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

  • Question 1 - Which ion channel does not contribute to the myocardial action potential? ...

    Correct

    • Which ion channel does not contribute to the myocardial action potential?

      Your Answer: Chloride channel

      Explanation:

      The upstroke in the cardiac action potential is due to opening of the sodium channels and an influx of sodium into the cell. The initial repolarization phase is due to transient opening of the potassium channels along with calcium channels. Influx of calcium causes the prolonged plateau phase of the action potential. Delayed opening of the rectifier potassium channel and delayed closure of the calcium channel leads to the repolarization phase of cardiac action potential.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.1
      Seconds

  • Question 2 - Which one of the following is a risk factor for torsade de pointes?...

    Incorrect

    • Which one of the following is a risk factor for torsade de pointes?

      Your Answer: Hyperkalaemia

      Correct Answer: Hypothermia

      Explanation:

      The following is a list of factors associated with an increased tendency toward torsades de pointes:- Hypokalaemia (low blood potassium)- Hypomagnesemia (low blood magnesium)- Hypocalcaemia (low blood calcium)- Bradycardia (slow heartbeat)- Heart failure- Left ventricular hypertrophy- Hypothermia- Subarachnoid haemorrhage- Hypothyroidism

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      251.1
      Seconds

  • Question 3 - 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
      3.2
      Seconds

  • Question 4 - The areas of extensive series of sarcoplasmic folds known as intercalated discs always...

    Incorrect

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

      Your Answer: M line

      Correct Answer: Z lines

      Explanation:

      The muscle fibers of the heart branch and interdigitate, but one complete unit is surrounded by a cell membrane. The place where one muscle fiber abuts the other, the cell membrane of both the fibers run parallel to each other through a series of extensive folds. These areas always occur on the Z lines and are known as intercalated discs.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.3
      Seconds

  • Question 5 - The rate of depolarization of the SA node membrane potential is modulated by...

    Incorrect

    • The rate of depolarization of the SA node membrane potential is modulated by the following:

      Your Answer: Autonomic tone

      Correct Answer: All of the above

      Explanation:

      Rate of depolarization of the SA node is modulated by all of these.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.2
      Seconds

  • Question 6 - Which statement about the 2nd heart sound is true? ...

    Correct

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

      Your Answer: It is caused by closure of the aortic and pulmonary valves.

      Explanation:

      The second heart sound is produced due to closure of the aortic and pulmonary valves. It is a high pitched dub sound.

      Normally the aortic closure sound (A2) occurs prior to the pulmonic closure sound (P2), and the interval between the two (splitting) widens on inspiration and narrows on expiration. With quiet respiration, A2 will normally precede P2 by 0.02 to 0.08 second (mean, 0.03 to 0.04 sec) with inspiration. In younger subjects inspiratory splitting averages 0.04 to 0.05 second during quiet respiration. With expiration, A2 and P2 may be superimposed and are rarely split as much as 0.04 second. If the second sound is split by greater than 0.04 second on expiration, it is usually abnormal. Therefore, the presence of audible splitting during expiration (i.e., the ability to hear two distinct sounds during expiration) is of greater significance at the bedside in identifying underlying cardiac pathology than is the absolute inspiratory increase in the A2–P2 interval.

      The respiratory variation of the second heart sound can be categorized as follows: (1) normal (physiologic) splitting; (2) persistent (audible expiratory) splitting, with normal respiratory variation; (3) persistent splitting without respiratory variation (fixed splitting); and (4) reversed (paradoxical) splitting.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17
      Seconds

  • Question 7 - Which structure forms the major part of the sternocostal surface of the heart?...

    Correct

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

      Your 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
      27.4
      Seconds

  • Question 8 - Transport of Ca2+ into the reticulum to initiate cardiac muscle relaxation in via:...

    Incorrect

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

      Your Answer: Voltage-gated Ca2+ channels

      Correct 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
      6.9
      Seconds

  • Question 9 - Which of the following structures of the cardiac conduction system is located in...

    Incorrect

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

      Your Answer: Bundle of his

      Correct 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
      29.8
      Seconds

  • Question 10 - Myocardial fibers have a resting membrane potential of approximately: ...

    Correct

    • Myocardial fibers have a resting membrane potential of approximately:

      Your Answer: -90mv

      Explanation:

      The resting membrane potential of the mammalian heart is about -90 mv.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      2.6
      Seconds

  • Question 11 - During which phase of the cardiac cycle does most of the ventricular filling...

    Incorrect

    • During which phase of the cardiac cycle does most of the ventricular filling occur?

      Your Answer: Atrial systole

      Correct Answer: Ventricular diastole

      Explanation:

      During the phase of ventricular diastole when the heart muscle relaxes and all the valves are open, blood flows easily into the heart. This is the phase of rapid ventricular filling. During isovolumetric contraction and relaxation the volume of blood in the heart does not change. During ventricular ejection blood enters into the aorta and pulmonary vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.7
      Seconds

  • Question 12 - Where would one normally find venous valves? ...

    Incorrect

    • Where would one normally find venous valves?

      Your Answer: Inferior vena cava

      Correct Answer: Saphenous vein

      Explanation:

      The intima of the limb veins is folded at intervals to form venous valves that prevent retrograde flow. There are no valves present in the very small veins, the great veins, or the veins in the brain and viscera.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.4
      Seconds

  • Question 13 - A 27-year-old man presents with a regular tachycardia of 190 bpm. He is...

    Correct

    • A 27-year-old man presents with a regular tachycardia of 190 bpm. He is healthy and has no past medical history. Blood pressure and blood tests are all within normal parameters however the ECG confirms a narrow complex tachycardia. The tachycardia persists after giving IV adenosine 6mg. What should be the next step in management of this patient?

      Your Answer: IV 12mg adenosine

      Explanation:

      For narrow complex tachycardias with no compromise then vagal manoeuvres should be trialled first. The Valsalva manoeuvre should be the first vagal manoeuvre tried and works by increasing intra-thoracic pressure and affecting baroreceptors (pressure sensors) within the arch of the aorta. It is carried out by asking the patient to hold his/her breath while trying to exhale forcibly as if straining during a bowel movement. Adenosine, an ultra-short-acting AV nodal blocking agent, is indicated if vagal manoeuvres are not effective. Adenosine may be safely used during pregnancy. In adults the recommended first dose of intravenous adenosine is 6 mg. The dose is administered rapidly and then followed by a saline flush. Adenosine is only present in the circulation for about 5 seconds, so it is an excellent drug for diagnosis and treatment. If there was a response to adenosine but it was not long lasting, an additional dose of 12 mg of adenosine intravenously can be attempted. Doses greater than 12 mg are not recommended. If adenosine fails then Verapamil or a beta blocker can be used as alternatives. If the patient is hemodynamically unstable or other treatments have not been effective, synchronized electrical cardioversion may be used.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      2820.9
      Seconds

  • Question 14 - The average end diastolic volume in a healthy individual’s ventricle is? ...

    Incorrect

    • The average end diastolic volume in a healthy individual’s ventricle is?

      Your Answer: 50 ml

      Correct Answer: 130 ml

      Explanation:

      The end diastolic volume in a healthy individual is about 130 ml.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.2
      Seconds

  • Question 15 - 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
      15.1
      Seconds

  • Question 16 - Where are the baroreceptors of the great arteries located? ...

    Correct

    • Where are the baroreceptors of the great arteries located?

      Your Answer: In the adventitia

      Explanation:

      Arterial baroreceptors are located in the aortic arch and carotid sinuses, and are formed by small nerve endings present in the adventitia of these vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.3
      Seconds

  • Question 17 - What is the main reason for checking the urea and electrolytes prior to...

    Incorrect

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

      Your Answer: To detect impaired renal function

      Correct Answer: To detect hypokalaemia

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.8
      Seconds

  • Question 18 - The function of ATP in cardiac muscle contraction includes: ...

    Correct

    • The function of ATP in cardiac muscle contraction includes:

      Your Answer: Binding to myosin after the power stroke to allow uncoupling of actin and myosin

      Explanation:

      After calcium binds to the troponin C, there is a conformational change in the structure of troponin I and tropomyosin, which moves out of the way and frees the site where myosin can bind to actin. This results in the formation of the cross linkage of the actin and myosin giving rise to the power stroke in the contraction phase. This occurs with the release of ADP. When ATP combines to this complex it breaks and the cycle repeats itself.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.9
      Seconds

  • Question 19 - 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
      14.6
      Seconds

  • Question 20 - Myocardium requires more oxygen to expel blood in: ...

    Incorrect

    • Myocardium requires more oxygen to expel blood in:

      Your Answer: None of the above

      Correct Answer: A stenotic aortic valve

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      762.8
      Seconds

  • Question 21 - 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
      6.8
      Seconds

  • Question 22 - Preload: ...

    Correct

    • Preload:

      Your Answer: Is the degree to which the myocardium is stretched before is contracts

      Explanation:

      Preload is end diastolic volume. It is the degree to which the heart muscle fiber is stretched when it fills up completely just before the heart contracts.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.5
      Seconds

  • Question 23 - Heart rate can be slowed by: ...

    Incorrect

    • Heart rate can be slowed by:

      Your Answer: Inspiration

      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
      5.1
      Seconds

  • Question 24 - Which of the following corresponds to an oblique line drawn from the sternal...

    Incorrect

    • 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: Pulmonary trunk

      Correct 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
      31.1
      Seconds

  • Question 25 - 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 4th right costal cartilage to the 5th left intercostal space

      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
      45.3
      Seconds

  • Question 26 - The T-tubular system in cardiac muscle is: ...

    Correct

    • The T-tubular system in cardiac muscle is:

      Your Answer: Transmits action potential from sarcolemma to the SR to allow for Ca2+ release into the cytoplasm

      Explanation:

      Action potentials are transmitted to the fibrils of a fiber through the T tubule system. It triggers the release of Ca 2+ from the terminal cisterns. Depolarization of the T tubules activates the sarcoplasmic reticulum through the dihydropyridine receptors, which are voltage gated calcium channels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.4
      Seconds

  • Question 27 - Which of the following is first to rise following myocardial infarction? ...

    Correct

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

      Your 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
      7.2
      Seconds

  • Question 28 - The a-wave is created by: ...

    Incorrect

    • The a-wave is created by:

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

      Correct Answer: Regurgitation of some blood to the great veins when the atria contracts in 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
      13.7
      Seconds

  • Question 29 - Where is the carotid sinus located? ...

    Correct

    • Where is the carotid sinus located?

      Your Answer: After the bifurcation of the carotid artery, on the internal carotid

      Explanation:

      The carotid sinus is a small dilation in the internal carotid artery just above its bifurcation into the external and internal carotid branch. Baroreceptors are present at this dilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.7
      Seconds

  • Question 30 - Concerning surface anatomy, where is the aortic valve found? ...

    Incorrect

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

      Your Answer: Situated in the right second intercostal space underneath the sternum

      Correct Answer: Situated in the left third intercostal space underneath the sternum

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      24
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (14/30) 47%
Medicine (14/30) 47%
Passmed
Retry this test Dashboard