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  • Question 1 - Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms ...

    Correct

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

      Your 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
      12.4
      Seconds

  • Question 2 - With regard to the endothelial structure, the epithelium constitute: ...

    Correct

    • With regard to the endothelial structure, the epithelium constitute:

      Your Answer: Simple squamous

      Explanation:

      The single layer of squamous epithelium lining the heart and blood vessels is known as the endothelium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      27.9
      Seconds

  • Question 3 - Most of the venous blood returns to the heart through the: ...

    Correct

    • Most of the venous blood returns to the heart through the:

      Your Answer: Coronary sinus and anterior cardiac veins

      Explanation:

      Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins which drain into the right atrium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.4
      Seconds

  • Question 4 - The T-tubular system in cardiac muscle is: ...

    Incorrect

    • The T-tubular system in cardiac muscle is:

      Your Answer: Has dihydropyridine receptors which act as calcium activated Ca2+ release channels.

      Correct 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
      68.9
      Seconds

  • Question 5 - According to Starling's law of the heart: ...

    Incorrect

    • According to Starling's law of the heart:

      Your Answer: Cardiac output is increased when the sympathetic nerves are stimulated

      Correct Answer: The extent of the preload is proportional to the end-diastolic volume

      Explanation:

      Frank starlings law describes that an increase in the venous return or the end diastolic volume will cause an increase in the stroke volume/ preload and also cardiac output. It stems from the fact that increased venous return will increase the stretch on the ventricular muscle fibers. The sarcomere will stretch a considerable length that is needed for maximum contraction and the development of tension in the muscle fiber. The greater the venous return the greater the cardiac output. This relationship is directly proportional.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      47.4
      Seconds

  • Question 6 - When looking at the JVP what does the c wave signify: ...

    Correct

    • When looking at the JVP what does the c wave signify:

      Your Answer: Isovolumetric ventricular contraction

      Explanation:

      The C wave signifies a rise in the atrial pressure during isovolumetric contraction due to the tricuspid valve bulging into the atria.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12
      Seconds

  • Question 7 - 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
      6.7
      Seconds

  • Question 8 - 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
      75.2
      Seconds

  • Question 9 - 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
      6.3
      Seconds

  • Question 10 - In a normal heart rate at rest, the left ventricular end-diastolic volume is...

    Correct

    • In a normal heart rate at rest, the left ventricular end-diastolic volume is ….

      Your Answer: 100-130 ml

      Explanation:

      In cardiovascular physiology, end-diastolic volume (EDV) is the volume of blood in the right and/or left ventricle at end load or filling in (diastole) or the amount of blood in the ventricles just before systole. Because greater EDVs cause greater distention of the ventricle, EDV is often used synonymously with preload, which refers to the length of the sarcomeres in cardiac muscle prior to contraction (systole). End-diastolic volume: Right = 144 mL(± 23mL) & Left = 142 mL (± 21 mL).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.2
      Seconds

  • Question 11 - The predominant receptors in the hearts conduction system are? ...

    Correct

    • The predominant receptors in the hearts conduction system are?

      Your Answer: Β1

      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
      6.2
      Seconds

  • Question 12 - Nitric oxide triggers vascular smooth muscle contraction through activation of which enzyme? ...

    Incorrect

    • Nitric oxide triggers vascular smooth muscle contraction through activation of which enzyme?

      Your Answer: Phospholipase c

      Correct Answer: Guanylyl cyclase

      Explanation:

      Impaired production or excess catabolism of NO impairs this endothelium-dependent vasodilator function and may contribute to excessive vasoconstriction under various pathological situations.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      66.4
      Seconds

  • Question 13 - The Plateau phase in myocyte action potentials does all of the following except:...

    Correct

    • The Plateau phase in myocyte action potentials does all of the following except:

      Your Answer: It allows early reactivation of the myocytes

      Explanation:

      The presence of the plateau in the action potential causes ventricular contraction to last as much as 15 times longer in cardiac muscle as in skeletal muscle. 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 (refractory) phase prevents early reactivation of the myocytes and directly determines the strength of contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      29.4
      Seconds

  • Question 14 - Concerning surface anatomy, where is the mitral valve found? ...

    Incorrect

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

      Your Answer: Situated in the 4th intercostal space in the mid clavicular line

      Correct Answer: Situated in the 4th intercostal space to the left of the sternum

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      42.3
      Seconds

  • Question 15 - What is pulse pressure? ...

    Correct

    • What is pulse pressure?

      Your Answer: Difference between systolic and diastolic pressure

      Explanation:

      The pulse pressure is the difference between the measured systolic and diastolic pressures.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      21.6
      Seconds

  • Question 16 - 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: Nitrates and hydralazine

      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
      9.8
      Seconds

  • Question 17 - 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
      28.2
      Seconds

  • Question 18 - Which vagus nerve mainly supplies the AV node? ...

    Incorrect

    • Which vagus nerve mainly supplies the AV node?

      Your Answer: Right vagus

      Correct Answer: Left vagus

      Explanation:

      As the AV node develops from the left side of the embryo It is supplied by the left vagus nerve.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.8
      Seconds

  • Question 19 - A sarcomere is the area between: ...

    Correct

    • A sarcomere is the area between:

      Your 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
      4.3
      Seconds

  • Question 20 - Why does arterial blood pressure drop during pregnancy? ...

    Correct

    • Why does arterial blood pressure drop during pregnancy?

      Your Answer: Progesterone relaxes vascular smooth muscle

      Explanation:

      Progesterone relaxes vascular smooth muscle thus resulting In a decrease in total peripheral resistance. This accounts for the increase in the cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      22.6
      Seconds

  • Question 21 - A 55 year old cardiac patient is comfortable at rest but heavy housework...

    Incorrect

    • A 55 year old cardiac patient is comfortable at rest but heavy housework results in fatigue, palpitations or dyspnoea. What New York Heart Association class best describes the severity of their disease?

      Your Answer: NYHA Class IV

      Correct Answer: NYHA Class II

      Explanation:

      New York Heart Association functional classification:

      Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities.

      Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.

      Class III: marked limitation of any activity; the patient is comfortable only at rest.

      Class IV: any physical activity brings on discomfort and symptoms occur at rest.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      29.9
      Seconds

  • Question 22 - According to Poiseuille’s formula, which 1 of the following will lead to increased...

    Incorrect

    • According to Poiseuille’s formula, which 1 of the following will lead to increased flow?

      Your Answer: Smaller pressure difference at 2 ends of tube

      Correct Answer: Shorter tube

      Explanation:

      V = π p r4 / 8 η lwhere V = discharge volume flow (m3/s)p = pressure difference between the ends of the pipe (N/m2, Pa)r = internal radius of pipe (m)l = length of pipe (m)η = viscosity of fluid

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      32.9
      Seconds

  • Question 23 - Which of the following does not contribute to increased stroke volume during exercise?...

    Correct

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

      Your 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
      15.1
      Seconds

  • Question 24 - Although variable, branches of which artery most often supply the SA and AV...

    Correct

    • Although variable, branches of which artery most often supply the SA and AV nodes?

      Your Answer: Right coronary artery

      Explanation:

      The RCA (right coronary artery) supplies the SA and the AV nodes along with the postero-basal wall of the left ventricle, posterior one third of the inferior vena cava, right ventricle and the posteromedial papillary muscle in the left ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.5
      Seconds

  • Question 25 - Which of the following affects the magnitude of the action potential? ...

    Incorrect

    • Which of the following affects the magnitude of the action potential?

      Your Answer: The amount of intracellular Ca2+

      Correct Answer: Changes in the external Na+ concentration

      Explanation:

      The magnitude of the action potential is determined by the sodium current. Increase in external sodium will result in increased influx of sodium and hence generation of a stronger action potential.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.8
      Seconds

  • Question 26 - Which of the following normally has a slow depolarizing “prepotential”? ...

    Incorrect

    • Which of the following normally has a slow depolarizing “prepotential”?

      Your Answer: Bundle of his

      Correct Answer: Sinoatrial node

      Explanation:

      There are 2 main types of action potentials (AP) in the heart, the slow response and the fast response:The slow response is initiated by the slow calcium-sodium channels, found in the SA node (which is the natural pacemaker of the heart) and the conduction fibers of the AV node.The fast response occurs in the atrial and ventricles muscle cells and the purkinje fibers.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      21.8
      Seconds

  • Question 27 - Water hammer pulse is found in: ...

    Incorrect

    • Water hammer pulse is found in:

      Your Answer: Tricuspid 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
      14.8
      Seconds

  • Question 28 - Which of the following is NOT associated with the development of aortic regurgitation?...

    Incorrect

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

      Your Answer: Bechet's disease

      Correct 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
      9.6
      Seconds

  • Question 29 - 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: 70/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
      10.4
      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 third 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
      17.3
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (16/30) 53%
Medicine (16/30) 53%
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