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  • Question 1 - 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
      18.8
      Seconds
  • Question 2 - Cholinergic nerves from the vagus innervate the SA and AV nodes via which...

    Correct

    • Cholinergic nerves from the vagus innervate the SA and AV nodes via which receptor in the heart?

      Your Answer: M2 receptor

      Explanation:

      M2 receptor is found in the heart. M3 and M4 are associated with smooth muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      18.7
      Seconds
  • Question 3 - The following determines the strength of contraction ...

    Incorrect

    • The following determines the strength of contraction

      Your Answer: None of the above

      Correct Answer: Plateau phase

      Explanation:

      The plateau phase which follows is unique to myocytes and results from a small, but sustained inward calcium current through L-type calcium channels lasting 200-400 ms. This calcium influx is caused by a combined increase in permeability of the cell and especially the sarcolemmal membranes to calcium. This plateau (or refractory) phase in myocyte action potential prevents early reactivation of the myocytes and directly determines the strength of contraction

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      21.1
      Seconds
  • Question 4 - 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
      10
      Seconds
  • Question 5 - The following are examples of the functions of the vascular endothelium except: ...

    Incorrect

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

      Your Answer: Prothrombotic

      Correct Answer: Tumour suppression

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      18.3
      Seconds
  • Question 6 - Calcium induced calcium release occurs in the sarcoplasmic reticulum by activation of which...

    Correct

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

      Your Answer: Ryanodine receptors

      Explanation:

      Calcium-induced calcium release (CICR) describes a biological process whereby calcium is able to activate calcium release from intracellular Ca2+ stores (e.g., endoplasmic reticulum or sarcoplasmic reticulum). CICR occurs when the resulting Ca2+ influx activates ryanodine receptors on the SR membrane, which causes more Ca2+ to be released into the cytosol.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.2
      Seconds
  • Question 7 - During exercise, a man consumes 2L O2/min, his arterial 02 content is 190...

    Correct

    • During exercise, a man consumes 2L O2/min, his arterial 02 content is 190 ml/l and the 02 content of his mixed venous blood is 130ml/l. His cardiac output is approximately:

      Your Answer: 33l/min

      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.Therefore CO = 2/(0.190-0.130) = 33l/minNote that (Ca – Cv) is also known as the arteriovenous oxygen difference.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      100.3
      Seconds
  • Question 8 - 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
      11.1
      Seconds
  • Question 9 - 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
      42.6
      Seconds
  • Question 10 - A 27-year-old man presents with a regular tachycardia of 190 bpm. He is...

    Correct

    • A 27-year-old man presents with a regular tachycardia of 190 bpm. He is healthy and has no past medical history. Blood pressure and blood tests are all within normal parameters however the ECG confirms a narrow complex tachycardia. The tachycardia persists after giving IV adenosine 6mg. What should be the next step in management of this patient?

      Your Answer: IV 12mg adenosine

      Explanation:

      For narrow complex tachycardias with no compromise then vagal manoeuvres should be trialled first. The Valsalva manoeuvre should be the first vagal manoeuvre tried and works by increasing intra-thoracic pressure and affecting baroreceptors (pressure sensors) within the arch of the aorta. It is carried out by asking the patient to hold his/her breath while trying to exhale forcibly as if straining during a bowel movement. Adenosine, an ultra-short-acting AV nodal blocking agent, is indicated if vagal manoeuvres are not effective. Adenosine may be safely used during pregnancy. In adults the recommended first dose of intravenous adenosine is 6 mg. The dose is administered rapidly and then followed by a saline flush. Adenosine is only present in the circulation for about 5 seconds, so it is an excellent drug for diagnosis and treatment. If there was a response to adenosine but it was not long lasting, an additional dose of 12 mg of adenosine intravenously can be attempted. Doses greater than 12 mg are not recommended. If adenosine fails then Verapamil or a beta blocker can be used as alternatives. If the patient is hemodynamically unstable or other treatments have not been effective, synchronized electrical cardioversion may be used.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17
      Seconds
  • Question 11 - Which of the following is NOT an effect of a positive inotropic agent...

    Correct

    • Which of the following is NOT an effect of a positive inotropic agent on the heart?

      Your Answer: It decreases the rate of rise in ventricular blood pressure during systole

      Explanation:

      Inotropic agents increase the contractility of the heart as well as the rate of rise in ventricular blood pressure during systole, generating a greater pressure and increasing the stroke volume e.g. like catecholamines do.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      35.3
      Seconds
  • Question 12 - Which of the following phases in depolarization and repolarization of cardiac muscle cells...

    Incorrect

    • Which of the following phases in depolarization and repolarization of cardiac muscle cells are caused by the inactivation of Na+ channels?

      Your Answer: Phase 2 : plateau

      Correct Answer: Phase 1 : rapid repolarization

      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
      181.6
      Seconds
  • Question 13 - In a 30 year old male with hypertrophic obstructive cardiomyopathy (HOCM), which of...

    Incorrect

    • In a 30 year old male with hypertrophic obstructive cardiomyopathy (HOCM), which of the following is not associated with increased risk of sudden death?

      Your Answer: Family history of sudden death

      Correct Answer: Age

      Explanation:

      Hypertrophic cardiomyopathy (HCM) is a disease in which a portion of the myocardium (heart muscle) is enlarged without any obvious cause, creating functional impairment of the heart. It is the leading cause of sudden death in young athletes. The major risk factors for sudden death (SD) are recent unexplained syncope unlikely to be neurocardiogenic; HCM-related SD in first-degree or other close relatives; repetitive and/or prolonged nonsustained ventricular tachycardia (NSVT) episodes on Holter or extended ambulatory monitoring; massive left ventricular hypertrophy (LVH) (wall thickness ≥30 mm); extensive/diffuse late gadolinium enhancement (LGE); end-stage heart failure usually with systolic dysfunction; and thin-walled akinetic LV apical aneurysm with regional scarring.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      14
      Seconds
  • Question 14 - Stroke volume in a average sized man lying in supine position is about?...

    Correct

    • Stroke volume in a average sized man lying in supine position is about?

      Your Answer: 70 ml

      Explanation:

      The stroke volume of an average sized man who is lying is the supine position is about 70 ml.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.5
      Seconds
  • Question 15 - In ventricular fibrillation (VF), the first defibrillation attempt (with a biphasic defibrillator) should...

    Correct

    • In ventricular fibrillation (VF), the first defibrillation attempt (with a biphasic defibrillator) should be made at:

      Your Answer: 200 J

      Explanation:

      Defibrillation is a common treatment for life-threatening cardiac dysrhythmias and ventricular fibrillation. If the patient is in Ventricular tachycardia (VT) or ventricular fibrillation (VF) on the monitor, immediately apply the pads and shock the patient with 120-200 Joules on a biphasic defibrillator or 360 Joules on a monophasic defibrillator.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17.5
      Seconds
  • Question 16 - How many molecules of myosin attach to actin at any given time? ...

    Correct

    • How many molecules of myosin attach to actin at any given time?

      Your Answer: 1

      Explanation:

      1 molecule of myosin binds to actin at any give time.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      40.3
      Seconds
  • Question 17 - 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
      4.5
      Seconds
  • Question 18 - Which of the following has the shortest duration: ...

    Incorrect

    • Which of the following has the shortest duration:

      Your Answer: Atrial diastole

      Correct Answer: Atrial systole

      Explanation:

      Atrial systole: 0.1s

      Atrial diastole: around 0.4s

      Ventricular diastole: 0.4-0.53s

      Ventricular systole: 0.27s

      PR interval: 0.12-0.2 s

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      29.6
      Seconds
  • Question 19 - The V wave in the jugular pulse is caused by: ...

    Correct

    • The V wave in the jugular pulse is caused by:

      Your Answer: Atrial filling

      Explanation:

      The v wave reflects the passive increase in pressure and volume of the right atrium as it fills in late systole and early diastole.

      The jugular vein pulsations usually have two elevations and two troughs. The first elevation (a wave) corresponds to the slight rise in atrial pressure resulting from atrial contraction. The first descent (x descent) reflects a fall in atrial pressure that starts with atrial relaxation. The second elevation (v wave) corresponds to ventricular systole when blood is entering the right atrium from the vena cavae while the tricuspid valve is closed. Finally, the second descent (y descent) reflects falling right atrial pressure as the tricuspid valve opens and blood drains from the atrium into the ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      18.3
      Seconds
  • Question 20 - Which of the following is true of the Natriuretic hormones? ...

    Correct

    • Which of the following is true of the Natriuretic hormones?

      Your Answer: They are released in response to hypervolemia

      Explanation:

      Natriuretic hormones are vasodilators released in response to hypervolemia.

      Natriuretic hormones (NH) include three groups of compounds: the natriuretic peptides NPs (ANP, BNP and CNP), the gastrointestinal peptides (guanylin and uroguanylin), and endogenous cardiac steroids. These substances induce the kidney to excrete sodium and therefore participate in the regulation of sodium and water homeostasis, blood volume, and blood pressure (BP). In addition to their peripheral functions, these hormones act as neurotransmitters or neuromodulators in the brain.

      Atrial natriuretic peptide (ANP) plays a crucial role in blood pressure regulation by inducing natriuresis and diuresis in the kidney, inhibiting renin secretion, aldosterone production, and promoting vasorelaxation.  Two paracrine factors derived from endothelial cells play important roles in modulating ANP secretion. Endothelin, a potent vasoconstrictor, stimulates ANP secretion and augments stretch induced ANP secretion. The dramatic increase in ANP release produced by cardiac ischemia appears to be mediated in part by endothelin. Nitric oxide (NO), an important vasodilator, is also produced by endothelial cells and inhibits ANP secretion.

      Brain natriuretic peptide (BNP) shares ANP’s receptor but is primarily associated with antifibrotic effects in ventricular remodeling, serving as a biomarker for heart failure and myocardial infarction.

      C-type natriuretic peptide (CNP) acts locally in an autocrine/paracrine manner, exerting potent cardiovascular effects, including vasorelaxation and vascular remodeling post-injury. NPs also demonstrate diverse effects beyond cardiovascular and renal systems, such as bronchodilation, anti-inflammatory actions, and metabolic effects on adipose tissue and long bones.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      30.3
      Seconds
  • Question 21 - Dicrotic notch is produced by which valves? ...

    Correct

    • Dicrotic notch is produced by which valves?

      Your Answer: Aortic

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.4
      Seconds
  • Question 22 - 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
      46.4
      Seconds
  • Question 23 - Depolarization of the T tubule membrane activates the sarcoplasmic reticulum via which receptors?...

    Incorrect

    • Depolarization of the T tubule membrane activates the sarcoplasmic reticulum via which receptors?

      Your Answer: Ryanodine receptors

      Correct Answer: Dihydropyridine receptors

      Explanation:

      Action potentials are transmitted to the fibrils of a fiber through the T tubule system. It triggers the release of Ca 2+ form the terminal cisterns. Depolarization of the T tubules activates the sarcoplasmic reticulum through the dihydropyridine receptors.

      Dihydropyridine receptors (DHPRs), are voltage-gated Ca2+ channels, and ryanodine receptors (RyRs), which are intracellular Ca2+ release channels, are expressed in diverse cell types, including skeletal and cardiac muscle.

      Ryanodine receptors (RyRs) are located in the sarcoplasmic/endoplasmic reticulum membrane and are responsible for the release of Ca2+ from intracellular stores during excitation-contraction coupling in both cardiac and skeletal muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      16.2
      Seconds
  • Question 24 - Which of the atrial pressure changes represents the a-wave of the JVP ...

    Correct

    • Which of the atrial pressure changes represents the a-wave of the JVP

      Your Answer: 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
      15.1
      Seconds
  • Question 25 - Which of the following conditions has no effect on cardiac output? ...

    Correct

    • Which of the following conditions has no effect on cardiac output?

      Your Answer: Sleep

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.2
      Seconds
  • Question 26 - Which statement about the 2nd heart sound is true? ...

    Correct

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

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

      Explanation:

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

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

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      16.2
      Seconds
  • Question 27 - Regarding the myofilament molecules, which of the following contains binding sites for calcium...

    Correct

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

      Your 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
      32.8
      Seconds
  • Question 28 - The branche(s) of the left coronary artery include: ...

    Correct

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

      Your 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
      12.6
      Seconds
  • Question 29 - 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
      8
      Seconds
  • Question 30 - The following is true of the sinus node: ...

    Incorrect

    • The following is true of the sinus node:

      Your Answer: It discharges at a rate of 80-100 bpm

      Correct 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
      24.4
      Seconds
  • Question 31 - With regards to the cardiac cycle which of the following is true ...

    Incorrect

    • With regards to the cardiac cycle which of the following is true

      Your Answer: Left ventricular ejection begins before right ventricular ejection

      Correct Answer: Right atrial systole occurs before left atrial systole: as below

      Explanation:

      Cardiac cycle: The first event in the cycle is atrial depolarization (a P wave on the surface ECG) follows by RIGHT ATRIAL and then LEFT ATRIAL contraction. Ventricular activation (QRS) follows after a short interval (the PR interval). LEFT VENTRICULAR contraction starts shortly thereafter RIGHT VENTRICULAR contraction begins. At the end, the aortic valve closure is followed by pulmonary valve closure.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      49.9
      Seconds
  • Question 32 - 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
      10.1
      Seconds
  • Question 33 - 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
      6
      Seconds
  • Question 34 - Coronary arteries arise from? ...

    Incorrect

    • Coronary arteries arise from?

      Your Answer: Ascending aorta

      Correct Answer: None of the above

      Explanation:

      Coronary arteries arise from the sinuses behind 2 of the cusps of the aortic valve at the root of aorta.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.5
      Seconds
  • Question 35 - What is pulse pressure? ...

    Incorrect

    • What is pulse pressure?

      Your Answer: 1/3 systolic plus 2/3 diastolic

      Correct Answer: Difference between systolic and diastolic pressure

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.4
      Seconds
  • Question 36 - Which of the following components regulate cardiac output? ...

    Incorrect

    • Which of the following components regulate cardiac output?

      Your Answer: Autonomic nervous system

      Correct Answer: All of the above

      Explanation:

      Cardiac output is regulated by the autonomic nervous system with sympathetic nerves having a positive chronotropic and inotropic effect and parasympathetic nerves having the opposite effect. An increase in preload will increase cardiac output likewise an afterload increase will also increase cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.3
      Seconds
  • Question 37 - Which of the following statements is true regarding pulsus alternans? ...

    Incorrect

    • Which of the following statements is true regarding pulsus alternans?

      Your Answer: It is found in patients with a small pericardial effusion

      Correct Answer: It is found in association with a third heart sound

      Explanation:

      Pulsus alternans is a physical finding with arterial pulse waveform showing alternating strong and weak beats. It is almost always indicative of left ventricular systolic impairment, and carries a poor prognosis. A pathological third heart sound is usually associated.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      15
      Seconds
  • Question 38 - 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
      10
      Seconds
  • Question 39 - 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
      15.8
      Seconds
  • Question 40 - What is the most common cardiac defect seen in patients with Down’s syndrome?...

    Incorrect

    • What is the most common cardiac defect seen in patients with Down’s syndrome?

      Your Answer: Ventricular septal defect

      Correct Answer: Atrioventricular septal defect

      Explanation:

      The rate of congenital heart disease in new-borns with Down syndrome is around 40%. Of those with heart disease, about 80% have an atrioventricular septal defect or ventricular septal defect with the former being more common. Mitral valve problems become common as people age, even in those without heart problems at birth.[3] Other problems that may occur include tetralogy of Fallot and patent ductus arteriosus.[38] People with Down syndrome have a lower risk of hardening of the arteries

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.8
      Seconds
  • Question 41 - Xanthines (for example Caffeine), exhibit their positive inotropic effect by: ...

    Incorrect

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

      Your Answer: Stimulating adenylyl cyclase

      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
      12.3
      Seconds
  • Question 42 - Which vagus nerve mainly supplies the AV node? ...

    Incorrect

    • Which vagus nerve mainly supplies the AV node?

      Your Answer: Right vagus

      Correct Answer: Left vagus

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.5
      Seconds
  • Question 43 - 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
      10.2
      Seconds
  • Question 44 - 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
      11
      Seconds
  • Question 45 - 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
      14.4
      Seconds
  • Question 46 - 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
      6.9
      Seconds
  • Question 47 - Where would one find pericytes around endothelial cells? ...

    Incorrect

    • Where would one find pericytes around endothelial cells?

      Your Answer: Smaller arteries

      Correct Answer: Post-capillary venules

      Explanation:

      Pericytes release a wide variety of vasoactive agents which regulate the flow through the junction between endothelial cells.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      8.1
      Seconds
  • Question 48 - 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
      9.4
      Seconds
  • Question 49 - Endothelial cells are attached to adjacent cells by adherent junctions via: ...

    Correct

    • Endothelial cells are attached to adjacent cells by adherent junctions via:

      Your Answer: Cadherins

      Explanation:

      Cadherins are calcium dependant molecules that mediate cell to cell adhesions in epithelial and endothelial cells among others.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      23.9
      Seconds
  • Question 50 - 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
      14.4
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (31/50) 62%
Medicine (31/50) 62%
Passmed