Test 3 Version 2 Flashcards
F5 gene controls the production of a protein called factor V (for 5), which helps the blood clot when needed (such as after an injury). Factor V facilitates the production of thrombin. Thrombin cleaves fibrinogen to form fibrin, which polymerizes to form the dense meshwork that makes up the majority of a clot. The factor V Leiden mutation changes the protein’s structure which prevents efficient inactivation of factor V, leading to an overproduction of thrombin, excess fibrin and excess clotting. Factor V is made in the liver and can be found in the plasma. Other components, such as____ are found in the blood; and their function includes ____?
A. Albumins; hormone transport
B. Ions; buffering
C. Leukocytes; immune response
D. Only B and C
E. A, B and C
E
The excessive clotting that can in occur in individuals with the factor V Leiden mutation is almost always restricted to the veins, where the clotting may cause a deep vein thrombosis (DVT). Symptoms of deep vein thrombosis (DVT) include pain and swelling. The most common life-threatening concern with DVT is the potential for a clot to embolize (detach from the veins), travel as an embolus through the right side of the heart, and become lodged in a pulmonary blood vessel. This is called a pulmonary embolism (PE). In a situation such as this, where is the most likely location of the PE?
A. the pulmonary vein
B. the right atria
C. the pulmonary artery
D. the aorta
E. the inferior vena cava
C
Balancing lipid levels in the blood is an important part of staying healthy. Abnormal levels of blood lipids cause fat deposits in artery walls, which can lead to atherosclerosis and disorders such as stroke and heart attack. Causes for high lipid levels include diabetes, alcoholism, kidney disease, hypothyroidism, liver disease, and stress. In the blood, lipids can be transported by ___
A. Myeloid stem cells
B. Globulins
C. Platelets
D. Fibrinogen
E. None of the above
B
Platelets, or thrombocytes, are small, colorless cell fragments in the blood that form clots and stop or prevent bleeding. Platelets are made in the bone marrow, the sponge-like tissue inside our bones. Bone marrow contains stem cells. Which of the following is/are true with regard to stem cells found in bone marrow?
A. The stem cells can be classified as myeloid or lymphoid
B. The stem cells arise from a multipotent progenitor cell
C. The stem cells from the red bone marrow give rise to red blood cells only (not white blood cells)
D. Only A and B
E. A, B and C
D
The sound of your heartbeat: lub, dub are the heart sounds heard through a stethoscope applied to the chest. The first sound (the lub) happens when the mitral and tricuspid valves close. The first sound, a lub, coincides with____
A. the beginning of ventricular systole
B. the beginning of diastole
C. the end of ventricular systole
D. the closure of valves in the aorta and pulmonary artery
E. None of the above
A
When heart valves are damaged and need to be replaced, they can be surgically replaced with a biological valve from a pig, cow or human, or a mechanical valve (made from metal or carbon). With regard to heart valves, which of the following statements is/are true?
A. Tricuspid: Lets oxygen-rich blood coming back from your lungs move from your left atrium (upper chamber) to your left ventricle (lower chamber).
B. Aortic: Lets oxygen-poor blood move from your right ventricle (lower chamber) to your pulmonary artery, which takes blood to your lungs to get oxygen.
C. Mitral: Lets oxygen-poor blood flow from your right atrium (upper chamber) to your right ventricle (lower chamber).
D. A, B and C are all true statements
E. A, B and C are all false (none are true statements).
E
The flow of blood through blood vessels is affected by both pressure and resistance (i.e. F=ΔP/R). What must be taken into consideration when calculating resistance?
A. the viscosity of the fluid
B. the length of the tube
C. the inside radius of the tube
D. A, B and C
E. A and C only
D
The most common pathologic process that increases afterload in the heart is systemic hypertension (high blood pressure). Other situations that increase afterload include aortic stenosis (a narrowing of the valve) and aortic regurgitation (the inadequate closure of the aortic valve during diastole that results in reverse blood flow through the aortic valve. In general, afterload can be decreased by any process that lowers blood pressure. Afterload ____
A. is equal to EDV-ESV
B. is the amount of resistance the heart must overcome to open the aortic semilunar valve and push the blood volume out into the systemic circulation.
C. is equal to the atrial pressure (in mmHg)
D. is the amount of ventricular stretch at the end of diastole.
E. is the amount of blood ejected per beat from left ventricle and measured in ml/beat
B
Congestive heart failure is a complex clinical syndrome in which the heart cannot pump enough blood to meet the body’s requirements. It results from any disorder that impairs ventricular filling or ejection of blood to the systemic circulation. Patients usually present with fatigue and dyspnea (labored breathing), reduced exercise tolerance, and fluid retention (pulmonary and peripheral edema). The amount of blood pumped by the heart in 1 minute as measured in L/min is ______. It is an important determinant of the hemodynamic state in patients with congestive heart failure.
A. the stroke volume
B. the ESV (end systolic volume)
C. the preload
D. systole
E. none of the above
E
In the heart, the force of contraction can be affected by ___
A. certain catecholamines
B. parasympathetic activity
C. sympathetic activity
D. B and C only
E. A, B and C
E
Johns Hopkins Medicine has a website that describes Broken Heart Syndrome as “a condition that can cause rapid and reversive heart muscle weakness, also known as stress cardiomyopathy”. It states that two kinds of stress — emotional or physical — often cause broken heart syndrome and that the symptoms include those of a heart attack, such as: chest pain, shortness of breath, and diaphoresis (sweating). The website goes on to suggest a possible cause: a substance “may bind to the heart cells directly, causing large amounts of calcium to enter the cells. This large intake of calcium can prevent the heart cells from beating properly.” What might this substance be and what would it bind to?
https://www.hopkinsmedicine.org/health/conditions-and-diseases/broken-heart-syndrome
A. Acetylcholine, M2 receptor
B. Serotonin, 5HT receptor
C. Norepinephrine, β-adrenergic receptor
D. Dopamine, D4 receptor
E. Both A and C
C
Autonomic nerves can have various effects on the heart. The vagus nerve ______
A. can cause a parasympathetic response by decreasing the contractility in the heart ventricular muscle.
B. can bring about an increase in the conduction rate in the AV node
C. carries parasympathetic fibers that innervate the SA node which can cause a decrease in the heart rate
D. carries sympathetic nerve fibers that release epinephrine
E. None of the above
C
Bradycardia (slow heart rate) is a characteristic cardiac phenotype that can be caused by a number of pathologies, such as clinical hypothyroidism, inflammation of heart tissue (myocarditis), and obstructive sleep apnea. How can the heart rate be slowed?
A. By the binding of a neurotransmitter to the M2 receptor
B. By increasing the permeability to potassium
C. By increasing the permeability to sodium and calcium
D. A, B and C
E. A and B only
E
The action potentials in the cardiac muscle cells and the SA nodes have unique features that are important for their unique functions. The cardiac muscle cell action potential____
A. involves funny channels that have a dual activation by voltage and by cyclic nucleotides.
B. has a longer duration that the action potential in the SA node
C. has a rise in permeability to potassium that is responsible for the depolarization that causes the cell to reach threshold.
D. B and C only
E. A, B and C
B
Electrical impulses coordinate contractions of the different parts of the heart to keep blood flowing the way it should. An ECG records these impulses to show how fast the heart is beating, the rhythm of the heart beats (steady or irregular), and the strength and timing of the electrical impulses as they move through the different parts of the heart. Changes in an ECG can be a sign of many heart-related conditions.
With regard to an ECG _____
A. the P-R interval represents the time between the onset of atrial depolarization and the onset of ventricular depolarization.
B. the QRS wave represents the repolarization of the ventricles
C. the S-T segment represents the wave of depolarization that spreads from the SA node throughout the atria
D. the p wave represents the repolarization of the ventricles
E. none of the above
A
The exchange of substances across capillary walls is affected by
A. the rate and amount of blood flow
B. the diffusion of substances along their concentration gradient
C. the pressure of the blood in comparison to the pressure of the interstitial fluid
D. A and B only
E. A, B and C
E
Flow autoregulation ___
A. is a response to a drop in blood pressure
B. is a local control that regulates arteriole diameter
C. occurs because a tissue is not getting enough blood flow
D. Both A and B
E. A, B and C
E
At the arteriole end of a capillary bed
A. the pressure of the blood is lower that the pressure of the interstitial fluid
B. the pressure of the blood is higher than the pressure of the interstitial fluid
C. water and small solutes are being forces into the capillaries due to hydrostatic pressure
D. fluid is being pulled back into the blood
E. None of the above
B
If, during protein starvation, the colloid osmotic pressure of the blood plasma on the venous side of capillary beds drops below the hydrostatic pressure in the capillary, then
A. hemoglobin will not release oxygen.
B. fluids will tend to accumulate in tissues.
C. the pH of the interstitial fluids will increase.
D. most carbon dioxide will be bound to hemoglobin and carried away from tissues.
E. plasma proteins will escape through the endothelium of the capillaries.
B
