00
Correct
00
Incorrect
00 : 00 : 0 00
Session Time
00 : 00
Average Question Time ( Secs)
Retry this test Dashboard

  • Question 1 - At the start of the cardiac cycle, towards the end of diastole, all...

    Incorrect

    • At the start of the cardiac cycle, towards the end of diastole, all of the following statements are true EXCEPT for:

      Your Answer: The atrial pressure is greater than the ventricular pressure.

      Correct Answer: The semilunar valves are open.

      Explanation:

      At the start of the cardiac cycle, towards the end of diastole, the whole of the heart is relaxed. The atrioventricular (AV) valves are open because the atrial pressure is still slightly greater than the ventricular pressure. The semilunar valves are closed, as the pressure in the pulmonary artery and aorta is greater than the ventricular pressures. The cycle starts when the sinoatrial node (SAN) initiates atrial systole.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      50.7
      Seconds

  • Question 2 - Which of the following best characterizes the correct administration of amiodarone for a...

    Incorrect

    • Which of the following best characterizes the correct administration of amiodarone for a shockable rhythm in adults on advanced life support:

      Your Answer: Give 300 mg IV amiodarone after 3 shocks, and then every 3 - 5 minutes thereafter

      Correct Answer: Give 300 mg IV amiodarone after 3 shocks

      Explanation:

      After three shocks, 300 mg IV amiodarone should be administered. After five defibrillation attempts, a further dose of 150 mg IV amiodarone may be considered. If amiodarone is not available, lidocaine may be used as a substitute, but it should not be given if amiodarone has previously been administered.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      56.8
      Seconds

  • Question 3 - Regarding hypertensive crises, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding hypertensive crises, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: In a hypertensive emergency, blood pressure should be reduced by 20 - 25% within 2 hours.

      Explanation:

      A hypertensive emergency is defined as severe hypertension (blood pressure ≥ 180/110 mmHg) with acute damage to the target organs. Prompt treatment with intravenous antihypertensive therapy is generally required; over the first few minutes or within 2 hours, blood pressure should be reduced by 20 – 25%. Severe hypertension without acute target organ damage is defined as hypertensive urgency.; blood pressure should be reduced gradually over 24 – 48 hours with oral antihypertensive therapy. If blood pressure is reduced too quickly in the management of hypertensive crises, there is a risk of reduced organ perfusion leading to cerebral infarction, blindness, deterioration in renal function, and myocardial ischaemia.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 4 - The mechanism of action of abciximab is by: ...

    Incorrect

    • The mechanism of action of abciximab is by:

      Your Answer:

      Correct Answer: Blocking the binding of fibrinogen to GPIIb/IIIa receptor sites

      Explanation:

      Abciximab is a glycoprotein IIb/IIIa inhibitors and prevents platelet aggregation by blocking the binding of fibrinogen to receptors on platelets.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 5 - Oedema can occur as a result of any of the following WITH THE...

    Incorrect

    • Oedema can occur as a result of any of the following WITH THE EXCEPTION OF:

      Your Answer:

      Correct Answer: Increased interstitial hydrostatic pressure

      Explanation:

      Oedema is defined as a palpable swelling produced by the expansion of the interstitial fluid volume. A variety of clinical conditions are associated with the development of oedema, including heart failure, cirrhosis, and nephrotic syndrome. The development of oedema requires an alteration in capillary dynamics in a direction that favours an increase in net filtration and also inadequate removal of the additional filtered fluid by lymphatic drainage. Oedema may form in response to an elevation in capillary hydraulic pressure (which increases the delta hydraulic pressure) or increased capillary permeability, or it can be due to disruption of the endothelial glycocalyx, decreased interstitial compliance, a lower plasma oncotic pressure (which reduces the delta oncotic pressure), or a combination of these changes. Oedema can also be induced by lymphatic obstruction since the fluid that is normally filtered is not returned to the systemic circulation.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 6 - Regarding the cardiac cycle, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding the cardiac cycle, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: The second heart sound occurs in late diastole caused by closure of the atrioventricular valves.

      Explanation:

      Diastole is usually twice the length of systole at rest, but decreases with increased heart rate. During systole, contraction of the ventricles compresses the coronary arteries and suppresses blood flow. This is particularly evident in the left ventricle, where during systole the ventricular pressure is the same as or greater than that in the arteries and as a result more than 85% of left ventricular perfusion occurs during diastole. This becomes a problem if the heart rate is increased as the diastolic interval is shorter and can result in ischaemia. The second heart sound, caused by closure of the semilunar valves, marks the end of systole.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 7 - Which JVP waveform correlates to atrial systole? ...

    Incorrect

    • Which JVP waveform correlates to atrial systole?

      Your Answer:

      Correct Answer: The a wave

      Explanation:

      JVP Waveform in Cardiac Cycle Physiology: a wave Right atrial contraction causes atrial systole (end diastole). the c wave During right isovolumetric ventricular contraction, the tricuspid valve bulges into the right atrium, resulting in isovolumetric contraction (early systole). descent by x Rapid ventricular ejection (mid systole) is caused by a combination of right atrial relaxation, tricuspid valve downward movement during right ventricular contraction, and blood ejection from both ventricles. the v-wave Ventricular ejection and isovolumetric relaxation (late systole) occur as a result of venous return filling the right atrium. y lineage Ventricular filling occurs when the tricuspid valve opens, allowing blood to flow rapidly from the right atrium to the right ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 8 - ACE inhibitors are indicated for all of the following EXCEPT for: ...

    Incorrect

    • ACE inhibitors are indicated for all of the following EXCEPT for:

      Your Answer:

      Correct Answer: Angina

      Explanation:

      ACE inhibitors have many uses and are generally well tolerated. They are indicated for:Heart failureHypertensionDiabetic nephropathySecondary prevention of cardiovascular events

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 9 - Which of the following statements is correct regarding the lymphatic system? ...

    Incorrect

    • Which of the following statements is correct regarding the lymphatic system?

      Your Answer:

      Correct Answer: Lymphatic vessels contain both smooth muscle and unidirectional valves.

      Explanation:

      Fluid filtration out of the capillaries is usually slightly greater than fluid absorption into the capillaries. About 8 L of fluid per day is filtered by the microcirculation and returns to the circulation by the lymphatic system. Lymphatic capillaries drain into collecting lymphatics, then into larger lymphatic vessels. Both of these containing smooth muscle and unidirectional valves. From this point, lymph is propelled by smooth muscle constriction and vessel compression by body movements into afferent lymphatics. It then goes to the lymph nodes where phagocytes remove bacteria and foreign materials. It is here that most fluid is reabsorbed by capillaries, and the remainder returns to the subclavian veins via efferent lymphatics and the thoracic duct. The lymphatic system has a major role to play in the body’s immune defence and also has a very important role in the absorption and transportation of fats.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 10 - What is the direct mechanism of action of digoxin as a positive inotrope:...

    Incorrect

    • What is the direct mechanism of action of digoxin as a positive inotrope:

      Your Answer:

      Correct Answer: Inhibition of Na+/K+ ATPase pump

      Explanation:

      Digoxin directly inhibits membrane Na+/K+ ATPase, which is responsible for Na+/K+ exchange across the myocyte cell membrane. This increases intracellular Na+ and produces a secondary increase in intracellular Ca2+ that increases the force of myocardial contraction. The increase in intracellular Ca2+ occurs because the decreased Na+ gradient across the membrane reduces the extrusion of Ca2+ by the Na+/Ca2+ exchanger that normally occurs during diastole. Digoxin and K+ ions compete for the receptor on the outside of the muscle cell membrane, and so the effects of digoxin may be dangerously increased in hypokalaemia.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 11 - What is the main mechanism of action of dopamine as an inotropic sympathomimetic: ...

    Incorrect

    • What is the main mechanism of action of dopamine as an inotropic sympathomimetic:

      Your Answer:

      Correct Answer: Beta1-receptor agonist

      Explanation:

      Dopamine is a neurotransmitter and a metabolic precursor of the catecholamines. It acts on beta1-receptors in cardiac muscle increasing cardiac contractility, and increases renal perfusion by stimulating dopamine receptors in the renal vasculature. This is of benefit in cardiogenic shock where deterioration of renal function is common.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 12 - Which of the following causes the first heart sound? ...

    Incorrect

    • Which of the following causes the first heart sound?

      Your Answer:

      Correct Answer: Closing of the atrioventricular valves

      Explanation:

      The heart sounds are as a result of the various parts of the cardiac cycle.Heart Sound – Phase of Cardiac Cycle – Mechanical Event:1st heart sound – Systole starts – there is closure of the atrioventricular (mitral & tricuspid) valves2nd heart sound – Systole ends – there is closure of the semilunar (aortic and pulmonary) valves3rd heart sound – Early diastole – this is caused by rapid flow of blood from the atria into the ventricles during the ventricular filling phase4th heart sound – Late diastole – this is caused by filling of an abnormally stiff ventricle in atrial systole

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 13 - Which of the following is NOT a common side effect of adenosine: ...

    Incorrect

    • Which of the following is NOT a common side effect of adenosine:

      Your Answer:

      Correct Answer: Yellow vision

      Explanation:

      Common side effects of adenosine include:ApprehensionDizziness, flushing, headache, nausea, dyspnoeaAngina (discontinue)AV block, sinus pause and arrhythmia (discontinue if asystole or severe bradycardia occur)

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 14 - Discontinuous capillaries are typically found where in the body: ...

    Incorrect

    • Discontinuous capillaries are typically found where in the body:

      Your Answer:

      Correct Answer: Reticuloendothelial system

      Explanation:

      Discontinuous capillaries, found in the reticuloendothelial system (bone marrow, liver and spleen), have large gaps between endothelial cells and are permeable to red blood cells.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 15 - What is the main mechanism of action of flecainide: ...

    Incorrect

    • What is the main mechanism of action of flecainide:

      Your Answer:

      Correct Answer: Blocks Na+ channels

      Explanation:

      Flecainide inhibits the transmembrane influx of extracellular Na+ ions via fast channels on cardiac tissues resulting in a decrease in rate of depolarisation of the action potential, prolonging the PR and QRS intervals. At high concentrations, it exerts inhibitory effects on slow Ca2+ channels, accompanied by moderate negative inotropic effect.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 16 - The QRS duration of a broad-complex tachyarrhythmia is: ...

    Incorrect

    • The QRS duration of a broad-complex tachyarrhythmia is:

      Your Answer:

      Correct Answer: Greater than or equal to 0.12 s

      Explanation:

      It’s a broad-complex tachycardia if the QRS duration is 0.12 seconds or more. It’s a narrow-complex tachycardia if the QRS complex is shorter than 0.12 seconds. The QRS duration should be examined if the patient with tachyarrhythmia is stable.  

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 17 - A 60-year-old patient had a sudden onset of palpitations and shortness of breath....

    Incorrect

    • A 60-year-old patient had a sudden onset of palpitations and shortness of breath. He had a history of poorly controlled hypertension and ischemic heart disease. His ECG also shows atrial fibrillation. Based on the patient’s condition, which pharmacologic cardioversion would be best to use?

      Your Answer:

      Correct Answer: Amiodarone

      Explanation:

      Chemical cardioversion, or pharmacologic cardioversion, is the treatment of abnormal heart rhythms using drugs. Flecainide and propafenone are examples of drugs used as chemical cardioverters. However, given the situation of the patient, these drugs are contraindicated for his ischaemic heart disease. Amiodarone is also an antiarrhythmic drug and is the best choice for this situation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 18 - Intracellular [Ca2+] rise in cardiac excitation-contraction coupling is mainly as a result of:...

    Incorrect

    • Intracellular [Ca2+] rise in cardiac excitation-contraction coupling is mainly as a result of:

      Your Answer:

      Correct Answer: Ca 2+ release from sarcoplasmic reticulum

      Explanation:

      Although Ca2+entry during the action potential (AP) is essential for contraction, it only accounts for about 25% of the rise in intracellular Ca2+. The rest is released from Ca2+stores in the sarcoplasmic reticulum (SR). APs travel down invaginations of the sarcolemma called T-tubules, which are close to, but do not touch, the terminal cisternae of the SR. During the AP plateau, Ca2+enters the cell and activates Ca2+sensitive Ca2+release channels in the sarcoplasmic reticulum allowing stored Ca2+to flood into the cytosol; this is called Ca2+-induced Ca2+release. The amount of Ca2+released is dependent on how much is stored, and on the size of the initial Ca2+influx during the AP.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 19 - Which of the following medications may lessen warfarin's anticoagulant effect: ...

    Incorrect

    • Which of the following medications may lessen warfarin's anticoagulant effect:

      Your Answer:

      Correct Answer: Phenytoin

      Explanation:

      Phenytoin will decrease the level or effect of warfarin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.Metronidazole will increase the level or effect of warfarin by affecting hepatic enzyme CYP2C9/10 metabolism.NSAIDs, when given with Warfarin, increase anticoagulation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 20 - Which of the following is NOT an adverse effect associated with statin therapy:...

    Incorrect

    • Which of the following is NOT an adverse effect associated with statin therapy:

      Your Answer:

      Correct Answer: Aplastic anaemia

      Explanation:

      Adverse effects of statins include:, Headache, Epistaxis, Gastrointestinal disorders (such as constipation, flatulence, dyspepsia, nausea, and diarrhoea), Musculoskeletal and connective tissue disorders (such as myalgia, arthralgia, pain in the extremity, muscle spasms, joint swelling, and back pain), Hyperglycaemia and diabetes, Myopathy and rhabdomyolysis, Interstitial lung disease and Hepatotoxicity

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 21 - What is the mechanism of action of captopril: ...

    Incorrect

    • What is the mechanism of action of captopril:

      Your Answer:

      Correct Answer: Angiotensin-converting enzyme inhibitor

      Explanation:

      Captopril is an angiotensin-converting enzyme (ACE) inhibitor, which inhibits the conversion of angiotensin I to angiotensin II.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 22 - The Frank-Starling curve is shifted downhill in heart failure due to which of...

    Incorrect

    • The Frank-Starling curve is shifted downhill in heart failure due to which of the following?

      Your Answer:

      Correct Answer: Decrease in contractility

      Explanation:

      The Frank–Starling mechanism states that the left ventricle can increase its force of contraction and hence stroke volume in response to increases in venous return and thus preload. Changes in afterload or inotropy cause the Frank–Starling curve to rise or fall. In heart failure, the Frank–Starling curve is shifted downward (flattened), requiring higher venous return and filling pressure to enhance contractility and stroke volume.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 23 - In the ventricular myocyte action potential, depolarisation occurs through the opening of: ...

    Incorrect

    • In the ventricular myocyte action potential, depolarisation occurs through the opening of:

      Your Answer:

      Correct Answer: Voltage-gated Na + channels

      Explanation:

      An action potential (AP) is initiated when the myocyte is depolarised to a threshold potential of about -65 mV, as a result of transmission from an adjacent myocyte via gap junctions. Fast voltage-gated Na+channels are activated and a Na+influx depolarises the membrane rapidly to about +30 mV. This initial depolarisation is similar to that in nerve and skeletal muscle, and assists the transmission to the next myocyte.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 24 - Which of the following is most true of the sinoatrial node: ...

    Incorrect

    • Which of the following is most true of the sinoatrial node:

      Your Answer:

      Correct Answer: Frequency of depolarisation is increased by sympathetic stimulation.

      Explanation:

      Cardiac myocyte contraction is not dependent on an external nerve supply but instead the heart generates its own rhythm, demonstrating inherent rhythmicity. The heartbeat is initiated by spontaneous depolarisation of the sinoatrial node (SAN), a region of specialised myocytes in the right atrium close to the coronary sinus, at a rate of 100-110 beats/min. This intrinsic rhythm is primarily influenced by autonomic nerves, with vagal influences being dominant over sympathetic influences at rest. This vagal tone reduces the resting heart rate down to 60-80 beats/min. To increase heart rate, the autonomic nervous system increases sympathetic outflow to the SAN, with concurrent inhibition of vagal tone. These changes mean the pacemaker potential more rapidly reaches the threshold for action potential generation.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 25 - Bendoflumethiazide may cause all of the following electrolyte imbalances EXCEPT for: ...

    Incorrect

    • Bendoflumethiazide may cause all of the following electrolyte imbalances EXCEPT for:

      Your Answer:

      Correct Answer: Hypocalcaemia

      Explanation:

      Common side effects of thiazide diuretics include:Excessive diuresis, postural hypotension, dehydration, renal impairmentAcid-base and electrolyte imbalanceHypokalaemia, hyponatraemia, hypomagnesaemia, hypercalcaemia, hypochloraemic alkalosisMetabolic imbalanceHyperuricaemia and goutImpaired glucose tolerance and hyperglycaemiaAltered plasma-lipid concentrationsMild gastrointestinal disturbances

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 26 - Which of the following drug classes may cause bronchoconstriction: ...

    Incorrect

    • Which of the following drug classes may cause bronchoconstriction:

      Your Answer:

      Correct Answer: Beta-blockers

      Explanation:

      Beta-blockers, including those considered to be cardioselective, should usually be avoided in patients with a history of asthma, bronchospasm or a history of obstructive airways disease. However, when there is no alternative, a cardioselective beta-blocker can be given to these patients with caution and under specialist supervision. In such cases the risk of inducing bronchospasm should be appreciated and appropriate precautions taken.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 27 - A 40-year-old man who has a history of asthma arrives at the emergency...

    Incorrect

    • A 40-year-old man who has a history of asthma arrives at the emergency department complaining of palpitations that have been going on for 5 days. Which of the following beta-blockers is the safest for an asthmatic patient?

      Your Answer:

      Correct Answer: Atenolol

      Explanation:

      Atenolol is a beta blocker, which is a type of medication that works by preventing certain natural substances in the body, such as epinephrine, from acting on the heart and blood vessels. This effect reduces heart rate, blood pressure, and cardiac strain. Atenolol, bisoprolol fumarate, metoprolol tartrate, nebivolol, and (to a lesser extent) acebutolol have a lower action on beta2 (bronchial) receptors and are thus cardio selective but not cardiac specific. They have a lower effect on airway resistance, although they are not without this adverse effect.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 28 - Which of the following increases the tendency for oedema to occur? ...

    Incorrect

    • Which of the following increases the tendency for oedema to occur?

      Your Answer:

      Correct Answer: Increased venous pressure

      Explanation:

      When more fluid is filtered out of the capillaries than can be returned to the circulation by the lymphatics, oedema occurs. Changes that increase capillary hydrostatic pressure or decrease plasma oncotic pressure will increase filtration. Arteriolar constriction reduces hydrostatic capillary pressure and transiently increase absorption of fluid. Dehydration increases plasma protein concentration and therefore increases plasma oncotic pressure and absorption. Capillary hydrostatic pressure and filtration are increased when there is increased venous pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 29 - The risk of renal impairment in a patient on ACE inhibitor therapy is...

    Incorrect

    • The risk of renal impairment in a patient on ACE inhibitor therapy is increased by concomitant treatment with which of the following drug classes:

      Your Answer:

      Correct Answer: NSAIDs

      Explanation:

      Concomitant treatment with NSAIDs increases the risk of renal damage, and with potassium-sparing diuretics (or potassium-containing salt substitutes) increases the risk of hyperkalaemia. Hyperkalaemia and other side effects of ACE inhibitors are more common in the elderly and in those with impaired renal function and the dose may need to be reduced.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 30 - Nitric oxide release from endothelium is stimulated by all of the following EXCEPT...

    Incorrect

    • Nitric oxide release from endothelium is stimulated by all of the following EXCEPT for:

      Your Answer:

      Correct Answer: Noradrenaline

      Explanation:

      Nitric oxide (NO) production by the endothelium is increased by factors that elevate intracellular Ca2+, including local mediators such as bradykinin, histamine and serotonin, and some neurotransmitters (e.g. substance P). Increased flow (shear stress) also stimulates NO production and additionally activates prostacyclin synthesis. The basal production of NO continuously modulates vascular resistance; increased production of nitric oxide acts to cause vasodilation. Nitric oxide also inhibits platelet activation and thrombosis.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (0/2) 0%
Physiology (0/1) 0%
Pharmacology (0/1) 0%
Passmed
Retry this test Dashboard