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  • Question 1 - Which of the following are responsible for the 4th heart sound? ...

    Correct

    • Which of the following are responsible for the 4th heart sound?

      Your Answer: Ventricular hypertrophy

      Explanation:

      The fourth heart sound is not normally audible in a normal adult. It occurs as a consequence of ventricular hypertrophy. It is caused by filling of the ventricle in atrial systole.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.7
      Seconds

  • Question 2 - Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms ...

    Incorrect

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

      Your Answer: Increases the number of actin and myosin

      Correct 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
      22.6
      Seconds

  • Question 3 - Where on the surface of the chest is the normal site of auscultation...

    Correct

    • Where on the surface of the chest is the normal site of auscultation for the mitral area?

      Your 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
      7
      Seconds

  • Question 4 - 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
      9
      Seconds

  • Question 5 - The following are examples of the functions of the vascular endothelium except: ...

    Correct

    • The following are examples of the functions of the vascular endothelium except:

      Your Answer: Tumour suppression

      Explanation:

      Vascular endothelium has many important functions including regulation of vascular tone, molecular exchange between blood and tissue compartments, hemostasis and signaling for the immune regulation and inflammation. Depending on specific tissue needs and local stresses, endothelial cells are capable of evoking either antithrombotic or prothrombotic events. Tumor suppression is related to genes, or anti-oncogenes, that regulate a cell during cell division and replication.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.4
      Seconds

  • Question 6 - The postextrasystolic potentiation of myocardial contractility is due to: ...

    Correct

    • The postextrasystolic potentiation of myocardial contractility is due to:

      Your Answer: Increase in intracellular Ca2+

      Explanation:

      The postextrasystolic potentiation of myocardial contractility Is not due to ventricular filling. It occurs in isolated locations in the heart and is due to increase availability of intracellular calcium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.9
      Seconds

  • Question 7 - Depolarization spreads rapidly through cardiac muscle fibers because of the presence of: ...

    Correct

    • Depolarization spreads rapidly through cardiac muscle fibers because of the presence of:

      Your Answer: Gap junctions

      Explanation:

      The cardiac muscles have gap junctions in between the cells. They allow for the formation of 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
      8.5
      Seconds

  • Question 8 - The end- diastolic ventricular volume is about? ...

    Correct

    • The end- diastolic ventricular volume is about?

      Your Answer: 130 ml

      Explanation:

      The end diastolic volume in a healthy individual is about 130 ml.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.8
      Seconds

  • Question 9 - Myocardial contractility is improved by: ...

    Correct

    • Myocardial contractility is improved by:

      Your Answer: Caffeine

      Explanation:

      Caffeine and other theophyllines breakdown cAMP and have a positive ionotropic effect on the heart. Drugs like quinidine, procainamide and conditions like hypoxia and hypercapnia decreases the contractility of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.5
      Seconds

  • Question 10 - Arterioles stemming from the coronary artery can also empty into the heart directly...

    Correct

    • Arterioles stemming from the coronary artery can also empty into the heart directly via the:

      Your Answer: Arteriosinusoidal vessels

      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. They include arteriosinusoidal vessels, which connect the arterioles to the heart chambers. The thebesian veins drain the capillaries into the chambers and the arterioluminal vessels drain small arteries directly into the chambers.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17.1
      Seconds

  • Question 11 - Myocyte action potentials – Choose the false statement: ...

    Incorrect

    • Myocyte action potentials – Choose the false statement:

      Your Answer: Depolarisation spreads rapidly through the individual fibers due to the presence of gap junctions

      Correct Answer: Repolarisation is due to net k+ influx

      Explanation:

      Final repolarization (phase 3) to the resting membrane potential (phase 4) is due to closure of the Ca2+ channels and a slow, delayed increase of K+ efflux through various types of K+ channels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      26.9
      Seconds

  • Question 12 - The following contributes to the rate of depolarization? ...

    Incorrect

    • The following contributes to the rate of depolarization?

      Your Answer: Hypoxia

      Correct Answer: All of the options given

      Explanation:

      Depolarization occurs due to impulses generated by the SA node. As the heart beats to the rhythm of the SA node, certain factors will effect the rate of depolarization. All the mentioned options effect the rate of depolarization.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.5
      Seconds

  • Question 13 - The heart rate can be accelerated by: ...

    Correct

    • The heart rate can be accelerated by:

      Your Answer: Exercise and thyroid hormones

      Explanation:

      The firing of the SA node will increase due to exercises and as the thyroid hormone has a chronotropic effect on the heart, it too will result in an increase in the heart rate via stimulation of the adrenergic receptors of the heart. As during exercise the sympathetic nervous system is activated, it will directly have an positive chronotropic effect on the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.7
      Seconds

  • Question 14 - Generalized vasoconstrictors include: ...

    Correct

    • Generalized vasoconstrictors include:

      Your Answer: Norepinephrine, endothelin, angiotensin ii

      Explanation:

      Vasopressin, angiotensin II, adrenaline and endothelin are generalized vasoconstrictors.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.1
      Seconds

  • Question 15 - The rate of depolarisation of the sinus node membrane potential is modulated by...

    Incorrect

    • The rate of depolarisation of the sinus node membrane potential is modulated by all the following except:

      Your Answer: Autonomic tone

      Correct Answer: Cardiac output

      Explanation:

      Cardiac output has no effect on the depolarization of the pacemaker potential of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.9
      Seconds

  • Question 16 - Which of the atrial pressure changes represents the a-wave of the JVP ...

    Incorrect

    • Which of the atrial pressure changes represents the a-wave of the JVP

      Your Answer: Rise in atrial pressure before tricuspid valve opens

      Correct Answer: Atrial systole

      Explanation:

      The a-wave created on the venous pulse curve occurs as a result of atrial systole. Due to the pressure build-up in the atria, it causes a back pressure in the vena cava. This pressure is exerted on the valve and this back pressure is what causes a slight increase in the venous pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      20.1
      Seconds

  • Question 17 - Which of the following factors serve to decrease cardiac output? ...

    Incorrect

    • Which of the following factors serve to decrease cardiac output?

      Your Answer: Pregnancy

      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
      5.5
      Seconds

  • Question 18 - The Plateau phase in myocyte action potentials does all of the following except:...

    Correct

    • The Plateau phase in myocyte action potentials does all of the following except:

      Your Answer: It allows early reactivation of the myocytes

      Explanation:

      The presence of the plateau in the action potential causes ventricular contraction to last as much as 15 times longer in cardiac muscle as in skeletal muscle. 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 (refractory) phase prevents early reactivation of the myocytes and directly determines the strength of contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.2
      Seconds

  • Question 19 - In the blood supply of the heart, ‘dominance’ refers to the coronary artery...

    Incorrect

    • In the blood supply of the heart, ‘dominance’ refers to the coronary artery which supplies the?

      Your Answer: Sinoatrial node

      Correct Answer: Posterior interventricular artery

      Explanation:

      Dominance of the coronary artery system is defined by the artery that gives rise to the posterior interventricular artery. Dominance of the right coronary artery is more common (68%). It gives rise to the large posterior interventricular branch which goes down to the apex of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.4
      Seconds

  • Question 20 - 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 right 3rd 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
      5.2
      Seconds

  • Question 21 - In which area is depolarization initiated? ...

    Incorrect

    • In which area is depolarization initiated?

      Your Answer: AV node

      Correct Answer: SA node

      Explanation:

      SA node is the pacemaker of the heart. It determines the rate of contractions. It is the place where depolarization is initiated. It exhibits phase 4 depolarization or automaticity. Electrical impulses then spread to the AV node, purkinje fibers, bundle of his and the ventricular muscles.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.1
      Seconds

  • Question 22 - 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
      24.4
      Seconds

  • Question 23 - Which coronary artery supplies the right atria? ...

    Incorrect

    • Which coronary artery supplies the right atria?

      Your Answer: Left coronary

      Correct Answer: Right coronary

      Explanation:

      The left coronary artery distributes blood to the left side of the heart, the left atrium and ventricle, and the interventricular septum. The circumflex artery arises from the left coronary artery and follows the coronary sulcus to the left. Eventually, it will fuse with the small branches of the right coronary artery. The right coronary artery proceeds along the coronary sulcus and distributes blood to the right atrium, portions of both ventricles, and the heart conduction system.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.6
      Seconds

  • Question 24 - Excitation-contraction coupling in cardiac muscle involves all of the following except: ...

    Incorrect

    • Excitation-contraction coupling in cardiac muscle involves all of the following except:

      Your Answer: Ca2+ conductance via the dihydropyridine receptor

      Correct 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
      8
      Seconds

  • Question 25 - Which structure forms the major part of the sternocostal surface of the heart?...

    Correct

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

      Your 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
      5.9
      Seconds

  • Question 26 - The ability of the SA node cells to allow ionic flow through channels...

    Incorrect

    • The ability of the SA node cells to allow ionic flow through channels activated in a hyperpolarized state is known as:

      Your Answer: Non of the above

      Correct Answer: Pace maker potential

      Explanation:

      Rhythmically discharging cells have a membrane potential that, after each impulse, declines to the firing level. Thus this prepotential or Pacemaker potential triggers the next impulse. The inherent leakiness of the sinus nodal fibers to Na+ and Ca2+ causes their self excitation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.9
      Seconds

  • Question 27 - In Jugular vein pressure the “a” wave represents? ...

    Incorrect

    • In Jugular vein pressure the “a” wave represents?

      Your Answer: Bulging of tricuspid valve

      Correct Answer: Atrial systole

      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 and two downward deflections 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
      11.7
      Seconds

  • Question 28 - 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: Bradykinin

      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
      9.6
      Seconds

  • Question 29 - The following products of the vascular endothelium produce vasodilation except: ...

    Incorrect

    • The following products of the vascular endothelium produce vasodilation except:

      Your Answer:

      Correct Answer: Endothelin

      Explanation:

      Vascular endothelial growth factor (VEGF) is a signal protein produced by cells that stimulates vasculogenesis and angiogenesis. It is part of the system that restores the oxygen supply to tissues when blood circulation is inadequate. VEGF’s normal function is to create new blood vessels during embryonic development, new blood vessels after injury, muscle following exercise, and new vessels (collateral circulation) to bypass blocked vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 30 - Absolute refractory period in a cardiac action potential graph occurs during. ...

    Incorrect

    • Absolute refractory period in a cardiac action potential graph occurs during.

      Your Answer:

      Correct Answer: All of the above

      Explanation:

      Absolute refractory period (ARP): the cell is completely unexcitable to a new stimulus and occurs from phase 0 – 2 i.e. depolarisation, early repolarisation and plateau phase.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (20/28) 71%
Medicine (20/28) 71%
Passmed
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