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  • Question 1 - With regards to the cardiac cycle which of the following is true ...

    Incorrect

    • With regards to the cardiac cycle which of the following is true

      Your Answer: Left atrial systole occurs before right atrial systole

      Correct Answer: Right atrial systole occurs before left atrial systole: as below

      Explanation:

      Cardiac cycle: The first event in the cycle is atrial depolarization (a P wave on the surface ECG) follows by RIGHT ATRIAL and then LEFT ATRIAL contraction. Ventricular activation (QRS) follows after a short interval (the PR interval). LEFT VENTRICULAR contraction starts shortly thereafter RIGHT VENTRICULAR contraction begins. At the end, the aortic valve closure is followed by pulmonary valve closure.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      54.1
      Seconds

  • Question 2 - 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
      13
      Seconds

  • Question 3 - The ‘c’ wave in JVP corresponds more closely with: ...

    Correct

    • The ‘c’ wave in JVP corresponds more closely with:

      Your Answer: Isovolumetric contraction

      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 (peaks) and two downward deflections (troughs) 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
      7.9
      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
      2.5
      Seconds

  • Question 5 - The predominant receptors in the hearts conduction system are? ...

    Correct

    • The predominant receptors in the hearts conduction system are?

      Your 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
      11.5
      Seconds

  • Question 6 - The Wiebel-Palade body found in the endothelial cells is responsible for the production...

    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
      79.3
      Seconds

  • Question 7 - 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
      4.8
      Seconds

  • Question 8 - 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
      17.6
      Seconds

  • Question 9 - Which of the following antiarrhythmic drugs may be used in the treatment of...

    Incorrect

    • Which of the following antiarrhythmic drugs may be used in the treatment of long QT syndrome?

      Your Answer: Amiodarone

      Correct Answer: Atenolol

      Explanation:

      Beta-blockers are the mainstay of treatment in long QT syndrome. Implantable cardioverter-defibrillators are the most effective treatment in genotypes with a high risk of recurrence.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.2
      Seconds

  • Question 10 - Where would one find pericytes around endothelial cells? ...

    Correct

    • Where would one find pericytes around endothelial cells?

      Your Answer: Post-capillary venules

      Explanation:

      Pericytes release a wide variety of vasoactive agents which regulate the flow through the junction between endothelial cells.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      48.7
      Seconds

  • Question 11 - The postextrasystolic potentiation of myocardial contractility is due to: ...

    Incorrect

    • The postextrasystolic potentiation of myocardial contractility is due to:

      Your Answer: Increased myocardial fiber length

      Correct 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
      25.7
      Seconds

  • Question 12 - According to Starling's law of the heart: ...

    Incorrect

    • According to Starling's law of the heart:

      Your Answer: Energy of contraction is proportional to the pressure in the left ventricle

      Correct 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
      56.4
      Seconds

  • Question 13 - Ventricular depolarization plus ventricular repolarization is shown by the _____ interval ...

    Correct

    • Ventricular depolarization plus ventricular repolarization is shown by the _____ interval

      Your Answer: QT

      Explanation:

      The QT interval represents ventricular depolarization as well as ventricular repolarization.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.3
      Seconds

  • Question 14 - Which of the following causes the closure of the ductus arteriosus during birth?...

    Incorrect

    • Which of the following causes the closure of the ductus arteriosus during birth?

      Your Answer: Reduction of pulmonary vascular resistance

      Correct Answer: Reduced levels of prostaglandins

      Explanation:

      Ductus arteriosus is kept open by the prostaglandin E2 which is a vasodilator. At birth the high levels of cyclooxygenase blocks the production of prostaglandins which results in the closure of the ductus arteriosus.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      21.6
      Seconds

  • Question 15 - The areas of extensive series of sarcoplasmic folds known as intercalated discs always...

    Incorrect

    • The areas of extensive series of sarcoplasmic folds known as intercalated discs always occur at what portion of the muscle fiber?

      Your Answer: A band

      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
      14.8
      Seconds

  • Question 16 - Factors influencing cardiac output include which of the following? ...

    Correct

    • Factors influencing cardiac output include which of the following?

      Your Answer: All of the above

      Explanation:

      There is a correlation between resting CO and body surface area. The output per min per square meter of body surface (the cardiac index) averages 3.2l.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.3
      Seconds

  • Question 17 - Which factor produced by the endothelium is responsible for the regulation of vascular...

    Correct

    • Which factor produced by the endothelium is responsible for the regulation of vascular cell growth?

      Your Answer: Vascular endothelial growth factor (VEGF)

      Explanation:

      VEGF is produced by the endothelial cells and is the major growth factor responsible for causing vasculogenesis. Some isoforms of this growth factor also have a prominent role in formation of lymphatic vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9
      Seconds

  • Question 18 - If both the noradrenergic and the cholinergic systems are blocked in the heart,...

    Incorrect

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

      Your Answer: 70/min

      Correct 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
      10.3
      Seconds

  • Question 19 - 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
      16
      Seconds

  • Question 20 - Which of the following normally has a slow depolarizing “prepotential”? ...

    Incorrect

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

      Your Answer: Ventricular muscle cells

      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
      10.2
      Seconds

  • Question 21 - Coronary flow is reduced during ...

    Incorrect

    • Coronary flow is reduced during

      Your Answer: Diastole

      Correct 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
      4.7
      Seconds

  • Question 22 - Which of the following corresponds to an oblique line drawn from the sternal...

    Correct

    • Which of the following corresponds to an oblique line drawn from the sternal end of the left 3rd costal cartilage to the sternal end of the right 6th costal cartilage?

      Your Answer: Atrio-ventricular (coronary) groove

      Explanation:

      The AV groove corresponds to the right border of the heart. The right border corresponds to a line drawn from the 3rd right costal cartilage to the 6th right costal cartilage; this border is slightly convex to the right.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      37.8
      Seconds

  • Question 23 - The bradycardia that occurs in patients with raised intracranial pressure is a result...

    Correct

    • The bradycardia that occurs in patients with raised intracranial pressure is a result of the?

      Your Answer: Cushing reflex

      Explanation:

      When intracranial pressure is increased, the blood supply to RVLM neurons is compromised. This results in an increase in their discharge as a result of hypoxia and hypercapnia. The resultant rise in systemic arterial pressure (Cushing reflex) tends to restore the blood flow to the medulla.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.3
      Seconds

  • Question 24 - 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
      4
      Seconds

  • Question 25 - 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
      17.2
      Seconds

  • Question 26 - 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
      8.5
      Seconds

  • Question 27 - Activation of baroreceptor reflex involves: ...

    Incorrect

    • Activation of baroreceptor reflex involves:

      Your Answer: None of the above

      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
      46.9
      Seconds

  • Question 28 - Which of the following has the shortest duration: ...

    Correct

    • Which of the following has the shortest duration:

      Your Answer: Atrial systole

      Explanation:

      Atrial systole: 0.1s

      Atrial diastole: around 0.4s

      Ventricular diastole: 0.4-0.53s

      Ventricular systole: 0.27s

      PR interval: 0.12-0.2 s

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      61.2
      Seconds

  • Question 29 - The V wave in the jugular pulse is caused by: ...

    Incorrect

    • The V wave in the jugular pulse is caused by:

      Your Answer: Ventricular filling

      Correct Answer: Atrial filling

      Explanation:

      The v wave reflects the passive increase in pressure and volume of the right atrium as it fills in late systole and early diastole.

      The jugular vein pulsations usually have two elevations and two troughs. The first elevation (a wave) corresponds to the slight rise in atrial pressure resulting from atrial contraction. The first descent (x descent) reflects a fall in atrial pressure that starts with atrial relaxation. The second elevation (v wave) corresponds to ventricular systole when blood is entering the right atrium from the vena cavae while the tricuspid valve is closed. Finally, the second descent (y descent) reflects falling right atrial pressure as the tricuspid valve opens and blood drains from the atrium into the ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.4
      Seconds

  • Question 30 - 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
      10.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (19/30) 63%
Medicine (19/30) 63%
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