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  • Question 1 - The major factor in controlling coronary artery blood flow is considered to be?...

    Correct

    • The major factor in controlling coronary artery blood flow is considered to be?

      Your Answer: Metabolites of oxygen consumption

      Explanation:

      There is a strong relationship between myocardial blood flow and oxygen consumption. This indicates that products of metabolism may cause vasodilation of the coronary artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.7
      Seconds
  • Question 2 - Which of the following occurs during a Valsalva manoeuvre? ...

    Incorrect

    • Which of the following occurs during a Valsalva manoeuvre?

      Your Answer: Disruption of autonomic function

      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
      27.3
      Seconds
  • Question 3 - What is the main reason for checking the urea and electrolytes prior to...

    Correct

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

      Your 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
      17.1
      Seconds
  • Question 4 - Endothelial cells produce the following substance(s): ...

    Correct

    • Endothelial cells produce the following substance(s):

      Your Answer: All of the above

      Explanation:

      Endothelial cells produce thromboxane, prostacyclins, nitric oxides, endothelins, IL-1 and TNF.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.1
      Seconds
  • Question 5 - 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
      22.1
      Seconds
  • Question 6 - 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
      4.6
      Seconds
  • Question 7 - 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
      12.8
      Seconds
  • Question 8 - Why does arterial blood pressure drop during pregnancy? ...

    Incorrect

    • Why does arterial blood pressure drop during pregnancy?

      Your Answer: The enlarged uterus leads to inferior vena cava compression

      Correct Answer: Progesterone relaxes vascular smooth muscle

      Explanation:

      Progesterone relaxes vascular smooth muscle thus resulting In a decrease in total peripheral resistance. This accounts for the increase in the cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10
      Seconds
  • Question 9 - 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
      2
      Seconds
  • Question 10 - The amount of a substance taken up by an organ (or whole body)...

    Correct

    • The amount of a substance taken up by an organ (or whole body) per unit time is = (the arterial level - the venous level) * the blood flow. This statement describes?

      Your Answer: The Fick principle

      Explanation:

      The essence of the Fick principle is that blood flow to an organ can be calculated using a marker substance if the following information is known:- Amount of marker substance taken up by the organ per unit time- Concentration of marker substance in arterial blood supplying the organ- Concentration of marker substance in venous blood leaving the organ

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      2.4
      Seconds
  • Question 11 - 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
      3.3
      Seconds
  • Question 12 - 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: H band

      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
      17.1
      Seconds
  • Question 13 - In Jugular vein pressure the “a” wave represents? ...

    Correct

    • In Jugular vein pressure the “a” wave represents?

      Your Answer: Atrial systole

      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 and two downward deflections 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
      7.3
      Seconds
  • Question 14 - 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
      21.1
      Seconds
  • Question 15 - Concerning S3, which of the following statements is INCORRECT? ...

    Correct

    • Concerning S3, which of the following statements is INCORRECT?

      Your Answer: Coincide with atrial contraction

      Explanation:

      A third heart sound also called a ventricular gallop occurs at the beginning of diastole after S2 and is lower in pitch than S1 or S2 as it is not of valvular origin. The third heart sound is benign in youth, some trained athletes, and sometimes in pregnancy but if it re-emerges later in life it may signal cardiac problems, such as a failing left ventricle as in dilated congestive heart failure (CHF). S3 is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by blood rushing in from the atria. The reason the third heart sound does not occur until the middle third of diastole is probably that during the early part of diastole, the ventricles are not filled sufficiently to create enough tension for reverberation. It may also be a result of tensing of the chordae tendineae during rapid filling and expansion of the ventricle. In other words, an S3 heart sound indicates increased volume of blood within the ventricle. An S3 heart sound is best heard with the bell-side of the stethoscope (used for lower frequency sounds). A left-sided S3 is best heard in the left lateral decubitus position and at the apex of the heart, which is normally located in the 5th left intercostal space at the midclavicular line. A right-sided S3 is best heard at the lower-left sternal border. The way to distinguish between a left and right-sided S3 is to observe whether it increases in intensity with inhalation or exhalation. A right-sided S3 will increase on inhalation, while a left-sided S3 will increase on exhalation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      32.5
      Seconds
  • Question 16 - 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: Non of the above

      Correct Answer: Calcium flux

      Explanation:

      The action potentials in the SA and AV nodes are largely due to Ca2+, with no contribution by Na+ influx.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      25
      Seconds
  • Question 17 - Which of the following corresponds to an oblique line drawn from the sternal...

    Correct

    • Which of the following corresponds to an oblique line drawn from the sternal end of the left 3rd costal cartilage to the sternal end of the right 6th costal cartilage?

      Your Answer: Atrio-ventricular (coronary) groove

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.9
      Seconds
  • Question 18 - The hyperpolarization phase of pacemaker cells is dominated by ____ current. ...

    Correct

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

      Your 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
      11.6
      Seconds
  • Question 19 - The following is true in relation to coronary venous drainage? ...

    Correct

    • The following is true in relation to coronary venous drainage?

      Your Answer: Most venous return ultimately drains into right atrium via the coronary sinus

      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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.3
      Seconds
  • Question 20 - Which of the following makes up the thick filaments in muscle fibers? ...

    Correct

    • Which of the following makes up the thick filaments in muscle fibers?

      Your Answer: Myosin

      Explanation:

      The thick filaments are made up of myosin and the thin filaments are made up of actin. The thick filaments are twice the size of the thin filaments and are aligned to form the A band. The thin filaments extending out from the A band form the less dense I bands.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      20
      Seconds
  • Question 21 - Which of the following is NOT associated with the development of aortic regurgitation?...

    Correct

    • Which of the following is NOT associated with the development of aortic regurgitation?

      Your 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
      8.3
      Seconds
  • Question 22 - 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
      17.1
      Seconds
  • Question 23 - Xanthines (for example Caffeine), exhibit their positive inotropic effect by: ...

    Correct

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

      Your 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
      6.2
      Seconds
  • Question 24 - The predominant receptors in the hearts conduction system are? ...

    Correct

    • The predominant receptors in the hearts conduction system are?

      Your Answer: Β1

      Explanation:

      All of the components of the intrinsic conduction system contain autorhythmic cells that spontaneously depolarize. In the absence of extrinsic neural or hormonal influences, the SA node pacing rate would be about 100 beats per minute (bpm). The heart rate and cardiac output, however, must vary in response to the needs of the body’s cells for oxygen and nutrients under varying conditions. In order to respond rapidly to changing requirements of the body’s tissues, the heart rate and contractility are regulated by the autonomic nervous system (ANS), hormones, and other factors. The ANS has two interacting systems: the sympathetic and parasympathetic systems.

      Sympathetic receptors: There are two types of adrenergic receptors: β and α. In the cardiovascular system there are β1, β2, α1, and α2 adrenergic receptors. β1 adrenergic receptors are expressed in the heart conduction system (in the SA node, AV node, and on atrial and ventricular cardiomyocytes). The activation of β1 receptors increases heart rate (via the SA node), and contractility.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      7.3
      Seconds
  • Question 25 - 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: Formation of myosin/troponin i cross-bridges

      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
      13.5
      Seconds
  • Question 26 - 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
      6
      Seconds
  • Question 27 - With regard to the endothelial structure, the epithelium constitute: ...

    Correct

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

      Your 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
      8.5
      Seconds
  • Question 28 - Factors influencing cardiac output include which of the following? ...

    Correct

    • Factors influencing cardiac output include which of the following?

      Your Answer: All of the above

      Explanation:

      There is a correlation between resting CO and body surface area. The output per min per square meter of body surface (the cardiac index) averages 3.2l.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.8
      Seconds
  • Question 29 - Which vagus nerve mainly supplies the AV node? ...

    Correct

    • Which vagus nerve mainly supplies the AV node?

      Your 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
      4.4
      Seconds
  • Question 30 - Which structure forms the major part of the sternocostal surface of the heart?...

    Correct

    • Which structure forms the major part of the sternocostal surface of the heart?

      Your Answer: Right ventricle

      Explanation:

      The anterior (sternocostal) surface is formed mainly by the right ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.6
      Seconds
  • Question 31 - Cross-bridges between actin and myosin filaments contain: ...

    Incorrect

    • Cross-bridges between actin and myosin filaments contain:

      Your Answer: ATPase

      Correct Answer: Calcium ions

      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 causes 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
      10.1
      Seconds
  • Question 32 - The principle by which the energy of contraction is proportional to the initial...

    Correct

    • The principle by which the energy of contraction is proportional to the initial length of cardiac muscle fiber is known as:

      Your Answer: Starling’s law

      Explanation:

      The Frank starling relationship describes that an increase in the venous return or the end diastolic volume will cause an increase in the stroke volume/ preload and also cardiac output. It stems from the fact that increase venous return will increase the stretch on the ventricular muscle fibers. The sarcomere will stretch a considerable length that is needed for maximum contraction and increased development of tension in the muscle fiber. The greater the venous return the greater the cardiac output. This relation is directly proportional.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9
      Seconds
  • Question 33 - The following are examples of the functions of the vascular endothelium except: ...

    Correct

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

      Your 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
      8.9
      Seconds
  • Question 34 - Blood flow to the subendocardial portions of the left ventricular muscle occurs mainly...

    Correct

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

      Your Answer: Diastole

      Explanation:

      The sub endocardium receives the least amount of blood from the coronary arteries. During systole the coronary arteries collapse as a result of the pressure from contraction that is exerted on them. During diastole the heart muscle relaxes and the pressure on the coronary vessels is relieved allowing blood to flow through them to the sub endocardium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.1
      Seconds
  • Question 35 - 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
      28.1
      Seconds
  • Question 36 - 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
      27.4
      Seconds
  • Question 37 - Why is the sub-endocardial portion of the left ventricle the most common site...

    Incorrect

    • Why is the sub-endocardial portion of the left ventricle the most common site for ischaemic damage and myocardial infarction?

      Your Answer: Ventricular pressure decreases often on this portion

      Correct Answer: No blood flow occurs during systole

      Explanation:

      The subendocardium receives the least amount of blood from the coronary arteries. 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
      12.5
      Seconds
  • Question 38 - Coronary vasoconstriction can be caused by: ...

    Correct

    • Coronary vasoconstriction can be caused by:

      Your 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
      22.4
      Seconds
  • Question 39 - How does pregnancy affect the cardiac output of a patient? ...

    Correct

    • How does pregnancy affect the cardiac output of a patient?

      Your Answer: Increased cardiac output due to increase in heart rate and stroke volume

      Explanation:

      Cardiac Output increases to a similar degree as the blood volume. During the first trimester cardiac output is 30-40% higher than in the non-pregnant state. Steady rises are shown on Doppler echocardiography, from an average of 6.7 litres/minute at 8-11 weeks to about 8.7 litres/minute flow at 36-39 weeks; they are due, primarily, to an increase in stroke volume (35%) and, to a lesser extent, to a more rapid heart rate (15%). There is a steady reduction in systemic vascular resistance (SVR) which contributes towards the hyperdynamic circulation observed in pregnancy

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      24.6
      Seconds
  • Question 40 - Initial depolarization of cardiac muscle is due to influx of: ...

    Correct

    • Initial depolarization of cardiac muscle is due to influx of:

      Your Answer: Na+

      Explanation:

      Initial depolarization of the cardiac muscle results from opening of the sodium voltage gated channels. This results in the influx of sodium and an increase in the membrane potential towards threshold. Potassium efflux results in repolarization.

      The cardiac action potential has 5 phases:

      • Phase 0—depolarization because of the opening of fast sodium channels. Potassium flux also decreases.
      • Phase 1—partial repolarization because of a rapid decrease in sodium ion passage as fast sodium channels close.
      • Phase 2—plateau phase in which the movement of calcium ions out of the cell, maintains depolarization.
      • Phase 3—repolarization, sodium, and calcium channels all close and membrane potential returns to baseline.
      • Phase 4—resting membrane potential (−90 mV), resulting from the activity of the Na+/K+ ATPase pump which creates a negative intracellular potential because of the exchange of three sodium ions for only two potassium ions.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.9
      Seconds
  • Question 41 - 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
      7
      Seconds
  • Question 42 - Preload: ...

    Correct

    • Preload:

      Your 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
      25.2
      Seconds
  • Question 43 - 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
      6.2
      Seconds
  • Question 44 - The a-wave is created by: ...

    Incorrect

    • The a-wave is created by:

      Your Answer: Rise in atrial pressure before the tricuspid valve opens

      Correct Answer: Regurgitation of some blood to the great veins when the atria contracts in atrial systole

      Explanation:

      The a-wave created on the venous pulse curve occurs as a result of atrial systole. Due to the pressure build-up in the atria, it causes a back pressure in the vena cava. This pressure is exerted on the valve and this back pressure is what causes a slight increase in the venous pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      6.3
      Seconds
  • Question 45 - 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
      18.1
      Seconds
  • Question 46 - Tunica intima is made up of? ...

    Correct

    • Tunica intima is made up of?

      Your 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
      7.4
      Seconds
  • Question 47 - Regarding the cardiac muscle striations as viewed under the microscope, which areas are...

    Incorrect

    • Regarding the cardiac muscle striations as viewed under the microscope, which areas are dark?

      Your Answer: H band and i band

      Correct Answer: A band and z line

      Explanation:

      Dark bands: a, h. Dark line: z. Clear band: i, m

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.4
      Seconds
  • Question 48 - The following determines the strength of contraction ...

    Correct

    • The following determines the strength of contraction

      Your 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
      9
      Seconds
  • Question 49 - The Plateau phase in myocyte action potentials does all of the following except:...

    Correct

    • The Plateau phase in myocyte action potentials does all of the following except:

      Your Answer: It allows early reactivation of the myocytes

      Explanation:

      The presence of the plateau in the action potential causes ventricular contraction to last as much as 15 times longer in cardiac muscle as in skeletal muscle. 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 (refractory) phase prevents early reactivation of the myocytes and directly determines the strength of contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4
      Seconds
  • Question 50 - All valves are closed in which phase of the cardiac cycle? ...

    Correct

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

      Your Answer: Isovolumetric relaxation

      Explanation:

      The cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat, and so includes the diastole, the systole, and the intervening pause.The first stage, diastole, is when the semilunar valves (the pulmonary valve and the aortic valve) close, the atrioventricular (AV) valves (the mitral valve and the tricuspid valve) open, and the whole heart is relaxed. The second stage, atrial systole, is when the atrium contracts, and blood flows from atrium to the ventricle.The third stage, isovolumic contraction is when the ventricles begin to contract, the AV and semilunar valves close, and there is no change in volume. The fourth stage, ventricular ejection, is when the ventricles are contracting and emptying, and the semilunar valves are open. During the fifth stage, isovolumic relaxation time, pressure decreases, no blood enters the ventricles, the ventricles stop contracting and begin to relax, and the semilunar valves close due to the pressure of blood in the aorta.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (37/50) 74%
Medicine (37/50) 74%
Passmed