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  • Question 1 - 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
      8.6
      Seconds

  • Question 2 - 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
      15.9
      Seconds

  • Question 3 - The following contributes to the rate of depolarization? ...

    Incorrect

    • The following contributes to the rate of depolarization?

      Your Answer:

      Correct Answer: All of the options given

      Explanation:

      Depolarization occurs due to impulses generated by the SA node. As the heart beats to the rhythm of the SA node, certain factors will effect the rate of depolarization. All the mentioned options effect the rate of depolarization.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 4 - 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:

      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
      0
      Seconds

  • Question 5 - Currents caused by opening of which of the following channels contribute to the...

    Incorrect

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

      Your Answer:

      Correct Answer: Potassium channels

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 6 - The areas of extensive series of sarcoplasmic folds known as intercalated discs always...

    Incorrect

    • The areas of extensive series of sarcoplasmic folds known as intercalated discs always occur at what portion of the muscle fiber?

      Your Answer:

      Correct Answer: Z lines

      Explanation:

      The muscle fibers of the heart branch and interdigitate, but one complete unit is surrounded by a cell membrane. The place where one muscle fiber abuts the other, the cell membrane of both the fibers run parallel to each other through a series of extensive folds. These areas always occur on the Z lines and are known as intercalated discs.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 7 - Transport of Ca2+ into the reticulum to initiate cardiac muscle relaxation in via:...

    Incorrect

    • Transport of Ca2+ into the reticulum to initiate cardiac muscle relaxation in via:

      Your Answer:

      Correct Answer: Serca (sarcoplasmic or endoplasmic reticulum Ca2+ ATPase)

      Explanation:

      Phosphorylation of phospholamban, which 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 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
      0
      Seconds

  • Question 8 - When looking at the JVP what does the c wave signify: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Isovolumetric ventricular contraction

      Explanation:

      The C wave signifies a rise in the atrial pressure during isovolumetric contraction due to the tricuspid valve bulging into the atria.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 9 - Myocardial oxygen consumption is increased by: ...

    Incorrect

    • Myocardial oxygen consumption is increased by:

      Your Answer:

      Correct Answer: An increase in after load

      Explanation:

      Cardiac oxygen consumption is directly related to the amount of tension that develops in the ventricles. It is increased by an increased size of heart, increased afterload, increased contractility and increased heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 10 - What is the effect of catecholamines (i.e. increased heart rate) on the pressure...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 11 - Myocardial contractility is improved by: ...

    Incorrect

    • Myocardial contractility is improved by:

      Your Answer:

      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
      0
      Seconds

  • Question 12 - The SA and AV nodes are usually supplied by which artery? ...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 13 - Myocardial fibers have a resting membrane potential of approximately: ...

    Incorrect

    • Myocardial fibers have a resting membrane potential of approximately:

      Your Answer:

      Correct Answer: -90mv

      Explanation:

      The resting membrane potential of the mammalian heart is about -90 mv.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 14 - Where would one normally find venous valves? ...

    Incorrect

    • Where would one normally find venous valves?

      Your Answer:

      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
      0
      Seconds

  • Question 15 - AV valves open during? ...

    Incorrect

    • AV valves open during?

      Your Answer:

      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
      0
      Seconds

  • Question 16 - Calcium is mobilized from the sarcoplasmic reticulum through: ...

    Incorrect

    • Calcium is mobilized from the sarcoplasmic reticulum through:

      Your Answer:

      Correct Answer: Ryanodine receptor (RyR2) calcium release channels

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 17 - 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:

      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
      0
      Seconds

  • Question 18 - Which of the following statements is true regarding pulsus alternans? ...

    Incorrect

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

      Your Answer:

      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
      0
      Seconds

  • Question 19 - Which of the following does not lower ventricular rate in atrial fibrillation? ...

    Incorrect

    • Which of the following does not lower ventricular rate in atrial fibrillation?

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 20 - The initial rapid depolarization in the action potential of cardiac muscle cells is...

    Incorrect

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

      Your Answer:

      Correct Answer: Opening of voltage-gated Na+ channels

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 21 - In the blood supply of the heart, ‘dominance’ refers to the coronary artery...

    Incorrect

    • In the blood supply of the heart, ‘dominance’ refers to the coronary artery which supplies the?

      Your Answer:

      Correct Answer: Posterior interventricular artery

      Explanation:

      Dominance of the coronary artery system is defined by the artery that gives rise to the posterior interventricular artery. Dominance of the right coronary artery is more common (68%). It gives rise to the large posterior interventricular branch which goes down to the apex of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 22 - The following is true of the sinus node: ...

    Incorrect

    • The following is true of the sinus node:

      Your Answer:

      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
      0
      Seconds

  • Question 23 - Cholinergic vagal supply to the SA and AV nodes results in slowing of...

    Incorrect

    • Cholinergic vagal supply to the SA and AV nodes results in slowing of the heart rate via:

      Your Answer:

      Correct Answer: M2 muscarinic receptors

      Explanation:

      M2 muscarinic receptors are the receptors for the parasympathetic system to the SA and the AV node.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 24 - Tunica intima is made up of? ...

    Incorrect

    • Tunica intima is made up of?

      Your Answer:

      Correct Answer: Endothelial cells

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 25 - Coronary arteries arise from? ...

    Incorrect

    • Coronary arteries arise from?

      Your Answer:

      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
      0
      Seconds

  • Question 26 - The function of ATP in cardiac muscle contraction includes: ...

    Incorrect

    • The function of ATP in cardiac muscle contraction includes:

      Your Answer:

      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
      0
      Seconds

  • Question 27 - Calcium needed for cardiac muscle contraction is made available during which phase of...

    Incorrect

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

      Your Answer:

      Correct Answer: 2

      Explanation:

      It is made available during the plateau phase of the action potential i.e. phase 2. During the plateau phase of the action potential, Calcium from the extracellular fluid enters through the L type of calcium channels. This entry triggers the release of more calcium from the sarcoplasmic reticulum via the ryanodine receptors.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 28 - The postextrasystolic potentiation of myocardial contractility is due to: ...

    Incorrect

    • The postextrasystolic potentiation of myocardial contractility is due to:

      Your Answer:

      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
      0
      Seconds

  • Question 29 - The hyperpolarization phase of pacemaker cells is dominated by ____ current. ...

    Incorrect

    • The hyperpolarization phase of pacemaker cells is dominated by ____ current.

      Your Answer:

      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
      0
      Seconds

  • Question 30 - When is the blood pressure at its lowest during pregnancy? ...

    Incorrect

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

      Your Answer:

      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
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (1/2) 50%
Medicine (1/2) 50%
Passmed
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