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  • Question 1 - Pacemaker cells in the SA node and the AV node are connected by?...

    Incorrect

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

      Your Answer: P cells

      Correct Answer: Gap junctions

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.7
      Seconds
  • Question 2 - Where on the surface of the chest is the normal site of auscultation...

    Incorrect

    • Where on the surface of the chest is the normal site of auscultation for the mitral area?

      Your Answer: 5th intercostal space in the left lower sternal border

      Correct Answer: 4th left intercostal space in the mid-clavicular line

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      19.9
      Seconds
  • Question 3 - 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
      14.5
      Seconds
  • Question 4 - Which of the following is NOT true of the parasympathetic control of the...

    Incorrect

    • Which of the following is NOT true of the parasympathetic control of the heart?

      Your Answer: It decreases conduction velocity via the AV node

      Correct Answer: It can be blocked by beta blockers

      Explanation:

      Parasympathetic fibers do not innervate the Beta receptors on the heart. They are innervated by the sympathetic nerve fibers. Then a beta blocker such as propranolol will block the sympathetic outflow and increase the parasympathetic tone of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      29.7
      Seconds
  • Question 5 - Which of the following best describes the cardiac muscle? ...

    Incorrect

    • Which of the following best describes the cardiac muscle?

      Your Answer: Striato-smooth and involuntary

      Correct 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
      27.7
      Seconds
  • Question 6 - All of the following are consistent with the indicator dilution method except--- ...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      18.3
      Seconds
  • Question 7 - Which of the following is true with AV nodal delay? ...

    Incorrect

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

      Your Answer: The delay is about 0.01s

      Correct 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
      8.2
      Seconds
  • Question 8 - The bradycardia that occurs in patients with raised intracranial pressure is a result...

    Correct

    • The bradycardia that occurs in patients with raised intracranial pressure is a result of the?

      Your Answer: Cushing reflex

      Explanation:

      When intracranial pressure is increased, the blood supply to RVLM neurons is compromised. This results in an increase in their discharge as a result of hypoxia and hypercapnia. The resultant rise in systemic arterial pressure (Cushing reflex) tends to restore the blood flow to the medulla.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.6
      Seconds
  • Question 9 - The coronary arteries fill during? ...

    Correct

    • The coronary arteries fill during?

      Your Answer: Diastole

      Explanation:

      During systole the coronary arteries collapse as a result of the pressure due to contraction that is exerted on them. During diastole the heart muscle relaxes and the pressure on the coronary vessels is relieved allowing blood to flow through them to the subendocardium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.4
      Seconds
  • Question 10 - Excitation-contraction coupling in cardiac muscle involves all of the following except: ...

    Incorrect

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

      Your Answer: Increase in permeability of muscle fiber to Na+

      Correct 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
      8.4
      Seconds
  • Question 11 - Which ion channel does not contribute to the myocardial action potential? ...

    Correct

    • Which ion channel does not contribute to the myocardial action potential?

      Your Answer: Chloride channel

      Explanation:

      The upstroke in the cardiac action potential is due to opening of the sodium channels and an influx of sodium into the cell. The initial repolarization phase is due to transient opening of the potassium channels along with calcium channels. Influx of calcium causes the prolonged plateau phase of the action potential. Delayed opening of the rectifier potassium channel and delayed closure of the calcium channel leads to the repolarization phase of cardiac action potential.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.7
      Seconds
  • Question 12 - 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: 50/ 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
      11.3
      Seconds
  • Question 13 - 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 III

      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
      25
      Seconds
  • Question 14 - The Wiebel-Palade body found in the endothelial cells is responsible for the production...

    Incorrect

    • The Wiebel-Palade body found in the endothelial cells is responsible for the production and release of which factor?

      Your Answer: Vascular endothelial growth factor

      Correct Answer: Von Willebrand factor

      Explanation:

      Weibel-Palade bodies are the storage granules of endothelial cells, the cells that form the inner lining of the blood vessels and heart. They store and release two principal molecules, von Willebrand factor and P-selectin, and thus play a dual role in haemostasis and inflammation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.1
      Seconds
  • Question 15 - Which one of the following ECG findings is least associated with digoxin use?...

    Incorrect

    • Which one of the following ECG findings is least associated with digoxin use?

      Your Answer: Down-sloping ST depression

      Correct 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
      16.3
      Seconds
  • Question 16 - Which part of the ECG represents ventricular repolarisation? ...

    Incorrect

    • Which part of the ECG represents ventricular repolarisation?

      Your Answer: QRS complex

      Correct Answer: T wave

      Explanation:

      Ventricular repolarisation is denoted by the T wave.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      2.7
      Seconds
  • Question 17 - The postextrasystolic potentiation of myocardial contractility is due to: ...

    Incorrect

    • The postextrasystolic potentiation of myocardial contractility is due to:

      Your Answer: Increase in intracellular cGMP

      Correct Answer: Increase in intracellular Ca2+

      Explanation:

      The postextrasystolic potentiation of myocardial contractility Is not due to ventricular filling. It occurs in isolated locations in the heart and is due to increase availability of intracellular calcium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10
      Seconds
  • Question 18 - The positive inotropic effect of digoxin is due to? ...

    Incorrect

    • The positive inotropic effect of digoxin is due to?

      Your Answer: Stimulation of calcium channels

      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
      7.4
      Seconds
  • Question 19 - Preload: ...

    Incorrect

    • Preload:

      Your Answer: Is inversely proportional to the end-diastolic volume

      Correct Answer: Is the degree to which the myocardium is stretched before is contracts

      Explanation:

      Preload is end diastolic volume. It is the degree to which the heart muscle fiber is stretched when it fills up completely just before the heart contracts.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      18.1
      Seconds
  • Question 20 - B1 adrenergic stimulation produces: ...

    Incorrect

    • B1 adrenergic stimulation produces:

      Your Answer: Decrease in cAMP

      Correct Answer: Increase in calcium cytosolic concentration

      Explanation:

      Norepinephrine secreted by the sympathetic endings binds to B1 receptors, and the resulting increase in intracellular cAMP facilitates the opening of L channels, increasing Ica and the rapidity of the depolarization phase of the impulse and activates PKA which leads to phosphorylation of the voltage-gated Ca2+ channels, causing them to spend more time in the open state.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.8
      Seconds
  • Question 21 - Direct conduction from the atrium to the ventricles is prevented by: ...

    Correct

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

      Your Answer: Annulus fibrosus

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5
      Seconds
  • Question 22 - What is troponin? ...

    Incorrect

    • What is troponin?

      Your Answer: A myosin light chain

      Correct Answer: A component of thin filaments

      Explanation:

      Skeletal muscle cytoplasmic proteins include myosin and actin (also known as thick and thin filaments, respectively) which are arranged in a repeating unit called a sarcomere. Troponin is a component of thin filaments (along with tropomyosin), and is the protein to which calcium binds.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.8
      Seconds
  • Question 23 - 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
      6.6
      Seconds
  • Question 24 - With regard to the endothelial structure, the epithelium constitute: ...

    Incorrect

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

      Your Answer: Cuboidal

      Correct 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
      8.8
      Seconds
  • Question 25 - What is cardiac output? ...

    Correct

    • What is cardiac output?

      Your Answer: Product of stroke volume and heart rate

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.7
      Seconds
  • Question 26 - Regarding blood supply to the heart; ...

    Correct

    • Regarding blood supply to the heart;

      Your Answer: Coronary arteries fill as the heart relaxes

      Explanation:

      The heart muscles acts like the skeletal muscle in the fact that it also compress the vessels during contraction. As the pressure in the ventricle is slightly greater than in the aorta the coronary vessels collapse during systole. Blood flows through them during the diastole phase of contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.3
      Seconds
  • Question 27 - Which of the following are responsible for the 4th heart sound? ...

    Correct

    • Which of the following are responsible for the 4th heart sound?

      Your Answer: Ventricular hypertrophy

      Explanation:

      The fourth heart sound is not normally audible in a normal adult. It occurs as a consequence of ventricular hypertrophy. It is caused by filling of the ventricle in atrial systole.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.7
      Seconds
  • Question 28 - 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: Changes in the intracellular K+ concentration

      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
      13.1
      Seconds
  • Question 29 - The function of ATP in cardiac muscle contraction includes: ...

    Incorrect

    • The function of ATP in cardiac muscle contraction includes:

      Your Answer: Act as a ligand for serca pump to allow for Ca2+ re-sequestration in the sarcoplasmic reticulum

      Correct Answer: Binding to myosin after the power stroke to allow uncoupling of actin and myosin

      Explanation:

      After calcium binds to the troponin C, there is a conformational change in the structure of troponin I and tropomyosin, which moves out of the way and frees the site where myosin can bind to actin. This results in the formation of the cross linkage of the actin and myosin giving rise to the power stroke in the contraction phase. This occurs with the release of ADP. When ATP combines to this complex it breaks and the cycle repeats itself.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.1
      Seconds
  • Question 30 - Which of the following supplies the AV node? ...

    Correct

    • Which of the following supplies the AV node?

      Your Answer: Right coronary artery

      Explanation:

      The AV node is supplied by the right coronary artery near the origin of the posterior IV artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.9
      Seconds
  • Question 31 - Coronary flow is reduced during ...

    Correct

    • Coronary flow is reduced during

      Your Answer: Tachycardia

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.4
      Seconds
  • Question 32 - Coronary arteries fill up during ...

    Correct

    • Coronary arteries fill up during

      Your Answer: Diastole

      Explanation:

      During contraction of the ventricular myocardium (systole), the subendocardial coronary vessels (the vessels that enter the myocardium) are compressed due to the high ventricular pressures. This compression results in momentary retrograde blood flow (i.e., blood flows backward toward the aorta) which further inhibits perfusion of myocardium during systole. However, the epicardial coronary vessels (the vessels that run along the outer surface of the heart) remain open. Because of this, blood flow in the sub endocardium stops during ventricular contraction. As a result, most myocardial perfusion occurs during heart relaxation (diastole) when the subendocardial coronary vessels are open and under lower pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.2
      Seconds
  • Question 33 - 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
      11.9
      Seconds
  • Question 34 - Calcium is mobilized from the sarcoplasmic reticulum through: ...

    Correct

    • Calcium is mobilized from the sarcoplasmic reticulum through:

      Your 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
      4
      Seconds
  • Question 35 - Which of the following occurs during a Valsalva manoeuvre? ...

    Incorrect

    • Which of the following occurs during a Valsalva manoeuvre?

      Your Answer: Forced inspiration against a closed glottis: no: forced expiration rather

      Correct 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
      12.3
      Seconds
  • Question 36 - The following products of the vascular endothelium produce vasodilation except: ...

    Incorrect

    • The following products of the vascular endothelium produce vasodilation except:

      Your Answer: Endothelial-derived hyperpolarizing factor

      Correct Answer: Endothelin

      Explanation:

      Endothelin: This is incorrect in the context of vasodilation. Endothelin is actually a potent vasoconstrictor produced by the endothelium, leading to the narrowing of blood vessels and increased blood pressure.

      Nitrous oxide (Nitric oxide): This is correct for vasodilation. Nitric oxide is a powerful vasodilator produced by the endothelium, which helps relax and widen blood vessels.

      Prostacyclin: This is correct for vasodilation. Prostacyclin (PGI2) is a vasodilator and inhibits platelet aggregation, helping to maintain blood flow and reduce clot formation.

      Endothelial-derived hyperpolarizing factor (EDHF): This is correct for vasodilation. EDHF causes vasodilation by hyperpolarizing the smooth muscle cells of blood vessels.

      Vascular endothelial growth factor (VEGF): This is correct for vasodilation. VEGF primarily promotes the growth of new blood vessels but also has vasodilatory effects through nitric oxide production.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      18.2
      Seconds
  • Question 37 - 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
      5.4
      Seconds
  • Question 38 - Following an action potential, cytosolic Ca2+ is increased. The binding of free Ca2+...

    Incorrect

    • Following an action potential, cytosolic Ca2+ is increased. The binding of free Ca2+ to troponin C results in all of the following except:

      Your Answer: Induction of a conformational change in tropomyosin

      Correct Answer: Weakening of the troponin i interaction with actin

      Explanation:

      At rest, troponin i is bound to actin and tropomyosin and covers the site where the myosin head interacts with actin. When Calcium enters into the muscle, it binds with troponin C and cause a structural change in troponin i which moves out of the myosin binding site and causes the cross bridges between the actin and myosin filaments to occur.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      93.3
      Seconds
  • Question 39 - 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
      13.1
      Seconds
  • Question 40 - Which of the following factors serve to decrease cardiac output? ...

    Correct

    • Which of the following factors serve to decrease cardiac output?

      Your Answer: Standing from a lying position

      Explanation:

      Sleep has no effect on the cardiac output. Anxiety, excitement, increased body temperature and pregnancy will increase the cardiac output. Standing from a lying position will decrease the cardiac output transiently.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.7
      Seconds
  • Question 41 - Which of the following results in the resting membrane potential of a myocyte?...

    Incorrect

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

      Your Answer: Activation of gated Na channels

      Correct 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
      15.1
      Seconds
  • Question 42 - Blood flow to the subendocardial portions of the left ventricular muscle occurs mainly...

    Incorrect

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

      Your Answer: Isovolumetric ventricular relaxation

      Correct 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
      7.7
      Seconds
  • Question 43 - Where is the carotid sinus located? ...

    Correct

    • Where is the carotid sinus located?

      Your Answer: After the bifurcation of the carotid artery, on the internal carotid

      Explanation:

      The carotid sinus is a small dilation in the internal carotid artery just above its bifurcation into the external and internal carotid branch. Baroreceptors are present at this dilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.1
      Seconds
  • Question 44 - Sinus bradycardia may be caused by disease of which of the following: ...

    Correct

    • Sinus bradycardia may be caused by disease of which of the following:

      Your Answer: Right coronary artery

      Explanation:

      Disease of the right coronary artery may cause sinus bradycardia and AV nodal block.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7
      Seconds
  • Question 45 - In the cardiac cycle, all of the following are true except: ...

    Correct

    • In the cardiac cycle, all of the following are true except:

      Your Answer: Mitral valve is closed by contraction of papillary muscles

      Explanation:

      Mitral valve is closed by contraction of papillary muscles: This statement is incorrect. The mitral valve closes due to the pressure difference between the left ventricle and the left atrium at the onset of ventricular systole. The papillary muscles contract to prevent prolapse of the valve into the atrium but do not cause the valve to close.

      The left ventricular volume is maximal at the end of atrial systole: This statement is true. At the end of atrial systole, the atria have pushed the remaining blood into the ventricles, making the ventricular volume maximal (end-diastolic volume).

      The left ventricular pressure is maximal just before the aortic valve opens: This statement is true. Left ventricular pressure peaks just before the aortic valve opens, as the ventricle contracts to overcome the pressure in the aorta.

      The ejection fraction is about 55%: This statement is true. The ejection fraction, which is the percentage of blood ejected from the ventricles with each contraction, is typically around 55%.

      The ‘a’ wave is due to atrial systole: This statement is true. The ‘a’ wave on the venous pressure curve corresponds to atrial systole, reflecting the increased pressure from atrial contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      16.9
      Seconds
  • Question 46 - What is the effect of catecholamines (i.e. increased heart rate) on the pressure...

    Correct

    • What is the effect of catecholamines (i.e. increased heart rate) on the pressure volume loop?

      Your Answer: Shifts the diastolic pressure curve upward and leftward

      Explanation:

      Catecholamines have a positive ionotropic and chronotropic effect on the heart. The ventricles develop greater tension during systole resulting in an increase in the stroke volume. The increase in stroke volume results in a decrease in the end diastolic volume. This pushes the loop towards the left and upwards.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17.6
      Seconds
  • Question 47 - Relaxation of the cardiac muscle at the actin-myosin cross bridges is initiated by...

    Incorrect

    • Relaxation of the cardiac muscle at the actin-myosin cross bridges is initiated by binding of which molecule to the exposed site on the myosin.

      Your Answer: Calcium ATPase

      Correct Answer: ATP

      Explanation:

      A crossbridge is a myosin projection, consisting of two myosin heads, that extends from the thick filaments. Each myosin head has two binding sites: one for ATP and another for actin. The binding of ATP to a myosin head detaches myosin from actin, thereby allowing myosin to bind to another actin molecule. Once attached, the ATP is hydrolysed by myosin, which uses the released energy to move into the cocked position whereby it binds weakly to a part of the actin binding site.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.6
      Seconds
  • Question 48 - Ventricular depolarization plus ventricular repolarization is shown by the _____ interval ...

    Incorrect

    • Ventricular depolarization plus ventricular repolarization is shown by the _____ interval

      Your Answer: QRS

      Correct Answer: QT

      Explanation:

      The QT interval represents ventricular depolarization as well as ventricular repolarization.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.8
      Seconds
  • Question 49 - Regarding the myofilament molecules, which of the following contains binding sites for calcium...

    Incorrect

    • Regarding the myofilament molecules, which of the following contains binding sites for calcium that helps to initiate contraction?

      Your Answer: Troponin i

      Correct Answer: Troponin c

      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
      7.4
      Seconds
  • Question 50 - Which of the following causes an increase in venous return? ...

    Incorrect

    • Which of the following causes an increase in venous return?

      Your Answer: A decrease in the normal negative intra-thoracic pressure

      Correct 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
      25.4
      Seconds
  • Question 51 - Xanthines (for example Caffeine), exhibit their positive inotropic effect by: ...

    Incorrect

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

      Your Answer: Stimulation of b1-adrenergic receptors

      Correct Answer: Inhibiting the breakdown cAMP

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.8
      Seconds
  • Question 52 - What is the main reason for checking the urea and electrolytes prior to...

    Incorrect

    • What is the main reason for checking the urea and electrolytes prior to commencing a patient on amiodarone?

      Your Answer: To detect impaired renal function

      Correct Answer: To detect hypokalaemia

      Explanation:

      All antiarrhythmic drugs have the potential to cause arrhythmias. Coexistent hypokalaemia significantly increases this risk.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.7
      Seconds
  • Question 53 - Arterioles stemming from the coronary artery can also empty into the heart directly...

    Incorrect

    • Arterioles stemming from the coronary artery can also empty into the heart directly via the:

      Your Answer: All arterioles empty into the coronary sinus or anterior cardiac vein

      Correct Answer: Arteriosinusoidal vessels

      Explanation:

      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. They include arteriosinusoidal vessels, which connect the arterioles to the heart chambers. The thebesian veins drain the capillaries into the chambers and the arterioluminal vessels drain small arteries directly into the chambers.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      16.7
      Seconds
  • Question 54 - The effects of β1 stimulation include the following ...

    Correct

    • The effects of β1 stimulation include the following

      Your Answer: Increased strength of contraction

      Explanation:

      β1 stimulation include the phosphorylation of L type Ca++ channels and phospholamban and increased Ca++ influx from myocytes.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14.9
      Seconds
  • Question 55 - 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: Ankylosing spondylitis

      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
      10.3
      Seconds
  • Question 56 - 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
      10.4
      Seconds
  • Question 57 - Which of the following structures of the cardiac conduction system is located in...

    Incorrect

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

      Your Answer: Purkinje system

      Correct 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
      13.8
      Seconds
  • Question 58 - The isoforms of nitric oxide synthase which are found in the nervous system...

    Correct

    • The isoforms of nitric oxide synthase which are found in the nervous system (NOS1) and endothelial cells (NOS3) are activated by agents that increase which of the following intracellular electrolytes?

      Your Answer: Ca

      Explanation:

      Synthesis of nitric oxide is stimulated by activation of the NMDA receptors by certain agents. This leads to opening of the Calcium channels and an influx of calcium into the cell. This will activate the nitric oxide synthase. Nitric oxide is produced on demand.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12
      Seconds
  • Question 59 - The AV Node: ...

    Correct

    • The AV Node:

      Your Answer: It decelerates impulses passing to the ventricles

      Explanation:

      The action potentials in the sinoatrial (SA) and atrioventricular (AV) nodes are largely due to Ca2+, with no contribution by Na+ influx. The depolarization continues to conduct slowly through the atrioventricular (AV) node. The AV node is located in the right posterior portion of the interatrial septum. This is small and bean-shaped. The atrial conductive system is organized so that the cardiac impulse does not travel from the atria into the ventricles too rapidly; this delay allows the atria to empty before ventricular contraction begins. It is the AV node and its adjacent conductive fibers that delay this transmission into the ventricles. Conduction through the AV Node is represented on the ECG by the PR interval.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      19.8
      Seconds
  • Question 60 - The basic unit of contraction in myocytes is: ...

    Correct

    • The basic unit of contraction in myocytes is:

      Your Answer: Sarcomere

      Explanation:

      Sarcomere is the organelle where calcium is stored to be released during contraction of the muscle. It is the basic unit of contraction in striated muscle fibers. As myocytes are also striated muscles, sarcomeres also forms the basic unit of contraction. The impulses travel along the membrane and via its interaction with the dihydropyridine receptors it releases the stored calcium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4
      Seconds
  • Question 61 - 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
      11.8
      Seconds
  • Question 62 - What is the function of the BK channel on the vascular smooth muscle...

    Correct

    • What is the function of the BK channel on the vascular smooth muscle membrane?

      Your 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
      32.6
      Seconds
  • Question 63 - Which factors increase the end-diastolic volume? ...

    Correct

    • Which factors increase the end-diastolic volume?

      Your Answer: Constriction of veins

      Explanation:

      End diastolic volume is also known as preload. It is the amount of blood the heart contracts against. Constriction of veins will decrease venous pooling and increase venous return, hence increasing the end diastolic volume. Standing will increase venous pooling hence decreasing venous return and end diastolic volume. Raised intrapericardial pressure will also decrease venous return and hence end diastolic volume.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.5
      Seconds
  • Question 64 - Angina pectoris develops when blood through the coronary artery becomes: ...

    Incorrect

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

      Your Answer: Atherosclerotic

      Correct 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
      6.2
      Seconds
  • Question 65 - The branche(s) of the left coronary artery include: ...

    Incorrect

    • The branche(s) of the left coronary artery include:

      Your Answer: Left circumflex artery

      Correct Answer: Left circumflex artery & anterior interventricular artery

      Explanation:

      The left main coronary divides into branches:

      1. The left anterior descending artery branches off the left coronary artery and supplies blood to the front of the left side of the heart.

      2. The circumflex artery branches off the left coronary artery and encircles the heart muscle.

      The anterior interventricular artery is otherwise known as the anterior descending branch. The posterior descending artery comes from Right coronary artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.5
      Seconds
  • Question 66 - Normal stroke volume is about: ...

    Correct

    • Normal stroke volume is about:

      Your Answer: 70 ml

      Explanation:

      Stroke volume is the amount of blood that is pumped from the heart into the aorta. It is typically 70 ml.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6
      Seconds
  • Question 67 - Activation of baroreceptor reflex involves: ...

    Correct

    • Activation of baroreceptor reflex involves:

      Your 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
      17.8
      Seconds
  • Question 68 - Activation of nitric oxide synthesis by endothelial cells is triggered by: ...

    Incorrect

    • Activation of nitric oxide synthesis by endothelial cells is triggered by:

      Your Answer: Bradykinin

      Correct Answer: All of the above

      Explanation:

      Acetylcholine, histamine, bradykinin, vasoactive intestinal peptide (VIP) and shear stress on the endothelial cells causing the release of NO. NO is formed from arginine and causes vasodilatation of the blood vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9
      Seconds
  • Question 69 - The SA and AV nodes are usually supplied by which artery? ...

    Correct

    • The SA and AV nodes are usually supplied by which artery?

      Your Answer: Right coronary artery

      Explanation:

      The right coronary artery supplies the right atrium, right ventricle, SA and AV nodes.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.9
      Seconds
  • Question 70 - 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
      6.2
      Seconds
  • Question 71 - Which of the following is the most common causative organism in infective endocarditis?...

    Incorrect

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

      Your Answer: Staphylococcus aureus

      Correct Answer: Streptococcus viridans

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.8
      Seconds
  • Question 72 - 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
      4.9
      Seconds
  • Question 73 - Impulse conduction through the AV node is slow and depends on the action...

    Incorrect

    • Impulse conduction through the AV node is slow and depends on the action potential produced by which of the following.

      Your Answer: Potassium flux

      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.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12
      Seconds
  • Question 74 - 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
      9.5
      Seconds
  • Question 75 - The heart rate can be accelerated by: ...

    Correct

    • The heart rate can be accelerated by:

      Your Answer: Exercise and thyroid hormones

      Explanation:

      The firing of the SA node will increase due to exercises and as the thyroid hormone has a chronotropic effect on the heart, it too will result in an increase in the heart rate via stimulation of the adrenergic receptors of the heart. As during exercise the sympathetic nervous system is activated, it will directly have an positive chronotropic effect on the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3
      Seconds
  • Question 76 - Which of the following isoforms of Nitric oxide synthase (NOS) is found in...

    Correct

    • Which of the following isoforms of Nitric oxide synthase (NOS) is found in endothelial cells?

      Your Answer: Nos 3

      Explanation:

      There are only 3 isoforms:NOS 1: found in nervous systemNOS 2: in macrophages and other immune cellsNOS 3: In endothelial cells

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9
      Seconds
  • Question 77 - In a normal heart rate at rest, the left ventricular end-diastolic volume is...

    Incorrect

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

      Your Answer: 70-100 ml

      Correct 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
      19.4
      Seconds
  • Question 78 - In the Fick‘s method of measuring cardiac output, the arterial oxygen content can...

    Incorrect

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

      Your Answer: The left ventricle

      Correct 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
      13.6
      Seconds
  • Question 79 - 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
      5.3
      Seconds
  • Question 80 - Isovolumetric ventricular contraction lasts for? ...

    Incorrect

    • Isovolumetric ventricular contraction lasts for?

      Your Answer: 0,5 s

      Correct Answer: 0,05 s

      Explanation:

      Isovolumetric contraction lasts for about 0.05 seconds.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.9
      Seconds
  • Question 81 - Concerning surface anatomy, where is the mitral valve found? ...

    Correct

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

      Your 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
      3.5
      Seconds
  • Question 82 - The coronary sinus drains into the: ...

    Incorrect

    • The coronary sinus drains into the:

      Your Answer: Pulmonary artery

      Correct 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
      30.8
      Seconds
  • Question 83 - Regarding cardiac muscle contractility, the afterload refers to: ...

    Incorrect

    • Regarding cardiac muscle contractility, the afterload refers to:

      Your Answer: Cardiac acceleration action of catecholamines

      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
      7.4
      Seconds
  • Question 84 - Which of the following pairs are correct concerning arteriolar tone? ...

    Incorrect

    • Which of the following pairs are correct concerning arteriolar tone?

      Your Answer: Metabolic control: vascular accumulation of waste products stimulates vasoconstriction

      Correct Answer: Hormonal control: catecholamines affect the adrenergic receptors of the vascular smooth muscle

      Explanation:

      Catecholamines released from the adrenal medulla act on the noradrenergic receptors of the vascular smooth muscles. In the skeletal muscles and liver it causes vasodilation whilst it causes vasoconstriction in the rest of the blood vessels of the body.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      11.5
      Seconds
  • Question 85 - Where would one normally find venous valves? ...

    Incorrect

    • Where would one normally find venous valves?

      Your Answer: Inferior vena cava

      Correct Answer: Saphenous vein

      Explanation:

      The intima of the limb veins is folded at intervals to form venous valves that prevent retrograde flow. There are no valves present in the very small veins, the great veins, or the veins in the brain and viscera.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      58.2
      Seconds
  • Question 86 - The ‘c’ wave in JVP corresponds more closely with: ...

    Incorrect

    • The ‘c’ wave in JVP corresponds more closely with:

      Your Answer: Closure of mitral valve

      Correct Answer: Isovolumetric contraction

      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 (peaks) and two downward deflections (troughs) 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
      11.3
      Seconds
  • Question 87 - Coronary vasoconstriction can be caused by: ...

    Incorrect

    • Coronary vasoconstriction can be caused by:

      Your Answer: Vagal tone

      Correct Answer: Beta blockage

      Explanation:

      Coronary arteries contain alpha and beta receptors. The alpha receptor stimulates vasoconstriction and beta receptors stimulate vasodilation. When the chronotropic and inotropic effects of noradrenergic receptors are blocked by a B blocking drug, stimulation of the noradrenergic nerves will cause coronary vasoconstriction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      21
      Seconds
  • Question 88 - Which statement about the 2nd heart sound is true? ...

    Incorrect

    • Which statement about the 2nd heart sound is true?

      Your Answer: It coincides with rapid ventricular filling.

      Correct Answer: It is caused by closure of the aortic and pulmonary valves.

      Explanation:

      The second heart sound is produced due to closure of the aortic and pulmonary valves. It is a high pitched dub sound.

      Normally the aortic closure sound (A2) occurs prior to the pulmonic closure sound (P2), and the interval between the two (splitting) widens on inspiration and narrows on expiration. With quiet respiration, A2 will normally precede P2 by 0.02 to 0.08 second (mean, 0.03 to 0.04 sec) with inspiration. In younger subjects inspiratory splitting averages 0.04 to 0.05 second during quiet respiration. With expiration, A2 and P2 may be superimposed and are rarely split as much as 0.04 second. If the second sound is split by greater than 0.04 second on expiration, it is usually abnormal. Therefore, the presence of audible splitting during expiration (i.e., the ability to hear two distinct sounds during expiration) is of greater significance at the bedside in identifying underlying cardiac pathology than is the absolute inspiratory increase in the A2–P2 interval.

      The respiratory variation of the second heart sound can be categorized as follows: (1) normal (physiologic) splitting; (2) persistent (audible expiratory) splitting, with normal respiratory variation; (3) persistent splitting without respiratory variation (fixed splitting); and (4) reversed (paradoxical) splitting.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9
      Seconds
  • Question 89 - Which of the following does not contribute to increased stroke volume during exercise?...

    Incorrect

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

      Your Answer: Increased end-diastolic volume

      Correct 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
      11
      Seconds
  • Question 90 - The hyperpolarization phase of pacemaker cells is dominated by ____ current. ...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      38.1
      Seconds
  • Question 91 - The triangle with the heart at its centre, using limb leads is called:...

    Incorrect

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

      Your Answer: Beethoven

      Correct 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
      18.2
      Seconds
  • Question 92 - Concerning coronary arteries, what is the net effect of B2 stimulation on the...

    Incorrect

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

      Your Answer: Vasoconstriction via production of metabolites

      Correct 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
      9.6
      Seconds
  • Question 93 - AV valves open during? ...

    Incorrect

    • AV valves open during?

      Your Answer: Systole

      Correct 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
      3.4
      Seconds
  • Question 94 - Which of the following regulates the calcium release channels? ...

    Incorrect

    • Which of the following regulates the calcium release channels?

      Your Answer: Troponin c

      Correct 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
      9
      Seconds
  • Question 95 - When is the blood pressure at its lowest during pregnancy? ...

    Incorrect

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

      Your Answer: First 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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.5
      Seconds
  • Question 96 - Myocardial contractility is improved by: ...

    Incorrect

    • Myocardial contractility is improved by:

      Your Answer: Quinidine

      Correct Answer: Caffeine

      Explanation:

      Caffeine and other theophyllines breakdown cAMP and have a positive ionotropic effect on the heart. Drugs like quinidine, procainamide and conditions like hypoxia and hypercapnia decreases the contractility of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.1
      Seconds
  • Question 97 - Regarding cardiac contractility, catecholamines exert their inotropic effect via: ...

    Incorrect

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

      Your Answer: Myocardial Na+/K+ ATPase

      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
      4.1
      Seconds
  • Question 98 - Calcium induced calcium release occurs in the sarcoplasmic reticulum by activation of which...

    Incorrect

    • Calcium induced calcium release occurs in the sarcoplasmic reticulum by activation of which receptors

      Your Answer: Alpha receptors

      Correct 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.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.8
      Seconds
  • Question 99 - The coronary sinus, which empties into the right atrium, serves to? ...

    Incorrect

    • The coronary sinus, which empties into the right atrium, serves to?

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds
  • Question 100 - When observing a JVP, which of the following would lead to prominent v...

    Incorrect

    • When observing a JVP, which of the following would lead to prominent v waves?

      Your Answer:

      Correct Answer: Tricuspid regurgitation

      Explanation:

      The v wave corresponds to Venous filling when the tricuspid valve is closed and venous pressure increases from venous return. In Tricuspid regurgitation there is additional blood from the regurgitant flow and thus this leads to a more prominent V wave.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (42/98) 43%
Medicine (42/98) 43%
Passmed