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  • Question 1 - Coronary vasoconstriction can be caused by: ...

    Incorrect

    • Coronary vasoconstriction can be caused by:

      Your Answer: Vagal tone

      Correct Answer: Beta blockage

      Explanation:

      Coronary arteries contain alpha and beta receptors. The alpha receptor stimulates vasoconstriction and beta receptors stimulate vasodilation. When the chronotropic and inotropic effects of noradrenergic receptors are blocked by a B blocking drug, stimulation of the noradrenergic nerves will cause coronary vasoconstriction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      39
      Seconds

  • Question 2 - The positive inotropic effect of digoxin is due to? ...

    Incorrect

    • The positive inotropic effect of digoxin is due to?

      Your Answer: Increased intracellular c amp

      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
      13.1
      Seconds

  • Question 3 - Which of the following best describes the cardiac muscle? ...

    Incorrect

    • Which of the following best describes the cardiac muscle?

      Your Answer: Smooth and involuntary

      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
      11.4
      Seconds

  • Question 4 - Which of the following conditions has no effect on cardiac output? ...

    Correct

    • Which of the following conditions has no effect on cardiac output?

      Your 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
      5.2
      Seconds

  • Question 5 - 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: Phase 2 : plateau

      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
      24.8
      Seconds

  • Question 6 - In Starling’s law of the heart, the decrease in tension developed by muscle...

    Incorrect

    • In Starling’s law of the heart, the decrease in tension developed by muscle contraction at high degrees of stretch is due to:

      Your Answer: A conformational change in the myosin head at high degrees of stretch.

      Correct Answer: Disruption of myocardial fibers

      Explanation:

      Starling law states that the force of contraction is directly proportional to the preload. When the heart muscle is stretched beyond its limit the tension that is developed decreases, this is not due to loss of formation of effective myosin and actin cross bridges. The heart muscles despite being fully stretched is never stretched to this point. The reason for this decreased tension is physical disruption of the myocardial fibers.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      27.9
      Seconds

  • Question 7 - 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
      11.9
      Seconds

  • Question 8 - When the heart rate is increased (to pathological levels) which of the following...

    Correct

    • When the heart rate is increased (to pathological levels) which of the following is correct when comparing the duration of diastole to systole?

      Your Answer: It is shortened to a greater degree

      Explanation:

      The duration of systole is more fixed than the duration of diastole. When the heart rate increases the timing of the systole remains more or less the same however diastole decreases.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.9
      Seconds

  • Question 9 - Which of the following structures is not part of the conducting system of...

    Correct

    • Which of the following structures is not part of the conducting system of the heart?

      Your 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
      6.2
      Seconds

  • Question 10 - Calcium induced calcium release occurs in the sarcoplasmic reticulum by activation of which...

    Incorrect

    • Calcium induced calcium release occurs in the sarcoplasmic reticulum by activation of which receptors

      Your Answer: Alpha 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
      3.5
      Seconds

  • Question 11 - Transport of Ca2+ into the reticulum to initiate cardiac muscle relaxation in via:...

    Correct

    • Transport of Ca2+ into the reticulum to initiate cardiac muscle relaxation in via:

      Your Answer: Serca (sarcoplasmic or endoplasmic reticulum Ca2+ ATPase)

      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
      15.9
      Seconds

  • Question 12 - 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
      7
      Seconds

  • Question 13 - All of the following are consistent with the indicator dilution method except--- ...

    Correct

    • All of the following are consistent with the indicator dilution method except---

      Your Answer: In thermodilution, the indicator used is warm saline

      Explanation:

      In thermodilution, the indicator used is cold saline.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      35.2
      Seconds

  • Question 14 - Which of the following is NOT true of the parasympathetic control of the...

    Correct

    • Which of the following is NOT true of the parasympathetic control of the heart?

      Your Answer: It can be blocked by beta blockers

      Explanation:

      Parasympathetic fibers do not innervate the Beta receptors on the heart. They are innervated by the sympathetic nerve fibers. Then a beta blocker such as propranolol will block the sympathetic outflow and increase the parasympathetic tone of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.1
      Seconds

  • Question 15 - With regard to the endothelial structure, the epithelium constitute: ...

    Correct

    • With regard to the endothelial structure, the epithelium constitute:

      Your Answer: Simple squamous

      Explanation:

      The single layer of squamous epithelium lining the heart and blood vessels is known as the endothelium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.5
      Seconds

  • Question 16 - The following products of the vascular endothelium produce vasodilation except: ...

    Correct

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

      Your Answer: Endothelin

      Explanation:

      Endothelin: This is incorrect in the context of vasodilation. Endothelin is actually a potent vasoconstrictor produced by the endothelium, leading to the narrowing of blood vessels and increased blood pressure.

      Nitrous oxide (Nitric oxide): This is correct for vasodilation. Nitric oxide is a powerful vasodilator produced by the endothelium, which helps relax and widen blood vessels.

      Prostacyclin: This is correct for vasodilation. Prostacyclin (PGI2) is a vasodilator and inhibits platelet aggregation, helping to maintain blood flow and reduce clot formation.

      Endothelial-derived hyperpolarizing factor (EDHF): This is correct for vasodilation. EDHF causes vasodilation by hyperpolarizing the smooth muscle cells of blood vessels.

      Vascular endothelial growth factor (VEGF): This is correct for vasodilation. VEGF primarily promotes the growth of new blood vessels but also has vasodilatory effects through nitric oxide production.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.7
      Seconds

  • Question 17 - The following contributes to the rate of depolarization? ...

    Incorrect

    • The following contributes to the rate of depolarization?

      Your Answer: pH

      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
      12.3
      Seconds

  • Question 18 - Which vaso metabolite decreases coronary blood flow? ...

    Correct

    • Which vaso metabolite decreases coronary blood flow?

      Your Answer: Endothelin

      Explanation:

      Decreased O2, increased CO2, lactate, prostaglandins, adenine nucleotides, adenosine, H+, K+ and cyanide produce vasodilation and thus an increase in coronary blood flow.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.9
      Seconds

  • Question 19 - Coronary arteries arise from? ...

    Correct

    • Coronary arteries arise from?

      Your Answer: None of the above

      Explanation:

      Coronary arteries arise from the sinuses behind 2 of the cusps of the aortic valve at the root of aorta.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9
      Seconds

  • Question 20 - Where would one find pericytes around endothelial cells? ...

    Incorrect

    • Where would one find pericytes around endothelial cells?

      Your Answer: Pre-capillary venules

      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
      15.7
      Seconds

  • Question 21 - Xanthines such as caffeine and theophylline are positively inotropic due to: ...

    Correct

    • Xanthines such as caffeine and theophylline are positively inotropic due to:

      Your 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
      16.8
      Seconds

  • Question 22 - 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
      6
      Seconds

  • Question 23 - Which of the following affects the magnitude of the action potential? ...

    Incorrect

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

      Your Answer: The amount of intracellular Ca2+

      Correct Answer: Changes in the external Na+ concentration

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      23.4
      Seconds

  • Question 24 - What is a characteristic findings on ECG in hyperkalaemia? ...

    Correct

    • What is a characteristic findings on ECG in hyperkalaemia?

      Your Answer: Tall, tented T waves

      Explanation:

      Hyperkalaemia leads to:

      – Prolonged PR interval

      – Small P waves

      – Tall, tented T waves

      – Widened QRS complexes and eventually asystole.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.3
      Seconds

  • Question 25 - Which of the following is NOT associated with the development of aortic regurgitation?...

    Incorrect

    • Which of the following is NOT associated with the development of aortic regurgitation?

      Your Answer: Bechet's disease

      Correct Answer: Dilated cardiomyopathy

      Explanation:

      Aortic insufficiency, is often due to the aortic root dilation, which is idiopathic in over 80% of cases, but otherwise may result from aging, syphilitic aortitis, osteogenesis imperfecta, aortic dissection, Bechet’s disease, reactive arthritis and systemic hypertension. Additionally, aortic insufficiency has been linked to the use of some medications and other potential causes that affect the valve directly including Marfan’s syndrome, Ehlers–Danlos syndrome, ankylosing spondylitis, and systemic lupus erythematosus. In acute cases of aortic insufficiency, the main causes are infective endocarditis, aortic dissection or trauma. Dilated cardiomyopathy is associated with the development of mitral regurgitation, not aortic regurgitation

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10
      Seconds

  • Question 26 - Which of the following occurs during a Valsalva manoeuvre? ...

    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:

      1. 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.
      2. 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.
      3. Phase III: Upon releasing the strain, there is a sudden drop in intrathoracic pressure, which momentarily decreases blood pressure.
      4. 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
      16.4
      Seconds

  • Question 27 - Which of the following structures of the cardiac conduction system is located in...

    Correct

    • Which of the following structures of the cardiac conduction system is located in the right posterior portion of the interatrial septum?

      Your Answer: AV node

      Explanation:

      AV node is located at the right posterior portion of the interatrial septum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.3
      Seconds

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

    Incorrect

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

      Your Answer: It occurs at the end of ventricular systole.

      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
      39.2
      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: Left ventricle

      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
      15.3
      Seconds

  • Question 30 - Concerning surface anatomy, where is the apex beat found? ...

    Correct

    • Concerning surface anatomy, where is the apex beat found?

      Your 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
      7.5
      Seconds

  • Question 31 - 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
      16.2
      Seconds

  • Question 32 - 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
      23.4
      Seconds

  • Question 33 - Dicrotic notch is produced by which valves? ...

    Incorrect

    • Dicrotic notch is produced by which valves?

      Your Answer: Pulmonary

      Correct Answer: Aortic

      Explanation:

      The graph of aortic pressure throughout the cardiac cycle displays a small dip (the incisure or dicrotic notch) which coincides with the aortic valve closure. The dip in the graph is immediately followed by a brief rise (the dicrotic wave) then gradual decline.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.2
      Seconds

  • Question 34 - Calcium is mobilized from the sarcoplasmic reticulum through: ...

    Correct

    • Calcium is mobilized from the sarcoplasmic reticulum through:

      Your Answer: Ryanodine receptor (RyR2) calcium release channels

      Explanation:

      During the plateau phase of the action potential, calcium from the extracellular fluid enters through the L type of calcium channels. This entry triggers the release of more calcium from the sarcoplasmic reticulum via the ryanodine receptors. As a result intracellular calcium increases binding to troponin C resulting in contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.4
      Seconds

  • Question 35 - 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
      14.2
      Seconds

  • Question 36 - Which of the atrial pressure changes represents the a-wave of the JVP ...

    Correct

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

      Your 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
      12.2
      Seconds

  • Question 37 - Nitric oxide triggers vascular smooth muscle contraction through activation of which enzyme? ...

    Incorrect

    • Nitric oxide triggers vascular smooth muscle contraction through activation of which enzyme?

      Your Answer: Adenylate cyclase

      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
      10.3
      Seconds

  • Question 38 - 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
      10.2
      Seconds

  • Question 39 - In a 30 year old male with hypertrophic obstructive cardiomyopathy (HOCM), which of...

    Correct

    • 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: 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
      27.8
      Seconds

  • Question 40 - Which of the following conditions does not influence the cardiac output? ...

    Correct

    • Which of the following conditions does not influence the cardiac output?

      Your Answer: Sleep

      Explanation:

      Sleep has no effect on the cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.1
      Seconds

  • Question 41 - The coronary arteries fill during? ...

    Correct

    • The coronary arteries fill during?

      Your Answer: Diastole

      Explanation:

      During systole the coronary arteries collapse as a result of the pressure due to 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 subendocardium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      2.4
      Seconds

  • Question 42 - Blood flow to the subendocardial portions of the left ventricular muscle occurs mainly...

    Correct

    • Blood flow to the subendocardial portions of the left ventricular muscle occurs mainly during:

      Your 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
      6.7
      Seconds

  • Question 43 - According to Starling's law of the heart: ...

    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
      18.3
      Seconds

  • Question 44 - In the Fick‘s method of measuring cardiac output, the arterial oxygen content can...

    Incorrect

    • In the Fick‘s method of measuring cardiac output, the arterial oxygen content can be measured in a sample obtained from

      Your Answer: The left atrium

      Correct Answer: The pulmonary vein

      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.Note that (Ca – Cv) is also known as the arteriovenous oxygen difference.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17.6
      Seconds

  • Question 45 - 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
      11.5
      Seconds

  • Question 46 - The process by which depolarization of the muscle fiber initiates contraction is called?...

    Correct

    • The process by which depolarization of the muscle fiber initiates contraction is called?

      Your Answer: Action potential

      Explanation:

      This process is known as an action potential. Upon generation of an action potential when depolarization reaches threshold, it spreads throughout the muscle fiber, resulting in generation of an excitation-contraction coupling leading to contraction of the muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.2
      Seconds

  • Question 47 - Activation of baroreceptor reflex involves: ...

    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
      15.7
      Seconds

  • Question 48 - Although variable, branches of which artery most often supply the SA and AV...

    Correct

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

      Your 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
      4.1
      Seconds

  • Question 49 - The initial rapid depolarization in the action potential of cardiac muscle cells is...

    Correct

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

      Your Answer: Opening of voltage-gated Na+ channels

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.6
      Seconds

  • Question 50 - Digoxin causes: ...

    Correct

    • Digoxin causes:

      Your Answer: Increase in cytosolic calcium concentration

      Explanation:

      Digoxin is a positive inotrope which inhibits NA/K ATPase, increases cardiac contractility and can cause hypokalaemia.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.9
      Seconds

  • Question 51 - A sarcomere is the area between: ...

    Correct

    • A sarcomere is the area between:

      Your Answer: Two adjacent z lines

      Explanation:

      The area that lies between the two adjacent Z lines is known as a sarcomere and is the contractile unit of the muscle. The line passing in the middle of the myosin filaments is the M line. It also passes through the middle of the sarcomere.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6
      Seconds

  • Question 52 - Myocardium requires more oxygen to expel blood in: ...

    Correct

    • Myocardium requires more oxygen to expel blood in:

      Your 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
      14.4
      Seconds

  • Question 53 - Myocyte action potentials – Choose the false statement: ...

    Correct

    • Myocyte action potentials – Choose the false statement:

      Your 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
      34.4
      Seconds

  • Question 54 - The coronary sinus, which empties into the right atrium, serves to? ...

    Correct

    • The coronary sinus, which empties into the right atrium, serves to?

      Your Answer: Drain the venous supply of the myocardium

      Explanation:

      The coronary sinus is a collection of veins joined together to form a large vessel that collects blood from the heart muscle (myocardium). It delivers deoxygenated blood to the right atrium, as do the superior and inferior vena cava.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.7
      Seconds

  • Question 55 - When looking at the JVP what does the c wave signify: ...

    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
      11.2
      Seconds

  • Question 56 - According to Poiseuille’s formula, which 1 of the following will lead to increased...

    Incorrect

    • According to Poiseuille’s formula, which 1 of the following will lead to increased flow?

      Your Answer: Smaller radius

      Correct Answer: Shorter tube

      Explanation:

      V = π p r4 / 8 η lwhere V = discharge volume flow (m3/s)p = pressure difference between the ends of the pipe (N/m2, Pa)r = internal radius of pipe (m)l = length of pipe (m)η = viscosity of fluid

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.2
      Seconds

  • Question 57 - 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
      2.1
      Seconds

  • Question 58 - The Sinoatrial node in the majority of people is supplied by the? ...

    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
      3.4
      Seconds

  • Question 59 - Which of the following components regulate cardiac output? ...

    Correct

    • Which of the following components regulate cardiac output?

      Your Answer: All of the above

      Explanation:

      Cardiac output is regulated by the autonomic nervous system with sympathetic nerves having a positive chronotropic and inotropic effect and parasympathetic nerves having the opposite effect. An increase in preload will increase cardiac output likewise an afterload increase will also increase cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.5
      Seconds

  • Question 60 - The celiac trunk consists of which arteries? ...

    Correct

    • The celiac trunk consists of which arteries?

      Your Answer: Left gastric, common hepatic, splenic

      Explanation:

      The celiac trunk is the first major branch of the abdominal aorta. It is 1.25 cm in length. Branching from the aorta at thoracic vertebra 12 (T12). There are three main divisions of the celiac artery:- left gastric artery- common hepatic artery- splenic artery

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (42/60) 70%
Medicine (42/60) 70%
Passmed
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