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  • Question 1 - What is the main reason for checking the urea and electrolytes prior to...

    Incorrect

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

      Your Answer: To detect impaired renal function

      Correct Answer: To detect hypokalaemia

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      29.7
      Seconds

  • Question 2 - Pacemaker cells in the SA node and the AV node are connected by?...

    Correct

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

      Your Answer: Gap junctions

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      25.7
      Seconds

  • Question 3 - 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
      148
      Seconds

  • Question 4 - Closure of the tricuspid valve is marked by which of the following features...

    Correct

    • Closure of the tricuspid valve is marked by which of the following features of the jugular venous waveform?

      Your Answer: c wave

      Explanation:

      The jugular venous pressure (JVP) classically has three upward deflections and two downward deflections. 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
      22.7
      Seconds

  • Question 5 - According to Poiseuille’s formula, which 1 of the following will lead to increased...

    Incorrect

    • According to Poiseuille’s formula, which 1 of the following will lead to increased flow?

      Your Answer: Less turbulent flow

      Correct Answer: Shorter tube

      Explanation:

      V = π p r4 / 8 η lwhere V = discharge volume flow (m3/s)p = pressure difference between the ends of the pipe (N/m2, Pa)r = internal radius of pipe (m)l = length of pipe (m)η = viscosity of fluid

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      36.5
      Seconds

  • Question 6 - 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
      24.4
      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
      27.3
      Seconds

  • Question 8 - The V wave in the jugular pulse is caused by: ...

    Incorrect

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

      Your Answer: Ventricular contraction

      Correct 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
      42.5
      Seconds

  • Question 9 - Coronary blood flow occurs in? ...

    Correct

    • Coronary blood flow occurs in?

      Your Answer: Diastole

      Explanation:

      Coronary arteries are unique in that they fill during diastole, when not occluded by valve cusps nor compressed by myocardial contraction).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.8
      Seconds

  • Question 10 - Regarding the surface anatomy of the orifices of the heart, where is the...

    Incorrect

    • Regarding the surface anatomy of the orifices of the heart, where is the aortic valve located?

      Your Answer: Opposite the right upper sternal border in the 2nd intercostal space

      Correct Answer: Opposite the left 3rd intercostal space to the left of the sternum

      Explanation:

      The aortic valve is situated in the left 3rd intercostal space just beneath the sternum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      28.8
      Seconds

  • Question 11 - Cholinergic nerves from the vagus innervate the SA and AV nodes via which...

    Incorrect

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

      Your Answer: B1 receptor

      Correct 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
      9.4
      Seconds

  • Question 12 - Cholinergic vagal supply to the SA and AV nodes results in slowing of...

    Correct

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

      Your 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
      12.1
      Seconds

  • Question 13 - 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
      12.3
      Seconds

  • Question 14 - Nitric oxide triggers vascular smooth muscle contraction through activation of which enzyme? ...

    Incorrect

    • Nitric oxide triggers vascular smooth muscle contraction through activation of which enzyme?

      Your Answer: Protein kinase a

      Correct Answer: Guanylyl cyclase

      Explanation:

      Impaired production or excess catabolism of NO impairs this endothelium-dependent vasodilator function and may contribute to excessive vasoconstriction under various pathological situations.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.9
      Seconds

  • Question 15 - Where would one normally find venous valves? ...

    Correct

    • Where would one normally find venous valves?

      Your 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
      13.1
      Seconds

  • Question 16 - 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
      6.5
      Seconds

  • Question 17 - Which of the following isoforms of Nitric oxide synthase (NOS) is found in...

    Incorrect

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

      Your Answer: Nos 2

      Correct 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
      7.8
      Seconds

  • Question 18 - 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
      25.7
      Seconds

  • Question 19 - Select the correct statement regarding the 4th heart sound, it? ...

    Correct

    • Select the correct statement regarding the 4th heart sound, it?

      Your Answer: Can be heard in atrial systole.

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      34.7
      Seconds

  • Question 20 - 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
      234
      Seconds

  • Question 21 - Which factors increase the end-diastolic volume? ...

    Incorrect

    • Which factors increase the end-diastolic volume?

      Your Answer: Myocardial infarction

      Correct Answer: Constriction of veins

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      36.9
      Seconds

  • Question 22 - Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms ...

    Incorrect

    • Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms

      Your Answer: Dephosphorylation of troponin l

      Correct Answer: Increased phosphorylation of phosholamban

      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
      28
      Seconds

  • Question 23 - Currents caused by opening of which of the following channels contribute to the...

    Correct

    • 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: 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
      16.5
      Seconds

  • Question 24 - 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
      9
      Seconds

  • Question 25 - 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
      21.7
      Seconds

  • Question 26 - 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
      10
      Seconds

  • Question 27 - The function of Troponin T in cardiac muscle is? ...

    Correct

    • The function of Troponin T in cardiac muscle is?

      Your Answer: Allows attachment of troponin components to tropomyosin

      Explanation:

      Troponin T binds the troponin components to tropomyosin. Troponin I inhibits the interaction of myosin with actin, and troponin C contains the binding sites for the Ca2+ that helps initiate contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      17.5
      Seconds

  • Question 28 - Isovolumetric ventricular contraction lasts for? ...

    Incorrect

    • Isovolumetric ventricular contraction lasts for?

      Your Answer: 0.25 s

      Correct Answer: 0,05 s

      Explanation:

      Isovolumetric contraction lasts for about 0.05 seconds.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      10.9
      Seconds

  • Question 29 - What is cardiac output? ...

    Correct

    • What is cardiac output?

      Your Answer: Product of stroke volume and heart rate

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.9
      Seconds

  • Question 30 - Hyperkalaemia [K+ =7meq/l] can lead to the following ECG changes [Ca++ normal] ...

    Correct

    • Hyperkalaemia [K+ =7meq/l] can lead to the following ECG changes [Ca++ normal]

      Your Answer: Peaked T waves

      Explanation:

      Hyperkalaemia causes the formation of tall tented T waves due to altered repolarization.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.5
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (19/30) 63%
Medicine (19/30) 63%
Passmed
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