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  • Question 1 - Which of the following intercellular connections is important in endothelial barrier function? ...

    Correct

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

      Your Answer: Tight junctions

      Explanation:

      Tight junctions surround the apical margins of the epithelial cells such as in the intestinal mucosa and the choroid plexus. They are also important to the endothelial barrier function. They are made up of ridges that adhere to each other strongly at the cell junction, obliterating the space completely between the cells.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.4
      Seconds
  • Question 2 - Which one of the following is a risk factor for torsade de pointes?...

    Correct

    • Which one of the following is a risk factor for torsade de pointes?

      Your 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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.9
      Seconds
  • Question 3 - In the Fick‘s method of measuring cardiac output, the arterial oxygen content can...

    Correct

    • In the Fick‘s method of measuring cardiac output, the arterial oxygen content can be measured in a sample obtained from

      Your Answer: The pulmonary vein

      Explanation:

      In Fick’s original method, the following variables are measured:VO2, oxygen consumption in ml of pure gaseous oxygen per minute. This may be measured using a spirometer within a closed rebreathing circuit incorporating a CO2 absorberCa, the oxygen concentration of blood taken from the pulmonary vein (representing oxygenated blood)Cv, the oxygen concentration of blood from an intravenous cannula (representing deoxygenated blood)From these values, we know that:VO2 = (CO x Ca) – (CO x Cv)where CO = Cardiac Output, Ca = Oxygen concentration of arterial blood and Cv = Oxygen concentration of mixed venous blood.This allows us to sayCO = VO2/{Ca – Cv}and hence calculate cardiac output.Note that (Ca – Cv) is also known as the arteriovenous oxygen difference.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.3
      Seconds
  • Question 4 - 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
      19.2
      Seconds
  • Question 5 - 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
      18.3
      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
      7.8
      Seconds
  • Question 7 - The triangle with the heart at its centre, using limb leads is called:...

    Correct

    • The triangle with the heart at its centre, using limb leads is called:

      Your Answer: Einthoven

      Explanation:

      The Einthoven triangle is formed by placing the limb leads on both the arms and on the left leg with the heart in the centre.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.3
      Seconds
  • Question 8 - The right border of the heart corresponds to which line on the surface...

    Correct

    • The right border of the heart corresponds to which line on the surface of the chest?

      Your Answer: Line drawn from the 3rd right costal cartilage to the 6th right costal cartilage

      Explanation:

      The right border corresponds to a line drawn from the 3rd right costal cartilage to the 6th right costal cartilage; this border is slightly convex to the right.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      32.1
      Seconds
  • Question 9 - The coronary sinus drains into the: ...

    Correct

    • The coronary sinus drains into the:

      Your Answer: Right atrium

      Explanation:

      The coronary sinus drains into the right atrium. Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins. Apart from these there are other vessels that drain directly into the heart chambers.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9
      Seconds
  • Question 10 - Calcium needed for cardiac muscle contraction is made available during which phase of...

    Incorrect

    • Calcium needed for cardiac muscle contraction is made available during which phase of the action potential?

      Your Answer: 3

      Correct Answer: 2

      Explanation:

      It is made available during the plateau phase of the action potential i.e. phase 2. 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.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.7
      Seconds
  • Question 11 - In which organ will you find extremely porous sinusoidal capillaries, with discontinuous endothelium?...

    Correct

    • In which organ will you find extremely porous sinusoidal capillaries, with discontinuous endothelium?

      Your Answer: Liver

      Explanation:

      The liver is the organ which contains sinusoidal capillaries with discontinuous endothelium. The brain, lungs and the intestine all contain continuous capillaries, however the kidney contains fenestrated capillaries to aid in filtration.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      16.8
      Seconds
  • Question 12 - The a-wave is created by: ...

    Correct

    • The a-wave is created by:

      Your 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
      16.7
      Seconds
  • Question 13 - Blood flow to the subendocardial portions of the left ventricular muscle occurs mainly...

    Correct

    • Blood flow to the subendocardial portions of the left ventricular muscle occurs mainly during:

      Your Answer: Diastole

      Explanation:

      The sub endocardium receives the least amount of blood from the coronary arteries. During systole the coronary arteries collapse as a result of the pressure from 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 sub endocardium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.6
      Seconds
  • Question 14 - 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
      21.1
      Seconds
  • Question 15 - The process by which depolarization of the muscle fiber initiates contraction is called?...

    Incorrect

    • The process by which depolarization of the muscle fiber initiates contraction is called?

      Your Answer: Excitation – contraction coupling

      Correct Answer: Action potential

      Explanation:

      This process is known as an action potential. Upon generation of an action potential when depolarization reaches threshold, it spreads throughout the muscle fiber, resulting in generation of an excitation-contraction coupling leading to contraction of the muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.7
      Seconds
  • Question 16 - 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
      68.3
      Seconds
  • Question 17 - AV valves open during? ...

    Correct

    • 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.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.3
      Seconds
  • Question 18 - Concerning surface anatomy, where is the base of the heart ...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      16
      Seconds
  • Question 19 - 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
      6.8
      Seconds
  • Question 20 - 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
      5.9
      Seconds
  • Question 21 - Tunica intima is made up of? ...

    Incorrect

    • Tunica intima is made up of?

      Your Answer: Smooth muscle cells

      Correct Answer: Endothelial cells

      Explanation:

      Tunica intima is a single cell thick lining of endothelial cells that lines the inside of the blood vessels. It is the inner most layer of the blood vessel.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.7
      Seconds
  • Question 22 - 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 23 - The following is true of the sinus node: ...

    Correct

    • The following is true of the sinus node:

      Your Answer: It generates impulses automatically & at a quicker rate than other cardiac cells

      Explanation:

      The SA node exhibits automaticity. It generates the impulses to which the heart beats. It fires at a faster speed than the rest of the nervous components of the heart i.e. the AV nodes, purkinje fibers. This is the reason when the SA node fails the heart beats to the rhythm of the AV node.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.1
      Seconds
  • Question 24 - Which of the following occurs during a Valsalva manoeuvre? ...

    Correct

    • Which of the following occurs during a Valsalva manoeuvre?

      Your Answer: An initial rise in blood pressure

      Explanation:

      The Valsalva maneuver involves forced expiration against a closed glottis. It has several phases, each affecting the cardiovascular system differently:

      1. Phase I: During the initial forced expiration against the closed glottis, there is a transient rise in intrathoracic pressure, which compresses the thoracic aorta and causes a brief increase in blood pressure.
      2. Phase II: Continued straining leads to decreased venous return to the heart, reducing cardiac output and causing a drop in blood pressure. This phase is characterized by a compensatory increase in heart rate.
      3. Phase III: Upon releasing the strain, there is a sudden drop in intrathoracic pressure, which momentarily decreases blood pressure.
      4. Phase IV: Blood pressure then rises rapidly as venous return to the heart is restored, leading to increased cardiac output. This is often followed by a reflex bradycardia (slow heart rate).

      Given these phases, the most accurate statement about what occurs during the Valsalva maneuver is the initial rise in blood pressure (Phase I).

      Other options explained:

      • Forced inspiration against a closed glottis: Incorrect. The Valsalva maneuver involves forced expiration, not inspiration, against a closed glottis.
      • Low intrathoracic pressures throughout: Incorrect. The Valsalva maneuver involves high intrathoracic pressures due to forced expiration.
      • Disruption of autonomic function: Incorrect. The Valsalva maneuver affects autonomic function but does not disrupt it. Instead, it triggers autonomic responses to changes in blood pressure and heart rate.
      • No change: Incorrect. The Valsalva maneuver causes significant changes in blood pressure and heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      31
      Seconds
  • Question 25 - Concerning surface anatomy, where is the aortic valve found? ...

    Incorrect

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

      Your Answer: Situated in the left second 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
      23.8
      Seconds
  • Question 26 - Which one of the following have not been shown to improve mortality in...

    Correct

    • 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)

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.5
      Seconds
  • Question 27 - All valves are closed in which phase of the cardiac cycle? ...

    Correct

    • All valves are closed in which phase of the cardiac cycle?

      Your Answer: Isovolumetric relaxation

      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.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.6
      Seconds
  • Question 28 - Which one of the following is a cause of a soft second heart...

    Incorrect

    • Which one of the following is a cause of a soft second heart sound?

      Your Answer: Aortic regurgitation

      Correct Answer: Aortic stenosis

      Explanation:

      Second heart sound (S2) forms the dub of lub-dub and is composed of components A2 and P2. •    loud: hypertension•    soft: AS•    fixed split: physiological split (normally occurs during inhalation), right bundle branch block, pulmonary stenosis, and atrial septal defect.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      42.2
      Seconds
  • Question 29 - Which of the following would be a contraindication to thrombolysis? ...

    Correct

    • Which of the following would be a contraindication to thrombolysis?

      Your Answer: Intracranial neoplasm

      Explanation:

      Absolute contraindications to thrombolysis include:

      • Previous intracranial bleeding at any time
      • Stroke in less than 6 months
      • Closed head or facial trauma within 3 months
      • Suspected aortic dissection
      • Ischemic stroke within 3 months (except in ischemic stroke within 3 hours time)
      • Active bleeding diathesis
      • Uncontrolled high blood pressure (>180 systolic or >100 diastolic)
      • Known structural cerebral vascular lesion
      • Arterio-venous malformations
      • Thrombocytopenia
      • Known coagulation disorders
      • Aneurysm
      • Brain tumours
      • Pericardial effusion
      • Septic embolus

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.6
      Seconds
  • Question 30 - 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
      26.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (22/30) 73%
Medicine (22/30) 73%
Passmed