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Medical Physiology Final Examination Samplex PART II – CVS Prepared by: Mary 08AM March 2009
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Page 1: questions 2

Medical PhysiologyFinal Examination

Samplex

PART II – CVSPrepared by: Mary 08AM

March 2009

Page 2: questions 2

Coverage: 1. Cell – 52. Nerve – 53. Muscle – 54. Blood – 105. Autonomics – 106. CVS – 307. Respi – 308. GIT – 30

Note: this is a compilation of finals samplex, it will be divided to parts according to the coverage. *^-^*

Page 3: questions 2

CVS

Page 4: questions 2

Which one of the following parameters is most similar in the pulmonary and systemic

circulation?

a. Vascular resistanceb. Stroke volumec. Afterloadd. Blood flow

Answer: B

Page 5: questions 2

Is NOT a characteristic of myocardial cells:

A. Can undergo sustained contractionB. Has intercalated discsC. Can regulate its own force of contractionD. Utilizes both intracellular and extracellular

calcium for contraction

Answer: A

Page 6: questions 2

An embolus was lodged in the pulmonary artery. This statement is TRUE

a. It must have come from the left ventricleb. It increases the workload on the right and left ventriclec. Interrupts the transmission of the impulse at the

AVNoded. It deceases pulmonary perfusion

Answer: B

Page 7: questions 2

The following induces positive inotropic effect on the myocardium EXCEPT:

a. Stretch on the fiberb. Adrenalinc. Acetylcholined. Increases heart rate

Answer: C

Page 8: questions 2

The volume of blood that determines the length of the muscle contraction is:

A. Stroke volumeB. End diastolic volumeC. End systolic volumeD. Afterload

Answer: B

Page 9: questions 2

The size of the ventricular chamber just before contraction is determined by:

a. End systolic volumeb. Stroke volumec. End diastolic volumed. Afterload

Answer: C

Page 10: questions 2

Which of the following events occur at the end of isovolumetric relaxation?

A. Closure of AV valvesB. Opening of AV valvesC. Opening of semilunar valvesD. Closure of semilunar valves

Answer: C

Page 11: questions 2

TRUE of the second heart sound

a. Atrial systoleb. Ventricular fillingc. Opening of the AV valvesd. Due to closure of the aortic and pulmonary valves

Answer: D

Page 12: questions 2

S2 (second heart sound) coincides with the closure of the:

a. Tricuspid and mitral valveb. Aortic and pulmonic valvec. Mitral and aortic valved. Pulmonic and mitral valve

Answer: B

Page 13: questions 2

Maximum percentage that cardiac output can increase above normal is known as:

A. Cardiac outputB. Cardiac reserveC. Cardiac indexD. Cardiac cycle

Answer: B

Page 14: questions 2

In order for the heart to function as a pump, the myocardial cells have to depolarize almost at the

same time. The fast spread of the impulse is made possible by:

a. Intercalated disc/ tight gap junctionsb. The branching of myocardial branchesc. Bothd. neither

Answer: C

Page 15: questions 2

A second stimulus in very close succession maybe not able to elicit another myocardial

contraction:

a. Some myocardial cells are automaticb. The duration of the action potential (period of

refractoriness) is very longc. Resting membrane potential are unstabled. The main source of calcium is the extracellular fluid

compartment

Answer: B

Page 16: questions 2

In the conducting pathway of the heart, which part is most common site of heart block?

A. AV nodeB. Bundle of HisC. Bundle branchesD. Purkinje fibers

Answer: A

Page 17: questions 2

The SA node is the primary pacemaker, it’s automaticity lies on:

A. Phase 0B. Phase 2C. Phase 3D. Phase 4

Answer: D

Page 18: questions 2

At the microcirculation this takes care of the net accumulation of fluid in the interstitial space:

a. Plasma colloidal osmotic pressureb. Capillary hydrostatic pressurec. Lymphatic drainaged. Sodium/Potassium pump

Answer: C

Page 19: questions 2

TRUE regarding myocardial perfusion EXCEPT:

a. All capillaries are perfused even at resting stateb. Decreases during systole due to increase resistancec. Controlled predominantly by autonomicsd. Regulation is largely influenced by its metabolic state

Answer: C

Page 20: questions 2

This is TRUE if impulse transmission thru the AV Node is completely blocked,

a. the pacemaker shifts to the purkinje cellsb. SANode is not longer functionalc. The ventricle dissociates from the atriumd. There will be atrial contraction but not ventricular

contractions

Answer: C

Page 21: questions 2

The following brings about an increase in capillary hydrostatic pressure EXCEPT:

a. Increase venous pressureb. Lymphatic obstructionc. Arteriolar vasodilationd. None of these

Answer: D

Page 22: questions 2

Interstitial fluid accumulation occurs when there is INCREASED:

A. Precapillary sphincter toneB. Plasma colloidal osmotic pressureC. Lymphatic drainageD. Capillary hydrostatic pressure

Answer: D

Page 23: questions 2

The parameter DECREASES as the distensibility of the aorta decreases

A. Vascular resistanceB. AfterloadC. Vascular complianceD. Systolic pressure

Answer: C

Page 24: questions 2

Which of the following is the best index for afterload:

a. Pulse pressureb. Venous returnc. Total peripheral resistanced. Effective filling pressure

Answer: C

Page 25: questions 2

What is the MAP (mean arterial pressure)?Given: SP= 180mmHg DP=90 mmHg HR=

120/min

A. 100 mmHgB. 120 mmHgC. 125 mmHgD. 130 mmHg

Answer: B

Page 26: questions 2

Are known to decrease vascular resistance:

A. AdenosineB. Thromboxane A2C. Angiotensin IID. Endothelin

Answer: A

Page 27: questions 2

When the blood flow to the brain is compromised as in increased intracranial

pressure, the reflex response is:

A. IncreaseB. DecreaseC. No change ..........blood pressure

Answer: A

Page 28: questions 2

These changes are associated with baroreceptor reflex response to hemorrhage EXCEPT:

A. Decreased rate of firing of carotid sinus neurons

B. Decreased vascular wall stretchC. Decreased efferent parasympathetic responseD. Decreased vascular toneAnswer: D

Page 29: questions 2

The most immediate regulation of blood pressure is thru:

a. Baroreceptors in the arch of aorta and the common carotids

b. Shift of fluids in the capillariesc. The renin-angiotensin-aldosterone systemd. The metabolic theory of regulation

Answer: A

Page 30: questions 2

The center of the baroreceptor reflex is located in the:

a. Cerebrumb. Brainstemc. Cerebellumd. Spinal cord

Answer: B

Page 31: questions 2

Following rapid intravenous fluid infusion on a patient thus increasing the blood volume

abruptly. The heartrate will be reflexly increased. This is known as:

A. Baroreceptor reflexB. Frank-starling’s lawC. Bainbridge reflexD. Cushing’s reaction

Answer: C

Page 32: questions 2

If the left heart fails, venous congestion is noted in the:

A. LiverB. Neck veinsC. LungsD. Lower extremities

Answer: C

Page 33: questions 2

The coronary arteries are best perfused during diastole because:

A. Diastolic pressure is lower than systolic pressureB. Intramyocardial branches of the coronaries are

compressed during systoleC. Myocardium is utilizing less oxygen at diastoleD. Peripheral vascular resistance is lower at diastole

Answer: B

Page 34: questions 2

SHADE:A – If increase in item A INCREASES Item BB – If increase in item A DECREASES Item B

If - Increase in item A does not affect item B

ITEM A1. Plasma Colloidal osmotic

pressure2. Serum potassium3. Venous pressure4. Aortic pressure5. Venous capacity6. Heart rate

ITEM B1. Interstitial accumulation2. Resting membrane

potential3. Capillary osmotic

pressure4. Ejection fraction5. Venous return6. Force of contraction1. B

2. B3. C4. B5. B6. A

Page 35: questions 2

SHADE:A – If increase in item A INCREASES Item BB – If increase in item A DECREASES Item B

If - Increase in item A does not affect item B

ITEM A1. Arteriolar diameter2. End systolic volume3. Myocardial calcium4. Tissue metabolic rate

ITEM B1. Plasma colloidal

osmotic pressure2. Effective filling

pressure3. Stroke volume4. Blood flow

1. C2. B3. A4. A

Page 36: questions 2

CAUSE and EFFECT:SHADE A- if INCREASE in item A INCREASES item BSHADE B- if INCREASE in item A DECREASES item B

SHADE C- if INCREASE in item A DOES NOT AFFECT item B

1. A.) Venous return –> B) Cardiac output2. A) nitric oxide –> B) vascular resistance3. A) calcium conductance –> B) inotropic effect4. A) afterload –> B) stroke volume5. A) parasympathetic stimulation –> B) force of

ventricular contraction1 – A2 – B3 – A4 – B5 – C

Page 37: questions 2

SHADE:A – If increase in item A INCREASES Item BB – If increase in item A DECREASES Item B

If - Increase in item A does not affect item B

ITEM A1. Inspiratory effort2. Heart rate3. Action potential

duration

ITEM B1. Venous return2. Myocardial calcium

concentration3. Period of

refractoriness

1. A2. C3. A

Page 38: questions 2

SHADEA – if Item A is GREATER/HIGHER than item B

B – if Item B is LESSER/LOWER than item BC – If items A and B are more or less equal

1. Intraventricular pressure:a. At isovolumetric contractionb. Period of ejection

2. Coronary blood flow:a. At systoleb. At diastole

ANSWER:1 – B2 – B

Page 39: questions 2

SHADEA – if Item A is GREATER/HIGHER than item B

B – if Item B is LESSER/LOWER than item BC – If items A and B are more or less equal

1. Stroke Volumea. Higher preloadb. Higher afterload

2. Resistance of blood flow:a. capillariesb. arterioles

ANSWER:1 – A2 – B

Page 40: questions 2

References

• 2008 Oct. 1st sem. SY 2008-2009. Finals Exam• 2006 Oct. 1st Sem. SY 2006-2007. Finals Exam• 2003 Oct. 1st Sem. SY 2003-2009. Finals Exam