WEEKLY QUESTIONSCARDIOVASCULAR SYSTEM (MODULE 11)WEEK 4 (18-22 MARCH 2012)

ARTERIAL BLOOD PRESSURE (1)

1. Choose the correct statement about the blood pressure?A. Pulse pressure is the difference between maximal pressure and minimal pressure in systemic

arteriesB. Systolic pressure ranging between 60-90 mmHgC. Mean pressure usually remains nearer the systolic levelD. Arterial blood pressure is identical in the different arteries of the same individual

2. The following are incorrect regarding Arterial blood pressure, EXCEPT:A. At birth, baby have a very high heart rate with high arterial blood pressureB. Arterial blood pressure depend mainly on arteriolar resistanceC. The blood pressure might falls progressively to approximately 0mmHg after flows through

systemic circulationD. Arteriolar resistance is very important in regulation of blood pressure

3. Which one of the following is important factor affecting blood pressure?I. Rise in stroke volume increased the systolic pressureII. Increase in diastolic pressure is affected by increase in heart rate with constant stroke

volumeIII. The resistance of peripheral circulation is directly proportional to the radius of vesselIV. The diameter of arterioles is controlled by local, nervous and chemical factorsA. I & IIB. I, II, & IIIC. I, II & IVD. All of the above

4. The following are true about the peripheral resistance EXCEPT:A. It is one of the main factor affecting the arterial blood pressureB. In polycythemia, the arterial blood pressure is increasesC. Concentration of plasma protein have larger effect on the blood viscosity rather than the

hematocrit valueD. Vein have large resistance despite of its large size

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5. Choose the correct answer regarding the factors affecting the ABP?A. The longer the length, the greater is the resistance, the lower the ABPB. Cardiac output will not be affected by the sympathetic nervous systemC. Respiratory activity did not affect the heart rate and subsequently the cardiac outputD. The capillaries have the highest resistance due to its small size

6. Which of the following statement is false about the blood pressure?A. The systolic pressure is the maximal pressure in the systemic arteries occurring during the

systoleB. The average value of pulse pressure is 40 mmHgC. The normal range for diastolic pressure is between 60-100 mmHgD. The mean pressure is the average pressure throughout the cardiac cycle

7. Choose the correct statement about the arterial blood pressureA. It is the force exerted by the blood against any unit area of the vessel wallB. It can be affected by the changes in the blood volumeC. All of the above D. None of the above

8. All of the following statements are true about the physiological variations of the arterial blood pressure exceptA. The diastolic pressure is usually high in obese personB. Women has slightly lower arterial blood pressure than menC. The arterial blood pressure rises slightly after meals D. During sleep, the systolic blood pressure falls about 15-20 mmHg

9. Choose the false statement about factors that affect the arterial blood pressureA. The arterial blood pressure depends primarily upon two factors that is the cardiac output and

the peripheral resistanceB. A rise in the stroke volume will raises the diastolic pressure because a larger amount of blood

has to be accommodated in the arterial systemC. The viscosity of blood is caused by two factors which are the blood cells and the plasma

proteinsD. Narrowing of the arterioles while the cardiac output being constant will leads to rise in the

diastolic pressure

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10. Which of the following statement is false regarding the normal standards and variations of arterial blood pressure?A. The average blood pressure of normal person is 120/80B. The arterial blood pressure may differ by 5-10 mm Hg in the corresponding arteries on both

sides of the bodyC. The arterial blood pressure in the femoral artery is lower than in the brachial by 10-15

mmHgD. The arterial blood pressure in the popliteal artery is 15-20 mmHg lower than in the femoral

artery

PATHOLOGY - INFECTIVE ENDOCARDITIS

11. Choose conditions that will lead to the following effects:

left atrium pressure increase pulmonary congestion right heart failure systemic congestion

I- Mitral stenosisII- Mitral incompetenceIII- Aortic stenosisIV- Aortic incompetence

A. I, II, IIIB. I, II IVC. II, III, IVD. I,II, III, IV

12. All the following are etiologies for infective endocarditis EXCEPTI- Periodontal infectionII- Skin infection; abscessIII- Genitourinary procedures; catheterizationIV- Cardiac catheterizationV- Neutropnea

A. I & IIB. II & IIIC. III & IVD. IV & VE. None of the above

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13. All the following is the microscopically morphology of infective endocarditis EXCEPTA. Outer cap; leukocytes and platelets adhesionsB. A core of dead cells and foam cells with extracellular matrixC. A zone of basophilic containing bacteriaD. Deeper zone: non-specific inflammation on the cusp itself

14. Which of the following types of bacterial endocarditis is WRONGLY paired to its clinical pictures?A. SABE – malaiseB. ABE – chills C. ABE – high grade feverD. SABE – low grade fever

15. Which of the following is NOT the death cause for infective endocarditis?A. Cardiac failureB. Renal failureC. Transient infectionD. Embolism to vital organE. Ruptures of mycotic aneurysm in cerebral artery

Staphylococcal Infection

16. Staphylococcus aureus can be differentiated from other staphylococci by:A. Coagulase positiveB. Arranged in grape-like structureC. They produece catalaseD. None of above

17. All of following are toxins produce by staph. Aureus EXCEPT:A. LeucocidinsB. HaemolysinsC. Staphylokinase D. Toxic Shock Syndrome Toxin -1

18. Exfoliative toxin may lead to :A. Damages plateletsB. Loss of motility and destruction of leukocyteC. Septic metastasisD. Desquamation of skin

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19. All the following true about Staph. Epidermis EXCEPT:A. Produce large amounts of a polysaccharide slime when bacteria grow on a solid surfaceB. Novobiocin resistantC. They are oppurtunistic pathogensD. They can cause endocarditis

20. Which of following are laboratory diagnosis of infective endocarditis :A. Non – specific testB. Cardiology investigationsC. Microbiological investigationsD. All of above

ARTERIAL BLOOD PRESSURE (3)

21. The pressure difference between contraction and relaxation of heart is known as A. Systolic pressureB. Diastolic pressureC. Pulse pressureD. Mean pressure

22. Which of the following lowering the ABP physiologically?A. Young ageB. StressC. Moderate exerciseD. Increase in size of body

23. The mean arterial pressure at the beginning of venous system is aboutA. 50mmHgB. 35mmHgC. 15mmHgD. 0mmHg

24. Which of the following factors affecting the arterial blood pressure?I. Changes in blood volumeII. Peripheral resistanceIII. Elasticity of large arteriesIV. Cardiac outputA. I, II and IVB. II, III and IVC. II and IIID. I, II,III and IV

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25. The capillaries have the smallest diameter, and thus have the highest resistanceA. TrueB. False

26. The total peripheral resistance is directly proportional toI. Length of vesselII. Blood viscosityIII. Fourth power of radiusIV. Thickness of the wall of vesselA. I and IIB. I and IIIC. II and IIID. III and IV

ANATOMY – VEINS OF HEAD AND NECK

27. The following are true EXCEPTA. The main veins of head and neck are internal and external jugular vein and anterior jugular

veinB. The external jugular vein is formed by the union of posterior auricular vein and posterior

division of retromandibular vein C. Suprascapular vein and deep cervical vein drain into external jugular veinD. The only tributary of subclavian vein is the external jugular vein

28. The following are true EXCEPTA. The anterior jugular vein which comes from the submental plexus of vein runs deep to

sternomastoid muscle and terminates in external jugular veinB. Internal jugular vein runs deep to sternomastoid muscle whereas external jugular vein runs

superficial to itC. The union of anterior division of retromandibular vein with anterior facial vein is one of the

tributaries of internal jugular veinD. The external jugular vein pierces the deep fascia, three cm above the midaxillary line

29. The following are true EXCEPTI. Internal jugular vein join the subclavian vein to form brachiocephalic vein

II. The cavernous venous sinus is connected to the internal jugular vein through superior petrosal sinus

III. The internal jugular vein pass through the jugular foramen as the continuation of sigmoid sinus

IV. The internal carotid artery is lateral to internal jugular vein in the carotid sheathA. I & II C. II & IVB. II & III D. III & IV

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30. The following are true EXCEPTI. Superior and inferior thyroid veins drain into internal jugular vein

II. Common facial vein and lingual veins are tributaries of internal jugular veinIII. Internal jugular vein has 7 tributariesIV. Internal jugular veins join the subclavian veins and form the brachiocephalic veins behind

the clavicleA. I, II & IIIB. I & IIIC. III & IVD. II, III & IV

State true or false

31. Superior and inferior pharyngeal veins come from the pharyngeal plexus and terminate into internal jugular vein ( )

Arteries of Upper Limb

32. Which of the following is TRUE regarding subclavian artery?A. Right subclavian artery arises from arch of aortaB. Left subclavian artery arises from brachiocephalic artery.C. Divided into 3 parts by pectoralis minor muscleD. It terminates at outer border of 1st rib to give axillary artery.

33. Which of the following are the branches of 2nd part of axillary artery?I- Subscapular arteryII- Superior thoracic arteryIII- Lateral thoracic arteryIV- Thoracoacromial arteryA. I and IIB. III and IVC. I,II and IVD. II,III and IV

34. Which of the following is TRUE regarding the course of ulnar artery.A. It is smaller than radial arteryB. It descends in forearm lateral to ulnar nerveC. It passes deep to flexor retinaculum to enter hand.D. It will continue as deep palmar arch.

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35. Which of the following is TRUE regarding arterial supply of hand?A. Superficial palmar arch lies proximal to outstretch thumbB. Deep palmar arch formed mainly by ulnar arteryC. Princeps pollicis is the main supply of thumbD. Radial indices supply ulnar side of index.

36. Which of the following branch will share in the anastomosis at surgical neck of humerus?I- Anterior circumflex humeral arteryII- Ascending branch of profunda brachiiIII- Pectoral branch of thoracoacromial arteryIV- Subscapular artery.A. I and IIB. III and IVC. I,II and IIID. II,III and IV

Regulation of Arterial Blood Pressure

37. The nervous pressure control mechanisms are important mechanism in controlling I. Bainbridge reflexII. Mary’s reflexIII. Changes in chemical compositionIV. CNS ischemic responseA. I, II and IIIB. I, II and IVC. II, III and IVD. I, II, III and IV

38.

-Initiated by blood pressure below 50/60 mmHg

-not one of mechanisms for regulating normal arterial pressure

The above statements are regarding to

A. Vasopressin Vasoconstrictor mechanismB. Bainbridge reflexC. Central ischemic responseD. Mary’s reflex

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39. Which of the following are true regarding atrial reflex in regulation of arterial blood pressure?I. Can increase the excretion of waterII. Can cause vasodilatation of arteriolesIII. Rapidly adapting reflexIV. Responds only when the arterial pressure falls below 80mmHgA. I and IIB. I and IIIC. II and IIID. III and IV

40. The most potent vasoconstrictor mechanism isA. Norepinephnrine-Epinephrine Vasoconstrictor MechanismB. Renin-Angiotensin Vasoconstrictor MechanismC. Vasopressin Vasoconstrictor MechanismD. Capillary fluid shift mechanism

41.

-This mechanism will not stop until the pressure rises back to normal

- Important in regulation of blood volume

-Controlled by several hormonal systems

The above statement is about

A. CapillariesB. KidneyC. Lymphatic systemD. Atrial reflex

Hypertension

42. Which of the following is not the constitutional risk factor of atherosclerosis?A. SexB. AgeC. DietD. Familial predisposition

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43. All the following are minor risk factors of atherosclerosis except?A. Obesity with high caloric intakeB. Behavioral pattern ( type B personality)C. High carbohydrate dietD. Physical inactivity

44. All the following are true about Monckeberg’s sclerosis except?A. Lesion characterized by focal calcium deposition in intimaB. Commonly affected the arteries of extremitiesC. The calcified medial sclerosis can be visualized radiologicallyD. Affected arteries may also develop atherosclerosis

45. Benign hypertension characterized by?A. Occurs in 5% of hypertension patientsB. Usually occurs in young adult malesC. Female more affected than male from the 4th-6th decadeD. Blood pressure is more than 200/ 120 mmHg

46. Which of the following is not the cause increase blood volume due to salt and water retention of secondary hypertension?A. Cushing’s syndromeB. Neurogenic stimulation of vasomotor centerC. Primary AldosteronismD. Rennin angiotensin sytem activation

ANTIHYPERTENSIVE DRUG 1

47. Choose the correct statement below;

I Hypertension can be lowered by managing the peripheral vascular resistanceII Vasodilator drug can be given to manage hypertensionIII Giving diuretics drug can increased blood pressureIV Decreasing cardiac output can lower increased blood pressureA I, II, IIIB II, III, IVC II , IVD All of the above

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48.All of the statement below are correct EXCEPT

A ACE inhibitors are contraindicated to pregnant womanB In hypertensive patient with asthma, the best prescription is by giving B-adrenoreceptor

blockerC Diuretics are one of the therapeutic treatments in treating hypertensionD Ca2+ channel blockers can increase the possibility of lowering blood pressure back to

normal

State TRUE or FALSE

49. We can manage hypertensive patient by giving the correct diet which is low in fat and high in potassium.

50. Ali is a Nigerian with the age of 54 , thus, he has low renin status.

51. Decreasing the cardiac output can decrease hypertension by giving negative chronotropic drug, negative inotropic drug, venous vasodilator drug, or even by diuretics.

Congenital anomalies of the heart

52. All of the following are FALSE about development of heart EXCEPT

A. Septum superium and left sinal valve will fuse with the atrial septum B. Foramens that are formed during heart development are foramen primum and secundum

onlyC. Absorption of distal part of bulbus cordis forms the smooth parts of right and left ventricleD. Muscular part of interventricular septum is formed by proliferation of bulbar and

atrioventricular cushions

53.

Which of the following congenital anomalies of heart characterized by characteristic above?

A. Cor- biloculateB. DextrocardiaC. Persitant truncus arteriosus and bulbus cordisD. Transposition of the great vesselsE. Unequal division of truncus arteriosus by spiral septum

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Failure of formation of spiral aortic-pulmonary septum Both of ascending aorta and pulmonary trunk are replaced by one vessel

54. All of the following are interseptal defect EXCEPT

A. Defect in the septum primum B. Defect in septum secundumC. Defect in septum superium D. Patent foramen ovale

55. Which of the following are the characteristics of Fallot’s tetralogy?

I. Roger’s diseaseII. Overriding of aorta

III. Pulmonary hypertensionIV. Right ventricular hypertrophyA. II and IVB. I, II and IIIC. I, II and IVD. All of the above

56. Anomalies of the heart valves are mainly in form of stenosis

A. TrueB. False

Fetal circulation and aortic arch development

57. The blood carried by umbilical vein enters the foetus through umbilical ring and

A. Half the blood passes into liver and half enters ductus venosusB. All the blood enters ductus venosusC. Half the blood passed into pancreas and half enters ductus venosusD. All the blood enters the pancreas

58. Which structures below prevents the backflow of mixed oxygenated blood from left atrium into right atrium?

A. Septum secundumB. Septum primumC. Foramen ovaleD. Atrial septum

59. From where does non-oxygenated blood come from?

A. Inferior vena cava and ductus venosusB. Superior vena cavaC. Umbilical veinD. Ductus arteriosus and left ventricle

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60. Match the foetal circulation structures below to their fate after birth and choose the correct order

Foramen ovale I. Closed due to adhesion between septum primum and septum secundum

Ductus arteriosus II. Ligamentum teres

Left umbilical vein III. Medial umbilical ligament

Distal part of umbilical artery IV. Ligamentum arteriosum

A. I, IV, II, IIIB. I, III, IV, IIC. I, II, IV, IIID. I, II, III, IV

61. Right subclavian artery is formed of

I Right fourth aortic archII Right seventh intersegmental arteryIII Part of dorsal aorta between right fourth aortic arch and seventh intersegmental arteryIV Left seventh intersegmental artery

A. I, II AND IIIB. I, II AND IVC. I,III AND IVD. All of the above

‘Sabar iku mustikaning laku’ : Sabar merupakan inti penghayatan hidup….

~Asian Philosophy~

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ANSWERS

1 A 131-2 13 B 228 25 B 37 D 49 TRUE 61 A LECTURE2 C 132-3 14 A 228 26 A 38 C 50 FALSE3 C 135-6 15 C 229 27 C 28 39 A 51 TRUE4 C 137 16 A 28 D 28 40 C 52 A 45 A 134-5 17 C 29 C 29 41 B 53 C 126 C 131 18 D 30 B 29 42 C 54 C 127 C 134 19 B 31 TRUE 43 B 55 A 138 A 132 20 D 32 D 37 44 A 56 A 139 B 135 21 C 33 B 38 45 C 57 A 2410 C 132 22 A 34 B 40 46 B 58 B 2411 D 224-5 23 C 35 C 41 47 C 59 B LECTURE12 E 226-7 24 D 36 A 43 48 B 60 A LECTURE

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