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  • Question 1 - 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
      6
      Seconds

  • Question 2 - Which ion channel does not contribute to the myocardial action potential? ...

    Incorrect

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

      Your Answer: Transient outward potassium channel

      Correct 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
      7
      Seconds

  • Question 3 - The following determines the strength of contraction ...

    Incorrect

    • The following determines the strength of contraction

      Your Answer:

      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
      0
      Seconds

  • Question 4 - Catecholamines… ...

    Incorrect

    • Catecholamines…

      Your Answer:

      Correct Answer: Activate adenylyl cyclase

      Explanation:

      Norepinephrine and epinephrine activate or deactivate adenylyl cyclase resulting in a decrease or an increase in the production of cAMP.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 5 - Sinus bradycardia may be caused by disease of which of the following: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Right coronary artery

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 6 - Water hammer pulse is found in: ...

    Incorrect

    • Water hammer pulse is found in:

      Your Answer:

      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
      0
      Seconds

  • Question 7 - When the heart rate is increased (to pathological levels) which of the following...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds

  • Question 8 - The interventricular septum is supplied anteriorly by the? ...

    Incorrect

    • The interventricular septum is supplied anteriorly by the?

      Your Answer:

      Correct Answer: Left anterior descending artery

      Explanation:

      The anterior interventricular artery or left anterior descending artery supplies the anterior 2/3rds of the interventricular septum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 9 - The heart rate can be accelerated by: ...

    Incorrect

    • The heart rate can be accelerated by:

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 10 - The predominant receptors in the hearts conduction system are? ...

    Incorrect

    • The predominant receptors in the hearts conduction system are?

      Your Answer:

      Correct Answer: Î’1

      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
      0
      Seconds

  • Question 11 - Myocardial oxygen consumption is increased by: ...

    Incorrect

    • Myocardial oxygen consumption is increased by:

      Your Answer:

      Correct Answer: An increase in after load

      Explanation:

      Cardiac oxygen consumption is directly related to the amount of tension that develops in the ventricles. It is increased by an increased size of heart, increased afterload, increased contractility and increased heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 12 - Which of the following intercellular connections is important in endothelial barrier function? ...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 13 - Myocardial fibers have a resting membrane potential of approximately: ...

    Incorrect

    • Myocardial fibers have a resting membrane potential of approximately:

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 14 - Which of the following components regulate cardiac output? ...

    Incorrect

    • Which of the following components regulate cardiac output?

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 15 - 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:

      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
      0
      Seconds

  • Question 16 - The function of Troponin T in cardiac muscle is? ...

    Incorrect

    • The function of Troponin T in cardiac muscle is?

      Your Answer:

      Correct Answer: Allows attachment of troponin components to tropomyosin

      Explanation:

      Troponin T binds the troponin components to tropomyosin. Troponin I inhibits the interaction of myosin with actin, and troponin C contains the binding sites for the Ca2+ that helps initiate contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 17 - Which of the following concerning PR interval is INCORRECT? ...

    Incorrect

    • Which of the following concerning PR interval is INCORRECT?

      Your Answer:

      Correct Answer: Always measured from the beginning of p wave to the beginning of r wave

      Explanation:

      The PR interval measures the time from the start of atrial depolarization to the start of ventricular depolarization. The PR interval is only measured from the beginning of P wave to beginning of R wave if the Q wave is absent.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 18 - Which of the following makes up the thick filaments in muscle fibers? ...

    Incorrect

    • Which of the following makes up the thick filaments in muscle fibers?

      Your Answer:

      Correct Answer: Myosin

      Explanation:

      The thick filaments are made up of myosin and the thin filaments are made up of actin. The thick filaments are twice the size of the thin filaments and are aligned to form the A band. The thin filaments extending out from the A band form the less dense I bands.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 19 - Ventricular depolarization plus ventricular repolarization is shown by the _____ interval ...

    Incorrect

    • Ventricular depolarization plus ventricular repolarization is shown by the _____ interval

      Your Answer:

      Correct Answer: QT

      Explanation:

      The QT interval represents ventricular depolarization as well as ventricular repolarization.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 20 - 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:

      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
      0
      Seconds

  • Question 21 - Which of the following conditions does not influence the cardiac output? ...

    Incorrect

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

      Your Answer:

      Correct Answer: Sleep

      Explanation:

      Sleep has no effect on the cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 22 - What is the main reason for checking the urea and electrolytes prior to...

    Incorrect

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

      Your Answer:

      Correct Answer: To detect hypokalaemia

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 23 - The V wave in the jugular pulse is caused by: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Atrial filling

      Explanation:

      The v wave reflects the passive increase in pressure and volume of the right atrium as it fills in late systole and early diastole.

      The jugular vein pulsations usually have two elevations and two troughs. The first elevation (a wave) corresponds to the slight rise in atrial pressure resulting from atrial contraction. The first descent (x descent) reflects a fall in atrial pressure that starts with atrial relaxation. The second elevation (v wave) corresponds to ventricular systole when blood is entering the right atrium from the vena cavae while the tricuspid valve is closed. Finally, the second descent (y descent) reflects falling right atrial pressure as the tricuspid valve opens and blood drains from the atrium into the ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 24 - Which of the following causes the closure of the ductus arteriosus during birth?...

    Incorrect

    • Which of the following causes the closure of the ductus arteriosus during birth?

      Your Answer:

      Correct Answer: Reduced levels of prostaglandins

      Explanation:

      Ductus arteriosus is kept open by the prostaglandin E2 which is a vasodilator. At birth the high levels of cyclooxygenase blocks the production of prostaglandins which results in the closure of the ductus arteriosus.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 25 - Which of the following does not lower ventricular rate in atrial fibrillation? ...

    Incorrect

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

      Your Answer:

      Correct Answer: Adrenaline

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 26 - 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:

      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
      0
      Seconds

  • Question 27 - The bradycardia that occurs in patients with raised intracranial pressure is a result...

    Incorrect

    • The bradycardia that occurs in patients with raised intracranial pressure is a result of the?

      Your Answer:

      Correct Answer: Cushing reflex

      Explanation:

      When intracranial pressure is increased, the blood supply to RVLM neurons is compromised. This results in an increase in their discharge as a result of hypoxia and hypercapnia. The resultant rise in systemic arterial pressure (Cushing reflex) tends to restore the blood flow to the medulla.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 28 - What is the function of the BK channel on the vascular smooth muscle...

    Incorrect

    • What is the function of the BK channel on the vascular smooth muscle membrane?

      Your Answer:

      Correct Answer: Massive K+ efflux, increasing membrane potential, and shutting off the voltage gated Ca2+ channel

      Explanation:

      BK channels, also known as large-conductance calcium-activated potassium channels, play a critical role in regulating vascular smooth muscle tone. When BK channels open, they allow a large efflux of potassium ions (K+) out of the cell. This efflux of K+ causes the membrane potential to become more negative (hyperpolarization), which in turn leads to the closure of voltage-gated calcium channels. The closure of these calcium channels reduces the influx of calcium ions (Ca2+) into the smooth muscle cells, resulting in decreased intracellular calcium levels and subsequent relaxation of the smooth muscle.

      Thus, BK channels promote smooth muscle relaxation by hyperpolarizing the membrane and reducing the activity of voltage-gated Ca2+ channels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 29 - Where on the surface of the chest is the normal site of auscultation...

    Incorrect

    • Where on the surface of the chest is the normal site of auscultation for the mitral area?

      Your Answer:

      Correct Answer: 4th left intercostal space in the mid-clavicular line

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 30 - Which one of the following have not been shown to improve mortality in...

    Incorrect

    • Which one of the following have not been shown to improve mortality in patients with chronic heart failure?

      Your Answer:

      Correct Answer: Furosemide

      Explanation:

      A number of drugs have been shown to improve mortality in patients with chronic heart failure:

      • ACE inhibitors (SAVE, SOLVD, CONSENSUS)
      • spironolactone (RALES)
      • beta-blockers (CIBIS)
      • hydralazine with nitrates (VHEFT-1)

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (1/2) 50%
Medicine (1/2) 50%
Passmed
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