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Cardiovascular System - 3rd year > 2016 Module Exam > Flashcards

2016 Module Exam Flashcards

Q's 1-24 = physiology Q's 25-31 = anatomy Q's 32-34 = micro Q's 35-40 = biochem Q's 41-59 = patho Q's 60-79 = pharma Q's 80-95 = clinical medicine Q's 96-98 = EBM/epi

1
Q

What mechanism explains increased systolic pressure?

a. Increased SV
b. Increased HR
c. Increased arterial compliance
d. Increased cardiac output with decreased vascular resistance (simultaneous)
e. Increased arterial compliance with increased speed of ejection (simultaneous)

A

a. Increased SV

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2
Q

What mechanism explains unchanged MAP?

a. Increased SV
b. Increased HR
c. Increased arterial compliance
d. Increased cardiac output with decreased vascular resistance (simultaneous)
e. Increased arterial compliance with increased speed of ejection (simultaneous)

A

d. Increased cardiac output with decreased vascular resistance (simultaneous)

(or c)

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3
Q

which of these has the slowest spontaneous diastolic depolarization?

  1. SA node
  2. AV node
  3. AV bundle
  4. terminal end of purkinje
  5. ventricular myocyte
A

b. AV node

(or D)

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4
Q

Which decreases CO?

a) increased central venous pressure
b) decreased peripheral venous pressure
c) increased HR to below 150bpm

A

b) decreased peripheral venous pressure

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5
Q

a 54 yr old woman with a resting cardiac output of 6000ml/min. Using the PV loop, calculate the heart rate.

  1. 50 BPM
  2. 70 BPM
  3. 100 BPM
  4. 120 BPM
  5. 140 BPM
A

c. 100 BPM

CO=HR • SV

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6
Q

Also in same pic, calculate the EF

  1. 60%
  2. 50%
  3. 30%
  4. 25%
A

b. 50%

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7
Q

This figure shows arterial blood pressure during Valsalva maneuver. What is the most likely cause of the arterial pressure increase in late phase 2?

  1. Increase in VR
  2. Increase in Afterload
A

a. Increase in VR

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8
Q

Bulging of the tricuspid valve occurs in which number(green) in pic?

A

2

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9
Q

opening of the mitral valve occurs in which number(green) in pic?

A

3

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10
Q

What causes blood movement during the slow ejection phase?

A

Energy of blood movement

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11
Q

what doesn’t cause an increase in pulse pressure?

A) increase in compliance

B) increase in heart rate

C) increase in sv

D) simultaneous increase in compliance and speed of ejection

A

B) increase in heart rate

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12
Q

what is the plateau of the cardiac output of a 24 yr old male who weighs 80kg?

  1. 25
  2. 13
  3. 3
A

b. 13

(this was the model answer but since he was an athlete the dr said A is also correct)

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13
Q
A

ST elevation

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14
Q

A hemodynamically stable person was sitting then he got up, what remains reduced?

A

SV

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15
Q

what does T-wave represent on action potential curve?

  1. Phase1
  2. Phase2
  3. Phase3
  4. Phase4
A

c. Phase3

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16
Q

A man wearing a shirt with a tight collar, when he was shaving, he turned his head and felt dizzy, what is the reason for that?

A

Decreased slope of phase 4

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17
Q

a person with fever of 38°C and he has bradycardia, what is the cause?

a. Hyperkaliemia surrounding the SA node
b. Sympathetic activation deactivates HCN channel
c. Vagal tone increases reducing the peak

A

a. Hyperkaliemia surrounding the SA node

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18
Q

What is responsible for cardiac relaxation?

a- phospholamban C activation

b- ATP induced calcium release

c- IP3 activation

A

a- phospholamban C activation

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19
Q

Which arrythmia results from this abnormality?

A

Ventricular Polymorphic Tachycardia

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20
Q

What contribute to blood flow in “Z” green highlighted?

a- Increase in adenosine

b-Increase in adenosine triphosphate

c-Decrease carbon dioxide

A

a- ​Increase in adenosine

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21
Q

Which of the following is involved in excitation-contraction coupling?

A- K(atp) channels

B- phospholamban

C- L-type ca channel

D- cl- channel

A

C- L-type ca channel

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22
Q

Secretion of which hormone will be most likely elevated in response to an increase in atrial blood pressure?

A

ANP

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23
Q

what is responsible for increasing the SV in the second beat in case of a high afterload?

a. high ESV
b. high EDV

A

b. high EDV

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24
Q

17 cm/sec velocity, ?? HR, ?? MAP, 23 mm descending aorta diameter. Calculate BF for descending aorta.

A

4.5 L/min

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25
Q

A coronary angiogram of 65 years old male who experienced MI showed LAD occlusion, which of the following will be depleted from oxygen?

a- Posterior 1/3 of the atria

b- Anterior 1/3 of the interventricular septum

c- Anterior 2/3 of the interatrial septum

d- Anterior 2/3 of the interventricular septum

A

d- Anterior 2/3 of the interventricular septum

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26
Q

A 60 yrs old male presented with previous myocardial infarction and hemopericadial, what is the source of blood in pericardial cavity?

a. Coronary artery rupture
b. Ruptured aortic artery
c. Ruptured pulmonary veins
d. Perfusion myocyte

A

d. Perfusion myocyte

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27
Q

A patient with cardiac tamponade, chest pain that radiates to the shoulders, which nerve is responsible for that?

  1. Subclavian
  2. Supraclavicular
A

a. Supraclavicular

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28
Q

What is present in the tunica media of common carotid artery?

  1. Elastin
  2. Actin
  3. Collagen 2
  4. Collagen 3
  5. Collagen 4
A

a. Elastin

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29
Q

what is more prominent in tunica intima of arteries?

  1. Elastin
  2. Actin
  3. Collagen 2
  4. Collagen 3
  5. Collagen 4
A

a. Collagen 4

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30
Q

A microdissection study is done to follow the SA node artery until it ends; where does this artery end in the surface of epicardium?

A- inferior end of sulcus terminalis

B- superior end of sulcus terminalis

C- right of left atrium

D- left of SVC entry

A

B- superior end of sulcus terminalis

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31
Q

What congenital disorder causes blue lips and tips?

A- transposition

B- Pulmonary Stenosis

A

A- transposition

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32
Q

Which Microorganism infects those who drink unpasteurized milk?

A

brucella Melintes

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33
Q

which microorganism was found in a patient who had an aortic valve replacement 6 months back?

  1. Viridians streptococci
  2. Kingella kingae
  3. Ekinella carrdens
  4. Coxiella burneti
A

a. Viridians streptococci

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34
Q

an intravenous drug addict. Which does he most likely have?

  1. Candida albicans
  2. Staph epidermis
  3. Brucella melitenisis
  4. Enterocouss faecalis
  5. Coxiella brutini
A

a. Candida albicans

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35
Q

The most important fuel when insulin is high

a- Glucose

b- Glycogen

c- Triglycerides

d- Fatty acids

e- Ketone bodies

A

a- Glucose

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36
Q

The most important fuel in both starvation and heart failure

a- Glucose

b- Glycogen

c- Triglycerides

d- Fatty acids

e- Ketone bodies

A

e- Ketone bodies

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37
Q

M2 macrophages are involved in which phase of atherosclerosis?

A. Initiation

B. Resolution

A

B. Resolution

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38
Q

Which is the main source of energy for adult heart?

a- Fatty acids

b- Glucose

c- Pyruvate

d- Ketone bodies

A

a- Fatty acids

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39
Q

what is a prominent change in cardiac metabolism during heart failure but

A) increased fatty acid oxidation

B) increased glycolysis

C)decreased ketone bodies

D)increased lactate oxidation

A

B) increased glycolysis

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40
Q

What receptor that is responsible for unregulated lipid uptake?

41
Q

An autopsy was performed on a 39-year-old male that showed inter ventricular septum of 27 mm, left ventricle of 15 mm, right ventricle of 7 mm and the heart weighed 500g. What is the diagnosis?

A) hypertrophic cardiomyopathy

B) dilated cardiomyopathy

C) restrictive cardiomyopathy

D) amyloid deposited

E) right ventricular arrhythmic cardiomyopathy

A

A) hypertrophic cardiomyopathy

42
Q

skin rash in rheumatic heart disease is called?

A

Erythema marginatum

43
Q

liquefactive necrosis in brain

A

lacunar infarct

44
Q

What is intermittent claudication?

A

Leg pain while walking and relieved by rest

45
Q

An autopsy was performed on a 39-year-old male that showed inter ventricular septum of 27 mm, left ventricle of 15 mm, right ventricle of 7 mm and the heart weighed 500g. What is the diagnosis?

46
Q

restrictive cardiomyopathy most common in?

a- multiple myeloma

b- eosinophilic infiltrate

A

a- multiple myeloma

47
Q

Long standing old hypertensive patient found to have small kidneys.

A

Benign hypertension

48
Q

Cardiac biopsy of 32 years old male was done, and he has a family history of cardiac disease. Biopsy shows interstitial fibrosis, myocyte disarray and enlarged cardiomyocytes.

A) Dilated cardiomyopathy

B) Hypertrophied cardiomyopathy

C) Restricted cardiomyopathy

A

B) Hypertrophied cardiomyopathy

49
Q

left ventricular hypertrophy caused by

A

aortic stenosis

50
Q

Patient with 90% occlusion with thrombus, what is the diagnosis?

A

transient ischemia (no unstable angina)

51
Q

A 15-year-old male died in a car accident, postmortem autopsy revealed yellowish streaks in the abdominal aorta. What could this be?

A. Intimal foam cells

B. Endothelial injury

C. Intimal fibro-fatty elevation

A

B. Endothelial injury

(or its A, aka fatty streak)

52
Q

Volume overload is caused by which of the following valve pathology?

  1. Mitral valve stenosis
  2. Aortic valve regurgitation
  3. Pulmonary valve stenosis
  4. Mitral valve prolapse
A

b. Aortic valve regurgitation

53
Q

what disease is associated with MYH7 mutation?

A

hypertrophic cardiomyopathy

54
Q

match the diagnosis with this hypertension complication: fibrinoid necrosis w/thrombus in renal arterioles

A

malignant hypertension

55
Q

Which of the following cause systemic HTN?

A- coarctation of aorta

B-Hepatic disease

C- diabetic

A

A- coarctation of aorta

56
Q

Hyaline arteriosclerosis in the renal arterioles is seen in which condition?

  1. Systemic HTN
  2. Polyarteritis nodosa
A

a. Systemic HTN

57
Q

A 22 y/o female with myocarditis died, on autopsy do we see?

A

flappy heart

58
Q

Familial Hypertrophic cardiomyopathy are known to have high penetrate. What is the frequency of SNP in high penetrance disease?

a) .0001
b) .1
c) .5

59
Q

63 yr old man had an MI and died after 3 weeks. What do you expect to see in his heart autopsy?

  1. Fibrosis
  2. High vascularization
A

a. Fibrosis

60
Q

Dosage of which drug should be monitored due to narrow therapeutic index?

61
Q

Patient with heart failure you give him A drug and he comes to you with irritation throat and cough which of the drugs cause this?

A-ACEI

B- BB

C-Diuretics

D- digoxin derivatives

62
Q

Which drug is contraindicated with sildenafil?

63
Q

Which drugs causes excessive hair growth?

64
Q

What is given to a pt with high risk of MI due to hypercholesteremia?

65
Q

What selectively binds to mineralocorticoid receptors?

A

Eplerenone

66
Q

Which of the following is concentrated in the heart?

a. flecainide
b. amrinone

A

a. flecainide

67
Q

Antivagal effect drug

68
Q

Which of the following have no effect on action potential duration in atria?

  1. Lidocaine
  2. class IA
  3. beta blockers
A

a. Lidocaine

69
Q

what phase is affected in antiarrhythmic drugs?

a. phase 1
b. phase 2
c. phase 3
d. phase 4

A

d. phase 4

70
Q

Which of the following drugs can prevent platelet aggregation and thrombosis in treatment of unstable angina pectoris?

  1. clopidogrel
  2. clonidine
  3. metoprolol
  4. isosorbide nitrate
  5. aliskiren
A

a. Clopidogrel

71
Q

What drug is contraindicated in patients with variant angina

A

?

(beta 1-receptor Antagonists)

72
Q

Which drug has less hormonal effect because it binds specifically to aldosterone receptors?

  1. Eplerenone
  2. Spironolactone
A

a. Eplerenone

73
Q

Which drug inhibits HMG coA reductase?

74
Q

which one describe the mechanism of dobutamine?

1-activation of aldosterone receptor

2-inhibition of Ace

3-activation of B1 receptor

4-release of nitric oxide

A

3-activation of B1 receptor

75
Q

what drug is administered sublingually and achieve a therapeutic blood level rapidly?

A

Nitroglycerin

76
Q

overdose of which drug causes severe nausea and bradycardia?

  1. Digoxin
  2. calcium channel blockers
  3. beta blockers
A

a. Digoxin

(they put them all correct)

77
Q

what produces bradycardia as a side effect?

78
Q

which of the following is AT1-R antagonist?

A) captopril

B) Losartan

C) verapamil

A

B) Losartan

79
Q

enzyme for clopidogrel?

80
Q

HfpEF is associated with what?

A

patients with LVH/HTN

81
Q

Which of the following statements is true?

(when are ACE drugs given?)

A

ACE is are given to asymptomatic pts with HF and EF <35

82
Q

An overdose of which of the following results bradycardia and nausea?

  1. Digoxin
  2. Beta blocker
  3. CCB
A

?

this is Dr. Zubaid’s fav question bc every year most of the students get it wrong, CCBs and Beta blockers can cause these side effects but in their NORMAL THERUBITIC DOSE, digoxin only causes them with overdose

83
Q

what is a manifestation of right heart failure?

  1. RUQ pain
  2. Blurred vision
  3. Decreased urine execration
  4. Headache
A

This is one of dr. zubaid’s fav questions too, RUQ pain is the answer bc what do we have in the RUQ? Liver, in RHF we will have hepatomegaly resulting in RUQ pain

84
Q

In a myocardial perfusion image study, what does a myocardial defect seen on both stress and rest images suggest?

A) Scar after infarction

B) Myocardial ischemia

C) Cardiomyopathy

D) Normal myocardium

A

A) Scar after infarction

85
Q

Patient with ventricular tachycardia with low BP and dizziness, what’s the treatment?

A) Digoxin

B) dc shock

C) adenosine

D) carotid massage

E) beta blocker

A

B) dc shock

86
Q

A condition, if not treated immediately, will affect the patient’s life.

A

Ventricular Fibrillation

87
Q

A condition that predisposes to thrombo-embolitic event.

A

Atrial Fibrillation

88
Q

What is true regarding EF?

A) it measures end diastolic volume

B) it measures diastolic function

C) it’s considered abnormal if it’s less than 60%

D) it’s normal in hypertensive patients

A

D) it’s normal in hypertensive patients

89
Q

Treatment of HTN w diabetic nephropathy?

90
Q

lymphoma patient is being treated with doxorubin (something like this) what test should be done to monitor the cardio toxicity?

91
Q

stiff heart /not filling means what kind of failure?

A

diastolic failure

92
Q

which is true about JVP?

  1. increases with increase in abdominal pressure
  2. it reflects left atrial pressure
  3. its independent of the patient’s position
  4. increases with increased pressure at the root of the neck fat
A

a. increases with increase in abdominal pressure

jugular venous pressure (JVP)

93
Q

Patient presented with left sided heart failure secondary to reduced ejection fraction. Which signs would this patient show?

A-Bradycardia

B-SOB when lying flat

C-Absence of S3 sound

D-Presence of ejection systolic murmur

A

B-SOB when lying flat

94
Q

Fibrinolytic therapy is absolutely contraindicated in which patients?

A

History of intracranial hemorrhage

95
Q

You diagnose a patient with HF-rEF. What of the following medication is indicated for her?

  1. Nitrates
  2. amlodipine
  3. Aldosterone antagonist
  4. Diltiazem
  5. Amiodarone
A

c. Aldosterone antagonist

96
Q

what happened to CVD rate in US and Europe between 1960 to 2000

a) increase by 25%
b) no change
c) increase by 60%
d) decrease by 60%

E) decrease by 25%

A

d) decrease by 60%

97
Q

If they tell u that they want to assess the risk of heart diseases using smoking as exposure, and they tell u that 58% of cases were MI patients wo have been smoking, and 31% of controls were smoking, what is the odds ratio?

98
Q

A case control study was done to check the correlation btw physical inactivity and CVD, cases are recently diagnosed pts with MI, controls were taken from walking thrills, which of the following is true?

a- Cases are unbiased, controls are biased, odds ratio is upwards biased

b- Cases are unbiased, controls are unbiased, odds ratio is upwards biased

c- Cases are unbiased, controls are biased, odds ratio is downwards biased

d- Cases are biased, controls are biased, odds ratio is upwards biased

A

a- Cases are unbiased, controls are biased, odds ratio is upwards biased

Cardiovascular System - 3rd year (23 decks)

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