week 2 cvs

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Blood supply of the heart

6. All of following are the correct answer regarding the common carotid artery EXCEPT:A. It ascend within the carotid sheath with internal jugular vein, internal carotid artery

andthe last four cranial nerves

B. It ends by giving two terminal branches, external and internal carotid arteryC. The right common carotid arises from the superior cephalic arteryD. Left common carotid artery arises from the arch of aorta

7. Choose the correct branches of external carotid arteryI- Common facial arteryII- Lingual arteryIII- Ascending pharyngeal arteryIV- Occipital arteryA. I & IIB. II & IIIC. II, III & IVD. All of the above

8. Choose the correct answer regarding external carotid artery:A. Superficial thyroid artery is the termination of external carotid artery at the level of

superior border of thyroid cartilage

B. Occipital artery supply the scalp after piercing the trapezius muscleC. Maxillary artery wind around the lower border of mandible to reach the faceD. Ascending pharyngeal artery ascend along the wall of larynx to supply it

9. All of the following are CORRECT regarding the internal carotid artery EXCEPT:A. It ascend horizontally in the neckB. It enters carotid canal in the base of the skullC. It reach foramen lacerumD. Curves up to enter floor of cavernous sinus

10.All are related to surface anatomy of the arteries supplying the head and neck, EXCEPT:A. The external carotid artery can be found at the midpoint between mastoid process

and angle of mandible

B. At superior border of thyroid cartilage, the external carotid artery beginsC. Opposite to the neck of mandible, ext. Carotid artery end as two terminal branchesD. Superficial temporal artery can be felt behind the auricle

Cardiac Cycle I

Answer TRUE or FALSE

11.Cardiac cycle is the phases of contraction and relaxation through associated changes ofpressure and volume in different chambers and great vessel also by closure of valves

12.Systole of all heart take place in 0.3 seconds

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13. Increasing heart rate affect more the diastolic time and may never affect cardiacperformance

14.Choose the right statements below regarding the whole cardiac cycleI . Ventricular systole consist of isovolumetric contraction and ventricular ejection

II. The stages of closure of all valves are during ventricular ejection and rapid

ventricular filling

III. The ventricular pressure during both isometric relaxation and contraction are

constant

IV. 75% ventricular filling is done by passive flow, through pressure gradient

A I , II, III

B II, III, IV

C I , III, IV

D All of the above

Match the stages with it duration of action correctly

15.Atrial systole A 0.3 seconds16.Ventricular systole B 0.1 seconds17.Diastole of all heart C 0.4 seconds18.Complete one beat D 0.8 secondsCardiac Cycle II

19.The following statements are true regarding P wave except:A. Produced by the spread of depolarization wave from SA node to AV nodeB. Wave spreads from right to left therefore it is a positive waveC. It represents atrial depolarization and starts 0.02 seconds before atrial contractionD. Its duration is 0.2 sec and its amplitude is 0.1-0.0.3 mV

20.Choose the false statement regarding the QRS complex:A. Produced by ventricular depolarizationB. Q wave is produced by depolarization of inter-ventricular septumC. R wave is produced by depolarization of the last segment of myocardiumD. Its duration is 0.04-0.12 sec and its amplitude is 1-2 mV

21.Which is the correct statement about the abnormalities of QRS complex?A. Q wave is present but smaller in amplitude in ventricular septal defectsB. Pathological deep Q wave appears in myocardial ischemiaC. Duration of QRS complex is more than 0.12 sec in bundle branch blockD. Amplitude of QRS complex decreases in ventricular hypertrophy

22.T wave is described as the following except:A. Due to the faster and stronger stage of ventricular depolarizationB. The mean direction of depolarization wave in the ventricles is opposite to

depolarization wave

C. Its duration is 0.25 sec and its amplitude is 0.2-0.3 mVD. T wave is flattened in old age and inverted in myocardial infarction

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23.All the following are true regarding P-R interval except:A. It is the time between the start of P wave to the start of R waveB. Its duration exceeding 0.2 sec indicates the second degree heart block C. Its normal duration is in 0.12-0.2 secD. Represents atrial depolarization and conduction through AV node and bundle

HISTOLOGY OF PERIPHERAL CIRCULATION

24.Which of the following regarding capillaries sites is WRONG?A. KidneyB. LungC. SkinD. MusclesE. Nerves

25.All the following fenestrated capillaries has their pores covered by a thin diaphragmEXCEPT

A. PancreasB. KidneyC. Intestine

26.Choose the correct sites for sinusoids.I- Bone marrowII- LiverIII- SpleenIV-

Certain endocrine glands

V- Renal glomeruliVI- SkinA. I, II, III, IVB. I, III, IV, VC. II, III, IV, V, VID. I, III, IV, V

27.Choose the correct sites for A-V shuntsI- PalmII- SoleIII- Thyroid glandIV- Bone marrowV- LipVI- NoseVII-SpleenA. I, II, III, IV, VB. II, III, V, VI, VIIC. I, II, III, V, VID. III, IV, V, VI, VIIE. I, III, IV, V

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28.What is the difference between sinusoid and lymph capillaries?A. Having wide lumenB. Irregular in shapeC. Lack of continuous basal laminaD. Having anchoring filaments to the surrounding collagen

Anti Arrythmic drug

29.

The phase 0 in the diagram equal to?

A. P-R interval

B. QRS complex

C. R-T interval

D. S-T interval

30. Which blocker that prolong action potential duration of cardiac muscle(refraction

period)?

A. Ca channel blocker

B. Beta blocker

C. Alpha blocker

D. K+ channel blocker

31. Which of the following blocker that increase the P-R interval?


B. Na channel blocker

C. Alpha blocker


32. Which of the following blocker that slowing the conduction action potential of cardiac

muscle?


B. Na channel blocker

C. Alpha blocker


33. Which of the following drugs that can produce Rythm Control?

A. Beta and Ca channel blocker

B. Alpha and Beta blocker

C. Alpha blockerD. Na and K+ channel blocker

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Cardiovascular regulatory mechanism

34. All of the following are TRUE about vasomotor neurons EXCEPT

A. Vasomotor tone occurs resulting from active vasoconstriction neurons during restB.

Stimulation of vasodilator neurons directly produce generalized vasodilation

C. Vasoconstrictor fibers from medulla excite vasoconstrictor neurons of sympatheticnervous system leading to increases in arterial blood pressure a pressor effect

D. Stimulation of vasoconstrictor neuron produces positive chronotropic, inotropic, anddromotropic effect

E. Medullary sensory area project output signal to these neurons to adjust theiractivity according to the situation

35. Which of the following are regarding cardioinhibitory neurons?

I. Control the parasympathetic activity of the heartII. Preganglionic fibers of the vagus relay in terminal ganglia at right atrium

III. The vagi dilate the coronary vesselsIV. The vagi continuously transmitting inhibitory impulses to decrease high rhythm of

the S-A node at any level of arterial blood pressure

V. Vagus tone is reflexly produced through the baroreceptorA. I, II and IIIB. I, II and VC. I, IV and VD. All of the above

36. All of the following are FALSE about innervations of the heart EXCEPT

A. Inhibitory vagal tone dominates over the +ve chronotropic sympathetic toneB. Sympathetic tonic discharge to the heart during activity increase the pumping

capacity of the heart by 20%

C. The sympathetic supply controlled by vasomotor neuronsD. Heart rate is directly proportional to the metabolic rate

37. Physiological variation of heart rate according to

I. Athletes have lower heart rate due to high vagal toneII. Circadian rhythm of heart rate is lowest in early morning and highest in evening

III. Heart rate slows down to 60 bpm during quite restIV. Heart rate increases during standing by up to 35%A. I and IIIB. II and IVC. I, II and IIID. I, II, III and IV

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38. Choose the incorrect pair concerning relationship between age and heart rate

A. Feotus 140-150 bpmB. Newborn 130-140 bpmC. 1-3 years 120-130 bpmD. Over 15 years- 70-80 bpm

Regulation of Myocardial Metabolism

39. The energy in the heart is mainly used in:

A. ContractionB. RelaxationC. Both contraction and relaxationD. None of the above

40. Which of the following used by the healthy heart (well-perfused human heart) to

generate energy?

I. CarbohydrateII. LactateIII. Fatty acidIV. ProteinA, I, II and III

B. I, III and IV

C. II, III and IV

D. I, II, III and IV

41. Lipolysis (breakdown of triglyceride) is regulated by the following hormone(s):

A. InsulinB. NoradrenalineC. AdrenalineD. All of the above

42. The following events/hormones increase the membrane capacitance for glucose

transport EXCEPT:

A. IschaemiaB.

CatecholaminesC. Insulin

D. Increase work demand43. Important factors for transporting glucose into the cell are:

I. Carnitine shuttle systemII. Presence of glucose transporterIII. Glucose gradientIV. Presence of adrenalineA. I and IIB. II and IIIC. II and IVD. III and IV

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44. Randle et al (Randle cycle) states that high rates of fatty acid oxidation inhibit the

uptake and oxidation of glucose and lactate by the heart. At which pathway does the

inhibition occurs?

A. Phosphorylation of glycose by hexokinaseB. B-oxidation of acyl-CoA to Acetyl-CoAC. Pyruvate decarboxylation to Acetyl-CoAD. Entry of pyruvate into mitochondria

45. Which of the following stimulate the inhibition of pyruvate dehydrogenase?

I. NADHII. ATPIII. Acetyl-CoAIV. PyruvateA. I, II and IIIB. I, II and IVC. I, III and IVD. II, III and IV

CARDIAC REGULATORY MECHANISM 2

46. Which of the following statement is false about heart rate?

A. The normal heart rate for adult male is about 75 beats per minuteB. Heart rate generally refers to the atrial rate of beating and not the ventricleC. Heart rate lower than 60 beat per minute is called bradycardia while heart rate

higher than 90 beat per minute is called tachycardia

D. The heart rate of female is slightly higher than male due to lower blood pressure andlower vagal tone

47. The heart rate of a person may vary according to

A. Metabolic rateB. RespirationC. Time of the dayD. All of the above

48. Which of the following is false about the physiological variation of heart rate?

A. Under basal condition with complete physical and mental rest, or during quiet sleep,the heart rate slows down to 60 beats per minute

B. Athletes have lower heart rate than non-athletes at rest due to high vagal toneC. The heart rate increases during standing by up to 35 per cent of its basal valueD. Male has lower heart rate than female during rest

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49. Which of the following heart rate is not matched correctly with its corresponding age?

A. Foetus 140-150 beats per minuteB. Newborn 130-140 beats per minuteC. From 1-3 years 100-120D. Over 15 years 70-80

50. What is the factor that affects the cardiovascular centre?

A. Changes in blood temperatureB. Impulses from higher centreC. Changes in the chemical composition of bloodD. All of the above

HAEMODYNAMICS CHANGES

51. Which of the following statement is FALSE regarding hyperemia & congestion.

A. Hyperemia occurs when arterial and arteriolar dilatation produces the effects thatopen inactive capillaries.

B. Congestion is due to impaired venous drainageC. Hyperemia is always pathological whereas congestion can be also due to

physiological

D. Grossly, hyperemia appear red while congestion appear much darker52. Choose the correct statements regarding localized and systemic congestion.

I. Localized venous congestion is due to impaired venous outflow from an organ whilethe systemic congestion is due to affection of central organII. The effects of the acute localized congestion depend on the condition of the

collateral.

III. Dilatation of vessels proximal to the obstruction is the effects of the chronic localcongestion

IV. Mitral stenosis is one of the cause of acute generalized venous congestionA. I,IIB. II,IIIC. I,III,IVD. I,II,III

53. Which of the following is NOT the general effects of venous congestion?

A. HypoxiaB. FibrosisC. CyanosisD. Edema

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54. Which of the following is False regarding chronic venous congestion at the lungs?

A. It is due to increase in the pressure at the left atriumB. Its cut surface is mottled and alternate with dark red areasC. At late stage it appears brown,firm and indurated.D. Macrophage in this case is known as heart failure cell

55. Choose the CORRECT statements regarding chronic venous congestion of the liver

A. It is cause by the right-sided heart failureB. At late stage,it will increase in size due to cardiac cirrhosisC. Central vein and the sinusoid is distended with bloodD. The tissues located nearest to the central region undergo atrophic

56. All the followings are higher centers involved in heart rate regulation EXCEPT:

A.Cerebral cortex

B. Thalamus and limbic systemC. Respiratory centerD.Hypothalamus

57. What is Bainbridge reflex?

A. During increase in arterial pressure, it will increase the heart rate and strength ofcontraction

B. Excitation of baroreceptors by increasing the pressure in arteries reflexly causes thearterial pressure to decrease

C. Increase of atrial heart pressure reflexly will increase heart rate.D. None of above

58. One degree centigrade rise in body temperature increases the heart rate by about :

A. 10 beats/minB. 15 beats/hourC. 10 beats/hourD. 15 beats/min

59. How mechanism of thyroxine hormone increase heart rate?

I. Directly stimulating SA nodeII. Increase metabolic rate of the bodyIII. Direct stimulating AV nodeIV. Stimulating effect on sympathetic systemA. I AND IIB. II, III AND IVC. I, II AND IVD. I, II ,III AND IV

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60. Which are the following is TRUE statement :

A. Hypoxia increases herat rate *B. Severe emotions lead to reflex increased in heart rateC. Chemoreceptors are sensitive to pressureD. Carbon dioxide excess in moderate amounts decrease the heart rate

Physiological properties of heart 2

61. All of the following are true about myocardial rhythmicity EXCEPT

A. Is myogenic in natureB. Is the ability of the cardiac muscle to generate action potential spontaneously and

regularly

C. Ectopic pacemaker possesses the greatest rhythmicity and initiate beat of the wholeheart

D. A-V nodal rhythm produce slower heart rate62. Choose the incorrect pair

A. S-A node - 105 beats /minuteB. A-V node - 45-60 beats /minuteC. Purkinje system - 25-40 beats/minuteD. Idioventricular rhythm - 30-50 beats/minute

63. Which of the following false regarding the factors affecting myocardial rhythmicity ?

I. Whole heart is innervated by vagus nerve and sympathetic nervous system exceptventricleII. S-A node discharges at a rate about 105 impulse/minute intrinsic heart rate

III. Myocardial rhythmicity increase with increase in body temperatureIV. Excess of calcium can increase the diastole until the heart stops in diastoleA. I and IIB. II and IIIC. III and IVD. I, II and IV

64. All of the following incorrect about conductivity of the heart EXCEPT

A. Physiologically, A-V node has very long relative refractory periodB. A-V node protect the ventricle from pathological hyperkinesis of atriaC. Rapid impulse conduction through purkinjes fiber because this fiber has many fascia

adherens and gap junction

D. A-V node is medium in size and its intercalated disc contain less gap junction

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65.

Which of the following physiological properties of the heart describe the table above

A. RhythmicityB. ConductivityC. ExcitabilityD. Contractility

Antiarrythmic Drug II

66. The following are true EXCEPT

A. Flecainide can be given to patients with myocardial infarctionB. All anti-dysrrhythmic drugs prolong QRS complex durationC. Lidocaine can be given to patients with heart failureD. Quinidine can be used in treatment of supraventricular dysrrhythmia

67. The following statements are true EXCEPT

A. Class Ia and Ib prolong QT intervalB. Torsade de pointes is not seen in calcium channel blocker drugsC. Lidocaine depresses nervous systemD. Depression of cardiac contractility is most significant in Ic administration

68. Choose the correct statements

I. Flecainide is used in both treatment of ventricular and supraventriculartachyarrhythmias

II. Non lethal reentrant ventricular tachyarrhythmias is induced by flecainideIII. Beta blockers can be used against arrhythmia in patient with myocardial infarctionIV. Torsade de pointes rarely occur in administration of amiodarone due to its ability to

block Na+ channel

A. I & IIB. II & IIIC. I & IIID. III & IV

S-A node A-V node bundle of His bundle branches terminal

purkinjes fiber

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69. Choose the correct statements

I. Extracardiac adverse effects of lidocaine can cause deathII.

All class I drugs are associated with proarrhythmia with the least significant being Ib

III. Verapamil is used in the acute management of paroxysmal atrial tachycardiaIV. Verapamil can cause death if used in patients with ventricular tachycardiasA. I & IIB. II & IIIC. III & IVD. II, III & IV

70. The following are false EXCEPT

A. Class II, III, IV and V antiarrhythmic drugs act by decreasing AV conductionB. Flecainide prolongs action potential durationC. Lidocaine must be given IV to have effects on the heart due to its minimal

absorption in the GIT if given orally

D. The safest antiarrhythmic drugs are class IV drugsANSWERS:

1 A

69

11 T 21 C 97 31 A 41 D 51 C 61 C

B7

2 B

68

12 F 22 D

97

32 B 42 B 52 D 62 D

87

3 B

69

13 F 23 B

98

33 D 43 B 53 B 63 D

87

4 A

70

14 C 24 A

72

34 B

106

44 C 54 B 64 B 89

5 D

70

15 B 25 B

73

35 B

105

45 A 55 B 65 B 89

6 C 26 16 A 26 A

74

36 A

106

46 B

107

56 B 66 A

7 C 27 17 C 27 C 74 37 C

107

47 D

107

57 C 67 A

8 B

27

18 D 28 D

76

38 C

107

48 C

107

58 D 68 C

9 A

28

19 D

96

29 B 39 C 49 C

107

59 C 69 D

10 D

27

20 C 97 30 D 40 A 50 D

108

60 A 70 A

YOUTH IS THE MOST PRECIOUS TIME OF YOUR LIFE, BE SURE TO MAKE THE BEST OUT OF IT!

ALL THE BEST!!

week 2 cvs

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