2008 Module Exam Flashcards
What is best used to identify a recessive monogenic disorder predisposing to (heart disease?)?
a. whole genome sequencing for all unaffected family members
b. whole genome sequencing for each family member
c. karyotyping
d. SNPB based linkage analysis
e. SNP based association approach
e.SNP based association approach
what psychological factor increase the risk of mortality by 5-6 times (after 1 year of having) MI?
a. depression
b. anxiety
c. type A behavior
d. social isolation
a. depression
In post epidemiologic transition countries
A) Low mortality, high fertility, infectious diseases
B) Low Mortality, low fertility, and chronic diseases
C) High mortality, low fertility, chronic diseases
D) High mortality, high fertility. Infectious diseases
B) Low mortality, low fertility, and chronic diseases
to which level the blood pressure should be lowered in a patient with hypertension and diabetes mellitus
a. 140/90
b. 139/89
c. 130/90
d. 130/80
d. 130/80
a male who experiences syncopal attack when pressure is applied to his neck
Vagal bradycardia due to carotid sinus hypersensitivity
what should paramedics do to a patient who is unconscious and have pulseless tachycardia?
a. CD Cardioversion
b. medications
a. CD Cardioversion
when a thrombolytic drug is used?
a. stable angina
b. unstable angina
c. old MI
d. acute MI
d. acute MI
(same question in other exams is B)
treatment of a patient with chest pain (symptoms of angina)
Beta-blocker, nitrate, and CCB
Which chamber receives blood from coronary sinus?
Right atrium
which fetal vessel allow the blood from placenta to bypass the liver?
Ductus venosus
which defect is caused by unequal separation of truncus arteriosus?
Pulmonary atresia
which congenital defect is associated with separation of sternum?
Ectopia cordis
mechanism of action of thiazide?
Bind to Cl site in Na/Cl co-transport system
mechanism of action of digoxin?
Inhibit Na/k ATPase
a consequence of using a drug that prevents the absorption of cholesterol into the gastrointestinal tract like cholestyramine?
Increase the density of LDL receptors
(not sure)
which drug has negative effects on the heart after using it for a long time for heart failure?
a. Digoxin
b. beta-blocker
c. beta-agonist
d. ACEI
c. beta agonist
dobutamine effect?
a. increase cAMP
b. activate β2 receptors
a. increase cAMP
angiotensin receptor blocker:
Losartan
a drug that blocks Na channels and reduce the slope of phase 4
Quinidine
weight gain when using clofibrate is due to:
Inhibiting lipolysis
angiotensin-converting enzyme inhibiter:
Captopril
a molecule with antithrombotic and vasodilatory effects
Nitric oxide
10-year-old boy fainted when playing football, systolic ejection murmur was heard in the right intercostal space and the murmur radiates to the neck. Diagnosis?
Aortic stenosis
full term neonate has cyanotic congenital heart defect, his aortic O2 saturation was 60 and pulmonary artery saturation 98%
a. tetralogy of Fallot
b. transposition of great artereies
c. persistent fetal circulation
d. tricuspid atresia
b. transposition of great artereies
apical pansystolic murmur means
Mitral regurgitation
what characterizes sinus rhythm?
Upstroke p wave followed by QRS complex
(not sure about question)
Otherwise healthy elderly developed isolated systolic blood pressure. What is most likely the cause?
Aortic rigidity
patient was admitted to the hospital after 5 days of onset of acute MI. best biomarker used is:
Troponin I
patient 60 pack of cigarettes/year experienced pain in his left calf when walking for 200m. ankle-brachial index was 0.6 and one of his legs was cooler than the other one:
Peripheral arterial disease
Question about rheumatic heart disease:
Aschoff nodules in endocardium
artery occlusion 90% Developed a thrombus that caused partial occlusion?
a. cerebrovascular event
b. unstable angina
c. acute MI
b. unstable angina
artery occlusion 90%. Developed a thrombus that caused total occlusion?
a. cerebrovascular event
b. unstable angina
c. acute MI
c. acute MI
effect of pulmonary embolism
a. right ventricle failure
b. pulmonary oedema
c. dilated right ventricle
a.right ventricle failure
What is the complication of carotid artery occlusion?
a. cerebrovascular event
b. unstable angina
c. acute MI
a. cerebrovascular event
effect of aortic regurgitation:
a. decreased perfusion of coronary arteries
b. prominent S2
a. decreased perfusion of coronary arteries
what is the pulmonary resistance if
Mean pulmonary pressure = 30mmgh
Mean right atrium pressure=1
Mean left atrium pressure=4
CO=5.6
?
what is the minimum HR that a 45-year-old male should reach to enhance his aerobic performance when performing aerobic exercise?
123
**How to calculate it: 220+45= 175
175×70/100
why does the diastolic blood pressure increases during isometric exercise?
Increased resistance
What causes closure of ductus arteriosus :
a. Increased O2 in aorta
b. increased prostaglandins
a. Increased O2 in aorta
young female had an accident, which resulted in massive bleeding. What is the initial response ( reflex?)
a. total peripheral vasodilation
b. vagal over activity
c. decreased sympathetic outflow
d. reflex tachypnea
d. reflex tachypnea
hemorrhage causes hypoxia → response by chemoreceptors
What is the compliance of vessels?
a. 1000
b. 100
c. 10
b. 100
(3500-2500)⁄(20-10)
Q about accident and bleeding. what’s maintaining coronary blood flow?
a. autoregulation
b. sympathetic activation
a. autoregulation
(not sure)
what is the cause of edema in a female with liver disease?
Decreased capillary oncotic pressure
What stimulates NO?
Velocity of blood (= shear stress)
what stimulates thirst center in a person who is deprived from water intake?
Angiotensin ΙΙ
what is the physiological cause of S2 splitting?
Prolonged ventricular ejection
(not sure about the Q)
(one of the ventricles has a high afterload, causing it to get out of sync with the other ventricle. They close at different times and that causes the S2 splitting)
what decreases stroke volume and ejection fraction in an angina patient?
a. increased central venous pressure
b. decreased arteriolar diameter
c. Increased heart rate
d. increased end-systolic volume
angina→decreased myocardial contractility →more volume of blood is left→increased”ESV)
what estimates stroke volume?
a. pulse pressure
b. pulmonary wedge pressure
c. systolic blood pressure
a. pulse pressure
which current differentiate between atrial and ventricular action potential?
a. fast Na
b. L-type Ca
c. inward rectifier K
d. transient outward K channel
d. transient outward K channel
the atrial action potential is triangular, while the action potential of the ventricle is quadrilateral→the difference”is”in”repolarization→K channels
decrease contractility
which point represent end-systolic pressure volume relationship?
F
at which point the isovolemic relaxation ends?
At which phase of the cardiac cycle the blood flow from the ventricles is highest?
Rapid ejection
the slowest spontaneous depolarization?
a. Purkinjie
b. atrial myocytes
a. Purkinjie
(b=although these can act as an ectopic pacemaker, but normally the pacemakers are SA node, AV node, and Purkinje fibers)
a. sinus tachycardia
b. atrial flatter
c. atrial fibrillation
a. sinus tachycardia
what represents AV node depolarization?
PR segment
absolute refractory period is caused by:
Inactivation of Na channels
young female with yellow streaks. What’s the histological evaluation of the yellow streaks?
a. fibro fatty
b. inflammatory
c. foam cells
c. foam cells
the initial step of atherosclerosis?
Vascular endothelial damage
patient with sterile vegetation and died from prostate cancer:
Marantic endocaditis
what would you find in renal artery of a patient with mild controlled hypertension for 20 years?
Hyaline areriolitis
what would a biopsy of the temporal artery of 70 year old lady with right side ( headache?) and visual disturbance shows?
Granulamatous panarteritis
female with dilated cardiomyopathy developed left hemiplegia, what’s the cause of the hemiplegia?
a. DVT in left leg
b. thrombophlebitis
c. embolization of Mural thrombus in the left (ventricle/atrium)
c. embolization of Mural thrombus in the left (ventricle/atrium)
young female collapsed while jogging, and she had asymmetrical interventricular septum and (fibrous?) disarray:
Hypertrophic cardiomyopathy
a heart with endomyocardial fibrosis
Restrictive cardiomyopathy
what is the function of ATP binding cassette?
Efflux of cholesterol
what’s the effect of glycosylation on LDL?
Impair its clearance from circulation
receptor expressed on vascular endothelium that can recognize oxidized LDL?
a. LOX1
b. Scavenger”Receptor
a. LOX1 (probably this, but unsure)
what valve prevent blood from going back from the right ventricle to the right atrium during systole OR (Defect in which structure would let the blood leak into the right atrium??)
tricuspid valve
a patient with mitral regurgitation (mitral systolic murmur?). No calcification was found on the leaflets of the valve. What may be the pathogenesis?
Calcification of mitral annulus
a question about a case African American + mumur radiates to the neck area
aortic stenosis
when one’s age is (55/more than 55?) what is his risk of developing hypertension?
>75%
a drug that causes elevated liver enzymes as a side effect
Lovastatin
(they also mention that it is a statin)
a drug that inhibits intestinal absorption of cholesterol?
Ezetimap
physiology question about calculating fluid movement
physiology question about calculation cardiac index (stroke volume, heart rate, body surface area were given)
?
blood pressure changes (values given) (I remember that the systolic increases by 5, while the diastolic by 10) what is the mechanism for blood pressure increase)
**we don’t remember the number, but the doctor told us that the actual numbers are critical; you must calculate MAP before the administration of the drug, and then calculate MAP after the administration of the drug, and then compare MAP1 with MAP2 to see if MAP increased/decreased/unchanged and answer accordingly!!
a previously sedentary man is exercising. What parameter increases?
stroke volume
what receptor mediates vasodilation in exercising skeletal muscles?
beta 2 receptor
physiology question. A curve that indicates decreased luisotropy. What may be the cause?
ventricular fibrosis
a patient with (symptoms of infective endocarditis) after (2 months?) of a valve replacement surgery. The culture showed gram-positive bacteria arranged in clusters?
staphylococcus epidermidis
a patient with symptoms of infective endocarditis) + showed gram positive bacteria arranged in (……..)
viridian streptococci
patient with symptoms of rheumatoid fever
staphylococcus pyogens (I know this does not make any sense, but this is the way it was written!!!)
a patient with intracranial tumor. What is the mechanism of high blood pressure?
Cushing reflex
a cuff was used to press on someone’s arm and then was released. What’s the mechanism of the increased blood flow?
Reactive hyperemia
the cause of atrial fibrillation in a female:
Increase in left atrial pressure
What contributes to the cyanosis associated with Eisenmenger’s syndrome?
Rightto left shunt
What would result from AV block?
Prolongation of PR
How does sympathetic activation affect action potential?
Phosphorylation of L+type calcium channels
What is the side effect of ACEI?
Cough
Why is the prevalence of hypertension in Kuwait misleading?
Because Kuwait is a relatively young population
What is the difference between arterial pulsation and jugular venous pressure?
Arterial pulsation has a single upstroke
Heavy neutrophilic infiltrate is the answer
??
Continuous murmur
Patentductus arteriosus
What structure allows the blood to flow from the aorta to the pulmonary trunk in the embryo?
Ductus arteriosus
How does sympathetic stimulation affects action potential?
Positive dromotropy
How do statins work?
Inhibition of HMG+Co reductase
