00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - Which one of the following ECG findings is least associated with digoxin use?...

    Correct

    • Which one of the following ECG findings is least associated with digoxin use?

      Your Answer: Prolonged QT interval

      Explanation:

      Digoxin ECG features:•    ST depression (‘reverse tick’)•    flattened/inverted T waves•  Prolonged PR interval•    short QT interval•    arrhythmias e.g. AV block, bradycardia, ventricular tachycardia or fibrillation (for example paroxysmal atrial tachycardia with A-V block – so-called PAT with block) is said to be pathognomonic (i.e. diagnostic) of digoxin toxicity.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      25
      Seconds
  • Question 2 - Coronary blood flow occurs in? ...

    Correct

    • Coronary blood flow occurs in?

      Your Answer: Diastole

      Explanation:

      Coronary arteries are unique in that they fill during diastole, when not occluded by valve cusps nor compressed by myocardial contraction).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.1
      Seconds
  • Question 3 - 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
      20.8
      Seconds
  • Question 4 - Heart rate can be slowed by: ...

    Incorrect

    • Heart rate can be slowed by:

      Your Answer: Hypoxia

      Correct Answer: Grief

      Explanation:

      Grief stimulates the parasympathetic nervous system, resulting in a decrease in the heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.7
      Seconds
  • Question 5 - In the Fick‘s method of measuring cardiac output, the arterial oxygen content can...

    Correct

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

      Your 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
      26.2
      Seconds
  • Question 6 - Which of the following is true with AV nodal delay? ...

    Incorrect

    • Which of the following is true with AV nodal delay?

      Your Answer: Ca++ plays a role in the delay

      Correct Answer: Shortened by sympathetic stimulation

      Explanation:

      AV nodal delay Is about 0.1s before the action potential spreads to the ventricles. It is shortened by stimulation of the sympathetic nervous system and lengthened by stimulation of the parasympathetic system.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      75.8
      Seconds
  • Question 7 - Activation of nitric oxide synthesis by endothelial cells is triggered by: ...

    Incorrect

    • Activation of nitric oxide synthesis by endothelial cells is triggered by:

      Your Answer: Bradykinin

      Correct Answer: All of the above

      Explanation:

      Acetylcholine, histamine, bradykinin, vasoactive intestinal peptide (VIP) and shear stress on the endothelial cells causing the release of NO. NO is formed from arginine and causes vasodilatation of the blood vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.6
      Seconds
  • Question 8 - Calcium is mobilized from the sarcoplasmic reticulum through: ...

    Incorrect

    • Calcium is mobilized from the sarcoplasmic reticulum through:

      Your Answer: “t” calcium channels

      Correct Answer: Ryanodine receptor (RyR2) calcium release channels

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.7
      Seconds
  • Question 9 - Sinus bradycardia may be caused by disease of which of the following: ...

    Correct

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

      Your 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
      11.3
      Seconds
  • Question 10 - 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: 1 mm ST depression in 1 chest lead

      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
      32.5
      Seconds
  • Question 11 - 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
      5.8
      Seconds
  • Question 12 - Regarding the surface anatomy of the orifices of the heart, where is the...

    Correct

    • Regarding the surface anatomy of the orifices of the heart, where is the aortic valve located?

      Your Answer: Opposite the left 3rd intercostal space to the left of the sternum

      Explanation:

      The aortic valve is situated in the left 3rd intercostal space just beneath the sternum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      22.9
      Seconds
  • Question 13 - Which of the following causes an increase in venous return? ...

    Correct

    • Which of the following causes an increase in venous return?

      Your Answer: An increase in the negative intra-thoracic pressure

      Explanation:

      During inspiration, intrathoracic pressure becomes more negative and intra-abdominal pressure more positive. This increases the venous pressure gradient from abdomen to thorax and promotes filling of the central veins.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.8
      Seconds
  • Question 14 - Endothelial cells produce the following substance(s): ...

    Correct

    • Endothelial cells produce the following substance(s):

      Your Answer: All of the above

      Explanation:

      Endothelial cells produce thromboxane, prostacyclins, nitric oxides, endothelins, IL-1 and TNF.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.3
      Seconds
  • Question 15 - The following products of the vascular endothelium produce vasodilation except: ...

    Incorrect

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

      Your Answer: Endothelial-derived hyperpolarizing factor

      Correct 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
      23.5
      Seconds
  • Question 16 - Which of the following is a method for measurement of cardiac output? ...

    Incorrect

    • Which of the following is a method for measurement of cardiac output?

      Your Answer: Starling method

      Correct Answer: Indicator dilution method

      Explanation:

      There are two methods of calculating the cardiac output in humans other than doppler with echocardiography: The direct Fick’s method and the indicator dilution method. In the indicator dilution technique, a known amount of a substance such as a dye or, more commonly, a radioactive isotope is injected into an arm vein and the concentration of the indicator in serial samples of arterial blood is determined. The output of the heart is equal to the amount of indicator injected divided by its average concentration in arterial blood after a single circulation through the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.1
      Seconds
  • Question 17 - Which of the following is NOT associated with the development of aortic regurgitation?...

    Correct

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

      Your 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
      14.3
      Seconds
  • Question 18 - Depolarization spreads rapidly through cardiac muscle fibers because of the presence of: ...

    Correct

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

      Your Answer: Gap junctions

      Explanation:

      The cardiac muscles have gap junctions in between the cells. They allow for the formation of low resistance passages, which allow ions to diffuse through every muscle fiber rapidly and result in the cardiac muscles functioning as a syncytium, without any protoplasmic bridges involved.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.4
      Seconds
  • Question 19 - 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
      9.2
      Seconds
  • Question 20 - Which of the following does not contribute to increased stroke volume during exercise?...

    Incorrect

    • Which of the following does not contribute to increased stroke volume during exercise?

      Your Answer: Increased sympathetic stimulation of ventricular muscle

      Correct Answer: Increased length of filling time during diastole

      Explanation:

      Prolonged aerobic exercise training may also increase stroke volume, which frequently results in a lower (resting) heart rate. Reduced heart rate prolongs ventricular diastole (filling), increasing end-diastolic volume, and ultimately allowing more blood to be ejected.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      36.1
      Seconds
  • Question 21 - Which of the following does not lower ventricular rate in atrial fibrillation? ...

    Correct

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

      Your 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
      21.7
      Seconds
  • Question 22 - Which of the following antiarrhythmic drugs may be used in the treatment of...

    Correct

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

      Your 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
      7.9
      Seconds
  • Question 23 - 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: 50/ 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
      14.8
      Seconds
  • Question 24 - Which of the following is first to rise following myocardial infarction? ...

    Incorrect

    • Which of the following is first to rise following myocardial infarction?

      Your Answer: Troponin I

      Correct Answer: Myoglobin

      Explanation:

      Myoglobin, is a sensitive indicator of muscle injury and is first to rise following MI within two hours but is nonspecific.Troponin and CK-MB both begin to rise approximately three hours after MI. The cardiac troponins T and I which are released within 4–6 hours of an attack of MI and remain elevated for up to 2 weeks, have nearly complete tissue specificity and are now the preferred markers for assessing myocardial damage.Lactate dehydrogenase (LDH) begins to rise approximately 12 hours after MI.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.6
      Seconds
  • Question 25 - The isoforms of nitric oxide synthase which are found in the nervous system...

    Incorrect

    • The isoforms of nitric oxide synthase which are found in the nervous system (NOS1) and endothelial cells (NOS3) are activated by agents that increase which of the following intracellular electrolytes?

      Your Answer: K

      Correct Answer: Ca

      Explanation:

      Synthesis of nitric oxide is stimulated by activation of the NMDA receptors by certain agents. This leads to opening of the Calcium channels and an influx of calcium into the cell. This will activate the nitric oxide synthase. Nitric oxide is produced on demand.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      42.1
      Seconds
  • Question 26 - When observing a JVP, which of the following would lead to prominent v...

    Correct

    • When observing a JVP, which of the following would lead to prominent v waves?

      Your Answer: Tricuspid regurgitation

      Explanation:

      The v wave corresponds to Venous filling when the tricuspid valve is closed and venous pressure increases from venous return. In Tricuspid regurgitation there is additional blood from the regurgitant flow and thus this leads to a more prominent V wave.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      20
      Seconds
  • Question 27 - The most resistant area in the brain to hypoxia is: ...

    Correct

    • The most resistant area in the brain to hypoxia is:

      Your Answer: Brain stem

      Explanation:

      The structures in the brainstem are more resistant to hypoxia than the cerebral cortex and the rest of the brain structures.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.1
      Seconds
  • Question 28 - Vasodilatation of coronary arteries is caused by: ...

    Correct

    • Vasodilatation of coronary arteries is caused by:

      Your Answer: Hypoxia

      Explanation:

      The heart is highly metabolically active and boasts the highest oxygen consumption by mass of any organ. This demand for oxygen is met by the coronary circulation, which is responsible for delivering blood to the myocardium and represents approximately 5% of cardiac output. Vasodilation may be due to the local effect of hypoxia on coronary vessels, or local metabolic vasodilation, or the activation of β-adrenoceptors or some combination of these mechanisms.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      29.8
      Seconds
  • Question 29 - Which part of the ECG represents ventricular repolarisation? ...

    Incorrect

    • Which part of the ECG represents ventricular repolarisation?

      Your Answer: QRS complex

      Correct Answer: T wave

      Explanation:

      Ventricular repolarisation is denoted by the T wave.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.2
      Seconds
  • Question 30 - Which of the following intercellular connections is important in endothelial barrier function? ...

    Correct

    • Which of the following intercellular connections is important in endothelial barrier function?

      Your Answer: Tight junctions

      Explanation:

      Tight junctions surround the apical margins of the epithelial cells such as in the intestinal mucosa and the choroid plexus. They are also important to the endothelial barrier function. They are made up of ridges that adhere to each other strongly at the cell junction, obliterating the space completely between the cells.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      22.4
      Seconds
  • Question 31 - 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
      11.7
      Seconds
  • Question 32 - Where would one find pericytes around endothelial cells? ...

    Incorrect

    • Where would one find pericytes around endothelial cells?

      Your Answer: Smaller arteries

      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
      14.6
      Seconds
  • Question 33 - Regarding blood supply to the heart; ...

    Correct

    • Regarding blood supply to the heart;

      Your Answer: Coronary arteries fill as the heart relaxes

      Explanation:

      The heart muscles acts like the skeletal muscle in the fact that it also compress the vessels during contraction. As the pressure in the ventricle is slightly greater than in the aorta the coronary vessels collapse during systole. Blood flows through them during the diastole phase of contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      30.2
      Seconds
  • Question 34 - The rate of depolarisation of the sinus node membrane potential is modulated by...

    Incorrect

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

      Your Answer: Acidosis

      Correct Answer: Cardiac output

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      50.4
      Seconds
  • Question 35 - Digoxin causes: ...

    Incorrect

    • Digoxin causes:

      Your Answer: Decrease in cardiac contractility

      Correct 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
      25.4
      Seconds
  • Question 36 - 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
      28.3
      Seconds
  • Question 37 - Depolarization of the T tubule membrane activates the sarcoplasmic reticulum via which receptors?...

    Correct

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

      Your 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
      23.8
      Seconds
  • Question 38 - Which of the following has the shortest duration: ...

    Incorrect

    • Which of the following has the shortest duration:

      Your Answer: PR interval

      Correct 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
      9.2
      Seconds
  • Question 39 - Which of the following results in the resting membrane potential of a myocyte?...

    Correct

    • Which of the following results in the resting membrane potential of a myocyte?

      Your Answer: Activation of outward K+ channels

      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
      14.6
      Seconds
  • Question 40 - Which of the following best describes the cardiac muscle? ...

    Correct

    • Which of the following best describes the cardiac muscle?

      Your 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
      12.5
      Seconds
  • Question 41 - The following determines the strength of contraction ...

    Incorrect

    • The following determines the strength of contraction

      Your Answer: Resting membrane potential

      Correct Answer: Plateau phase

      Explanation:

      The plateau phase which follows is unique to myocytes and results from a small, but sustained inward calcium current through L-type calcium channels lasting 200-400 ms. This calcium influx is caused by a combined increase in permeability of the cell and especially the sarcolemmal membranes to calcium. This plateau (or refractory) phase in myocyte action potential prevents early reactivation of the myocytes and directly determines the strength of contraction

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.4
      Seconds
  • Question 42 - 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
      7
      Seconds
  • Question 43 - The coronary arteries supply which part of the heart’s subendocardial region exclusively in...

    Incorrect

    • The coronary arteries supply which part of the heart’s subendocardial region exclusively in diastole?

      Your Answer: All chambers of the heart ( all of the above if you want )

      Correct Answer: Left ventricle

      Explanation:

      It is only during diastole that the blood flows to the subendocardial portion of the left ventricle, as the heart muscle relaxes and the coronary arteries regain their patency.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      32.4
      Seconds
  • Question 44 - Hyperkalaemia [K+ =7meq/l] can lead to the following ECG changes [Ca++ normal] ...

    Correct

    • Hyperkalaemia [K+ =7meq/l] can lead to the following ECG changes [Ca++ normal]

      Your Answer: Peaked T waves

      Explanation:

      Hyperkalaemia causes the formation of tall tented T waves due to altered repolarization.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.5
      Seconds
  • Question 45 - How many molecules of myosin attach to actin at any given time? ...

    Incorrect

    • How many molecules of myosin attach to actin at any given time?

      Your Answer: 2

      Correct Answer: 1

      Explanation:

      1 molecule of myosin binds to actin at any give time.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.4
      Seconds
  • Question 46 - Cholinergic nerves from the vagus innervate the SA and AV nodes via which...

    Incorrect

    • Cholinergic nerves from the vagus innervate the SA and AV nodes via which receptor in the heart?

      Your Answer: M1 receptor

      Correct Answer: M2 receptor

      Explanation:

      M2 receptor is found in the heart. M3 and M4 are associated with smooth muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.7
      Seconds
  • Question 47 - What is the isolated effect of B2 stimulation on the coronaries? ...

    Correct

    • What is the isolated effect of B2 stimulation on the coronaries?

      Your Answer: Vasodilatation

      Explanation:

      Norepinephrine and epinephrine are agonists for all adrenergic receptor subtypes, although with varying affinities. Based on their physiology and pharmacology, adrenergic receptors have been divided into two principal types: alpha and beta. These types have been further differentiated into alpha-1, alpha-2, b1, and b2 receptors.

      Alpha-1 Receptors are located on postsynaptic cells in smooth muscle and elicit vasoconstriction.

      Alpha-2 receptors are localized on presynaptic membranes of postganglionic nerve terminals that synthesize norepinephrine. When activated by catecholamines, alpha-2 receptors act as negative feedback controllers, inhibiting further norepinephrine release.

      Activation of myocardial b1 receptors stimulates the rate and strength of cardiac contraction, and consequently increases cardiac output. b1 Receptor activation also stimulates renin release from the kidney. Another class of antihypertensive agents acts by inhibiting b1 receptors.

      Activation of b2 receptors by epinephrine relaxes vascular smooth muscle and results in vasodilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      22.2
      Seconds
  • Question 48 - Following an action potential, cytosolic Ca2+ is increased. The binding of free Ca2+...

    Correct

    • Following an action potential, cytosolic Ca2+ is increased. The binding of free Ca2+ to troponin C results in all of the following except:

      Your Answer: Weakening of the troponin i interaction with actin

      Explanation:

      At rest, troponin i is bound to actin and tropomyosin and covers the site where the myosin head interacts with actin. When Calcium enters into the muscle, it binds with troponin C and cause a structural change in troponin i which moves out of the myosin binding site and causes the cross bridges between the actin and myosin filaments to occur.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      30.6
      Seconds
  • Question 49 - Regarding cardiac muscle contractility, the afterload refers to: ...

    Incorrect

    • Regarding cardiac muscle contractility, the afterload refers to:

      Your Answer: The degree of myocardial stretch before contraction

      Correct Answer: The resistance against which blood is expected

      Explanation:

      The afterload for the left ventricle is the aortic pressure. Hence it is this pressure that offers resistance against which the blood is to be expelled from the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      24.4
      Seconds
  • Question 50 - The AV Node: ...

    Incorrect

    • The AV Node:

      Your Answer: It is a complex spindle shaped structure located in the interventricular septum

      Correct Answer: It decelerates impulses passing to the ventricles

      Explanation:

      The action potentials in the sinoatrial (SA) and atrioventricular (AV) nodes are largely due to Ca2+, with no contribution by Na+ influx. The depolarization continues to conduct slowly through the atrioventricular (AV) node. The AV node is located in the right posterior portion of the interatrial septum. This is small and bean-shaped. The atrial conductive system is organized so that the cardiac impulse does not travel from the atria into the ventricles too rapidly; this delay allows the atria to empty before ventricular contraction begins. It is the AV node and its adjacent conductive fibers that delay this transmission into the ventricles. Conduction through the AV Node is represented on the ECG by the PR interval.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      24.4
      Seconds
  • Question 51 - Water hammer pulse is found in: ...

    Incorrect

    • Water hammer pulse is found in:

      Your Answer: Mitral incompetence

      Correct Answer: Aortic insufficiency

      Explanation:

      Watson’s water hammer pulse is the medical sign which describes a pulse that is bounding and forceful, rapidly increasing and subsequently collapsing, as if it were the sound of a water hammer that was causing the pulse. A water hammer was a Victorian toy in which a tube was half filled with fluid, the remainder being a vacuum. The child would invert and reinvert the tube; each time the impact of the fluid at each end would sound like a hammer blow. This is associated with increased stroke volume of the left ventricle and decrease in the peripheral resistance leading to the widened pulse pressure of aortic regurgitation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      23.9
      Seconds
  • Question 52 - Which of the atrial pressure changes represents the a-wave of the JVP ...

    Incorrect

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

      Your Answer: Bulging of the tricuspid valve into the atrium during isovolumetric ventricular contraction

      Correct Answer: Atrial systole

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      23.2
      Seconds
  • Question 53 - 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
      3
      Seconds
  • Question 54 - Which coronary artery supplies the right atria? ...

    Correct

    • Which coronary artery supplies the right atria?

      Your Answer: Right coronary

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.9
      Seconds
  • Question 55 - What is the effect of catecholamines (i.e. increased heart rate) on the pressure...

    Incorrect

    • What is the effect of catecholamines (i.e. increased heart rate) on the pressure volume loop?

      Your Answer: No effect

      Correct Answer: Shifts the diastolic pressure curve upward and leftward

      Explanation:

      Catecholamines have a positive ionotropic and chronotropic effect on the heart. The ventricles develop greater tension during systole resulting in an increase in the stroke volume. The increase in stroke volume results in a decrease in the end diastolic volume. This pushes the loop towards the left and upwards.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8
      Seconds
  • Question 56 - The approximate incidence of deep venous thrombosis (DVT) in the general population each...

    Incorrect

    • The approximate incidence of deep venous thrombosis (DVT) in the general population each year is:

      Your Answer: 50 per 1000

      Correct Answer: 1 per 1000

      Explanation:

      About 1 in 1000 adults per year has DVT, but as of 2011, available data is dominated by North American and European populations. DVT is rare in children, with an incidence of about 1 in 100,000 a year. From childhood to old age, incidence increases by a factor of about 1000, with almost 1% of the elderly experiencing DVTs yearly.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.2
      Seconds
  • Question 57 - What type of intercellular connection found between cardiac muscle fibers allow for the...

    Correct

    • What type of intercellular connection found between cardiac muscle fibers allow for the spread of excitation from one cell to another?

      Your Answer: Gap junctions

      Explanation:

      The cardiac muscles have gap junctions in-between the cells. They form low resistance passages, which allow ions to diffuse through every muscle fiber rapidly and result in the cardiac muscles functioning as a syncytium, without any protoplasmic bridges involved.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17.2
      Seconds
  • Question 58 - The right border of the heart corresponds to which line on the surface...

    Incorrect

    • The right border of the heart corresponds to which line on the surface of the chest?

      Your Answer: Line drawn from the 3rd left costal cartilage to the 6th left costal cartilage

      Correct Answer: Line drawn from the 3rd right costal cartilage to the 6th right costal cartilage

      Explanation:

      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
      11.1
      Seconds
  • Question 59 - Concerning surface anatomy, where is the base of the heart ...

    Incorrect

    • Concerning surface anatomy, where is the base of the heart

      Your Answer: 5th intercostal space mid clavicular line

      Correct Answer: 2nd left costal to 3rd right costal cartilage

      Explanation:

      The base of the heart, also known as the superior border of the heart corresponds to a line connecting the inferior border of the 2nd left costal cartilage to the superior border of the 3rd right costal cartilage.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.4
      Seconds
  • Question 60 - Concerning surface anatomy, where is the apex beat found? ...

    Incorrect

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

      Your Answer: 5th intercostal space anterior axillary line

      Correct Answer: 5th intercostal space mid clavicular line

      Explanation:

      The location of the apex beat may vary but it is mostly found in the left 5th intercostal space 6 cm from the anterior median line or in the mid clavicular line.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (31/60) 52%
Medicine (31/60) 52%
Passmed