00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
Retry this test Dashboard

  • Question 1 - Which of the following is NOT a common side effect of adenosine: ...

    Correct

    • Which of the following is NOT a common side effect of adenosine:

      Your Answer: Yellow vision

      Explanation:

      Common side effects of adenosine include:
      Apprehension
      Dizziness, flushing, headache, nausea, dyspnoea
      Angina (discontinue)
      AV block, sinus pause and arrhythmia (discontinue if asystole or severe bradycardia occur)

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      8.8
      Seconds

  • Question 2 - What is nimodipine used predominantly in the treatment of? ...

    Correct

    • What is nimodipine used predominantly in the treatment of?

      Your Answer: Prevention and treatment of vascular spasm following subarachnoid haemorrhage

      Explanation:

      Nimodipine is a smooth muscle relaxant that is related to nifedipine, but the effects preferentially act on cerebral arteries. It is exclusively used for the prevention and treatment of vascular spasm after an aneurysmal subarachnoid haemorrhage.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      10.8
      Seconds

  • Question 3 - Which of the following medications may lessen warfarin's anticoagulant effect: ...

    Incorrect

    • Which of the following medications may lessen warfarin's anticoagulant effect:

      Your Answer: NSAIDs

      Correct Answer: Phenytoin

      Explanation:

      Phenytoin will decrease the level or effect of warfarin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
      Metronidazole will increase the level or effect of warfarin by affecting hepatic enzyme CYP2C9/10 metabolism.
      NSAIDs, when given with Warfarin, increase anticoagulation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      11.7
      Seconds

  • Question 4 - Which of the following drugs is first line treatment for a stable regular...

    Correct

    • Which of the following drugs is first line treatment for a stable regular broad-complex tachycardia:

      Your Answer: Amiodarone

      Explanation:

      A regular broad-complex tachycardia is likely to be ventricular tachycardia or a regular supraventricular rhythm with bundle branch block. A ventricular tachycardia (or broad-complex tachycardia of uncertain origin) should be treated with amiodarone 300 mg IV over 10 – 60 min, followed by an infusion of 900 mg over the next 24 hours. If previously confirmed as SVT with bundle branch block, the patient should be treated as for narrow-complex tachycardia.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      6.8
      Seconds

  • Question 5 - Regarding calcium channel blockers, which of the following statements is CORRECT: ...

    Correct

    • Regarding calcium channel blockers, which of the following statements is CORRECT:

      Your Answer: Calcium channel blockers inhibit L-type voltage-sensitive calcium channels in arterial smooth muscle causing vasodilation.

      Explanation:

      Calcium channel blockers inhibit L-type voltage-sensitive calcium channels in arterial smooth muscle, causing relaxation and vasodilation (reduction in peripheral vascular resistance). They also block calcium channels within the myocardium and conducting tissues of the heart which produces a negative inotropic effect by reducing calcium influx during the plateau phase of the action potential.
      They have a variety of uses, including:
      Hypertension
      Angina
      Atrial fibrillation
      Migraine
      Calcium channel blockers have been found to be moderately useful in the prevention of migraines. The best evidence is for this is with verapamil. This may be due to the prevention of the arteriolar constriction that is associated with migraine. They are commonly used for this elsewhere in the world but are not currently licensed for this use in the UK.
      The following are common side effects of all calcium-channel blockers:
      Abdominal pain
      Dizziness
      Drowsiness
      Flushing
      Headache
      Nausea and vomiting
      Palpitations
      Peripheral oedema
      Skin reactions
      Tachycardia
      Verapamil is highly negatively inotropic and reduces cardiac output, slows the heart rate and may impair atrioventricular conduction. It may precipitate heart failure, exacerbate conduction disorders, and cause hypotension at high doses and should not be used with beta-blockers. Nifedipine has less myocardial effects than verapamil and has no antiarrhythmic properties but has more influence on the vessels. Nimodipine is used solely for the prevention and treatment of vascular spasm following aneurysmal subarachnoid haemorrhage.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      32.3
      Seconds

  • Question 6 - Discontinuous capillaries are typically found where in the body: ...

    Incorrect

    • Discontinuous capillaries are typically found where in the body:

      Your Answer: Lungs

      Correct Answer: Reticuloendothelial system

      Explanation:

      Discontinuous capillaries, found in the reticuloendothelial system (bone marrow, liver and spleen), have large gaps between endothelial cells and are permeable to red blood cells.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      13.8
      Seconds

  • Question 7 - In the ventricular myocyte action potential, depolarisation occurs through the opening of: ...

    Incorrect

    • In the ventricular myocyte action potential, depolarisation occurs through the opening of:

      Your Answer: Voltage-gated Ca 2+ channels

      Correct Answer: Voltage-gated Na + channels

      Explanation:

      An action potential (AP) is initiated when the myocyte is depolarised to a threshold potential of about -65 mV, as a result of transmission from an adjacent myocyte via gap junctions. Fast voltage-gated Na+channels are activated and a Na+influx depolarises the membrane rapidly to about +30 mV. This initial depolarisation is similar to that in nerve and skeletal muscle, and assists the transmission to the next myocyte.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      19.8
      Seconds

  • Question 8 - In adult advanced life support, which of the following best describes the correct...

    Incorrect

    • In adult advanced life support, which of the following best describes the correct administration of adrenaline for a non-shockable rhythm:

      Your Answer: Give 1 mg of adrenaline after 2 minutes of compressions and every 3 - 5 minutes thereafter

      Correct Answer: Give 1 mg of adrenaline as soon as intravenous access is achieved and every 3 - 5 minutes thereafter

      Explanation:

      IV adrenaline 1 mg (10 mL of 1:10,000 solution) should be given after 3 shocks and every 3 – 5 minutes/after alternate shocks thereafter.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      47.7
      Seconds

  • Question 9 - Which of the following is NOT a pharmacological effect of beta-blockers: ...

    Correct

    • Which of the following is NOT a pharmacological effect of beta-blockers:

      Your Answer: Reduced AV conduction time

      Explanation:

      Effects of beta-blockers:
      Cardiovascular system:
      Reduce blood pressure
      Reduce heart rate, contractility and cardiac output
      Increase AV conduction time, refractoriness and suppress automaticity

      Eye:
      Reduce intraocular pressure

      Respiratory system:
      Cause bronchoconstriction

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      8.5
      Seconds

  • Question 10 - What is the main mechanism of action of dopamine as an inotropic sympathomimetic: ...

    Incorrect

    • What is the main mechanism of action of dopamine as an inotropic sympathomimetic:

      Your Answer: Dopamine receptor agonist

      Correct Answer: Beta1-receptor agonist

      Explanation:

      Dopamine is a neurotransmitter and a metabolic precursor of the catecholamines. It acts on beta1-receptors in cardiac muscle increasing cardiac contractility, and increases renal perfusion by stimulating dopamine receptors in the renal vasculature. This is of benefit in cardiogenic shock where deterioration of renal function is common.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      9.5
      Seconds

  • Question 11 - What is the recommended dosing regime for amiodarone in the treatment of a...

    Correct

    • What is the recommended dosing regime for amiodarone in the treatment of a stable regular broad-complex tachycardia:

      Your Answer: 300 mg IV over 10 - 60 minutes, followed by an IV infusion of 900 mg over the next 24 hours

      Explanation:

      A ventricular tachycardia (or broad-complex tachycardia of uncertain origin) should be treated with amiodarone 300 mg IV over 10 – 60 min, followed by an infusion of 900 mg over the next 24 hours.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      23.8
      Seconds

  • Question 12 - Which of the following is NOT an adverse effect associated with statin therapy:...

    Correct

    • Which of the following is NOT an adverse effect associated with statin therapy:

      Your Answer: Aplastic anaemia

      Explanation:

      Adverse effects of statins include:, Headache, Epistaxis, Gastrointestinal disorders (such as constipation, flatulence, dyspepsia, nausea, and diarrhoea), Musculoskeletal and connective tissue disorders (such as myalgia, arthralgia, pain in the extremity, muscle spasms, joint swelling, and back pain), Hyperglycaemia and diabetes, Myopathy and rhabdomyolysis, Interstitial lung disease and Hepatotoxicity

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      6.9
      Seconds

  • Question 13 - If the ejection fraction increases, there will be a decrease in: ...

    Correct

    • If the ejection fraction increases, there will be a decrease in:

      Your Answer: End-systolic volume

      Explanation:

      An increase in ejection fraction means that a higher fraction of the end-diastolic volume is ejected in the stroke volume (e.g. because of the administration of a positive inotropic agent). When this situation occurs, the volume remaining in the ventricle after systole, the end-systolic volume, will be reduced. Cardiac output, stroke volume, and mean arterial pressure will be increased.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      8.7
      Seconds

  • Question 14 - A 40-year-old man who has a history of asthma arrives at the emergency...

    Correct

    • A 40-year-old man who has a history of asthma arrives at the emergency department complaining of palpitations that have been going on for 5 days. Which of the following beta-blockers is the safest for an asthmatic patient?

      Your Answer: Atenolol

      Explanation:

      Atenolol is a beta blocker, which is a type of medication that works by preventing certain natural substances in the body, such as epinephrine, from acting on the heart and blood vessels.

      This effect reduces heart rate, blood pressure, and cardiac strain. Atenolol, bisoprolol fumarate, metoprolol tartrate, nebivolol, and (to a lesser extent) acebutolol have a lower action on beta2 (bronchial) receptors and are thus cardio selective but not cardiac specific.

      They have a lower effect on airway resistance, although they are not without this adverse effect.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      13.2
      Seconds

  • Question 15 - Which of the following best describes digoxin: ...

    Correct

    • Which of the following best describes digoxin:

      Your Answer: A positive inotrope and negative chronotrope

      Explanation:

      Digoxin is a cardiac glycoside used in the treatment of atrial fibrillation and flutter, and congestive cardiac failure. It acts by inhibiting the membrane Na/K ATPase in cardiac myocytes. This raises intracellular sodium concentration and increases intracellular calcium availability indirectly via Na/Ca exchange. The increase in intracellular calcium levels causes an increases the force of myocardial contraction (positive inotrope), and slows the heart rate (negative chronotrope).

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      13.9
      Seconds

  • Question 16 - All of the following are indications for beta-blockers EXCEPT for: ...

    Correct

    • All of the following are indications for beta-blockers EXCEPT for:

      Your Answer: Raynaud's disease

      Explanation:

      Beta-blockers are contraindicated in Raynaud’s syndrome.
      Beta-blockers may be indicated in:
      Hypertension
      Pheochromocytoma (only with an alpha-blocker)
      Angina
      Secondary prevention after ACS
      Arrhythmias including atrial fibrillation
      Heart failure
      Thyrotoxicosis
      Anxiety
      Prophylaxis of migraine
      Essential tremor
      Glaucoma

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      6.6
      Seconds

  • Question 17 - What is the mechanism of action of captopril: ...

    Correct

    • What is the mechanism of action of captopril:

      Your Answer: Angiotensin-converting enzyme inhibitor

      Explanation:

      Captopril is an angiotensin-converting enzyme (ACE) inhibitor, which inhibits the conversion of angiotensin I to angiotensin II.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      6.4
      Seconds

  • Question 18 - Regarding cardiac excitation-contraction coupling, which of the following statements is CORRECT: ...

    Correct

    • Regarding cardiac excitation-contraction coupling, which of the following statements is CORRECT:

      Your Answer: The Treppe effect refers to an increase in contractility secondary to an increase in heart rate.

      Explanation:

      Although Ca2+entry during the action potential (AP) is essential for contraction, it only accounts for about 25% of the rise in intracellular Ca2+. The rest is released from Ca2+stores in the sarcoplasmic reticulum (SR). In relaxation, about 80% of Ca2+is rapidly pumped back into the SR (sequestered) by Ca2+ATPase pumps. The Ca2+that entered the cell during the AP is transported out of the cell primarily by the Na+/Ca2+exchanger in the membrane. When more action potentials occur per unit time, more Ca2+enters the cell during the AP plateau, more Ca2+is stored in the SR, more Ca2+is released from the SR and thus more Ca2+is left inside the cell and greater tension is produced during contraction. Increased heart rate increases the force of contraction in a stepwise fashion as intracellular [Ca2+] increases cumulatively over several beats; this is the Treppe effect. Cardiac glycosides such as digoxin have a positive inotropic effect.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      7.1
      Seconds

  • Question 19 - Digoxin exhibits its positive inotropic effect by which of the following mechanisms: ...

    Correct

    • Digoxin exhibits its positive inotropic effect by which of the following mechanisms:

      Your Answer: Inhibits the Na+/K+ pump on the myocyte membrane

      Explanation:

      Cardiac glycosides (e.g. digoxin) slow the removal of Ca2+from the cell by inhibiting the membrane Na+pump (Na+/K+ATPase) which generates the Na+gradient required for driving the export of Ca2+by Na+/Ca2+exchange; consequently the removal of Ca2+from the myocyte is slowed and more Ca2+is available for the next contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      10
      Seconds

  • Question 20 - All of the following statement about the microcirculation are correct except: ...

    Incorrect

    • All of the following statement about the microcirculation are correct except:

      Your Answer: The crystalloid osmotic pressure is the same either side of the capillary wall.

      Correct Answer: Over the capillary bed, there is a net absorption of fluid.

      Explanation:

      The hydrostatic pressure along the length of the capillary is usually greater than plasma oncotic pressure. As a result, there is a small net filtration of fluid from the capillary into the interstitial space. The regulation of blood flow into the microcirculation is via the vasoconstriction of small arterioles, which is activated by the sympathetic nervous system through numerous nerve endings in their walls. Unlike proteins, most ions and small molecules diffuse easily across capillary walls and thus the crystalloid osmotic pressure they exert is roughly the same on either side of the capillary wall. Because the plasma colloid osmotic pressure is higher than interstitial colloid osmotic, fluid is drawn intravascularly. A reduction of hydrostatic capillary pressure and transient increase in absorption of fluid is a result of arteriolar constriction.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      63.5
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (14/20) 70%
Pharmacology (11/14) 79%
Physiology (3/6) 50%
Passmed
Retry this test Dashboard