00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - The following are examples of the functions of the vascular endothelium except: ...

    Correct

    • The following are examples of the functions of the vascular endothelium except:

      Your Answer: Tumour suppression

      Explanation:

      Vascular endothelium has many important functions including regulation of vascular tone, molecular exchange between blood and tissue compartments, hemostasis and signaling for the immune regulation and inflammation. Depending on specific tissue needs and local stresses, endothelial cells are capable of evoking either antithrombotic or prothrombotic events. Tumor suppression is related to genes, or anti-oncogenes, that regulate a cell during cell division and replication.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.3
      Seconds
  • Question 2 - Vasodilatation in skeletal muscle can be caused by: ...

    Correct

    • Vasodilatation in skeletal muscle can be caused by:

      Your Answer: Sympathetic cholinergic nerves

      Explanation:

      In skeletal muscles some fibers that cause vasodilation run with the nerves of the sympathetic system but are cholinergic in nature. These nerves are not active during rest but become active during exercise and stress.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      29.6
      Seconds
  • Question 3 - Dicrotic notch is produced by which valves? ...

    Correct

    • Dicrotic notch is produced by which valves?

      Your Answer: Aortic

      Explanation:

      The graph of aortic pressure throughout the cardiac cycle displays a small dip (the incisure or dicrotic notch) which coincides with the aortic valve closure. The dip in the graph is immediately followed by a brief rise (the dicrotic wave) then gradual decline.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.4
      Seconds
  • Question 4 - Excitation-contraction coupling in cardiac muscle involves all of the following except: ...

    Correct

    • Excitation-contraction coupling in cardiac muscle involves all of the following except:

      Your Answer: Binding of Ca2+ to calmodulin

      Explanation:

      In the excitation contraction coupling model, an action potential is 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. These are voltage gates calcium channels. Calcium binds to calmodulin during contraction of the smooth muscle and not the cardiac muscles.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.3
      Seconds
  • Question 5 - Regarding cardiac contractility, catecholamines exert their inotropic effect via: ...

    Incorrect

    • Regarding cardiac contractility, catecholamines exert their inotropic effect via:

      Your Answer: Reduced intracellular cAMP

      Correct Answer: Β1-adrenergic receptors and gs

      Explanation:

      Catecholamines exert their inotropic effect on the heart via the B1 adrenergic receptors and Gs, stimulating adenyl cyclase and increasing the production of cAMP.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.6
      Seconds
  • Question 6 - 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
      Seconds
  • Question 7 - The approximate incidence of deep venous thrombosis (DVT) in the general population each...

    Correct

    • The approximate incidence of deep venous thrombosis (DVT) in the general population each year is:

      Your 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
      16.2
      Seconds
  • Question 8 - Regarding cardiac muscle contractility, the afterload refers to: ...

    Incorrect

    • Regarding cardiac muscle contractility, the afterload refers to:

      Your Answer: The degree of myocardial stretch before contraction

      Correct Answer: The resistance against which blood is expected

      Explanation:

      The afterload for the left ventricle is the aortic pressure. Hence it is this pressure that offers resistance against which the blood is to be expelled from the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.6
      Seconds
  • Question 9 - Which of the following structures of the cardiac conduction system is located in...

    Correct

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

      Your 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
      23.2
      Seconds
  • Question 10 - During which phase of the cardiac cycle does most of the ventricular filling...

    Correct

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

      Your 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
      8.6
      Seconds
  • Question 11 - Water hammer pulse is found in: ...

    Incorrect

    • Water hammer pulse is found in:

      Your Answer: Aortic stenosis

      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
      12.1
      Seconds
  • Question 12 - The positive inotropic effect of digoxin is due to? ...

    Incorrect

    • The positive inotropic effect of digoxin is due to?

      Your Answer: Increased intracellular c amp

      Correct Answer: Inhibition of the sodium potassium ATPase in the myocardium

      Explanation:

      Digitalis compounds are potent inhibitors of cellular Na+/K+-ATPase. This ion transport system moves sodium ions out of the cell and brings potassium ions into the cell. By inhibiting the Na+/K+-ATPase, cardiac glycosides cause the intracellular sodium concentration to increase. This then leads to an accumulation of intracellular calcium via the Na+/Ca++ exchange system. In the heart, increased intracellular calcium causes more calcium to be released by the sarcoplasmic reticulum, thereby making more calcium available to bind to troponin-C, which increases contractility (inotropy).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      33.4
      Seconds
  • Question 13 - The principle by which the energy of contraction is proportional to the initial...

    Correct

    • The principle by which the energy of contraction is proportional to the initial length of cardiac muscle fiber is known as:

      Your Answer: Starling’s law

      Explanation:

      The Frank starling relationship 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 increase 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 increased development of tension in the muscle fiber. The greater the venous return the greater the cardiac output. This relation is directly proportional.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      46.6
      Seconds
  • Question 14 - The initial rapid depolarization in the action potential of cardiac muscle cells is...

    Correct

    • The initial rapid depolarization in the action potential of cardiac muscle cells is due to:

      Your Answer: Opening of voltage-gated Na+ channels

      Explanation:

      The initial depolarization of the action potential in a cardiac muscle cell is due to the sodium current generated by opening of the voltage gated sodium channels leading to an influx of sodium ions into the cell and raising the membrane potential towards threshold.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11
      Seconds
  • Question 15 - 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
      5.7
      Seconds
  • Question 16 - Angina pectoris develops when blood through the coronary artery becomes: ...

    Correct

    • Angina pectoris develops when blood through the coronary artery becomes:

      Your Answer: Restricted, limiting blood blow

      Explanation:

      Angina pectoris develops when stenosis ( >70%) of the artery occurs as a result of formation of an atherosclerotic plaque. This leads to a decrease in the O2 carried to the thickened heart muscle by the blood, leading to the characteristic chest pain associated with angina pectoris.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.1
      Seconds
  • Question 17 - Which factor produced by the endothelium is responsible for the regulation of vascular...

    Correct

    • Which factor produced by the endothelium is responsible for the regulation of vascular cell growth?

      Your Answer: Vascular endothelial growth factor (VEGF)

      Explanation:

      VEGF is produced by the endothelial cells and is the major growth factor responsible for causing vasculogenesis. Some isoforms of this growth factor also have a prominent role in formation of lymphatic vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      19.8
      Seconds
  • Question 18 - When is the blood pressure at its lowest during pregnancy? ...

    Incorrect

    • When is the blood pressure at its lowest during pregnancy?

      Your Answer: Post partum

      Correct Answer: Second trimester

      Explanation:

      It is lowest during the second trimester.

      Previous studies have reported changes in blood pressure (BP) throughout pregnancy, and it was generally accepted that in clinically healthy pregnant women, BP falls gradually at first trimester, reaching the lowest around 22–24 weeks, rising again from 28 weeks, and reaching preconception levels by 36 weeks of gestation

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.1
      Seconds
  • Question 19 - Digoxin causes: ...

    Correct

    • Digoxin causes:

      Your Answer: Increase in cytosolic calcium concentration

      Explanation:

      Digoxin is a positive inotrope which inhibits NA/K ATPase, increases cardiac contractility and can cause hypokalaemia.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.6
      Seconds
  • Question 20 - 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
      15.7
      Seconds
  • Question 21 - In which area is depolarization initiated? ...

    Correct

    • In which area is depolarization initiated?

      Your 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
      4.1
      Seconds
  • Question 22 - Calcium is mobilized from the sarcoplasmic reticulum through: ...

    Incorrect

    • Calcium is mobilized from the sarcoplasmic reticulum through:

      Your Answer: Passive diffusion

      Correct Answer: Ryanodine receptor (RyR2) calcium release channels

      Explanation:

      During the plateau phase of the action potential, calcium from the extracellular fluid enters through the L type of calcium channels. This entry triggers the release of more calcium from the sarcoplasmic reticulum via the ryanodine receptors. As a result intracellular calcium increases binding to troponin C resulting in contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      18.4
      Seconds
  • Question 23 - Which of the following regulates the calcium release channels? ...

    Correct

    • Which of the following regulates the calcium release channels?

      Your Answer: Calstabin 2

      Explanation:

      Ca2+ is released from the SR through a Ca2+ release channel, a cardiac isoform of the ryanodine receptor (RyR2), which controls intracytoplasmic [Ca2+] and, as in vascular smooth-muscle cells, leads to the local changes in intracellular [Ca2+] called calcium sparks. A number of regulatory proteins, including calstabin 2, inhibit RyR2 and, thereby, the release of Ca2+ from the SR.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      18.1
      Seconds
  • Question 24 - Regarding the surface anatomy of the orifices of the heart, where is the...

    Incorrect

    • Regarding the surface anatomy of the orifices of the heart, where is the aortic valve located?

      Your Answer: Opposite the right upper sternal border in the 2nd intercostal space

      Correct Answer: Opposite the left 3rd intercostal space to the left of 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
      20.5
      Seconds
  • Question 25 - Hyperkalaemia [K+ =7meq/l] can lead to the following ECG changes [Ca++ normal] ...

    Correct

    • Hyperkalaemia [K+ =7meq/l] can lead to the following ECG changes [Ca++ normal]

      Your Answer: Peaked T waves

      Explanation:

      Hyperkalaemia causes the formation of tall tented T waves due to altered repolarization.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.6
      Seconds
  • Question 26 - When looking at the JVP what does the c wave signify: ...

    Incorrect

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

      Your Answer: Atrial systole

      Correct 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
      4.5
      Seconds
  • Question 27 - 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
      6.8
      Seconds
  • Question 28 - 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
      4
      Seconds
  • Question 29 - 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
      3
      Seconds
  • Question 30 - Vasodilatation of coronary arteries is caused by: ...

    Incorrect

    • Vasodilatation of coronary arteries is caused by:

      Your Answer: Hypocapnia

      Correct Answer: Hypoxia

      Explanation:

      The heart is highly metabolically active and boasts the highest oxygen consumption by mass of any organ. This demand for oxygen is met by the coronary circulation, which is responsible for delivering blood to the myocardium and represents approximately 5% of cardiac output. Vasodilation may be due to the local effect of hypoxia on coronary vessels, or local metabolic vasodilation, or the activation of β-adrenoceptors or some combination of these mechanisms.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      25.9
      Seconds
  • Question 31 - 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: Massive K+ influx, increasing membrane potential, and shutting off the voltage gated Ca2+ channel

      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
      36.2
      Seconds
  • Question 32 - The function of Troponin T in cardiac muscle is? ...

    Correct

    • The function of Troponin T in cardiac muscle is?

      Your 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
      68.6
      Seconds
  • Question 33 - Currents caused by opening of which of the following channels contribute to the...

    Correct

    • Currents caused by opening of which of the following channels contribute to the repolarization phase of the action potential of the ventricular muscle fibers?

      Your Answer: Potassium channels

      Explanation:

      Depolarization occurs due to opening of the voltage gated sodium channels. Repolarization occurs due to opening of the voltage gates potassium channels causing an out flux of potassium ions, decreasing the membrane potential towards resting potential.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      24.6
      Seconds
  • Question 34 - 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
      12.3
      Seconds
  • Question 35 - The coronary arteries supply which part of the heart’s subendocardial region exclusively in...

    Incorrect

    • The coronary arteries supply which part of the heart’s subendocardial region exclusively in diastole?

      Your Answer: All chambers of the heart ( all of the above if you want )

      Correct Answer: Left ventricle

      Explanation:

      It is only during diastole that the blood flows to the subendocardial portion of the left ventricle, as the heart muscle relaxes and the coronary arteries regain their patency.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.8
      Seconds
  • Question 36 - Concerning coronary arteries, what is the net effect of B2 stimulation on the...

    Correct

    • Concerning coronary arteries, what is the net effect of B2 stimulation on the heart (e.g. Running athlete)?

      Your Answer: Vasodilation via production of metabolites

      Explanation:

      The coronary arterioles contain α-adrenergic receptors, which cause vasoconstriction, and β-adrenergic receptors, which cause vasodilation. Activity in the noradrenergic nerves to the heart and injections of norepinephrine cause coronary vasodilation. However, norepinephrine also increases the heart rate and the force of cardiac contraction, and the vasodilation is due to production of vasodilator metabolites in the myocardium secondary to the increase in its activity. As exercise has the same effect as sympathetic stimulation, it will result in vasodilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.1
      Seconds
  • Question 37 - The Plateau phase in myocyte action potentials does all of the following except:...

    Incorrect

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

      Your Answer: It is a refractory phase

      Correct 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
      37.9
      Seconds
  • Question 38 - The a-wave is created by: ...

    Incorrect

    • The a-wave is created by:

      Your Answer: Rise in atrial pressure before the tricuspid valve opens

      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
      13.6
      Seconds
  • Question 39 - Which membrane bound protein in the sarcoplasmic reticulum regulates calcium return from the...

    Incorrect

    • Which membrane bound protein in the sarcoplasmic reticulum regulates calcium return from the cytosol to the sarcoplasmic reticulum?

      Your Answer: Calmodulin

      Correct Answer: Phospholamban

      Explanation:

      Phosphorylation of phospholamban 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 sarcoplasmic reticulum (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
      17.7
      Seconds
  • Question 40 - According to Starling's law of the heart: ...

    Correct

    • According to Starling's law of the heart:

      Your 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
      35
      Seconds
  • Question 41 - The internodal tract of Bachman: ...

    Correct

    • The internodal tract of Bachman:

      Your Answer: Connects the SA node to the AV node

      Explanation:

      Internodal tract of Bachman connects the SA node to the AV node conducting the electrical impulses generated from the SA node to the AV node and from the AV node to the rest of the electrical complex of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.8
      Seconds
  • Question 42 - Concerning S3, which of the following statements is INCORRECT? ...

    Correct

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

      Your 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
      24.6
      Seconds
  • Question 43 - Which of the following is the most common causative organism in infective endocarditis?...

    Correct

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

      Your 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
      6.6
      Seconds
  • Question 44 - The major factor in controlling coronary artery blood flow is considered to be?...

    Correct

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

      Your 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
      23
      Seconds
  • Question 45 - Activation of baroreceptor reflex involves: ...

    Incorrect

    • Activation of baroreceptor reflex involves:

      Your Answer: Inhibition of neurons in the caudal ventrolateral medulla (CVLM)

      Correct Answer: Short term regulation of systemic blood pressure

      Explanation:

      Baroreceptors are found in the heart and the blood vessels. They are the carotid sinus and the aortic arch receptors and respond to the minute to minute change in the blood pressure i.e. a change in the pulsatile pressure and not to a change in the mean arterial pressure. If the pulse pressure decreases, the rate of firing of the receptors decreases, stimulating an increase in the heart rate and blood pressure. Mechanisms that regulate the long term blood pressure control include the renin-angiotensin-aldosterone mechanism.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      36.8
      Seconds
  • Question 46 - Which of the following is true with AV nodal delay? ...

    Correct

    • Which of the following is true with AV nodal delay?

      Your Answer: Shortened by sympathetic stimulation

      Explanation:

      AV nodal delay Is about 0.1s before the action potential spreads to the ventricles. It is shortened by stimulation of the sympathetic nervous system and lengthened by stimulation of the parasympathetic system.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      41.8
      Seconds
  • Question 47 - Which of the following results in the resting membrane potential of a myocyte?...

    Correct

    • Which of the following results in the resting membrane potential of a myocyte?

      Your Answer: Activation of outward K+ channels

      Explanation:

      Phase 0 is caused by the sodium current. Voltage gated sodium channels open leading to the influx of sodium into the cardiac muscle cell. Phase 1 is the rapid transient repolarization phase which is caused by the inactivation of the voltage gated sodium channels and opening of the voltage gated potassium channels along with opening of the slow calcium channels. Phase 2 which is the plateau is caused by opening of the slow calcium channels. Phase 4 is caused by closing of the slow calcium channels and opening of the potassium channels leading to efflux of potassium leading to the establishment of the resting membrane potential.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.1
      Seconds
  • Question 48 - Concerning surface anatomy, where is the apex beat found? ...

    Correct

    • Concerning surface anatomy, where is the apex beat found?

      Your Answer: 5th intercostal space mid clavicular line

      Explanation:

      The location of the apex beat may vary but it is mostly found in the left 5th intercostal space 6 cm from the anterior median line or in the mid clavicular line.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.8
      Seconds
  • Question 49 - Which is the commonest cardiovascular abnormality seen in an adult patient with Marfan’s...

    Correct

    • Which is the commonest cardiovascular abnormality seen in an adult patient with Marfan’s syndrome?

      Your Answer: Aortic aneurysm

      Explanation:

      Marfan syndrome (MFS) is a genetic disorder of connective tissue. The degree to which people are affected varies. People with Marfan’s tend to be tall, and thin, with long arms, legs, fingers and toes. They also typically have flexible joints and scoliosis. The most serious complications involve the heart and aorta with an increased risk of mitral valve prolapse and aortic aneurysm.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14
      Seconds
  • Question 50 - 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
      16.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (35/50) 70%
Medicine (35/50) 70%
Passmed