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Question 1
Correct
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AV valves open during?
Your Answer: Early diastole
Explanation:The cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat, and so includes the diastole, the systole, and the intervening pause.The first stage, diastole, is when the semilunar valves (the pulmonary valve and the aortic valve) close, the atrioventricular (AV) valves (the mitral valve and the tricuspid valve) open, and the whole heart is relaxed. The second stage, atrial systole, is when the atrium contracts, and blood flows from atrium to the ventricle.The third stage, isovolumic contraction is when the ventricles begin to contract, the AV and semilunar valves close, and there is no change in volume. The fourth stage, ventricular ejection, is when the ventricles are contracting and emptying, and the semilunar valves are open. During the fifth stage, isovolumic relaxation time, pressure decreases, no blood enters the ventricles, the ventricles stop contracting and begin to relax, and the semilunar valves close due to the pressure of blood in the aorta.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 2
Incorrect
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Vasodilatation in skeletal muscle can be caused by:
Your Answer: Endothelin-1
Correct 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.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 3
Incorrect
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The celiac trunk consists of which arteries?
Your Answer: Right gastric, common hepatic, splenic
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
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 4
Correct
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Which one of the following have not been shown to improve mortality in patients with chronic heart failure?
Your 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)
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 5
Incorrect
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Which one of the following is a risk factor for torsade de pointes?
Your Answer: Hyperkalaemia
Correct Answer: Hypothermia
Explanation:The following is a list of factors associated with an increased tendency toward torsades de pointes:- Hypokalaemia (low blood potassium)- Hypomagnesemia (low blood magnesium)- Hypocalcaemia (low blood calcium)- Bradycardia (slow heartbeat)- Heart failure- Left ventricular hypertrophy- Hypothermia- Subarachnoid haemorrhage- Hypothyroidism
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 6
Correct
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Which of the following conditions has no effect on cardiac output?
Your Answer: Sleep
Explanation:Sleep has no effect on the cardiac output. Anxiety, excitement and pregnancy will increase the cardiac output. Standing from a lying position will decrease the cardiac output transiently.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 7
Incorrect
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Vasodilatation of coronary arteries is caused by:
Your Answer: Carbon-monoxide
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.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 8
Correct
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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.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 9
Incorrect
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The hyperpolarization phase of pacemaker cells is dominated by ____ current.
Your Answer: Ca++
Correct Answer: K+
Explanation:The hyperpolarization phase is a continuation of the repolarization phase but the membrane potential dips below the resting membrane potential. This results due to the fact that the K+ channels take a longer time to close than the Na+ channels. Hence efflux of the K+ will result in hyperpolarization.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 10
Correct
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The steps of cardiac cycle in sequence are:
Your Answer: Isovolumic contraction, ejection, isovolumic relaxation, passive ventricular filling, active ventricular filling.
Explanation:The cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat, and so includes the diastole, the systole, and the intervening pause.1st stage: diastole, or passive filling is when the semilunar valves (the pulmonary valve and the aortic valve) close, the atrioventricular (AV) valves (the mitral valve and the tricuspid valve) open, and the whole heart is relaxed. 2nd stage: atrial systole, is when the atrium contracts, and blood flows from atrium to the ventricle (active filling).3rd stage: isovolumic contraction is when the ventricles begin to contract, the AV and semilunar valves close, and there is no change in volume. 4th stage: ventricular ejection, is when the ventricles are contracting and emptying, and the semilunar valves are open. 5th stage: isovolumic relaxation time, pressure decreases, no blood enters the ventricles, the ventricles stop contracting and begin to relax, and the semilunar valves close due to the pressure of blood in the aorta.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 11
Correct
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What is the isolated effect of B2 stimulation on the coronaries?
Your Answer: Vasodilatation
Explanation:Norepinephrine and epinephrine are agonists for all adrenergic receptor subtypes, although with varying affinities. Based on their physiology and pharmacology, adrenergic receptors have been divided into two principal types: alpha and beta. These types have been further differentiated into alpha-1, alpha-2, b1, and b2 receptors.
Alpha-1 Receptors are located on postsynaptic cells in smooth muscle and elicit vasoconstriction.
Alpha-2 receptors are localized on presynaptic membranes of postganglionic nerve terminals that synthesize norepinephrine. When activated by catecholamines, alpha-2 receptors act as negative feedback controllers, inhibiting further norepinephrine release.
Activation of myocardial b1 receptors stimulates the rate and strength of cardiac contraction, and consequently increases cardiac output. b1 Receptor activation also stimulates renin release from the kidney. Another class of antihypertensive agents acts by inhibiting b1 receptors.
Activation of b2 receptors by epinephrine relaxes vascular smooth muscle and results in vasodilation.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 12
Correct
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Which of the following has the shortest duration:
Your Answer: Atrial systole
Explanation:Atrial systole: 0.1s
Atrial diastole: around 0.4s
Ventricular diastole: 0.4-0.53s
Ventricular systole: 0.27s
PR interval: 0.12-0.2 s
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 13
Correct
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Question 14
Incorrect
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When is the blood pressure at its lowest during pregnancy?
Your Answer: Third trimester
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
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 15
Correct
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Question 16
Correct
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The coronary sinus, which empties into the right atrium, serves to?
Your Answer: Drain the venous supply of the myocardium
Explanation:The coronary sinus is a collection of veins joined together to form a large vessel that collects blood from the heart muscle (myocardium). It delivers deoxygenated blood to the right atrium, as do the superior and inferior vena cava.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 17
Correct
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The interventricular septum is supplied anteriorly by the?
Your Answer: Left anterior descending artery
Explanation:The anterior interventricular artery or left anterior descending artery supplies the anterior 2/3rds of the interventricular septum.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 18
Incorrect
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Absolute refractory period in a cardiac action potential graph occurs during.
Your Answer: Late repolarization
Correct Answer: All of the above
Explanation:Absolute refractory period (ARP): the cell is completely unexcitable to a new stimulus and occurs from phase 0 – 2 i.e. depolarisation, early repolarisation and plateau phase.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 19
Incorrect
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Impulse conduction through the AV node is slow and depends on the action potential produced by which of the following.
Your Answer: All of the above
Correct Answer: Calcium flux
Explanation:The action potentials in the SA and AV nodes are largely due to Ca2+, with no contribution by Na+ influx.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 20
Incorrect
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The rate of depolarization of the SA node membrane potential is modulated by the following:
Your Answer: Autonomic tone
Correct Answer: All of the above
Explanation:Rate of depolarization of the SA node is modulated by all of these.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 21
Correct
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Which of the following suggests the presence of mitral regurgitation as well as mitral stenosis?
Your Answer: Displaced apex beat
Explanation:Mitral stenosis on its own does not lead to left ventricular dilatation and hence a displaced apex beat. Thus a displaced apex beat is suggestive of mixed mitral disease. The other options occur in mitral stenosis.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 22
Correct
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Question 23
Incorrect
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The posterior aspect of the interventricular septum is supplied by:
Your Answer: A branch of the anterior interventricular 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.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 24
Correct
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Calcium induced calcium release occurs in the sarcoplasmic reticulum by activation of which receptors
Your Answer: Ryanodine receptors
Explanation:Calcium-induced calcium release (CICR) describes a biological process whereby calcium is able to activate calcium release from intracellular Ca2+ stores (e.g., endoplasmic reticulum or sarcoplasmic reticulum). CICR occurs when the resulting Ca2+ influx activates ryanodine receptors on the SR membrane, which causes more Ca2+ to be released into the cytosol.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 25
Incorrect
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Where does the SA node develop?
Your Answer: From the endocardium
Correct Answer: From structures on the right side of the embryo.
Explanation:The SA node develops from the right side of the embryo and the AV node from the left. This is the reason why in adults the right vagus supplies the SA node and the left vagus supplies the AV node.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 26
Incorrect
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With regard to the endothelial structure, the epithelium constitute:
Your Answer: Simple columnar
Correct Answer: Simple squamous
Explanation:The single layer of squamous epithelium lining the heart and blood vessels is known as the endothelium.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 27
Correct
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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.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 28
Correct
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Question 29
Incorrect
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All of the following are consistent with the indicator dilution method except---
Your Answer: When saline is used as an indicator, it is easy to make repeated determinations
Correct Answer: In thermodilution, the indicator used is warm saline
Explanation:In thermodilution, the indicator used is cold saline.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 30
Incorrect
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Concerning surface anatomy, where is the base of the heart
Your Answer: 5th intercostal space mid clavicular line
Correct Answer: 2nd left costal to 3rd right costal cartilage
Explanation:The base of the heart, also known as the superior border of the heart corresponds to a line connecting the inferior border of the 2nd left costal cartilage to the superior border of the 3rd right costal cartilage.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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