderly experiencing DVTs yearly.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 8
Incorrect
-
Which of the following statements is true regarding pulsus alternans?
Your Answer: It is found in patients with a small pericardial effusion
Correct 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
-
-
Question 9
Incorrect
-
Concerning surface anatomy, where is the apex beat found?
Your Answer: 3rd intercostal space mid clavicular 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
-
-
Question 10
Incorrect
-
The T-tubular system in cardiac muscle is:
Your Answer: Has dihydropyridine receptors which act as calcium activated Ca2+ release channels.
Correct Answer: Transmits action potential from sarcolemma to the SR to allow for Ca2+ release into the cytoplasm
Explanation:Action potentials are 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, which are voltage gated calcium channels.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 11
Incorrect
-
The following determines the strength of contraction
Your Answer: Resting membrane potential
Correct Answer: Plateau phase
Explanation:The plateau phase which follows is unique to myocytes and results from a small, but sustained inward calcium current through L-type calcium channels lasting 200-400 ms. This calcium influx is caused by a combined increase in permeability of the cell and especially the sarcolemmal membranes to calcium. This plateau (or refractory) phase in myocyte action potential prevents early reactivation of the myocytes and directly determines the strength of contraction
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 12
Correct
-
When looking at the JVP what does the c wave signify:
Your 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
-
-
Question 13
Incorrect
-
The SA and AV nodes are usually supplied by which artery?
Your Answer: Superior vena cava
Correct Answer: Right coronary artery
Explanation:The right coronary artery supplies the right atrium, right ventricle, SA and AV nodes.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 14
Correct
-
Which factors increase the end-diastolic volume?
Your 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
-
-
Question 15
Correct
-
The Sinoatrial node in the majority of people is supplied by the?
Your Answer: Right coronary artery
Explanation:In 60% of people, the SA node is supplied by the right coronary artery branch and in 40% of the people by the left coronary artery.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 16
Incorrect
-
Water hammer pulse is found in:
Your Answer: Mitral incompetence
Correct 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
-
-
Question 17
Incorrect
-
Question 18
Incorrect
-
Which is the most common site for primary cardiac tumours to occur in adults?
Your Answer: Right ventricle
Correct 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
-
-
Question 19
Incorrect
-
Stroke volume in a average sized man lying in supine position is about?
Your Answer: 85 ml
Correct Answer: 70 ml
Explanation:The stroke volume of an average sized man who is lying is the supine position is about 70 ml.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 20
Incorrect
-
Blood flow to the subendocardial portions of the left ventricular muscle occurs mainly during:
Your Answer: Atrial systole
Correct Answer: Diastole
Explanation:The sub endocardium receives the least amount of blood from the coronary arteries. During systole the coronary arteries collapse as a result of the pressure from contraction that is exerted on them. During diastole the heart muscle relaxes and the pressure on the coronary vessels is relieved allowing blood to flow through them to the sub endocardium.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 21
Correct
-
According to Starling's law of the heart:
Your Answer: The extent of the preload is proportional to the end-diastolic volume
Explanation:Frank starlings law describes that an increase in the venous return or the end diastolic volume will cause an increase in the stroke volume/ preload and also cardiac output. It stems from the fact that increased venous return will increase the stretch on the ventricular muscle fibers. The sarcomere will stretch a considerable length that is needed for maximum contraction and the development of tension in the muscle fiber. The greater the venous return the greater the cardiac output. This relationship is directly proportional.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 22
Incorrect
-
The triangle with the heart at its centre, using limb leads is called:
Your Answer: Jones
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
-
-
Question 23
Incorrect
-
Endothelial cells are attached to adjacent cells by adherent junctions via:
Your Answer: Mucins
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
-
-
Question 24
Incorrect
-
Which of the following conditions has no effect on cardiac output?
Your Answer: Anxiety
Correct Answer: Sleep
Explanation:Sleep has no effect on the cardiac output. Anxiety, excitement and pregnancy will increase the cardiac output. Standing from a lying position will decrease the cardiac output transiently.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 25
Incorrect
-
Question 26
Incorrect
-
Hyperkalaemia [K+ =7meq/l] can lead to the following ECG changes [Ca++ normal]
Your Answer: Prominent U wave
Correct Answer: Peaked T waves
Explanation:Hyperkalaemia causes the formation of tall tented T waves due to altered repolarization.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 27
Incorrect
-
Calcium is mobilized from the sarcoplasmic reticulum through:
Your Answer: Passive diffusion
Correct 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
-
-
Question 28
Incorrect
-
What is the isolated effect of B2 stimulation on the coronaries?
Your Answer: Vasoconstriction
Correct 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
-
-
Question 29
Incorrect
-
In a normal heart rate at rest, the left ventricular end-diastolic volume is ….
Your Answer: 10-30 ml
Correct Answer: 100-130 ml
Explanation:In cardiovascular physiology, end-diastolic volume (EDV) is the volume of blood in the right and/or left ventricle at end load or filling in (diastole) or the amount of blood in the ventricles just before systole. Because greater EDVs cause greater distention of the ventricle, EDV is often used synonymously with preload, which refers to the length of the sarcomeres in cardiac muscle prior to contraction (systole). End-diastolic volume: Right = 144 mL(± 23mL) & Left = 142 mL (± 21 mL).
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 30
Incorrect
-
Most of the venous blood returns to the heart through the:
Your Answer: Left ventricle
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
-
-
Question 31
Correct
-
The Wiebel-Palade body found in the endothelial cells is responsible for the production and release of which factor?
Your Answer: Von Willebrand factor
Explanation:Weibel-Palade bodies are the storage granules of endothelial cells, the cells that form the inner lining of the blood vessels and heart. They store and release two principal molecules, von Willebrand factor and P-selectin, and thus play a dual role in haemostasis and inflammation.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 32
Incorrect
-
The following is true of the sinus node:
Your Answer: It has the same action potentials as myocytes
Correct Answer: It generates impulses automatically & at a quicker rate than other cardiac cells
Explanation:The SA node exhibits automaticity. It generates the impulses to which the heart beats. It fires at a faster speed than the rest of the nervous components of the heart i.e. the AV nodes, purkinje fibers. This is the reason when the SA node fails the heart beats to the rhythm of the AV node.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 33
Incorrect
-
Activation of nitric oxide synthesis by endothelial cells is triggered by:
Your Answer: None of the above
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
-
-
Question 34
Incorrect
-
Impulse conduction through the AV node is slow and depends on the action potential produced by which of the following.
Your Answer: All of the above
Correct Answer: Calcium flux
Explanation:The action potentials in the SA and AV nodes are largely due to Ca2+, with no contribution by Na+ influx.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 35
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
-
-
Question 36
Correct
-
Afferent fibers from the baroreceptors of the great arteries form branches of which cranial nerves?
Your 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
-
-
Question 37
Incorrect
-
Xanthines such as caffeine and theophylline are positively inotropic due to:
Your Answer: Circulating catecholamines
Correct Answer: Inhibition of cAMP breakdown
Explanation:Xanthines exert their positive inotropic effect by inhibiting the breakdown of the cAMP resulting in stronger and sustained contractions.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 38
Incorrect
-
Calcium induced calcium release occurs in the sarcoplasmic reticulum by activation of which receptors
Your Answer: M2 receptors
Correct Answer: Ryanodine receptors
Explanation:Calcium-induced calcium release (CICR) describes a biological process whereby calcium is able to activate calcium release from intracellular Ca2+ stores (e.g., endoplasmic reticulum or sarcoplasmic reticulum). CICR occurs when the resulting Ca2+ influx activates ryanodine receptors on the SR membrane, which causes more Ca2+ to be released into the cytosol.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 39
Incorrect
-
Regarding the myofilament molecules, which of the following contains binding sites for calcium that helps to initiate contraction?
Your Answer: Troponin i
Correct Answer: Troponin c
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
-
-
Question 40
Correct
-
Which of the following would be a contraindication to thrombolysis?
Your Answer: Intracranial neoplasm
Explanation:Absolute contraindications to thrombolysis include:
- Previous intracranial bleeding at any time
- Stroke in less than 6 months
- Closed head or facial trauma within 3 months
- Suspected aortic dissection
- Ischemic stroke within 3 months (except in ischemic stroke within 3 hours time)
- Active bleeding diathesis
- Uncontrolled high blood pressure (>180 systolic or >100 diastolic)
- Known structural cerebral vascular lesion
- Arterio-venous malformations
- Thrombocytopenia
- Known coagulation disorders
- Aneurysm
- Brain tumours
- Pericardial effusion
- Septic embolus
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 41
Incorrect
-
Angina pectoris develops when blood through the coronary artery becomes:
Your Answer: Thrombotic
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
-
-
Question 42
Correct
-
B1 adrenergic stimulation produces:
Your Answer: Increase in calcium cytosolic concentration
Explanation:Norepinephrine secreted by the sympathetic endings binds to B1 receptors, and the resulting increase in intracellular cAMP facilitates the opening of L channels, increasing Ica and the rapidity of the depolarization phase of the impulse and activates PKA which leads to phosphorylation of the voltage-gated Ca2+ channels, causing them to spend more time in the open state.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 43
Incorrect
-
The predominant receptors in the hearts conduction system are?
Your Answer: Both β1 and β2
Correct Answer: Β1
Explanation:All of the components of the intrinsic conduction system contain autorhythmic cells that spontaneously depolarize. In the absence of extrinsic neural or hormonal influences, the SA node pacing rate would be about 100 beats per minute (bpm). The heart rate and cardiac output, however, must vary in response to the needs of the body’s cells for oxygen and nutrients under varying conditions. In order to respond rapidly to changing requirements of the body’s tissues, the heart rate and contractility are regulated by the autonomic nervous system (ANS), hormones, and other factors. The ANS has two interacting systems: the sympathetic and parasympathetic systems.
Sympathetic receptors: There are two types of adrenergic receptors: β and α. In the cardiovascular system there are β1, β2, α1, and α2 adrenergic receptors. β1 adrenergic receptors are expressed in the heart conduction system (in the SA node, AV node, and on atrial and ventricular cardiomyocytes). The activation of β1 receptors increases heart rate (via the SA node), and contractility.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 44
Correct
-
Stimulation of the carotid sinus results in:
Your Answer: Drop in blood pressure
Explanation:Stimulation of the carotid sinus will result in an increase in the baroreceptor discharge. This will travel via the afferent nerves to the medulla. Signals will pass through the vagus nerve to decrease the sympathetic outflow to the heart and the blood vessels. This inhibition will result in vasodilation of the blood vessels, venodilation and bradycardia hence decreasing the total peripheral resistance and lowering the blood pressure.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 45
Incorrect
-
Which of the following occurs during a Valsalva manoeuvre?
Your Answer: Forced inspiration against a closed glottis: no: forced expiration rather
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:
- 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.
- 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.
- Phase III: Upon releasing the strain, there is a sudden drop in intrathoracic pressure, which momentarily decreases blood pressure.
- 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
-
-
Question 46
Correct
-
The amount of a substance taken up by an organ (or whole body) per unit time is = (the arterial level - the venous level) * the blood flow. This statement describes?
Your Answer: The Fick principle
Explanation:The essence of the Fick principle is that blood flow to an organ can be calculated using a marker substance if the following information is known:- Amount of marker substance taken up by the organ per unit time- Concentration of marker substance in arterial blood supplying the organ- Concentration of marker substance in venous blood leaving the organ
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 47
Incorrect
-
The major factor in controlling coronary artery blood flow is considered to be?
Your Answer: Parasympathetic input
Correct Answer: Metabolites of oxygen consumption
Explanation:There is a strong relationship between myocardial blood flow and oxygen consumption. This indicates that products of metabolism may cause vasodilation of the coronary artery.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 48
Incorrect
-
Where would one normally find venous valves?
Your Answer: Brain
Correct 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
-
-
Question 49
Incorrect
-
The direct determinants of cardiac output are
Your Answer: Ejection fraction and heart rate
Correct 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
-
-
Question 50
Incorrect
-
The areas of extensive series of sarcoplasmic folds known as intercalated discs always occur at what portion of the muscle fiber?
Your Answer: M line
Correct Answer: Z lines
Explanation:The muscle fibers of the heart branch and interdigitate, but one complete unit is surrounded by a cell membrane. The place where one muscle fiber abuts the other, the cell membrane of both the fibers run parallel to each other through a series of extensive folds. These areas always occur on the Z lines and are known as intercalated discs.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 51
Incorrect
-
Which of the following structures is not part of the conducting system of the heart?
Your Answer: Internodal pathway
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
-
-
Question 52
Incorrect
-
During exercise, a man consumes 2L O2/min, his arterial 02 content is 190 ml/l and the 02 content of his mixed venous blood is 130ml/l. His cardiac output is approximately:
Your Answer: 3,3 l/min
Correct Answer: 33l/min
Explanation:In Fick’s original method, the following variables are measured:VO2, oxygen consumption in ml of pure gaseous oxygen per minute. This may be measured using a spirometer within a closed rebreathing circuit incorporating a CO2 absorberCa, the oxygen concentration of blood taken from the pulmonary vein (representing oxygenated blood)Cv, the oxygen concentration of blood from an intravenous cannula (representing deoxygenated blood)From these values, we know that:VO2 = (CO x Ca) – (CO x Cv)where CO = Cardiac Output, Ca = Oxygen concentration of arterial blood and Cv = Oxygen concentration of mixed venous blood.This allows us to sayCO = VO2/{Ca – Cv}and hence calculate cardiac output.Therefore CO = 2/(0.190-0.130) = 33l/minNote that (Ca – Cv) is also known as the arteriovenous oxygen difference.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 53
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
-
-
Question 54
Incorrect
-
Which of the following intercellular connections is important in endothelial barrier function?
Your Answer: Gap junctions
Correct Answer: Tight junctions
Explanation:Tight junctions surround the apical margins of the epithelial cells such as in the intestinal mucosa and the choroid plexus. They are also important to the endothelial barrier function. They are made up of ridges that adhere to each other strongly at the cell junction, obliterating the space completely between the cells.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 55
Incorrect
-
Which of the following factors serve to decrease cardiac output?
Your Answer: Increased ambient temperature
Correct Answer: Standing from a lying position
Explanation:Sleep has no effect on the cardiac output. Anxiety, excitement, increased body temperature and pregnancy will increase the cardiac output. Standing from a lying position will decrease the cardiac output transiently.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 56
Incorrect
-
Activation of baroreceptor reflex involves:
Your Answer: Increase in heart rate base of inhibition of the vagal cardiac motor neurons
Correct Answer: Short term regulation of systemic blood pressure
Explanation:Baroreceptors are found in the heart and the blood vessels. They are the carotid sinus and the aortic arch receptors and respond to the minute to minute change in the blood pressure i.e. a change in the pulsatile pressure and not to a change in the mean arterial pressure. If the pulse pressure decreases, the rate of firing of the receptors decreases, stimulating an increase in the heart rate and blood pressure. Mechanisms that regulate the long term blood pressure control include the renin-angiotensin-aldosterone mechanism.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 57
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
-
-
Question 58
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:
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
-
-
Question 59
Incorrect
-
Direct conduction from the atrium to the ventricles is prevented by:
Your Answer:
Correct 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
-
-
Question 60
Incorrect
-
Coronary blood flow occurs in?
Your Answer:
Correct Answer: Diastole
Explanation:Coronary arteries are unique in that they fill during diastole, when not occluded by valve cusps nor compressed by myocardial contraction).
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
SESSION STATS - PERFORMANCE PER SPECIALTY
