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  • Question 1 - Stimulation of the carotid sinus results in: ...

    Correct

    • Stimulation of the carotid sinus results in:

      Your Answer: Drop in blood pressure

      Explanation:

      Stimulation of the carotid sinus will result in an increase in the baroreceptor discharge. This will travel via the afferent nerves to the medulla. Signals will pass through the vagus nerve to decrease the sympathetic outflow to the heart and the blood vessels. This inhibition will result in vasodilation of the blood vessels, venodilation and bradycardia hence decreasing the total peripheral resistance and lowering the blood pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      33.5
      Seconds

  • Question 2 - Factors influencing cardiac output include which of the following? ...

    Correct

    • Factors influencing cardiac output include which of the following?

      Your Answer: All of the above

      Explanation:

      There is a correlation between resting CO and body surface area. The output per min per square meter of body surface (the cardiac index) averages 3.2l.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      26.3
      Seconds

  • Question 3 - 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
      11.1
      Seconds

  • Question 4 - Which of the following makes up the thick filaments in muscle fibers? ...

    Correct

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

      Your 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
      26.5
      Seconds

  • Question 5 - Concerning S3, which of the following statements is INCORRECT? ...

    Incorrect

    • Concerning S3, which of the following statements is INCORRECT?

      Your Answer: Normal in children

      Correct Answer: Coincide with atrial contraction

      Explanation:

      A third heart sound also called a ventricular gallop occurs at the beginning of diastole after S2 and is lower in pitch than S1 or S2 as it is not of valvular origin. The third heart sound is benign in youth, some trained athletes, and sometimes in pregnancy but if it re-emerges later in life it may signal cardiac problems, such as a failing left ventricle as in dilated congestive heart failure (CHF). S3 is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by blood rushing in from the atria. The reason the third heart sound does not occur until the middle third of diastole is probably that during the early part of diastole, the ventricles are not filled sufficiently to create enough tension for reverberation. It may also be a result of tensing of the chordae tendineae during rapid filling and expansion of the ventricle. In other words, an S3 heart sound indicates increased volume of blood within the ventricle. An S3 heart sound is best heard with the bell-side of the stethoscope (used for lower frequency sounds). A left-sided S3 is best heard in the left lateral decubitus position and at the apex of the heart, which is normally located in the 5th left intercostal space at the midclavicular line. A right-sided S3 is best heard at the lower-left sternal border. The way to distinguish between a left and right-sided S3 is to observe whether it increases in intensity with inhalation or exhalation. A right-sided S3 will increase on inhalation, while a left-sided S3 will increase on exhalation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      33.4
      Seconds

  • Question 6 - 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
      64.7
      Seconds

  • Question 7 - What is cardiac output? ...

    Correct

    • What is cardiac output?

      Your Answer: Product of stroke volume and heart rate

      Explanation:

      Cardiac output is the product of stroke volume and heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      84
      Seconds

  • Question 8 - The celiac trunk consists of which arteries? ...

    Incorrect

    • The celiac trunk consists of which arteries?

      Your Answer: Superior mesenteric and inferior mesenteric

      Correct Answer: Left gastric, common hepatic, splenic

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      145.4
      Seconds

  • Question 9 - Direct conduction from the atrium to the ventricles is prevented by: ...

    Incorrect

    • Direct conduction from the atrium to the ventricles is prevented by:

      Your Answer: Bundle of his

      Correct Answer: Annulus fibrosus

      Explanation:

      The annulus fibrosus disconnects the syncytium complex. The atria are rapidly activated however the activation peters out when the insulating layer-the annulus fibrosus-is reached.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      37.5
      Seconds

  • Question 10 - Which of the following is the most common causative organism in infective endocarditis?...

    Incorrect

    • Which of the following is the most common causative organism in infective endocarditis?

      Your Answer: Staphylococcus aureus

      Correct Answer: Streptococcus viridans

      Explanation:

      Viridans Alpha-haemolytic streptococci, that are present in the mouth are the most frequently isolated microorganisms when the infection is acquired in a community setting. In contrast, Staphylococcus blood stream infections are frequently acquired in a health care setting where they can enter the blood stream through procedures that cause break in the integrity of skin like surgery, catheterisation or during access of long term indwelling catheters or secondary to intravenous injection of recreational drugs.Prosthetic valve endocarditis is commonly caused by Staphylococcus epidermidis as it is capable of growing as a biofilm on plastic surfaces

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      74.5
      Seconds

  • Question 11 - Which of the following structures is not part of the conducting system of...

    Correct

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

      Your Answer: Ventricular wall

      Explanation:

      The conduction system of the heart consists of the SA node, AV node, internodal pathway between these two nodes, Bundle of His and the purkinje fibers

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      115.2
      Seconds

  • Question 12 - Regarding the length of systole and diastole which of the following is true?...

    Incorrect

    • Regarding the length of systole and diastole which of the following is true?

      Your Answer: At very rapid heart rates diastole is adequate

      Correct Answer: The duration of systole is more fixed than diastole

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      29.9
      Seconds

  • Question 13 - 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
      86
      Seconds

  • Question 14 - Coronary flow is reduced during ...

    Incorrect

    • Coronary flow is reduced during

      Your Answer: None of the above

      Correct Answer: Tachycardia

      Explanation:

      Maximum amount of blood flow in the coronary arteries occur during diastole. When the heart rate increases which is also called tachycardia the duration of diastole decreases. Hence the amount of blood flow to the cardiac muscle also decreases.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      112
      Seconds

  • Question 15 - Depolarization spreads rapidly through cardiac muscle fibers because of the presence of: ...

    Incorrect

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

      Your Answer: Desmosomes

      Correct 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
      19.6
      Seconds

  • Question 16 - Xanthines (for example Caffeine), exhibit their positive inotropic effect by: ...

    Incorrect

    • Xanthines (for example Caffeine), exhibit their positive inotropic effect by:

      Your Answer: Inhibiting the myocardial Na+/K+ ATPase

      Correct Answer: Inhibiting the breakdown cAMP

      Explanation:

      Xanthines exert their positive inotropic effect by inhibiting the breakdown of the cAMP resulting in stronger and sustained contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      30
      Seconds

  • Question 17 - Pacemaker cells in the SA node and the AV node are connected by?...

    Incorrect

    • Pacemaker cells in the SA node and the AV node are connected by?

      Your Answer: P cells

      Correct Answer: Gap junctions

      Explanation:

      Gap junctions allows for rapid propagation of the action potential from one cell to the other. The cells of the heart are connected by gap junctions.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      46.2
      Seconds

  • Question 18 - In which area is depolarization initiated? ...

    Incorrect

    • In which area is depolarization initiated?

      Your Answer: Purkinje fibers

      Correct Answer: SA node

      Explanation:

      SA node is the pacemaker of the heart. It determines the rate of contractions. It is the place where depolarization is initiated. It exhibits phase 4 depolarization or automaticity. Electrical impulses then spread to the AV node, purkinje fibers, bundle of his and the ventricular muscles.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17.9
      Seconds

  • Question 19 - 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
      29.8
      Seconds

  • Question 20 - A 27-year-old man presents with a regular tachycardia of 190 bpm. He is...

    Incorrect

    • 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: DC Cardioversion

      Correct 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
      37.3
      Seconds

  • Question 21 - Initial depolarization of cardiac muscle is due to influx of: ...

    Incorrect

    • Initial depolarization of cardiac muscle is due to influx of:

      Your Answer: H+

      Correct Answer: Na+

      Explanation:

      Initial depolarization of the cardiac muscle results from opening of the sodium voltage gated channels. This results in the influx of sodium and an increase in the membrane potential towards threshold. Potassium efflux results in repolarization.

      The cardiac action potential has 5 phases:

      • Phase 0—depolarization because of the opening of fast sodium channels. Potassium flux also decreases.
      • Phase 1—partial repolarization because of a rapid decrease in sodium ion passage as fast sodium channels close.
      • Phase 2—plateau phase in which the movement of calcium ions out of the cell, maintains depolarization.
      • Phase 3—repolarization, sodium, and calcium channels all close and membrane potential returns to baseline.
      • Phase 4—resting membrane potential (−90 mV), resulting from the activity of the Na+/K+ ATPase pump which creates a negative intracellular potential because of the exchange of three sodium ions for only two potassium ions.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      28.9
      Seconds

  • Question 22 - In Jugular vein pressure the “a” wave represents? ...

    Correct

    • In Jugular vein pressure the “a” wave represents?

      Your Answer: Atrial systole

      Explanation:

      The jugular venous pressure (JVP, sometimes referred to as jugular venous pulse) is the indirectly observed pressure over the venous system via visualization of the internal jugular vein. It can be useful in the differentiation of different forms of heart and lung disease. Classically three upward deflections and two downward deflections have been described: The upward deflections are the a (atrial contraction), c (ventricular contraction and resulting bulging of tricuspid into the right atrium during isovolumetric systole) and v = venous filling.The downward deflections of the wave are the x (the atrium relaxes and the tricuspid valve moves downward) and the y descent (filling of ventricle after tricuspid opening).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      33.6
      Seconds

  • Question 23 - A sarcomere is the area between: ...

    Incorrect

    • A sarcomere is the area between:

      Your Answer: Two adjacent m bands

      Correct Answer: Two adjacent z lines

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8
      Seconds

  • Question 24 - Xanthines such as caffeine and theophylline are positively inotropic due to: ...

    Incorrect

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

      Your Answer: Inhibition of Na/K ATPase in the myocardium

      Correct Answer: Inhibition of cAMP breakdown

      Explanation:

      Xanthines exert their positive inotropic effect by inhibiting the breakdown of the cAMP resulting in stronger and sustained contractions.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      45.6
      Seconds

  • Question 25 - The major factor in controlling coronary artery blood flow is considered to be?...

    Incorrect

    • The major factor in controlling coronary artery blood flow is considered to be?

      Your Answer: Parasympathetic input

      Correct Answer: Metabolites of oxygen consumption

      Explanation:

      There is a strong relationship between myocardial blood flow and oxygen consumption. This indicates that products of metabolism may cause vasodilation of the coronary artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      245.3
      Seconds

  • Question 26 - Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms ...

    Incorrect

    • Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms

      Your Answer: Increases the number of actin and myosin

      Correct Answer: Increased phosphorylation of phosholamban

      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
      82.6
      Seconds

  • Question 27 - Endothelial cells are attached to adjacent cells by adherent junctions via: ...

    Correct

    • Endothelial cells are attached to adjacent cells by adherent junctions via:

      Your Answer: Cadherins

      Explanation:

      Cadherins are calcium dependant molecules that mediate cell to cell adhesions in epithelial and endothelial cells among others.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      56.8
      Seconds

  • Question 28 - The posterior aspect of the interventricular septum is supplied by: ...

    Incorrect

    • The posterior aspect of the interventricular septum is supplied by:

      Your Answer: A branch of the left coronary artery

      Correct Answer: A branch of the right coronary artery

      Explanation:

      The posterior aspect of the heart is supplied by the posterior interventricular artery which is a branch of the right coronary artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      69.6
      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: 5th left intercostal space mid-axillary line

      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
      34.7
      Seconds

  • Question 30 - 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

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (20/29) 69%
Medicine (20/29) 69%
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