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  • Question 1 - The coronary sinus drains into the: ...

    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
      6.9
      Seconds

  • Question 2 - Cholinergic vagal supply to the SA and AV nodes results in slowing of...

    Incorrect

    • Cholinergic vagal supply to the SA and AV nodes results in slowing of the heart rate via:

      Your Answer: M1 muscarinic receptors

      Correct Answer: M2 muscarinic receptors

      Explanation:

      M2 muscarinic receptors are the receptors for the parasympathetic system to the SA and the AV node.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      20.5
      Seconds

  • Question 3 - Regarding cardiac output, an increased ejection fraction results from increases in which of...

    Correct

    • Regarding cardiac output, an increased ejection fraction results from increases in which of the following?

      Your Answer: Strength of contraction without increase in muscle fiber length

      Explanation:

      When the strength of contraction increases without an increase in fiber length, the EF increases.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      25.7
      Seconds

  • Question 4 - What are the diagnostic criteria for an ST segment elevation type of acute...

    Incorrect

    • What are the diagnostic criteria for an ST segment elevation type of acute myocardial infarction?

      Your Answer: Q waves in any two leads

      Correct Answer: 1 mm ST elevation in 2 limb leads

      Explanation:

      The current guidelines for the ECG diagnosis of the ST segment elevation type of acute myocardial infarction require at least 1 mm (0.1 mV) of ST segment elevation in the limb leads, and at least 2 mm elevation in the precordial leads. These elevations must be present in anatomically contiguous leads. (I, aVL, V5, V6 correspond to the lateral wall; V3-V4 correspond to the anterior wall ; V1-V2 correspond to the septal wall; II, III, aVF correspond to the inferior wall.)

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      24.5
      Seconds

  • Question 5 - The V wave in the jugular pulse is caused by: ...

    Incorrect

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

      Your Answer:

      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
      0
      Seconds

  • Question 6 - Although variable, branches of which artery most often supply the SA and AV...

    Incorrect

    • Although variable, branches of which artery most often supply the SA and AV nodes?

      Your Answer:

      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
      0
      Seconds

  • Question 7 - Which of the following supplies the AV node? ...

    Incorrect

    • Which of the following supplies the AV node?

      Your Answer:

      Correct Answer: Right coronary artery

      Explanation:

      The AV node is supplied by the right coronary artery near the origin of the posterior IV artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 8 - Factors influencing cardiac output include which of the following? ...

    Incorrect

    • Factors influencing cardiac output include which of the following?

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 9 - Which statement about the 2nd heart sound is true? ...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 10 - Stimulation of the carotid sinus results in: ...

    Incorrect

    • Stimulation of the carotid sinus results in:

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 11 - 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

  • Question 12 - What is the main reason for checking the urea and electrolytes prior to...

    Incorrect

    • What is the main reason for checking the urea and electrolytes prior to commencing a patient on amiodarone?

      Your Answer:

      Correct Answer: To detect hypokalaemia

      Explanation:

      All antiarrhythmic drugs have the potential to cause arrhythmias. Coexistent hypokalaemia significantly increases this risk.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 13 - Myocardium requires more oxygen to expel blood in: ...

    Incorrect

    • Myocardium requires more oxygen to expel blood in:

      Your Answer:

      Correct Answer: A stenotic aortic valve

      Explanation:

      In aortic valve stenosis, increased ventricular pressure Is needed to expel the blood into the aorta. Increased pressure means increased contractility hence increase O2 consumption by the heart muscles.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 14 - Which of the following is true of the Natriuretic hormones? ...

    Incorrect

    • Which of the following is true of the Natriuretic hormones?

      Your Answer:

      Correct Answer: They are released in response to hypervolemia

      Explanation:

      Natriuretic hormones are vasodilators released in response to hypervolemia.

      Natriuretic hormones (NH) include three groups of compounds: the natriuretic peptides NPs (ANP, BNP and CNP), the gastrointestinal peptides (guanylin and uroguanylin), and endogenous cardiac steroids. These substances induce the kidney to excrete sodium and therefore participate in the regulation of sodium and water homeostasis, blood volume, and blood pressure (BP). In addition to their peripheral functions, these hormones act as neurotransmitters or neuromodulators in the brain.

      Atrial natriuretic peptide (ANP) plays a crucial role in blood pressure regulation by inducing natriuresis and diuresis in the kidney, inhibiting renin secretion, aldosterone production, and promoting vasorelaxation.  Two paracrine factors derived from endothelial cells play important roles in modulating ANP secretion. Endothelin, a potent vasoconstrictor, stimulates ANP secretion and augments stretch induced ANP secretion. The dramatic increase in ANP release produced by cardiac ischemia appears to be mediated in part by endothelin. Nitric oxide (NO), an important vasodilator, is also produced by endothelial cells and inhibits ANP secretion.

      Brain natriuretic peptide (BNP) shares ANP’s receptor but is primarily associated with antifibrotic effects in ventricular remodeling, serving as a biomarker for heart failure and myocardial infarction.

      C-type natriuretic peptide (CNP) acts locally in an autocrine/paracrine manner, exerting potent cardiovascular effects, including vasorelaxation and vascular remodeling post-injury. NPs also demonstrate diverse effects beyond cardiovascular and renal systems, such as bronchodilation, anti-inflammatory actions, and metabolic effects on adipose tissue and long bones.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 15 - Which is the commonest cardiovascular abnormality seen in an adult patient with Marfan’s...

    Incorrect

    • Which is the commonest cardiovascular abnormality seen in an adult patient with Marfan’s syndrome?

      Your Answer:

      Correct Answer: Aortic aneurysm

      Explanation:

      Marfan syndrome (MFS) is a genetic disorder of connective tissue. The degree to which people are affected varies. People with Marfan’s tend to be tall, and thin, with long arms, legs, fingers and toes. They also typically have flexible joints and scoliosis. The most serious complications involve the heart and aorta with an increased risk of mitral valve prolapse and aortic aneurysm.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 16 - 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:

      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
      0
      Seconds

  • Question 17 - The initial rapid depolarization in the action potential of cardiac muscle cells is...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 18 - Depolarization of the T tubule membrane activates the sarcoplasmic reticulum via which receptors?...

    Incorrect

    • Depolarization of the T tubule membrane activates the sarcoplasmic reticulum via which receptors?

      Your Answer:

      Correct Answer: Dihydropyridine receptors

      Explanation:

      Action potentials are transmitted to the fibrils of a fiber through the T tubule system. It triggers the release of Ca 2+ form the terminal cisterns. Depolarization of the T tubules activates the sarcoplasmic reticulum through the dihydropyridine receptors.

      Dihydropyridine receptors (DHPRs), are voltage-gated Ca2+ channels, and ryanodine receptors (RyRs), which are intracellular Ca2+ release channels, are expressed in diverse cell types, including skeletal and cardiac muscle.

      Ryanodine receptors (RyRs) are located in the sarcoplasmic/endoplasmic reticulum membrane and are responsible for the release of Ca2+ from intracellular stores during excitation-contraction coupling in both cardiac and skeletal muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 19 - Which of the following phases in depolarization and repolarization of cardiac muscle cells...

    Incorrect

    • Which of the following phases in depolarization and repolarization of cardiac muscle cells are caused by the inactivation of Na+ channels?

      Your Answer:

      Correct Answer: Phase 1 : rapid repolarization

      Explanation:

      Phase 0 is caused by the sodium current. Voltage gated sodium channels open leading to the influx of sodium into the cardiac muscle cell. Phase 1 is the rapid transient repolarization phase which is caused by the inactivation of the voltage gated sodium channels and opening of the voltage gated potassium channels along with opening of the slow calcium channels. Phase 2 which is the plateau is caused by opening of the slow calcium channels. Phase 4 is caused by closing of the slow calcium channels and opening of the potassium channels leading to efflux of potassium leading to the establishment of the resting membrane potential.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 20 - Which of the following does not lower ventricular rate in atrial fibrillation? ...

    Incorrect

    • Which of the following does not lower ventricular rate in atrial fibrillation?

      Your Answer:

      Correct Answer: Adrenaline

      Explanation:

      Adrenaline is a sympathetic neurotransmitter which increases the heart rate. During atrial fibrillation the atria is contracting at more than 200 beats/min. Acetylcholine is a parasympathetic neurotransmitter decreasing the heart rate. Digital also depresses the conduction at the AV conduction. Vagal discharge and occulocardiac reflux decrease the heart rate and convert the tachycardia into normal sinus rhythm.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 21 - Concerning surface anatomy, where is the mitral valve found? ...

    Incorrect

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

      Your Answer:

      Correct Answer: Situated in the 4th intercostal space to the left of the sternum

      Explanation:

      The mitral valve is situated in the left 4th intercostal space just beneath the sternum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 22 - Where is the carotid sinus located? ...

    Incorrect

    • Where is the carotid sinus located?

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 23 - Which of the following best describes the cardiac muscle? ...

    Incorrect

    • Which of the following best describes the cardiac muscle?

      Your Answer:

      Correct Answer: Striated and involuntary

      Explanation:

      Cardiac muscle (heart muscle) is an involuntary, striated muscle that is found in the walls and histological foundation of the heart, specifically the myocardium. Cardiac muscle is one of three major types of muscle, the others being skeletal and smooth muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 24 - The positive inotropic effect of digoxin is due to? ...

    Incorrect

    • The positive inotropic effect of digoxin is due to?

      Your Answer:

      Correct Answer: Inhibition of the sodium potassium ATPase in the myocardium

      Explanation:

      Digitalis compounds are potent inhibitors of cellular Na+/K+-ATPase. This ion transport system moves sodium ions out of the cell and brings potassium ions into the cell. By inhibiting the Na+/K+-ATPase, cardiac glycosides cause the intracellular sodium concentration to increase. This then leads to an accumulation of intracellular calcium via the Na+/Ca++ exchange system. In the heart, increased intracellular calcium causes more calcium to be released by the sarcoplasmic reticulum, thereby making more calcium available to bind to troponin-C, which increases contractility (inotropy).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 25 - Regarding the myofilament molecules, which of the following contains binding sites for calcium...

    Incorrect

    • Regarding the myofilament molecules, which of the following contains binding sites for calcium that helps to initiate contraction?

      Your Answer:

      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
      0
      Seconds

  • Question 26 - Which heart sounds are matched correctly? ...

    Incorrect

    • Which heart sounds are matched correctly?

      Your Answer:

      Correct Answer: All of the above

      Explanation:

      In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the atrioventricular valves and semilunar valves, respectively. In addition to these normal sounds, a variety of other sounds may be present including heart murmurs, adventitious sounds, and gallop rhythms S3 and S4. S3 is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by blood rushing in from the atria. The reason the third heart sound does not occur until the middle third of diastole is probably that during the early part of diastole, the ventricles are not filled sufficiently to create enough tension for reverberation. S4 when audible in an adult is called a presystolic gallop or atrial gallop. This gallop is produced by the sound of blood being forced into a stiff or hypertrophic ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 27 - Sinus bradycardia may be caused by disease of which of the following: ...

    Incorrect

    • Sinus bradycardia may be caused by disease of which of the following:

      Your Answer:

      Correct Answer: Right coronary artery

      Explanation:

      Disease of the right coronary artery may cause sinus bradycardia and AV nodal block.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 28 - Where would one find pericytes around endothelial cells? ...

    Incorrect

    • Where would one find pericytes around endothelial cells?

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 29 - Which structure forms the major part of the sternocostal surface of the heart?...

    Incorrect

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

      Your Answer:

      Correct Answer: Right ventricle

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 30 - The following contributes to the rate of depolarization? ...

    Incorrect

    • The following contributes to the rate of depolarization?

      Your Answer:

      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
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (2/4) 50%
Medicine (2/4) 50%
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