CVS Trial Exam

8/12/2019 CVS Trial Exam

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Physiology :

1-Which of the following is not a vasodilator ?

a) H+b) Ca+2c) K+d) Mg+2

Ans : B , Ca+2 is a vasoconstrictor

2- Which of the following is false ?

a) Brain capillaries have no poresb) Interstitial fluid is actually a free fluid that allow substances to flow easily

through itc) Not all capillaries are openedd) Precapillary sphincters play an important role in controlling blood flow

Ans : b , bcz interstitial fluid is a fluid GEL

3- All can cause edema except :

a) Kidney failureb) Liver cirrhosis

c)

Decrease protein from dietd) Vasoconstrictor drugs

Ans : D

4- What is Mean Arterial Blood Pressure for a patient with B.P = 160/100 mmHg ?

a) 130b) 120c) 110d) 153

Ans : B , MABP = 100 + 1/3(160-100)


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5- After standing up suddenly from a supine position , what is the most likely tooccur ?

a) Baroreceptors will sense the decreased BP and send signals to vasomotorcenter in the brain to stimulate sympathetic response .

b) Baroreceptors will sense the decreased BP and send signals to vasomotorcenter in the brain to inhibit parasympathetic response .

c) Baroreceptors will sense the increased BP and send signals to vasomotorcenter in the brain to inhibit parasympathetic response.

d) Baroreceptors will sense the increased BP and send signals to vasomotorcenter in the brain to inhibit sympathetic response .

Ans : A

6- BP evaluations are mostly related to:

a) Peripheral resistance which is related to systolic pressure .b) Peripheral resistance which is related to diastolic pressure .c) Blood flow which is related to systolic pressure .d) Blood flow which is related to diastolic pressure .

Ans : B, bcz systolic pressure is mostly related to cardiac output , heart rate , sympathetic stimulation , and BP is related to resistance not to blood flow .

7- What are the additional tests should you d o if you suspect Cushings Syndrome

?

a) Check epinephrine and norepinephrine .b) 2 answers are correct.c) Check cotisol level.d) Check if he/she has a moon face

Ans : B

8- During Exercise :

a) There is an increase in both systolic and diastolic pressure .b) Increase in diastolic but decrease in systolic .c) Increase in systolic and decrease in diastolic .d) Both systole and diastole are decreased .

Ans : C , increase in systole is due to increase in blood flow , cardiac outputand sympathetic stimulation and increase in diastolic due to vasodilation .


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9- After losing large amounts of blood due to an accident , what will be the mostefficient way to re-establish a normal BP?

a) Chemoreceptors .b) Low pressure receptors.c) Macula densa .d) Capillary shift fluid .

Ans : c

10- What is the example of volume loading hypertension ?

a) V will later lead to TPR (as a 2ed mechanism ). b) V will later lead to TPR (as a 2ed mechanism ). c) V will later lead to no change to TPR.

d) None of the above . Ans: A , V will later lead to C.O which will B.P (which causebaroreceptors to R by vasodilation ) but the kidneys are more efficientand so will urine output BP (which will be sensed by baroreceptors and

so will R so BP ( as a 2ed mechanism ), therefore maintaining BP high ) .

11- From the curve shoeing the relation btw urinary volume output , BP , waterand salt intake , if you keep intake constant but with a renal disease that has the urine output , what will happen to the curve :

a) Shifts to the leftb) Shifts to the rightc) Shifts upwardd) Shifts downward

Ans : B

12- Your friend is feeling dissy , you ask him to lay down on the floor and raise hislegs up , after staying in this position for several minutes , he still feels dizzy , whatdoes it mean ?

a) He has malignant HTNb) He has labile HTN due to some ADS of drug .c) He has hypoglycemia , and you offer him some sweets .d) It is too sever , he need to go to the hospital .

Ans : c


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13- During exercise , what is the most likely to happen?

a) Nervous control is stronger than local metabolic one .b) Sympathetic (nervous control) causes vasoconstriction of coronary blood

vessels but indirect increased metabolism is more dominant and so result invasodilation.

c) 2 answers are correct .d) Parasympathetic nervous control will cause vasodilation and therefore

increase blood flow in vessels. Ans :B

14- A patient suffers from retrosternal pain and an ECG that shows ST depressionin addition to enzymatic changes , what is the more likely the cause of his pain ?

a) Angina pectorisb) 2 answers are correct .c) MI.d) Heart attack.

Ans: C

15- we expect stable angina , we decide to do an exercise ECG , when do we stop ?

a) When we reach 85% of max heart rate .b) When the patient is exhausted .c) When we start to observe ECG changes .d) All of the above.

Ans : d

16- All are present in aortic arch and carotid bodies , EXCEPT :

a) Chemoreceptors .b) Baroreceptors .

c) Low-presser receptors.d) None of the above.

Ans : C , it is present in atria and pulmonary arteries.


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21- calculate the CO if oxygen consumption in the lungs = 250ml/min, O2concentration in venous blood = 50ml/L , O2 concentration in arterial blood =100ml/L.

answ: 5 L/min

22- the highest tendency of turbulent blood flow is when Reynold's number =

a ) 1000b) 100c) 900d) 3000

Ans : D

23- critical closing pressure will be at its highest value :

a) in isolated veins.b) in normal body veins.c) during sympathetic stimulation.

Ans :C

24 - the abnormal sound produced at aortic valve during diastole is due to : : a) mitral valve stenosis.b) aortic stenisis.c) aortic incompetence (regurgitation ).d) both b & c.

Ans :C

25- the reference point in the heart at which BP will not change if we change the position of the body, is:

a) level of aortic valve.b) level of tricuspid valve.c) left atrium .d) right ventricle.


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Ans :B

26- one of the following is not considered as reservoir of blood:

a)spleen.b) liver.c) plexus of GIT.d) brain.

Ans : D

27- one of the following is considered as both acute and long term regulator oflocal blood flow :

a) collateral circulation formation .b) angiogensis .c) oxygen lack theory.

Ans : A

28- pathological Q wave (more than 3 mm) on ECG indicates:

a) stable anginab) unstable angina.c) old MI.d) heart failure.

Ans : C

29- during exercise :

a) blood flow to all body parts is equal.b) sympathetic stimulation will cause vasoconstriction all over the bodyincluding skeletal muscles.c) systolic and diastolic BP will increase .d) only systolic BP will increase.

Ans : D


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30- one of the following will happen in left sided heart failure:

a) increase in renin secretion.b) decrease in aldosteron secretion.c) increase in venous return.d) peripheral edema.

Ans : A

31- congestive heart failure is failure of:

a) left ventricle.b) right ventricle.

c) both a & b.

Ans : C

32-The extrasystolic beat would produce :

a) increased pulse pressure because contractility is increased.b) increased pulse pressure because heart rate is increased.c) decreased pulse pressure because ventricular filling time is increased.d) decreased pulse pressure because stroke volume is decreased.e) decreased pulse pressure because the PR interval is increased.

Ans : D

33- Depending on the following ECG, answer the following 3 questions :

34- The end of systole is at the end of :

a) Cb) Dc) Ad) Ee) F


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Ans : D

35- Which of the following is correct :

a) The Second heart sound is caused by the opening Aortic Valve.b) The First heart sound can be heard during E.c) The Second heart sound can be heard during C.d) The First heart sound is caused by the opening Aortic Valve.e) The First heart sound can be heard during C.

Ans :E

36- Which of the following is false :

a) Both Ventricular pressure & Volume do not change significantly duringF because of diastasis.

b) The period during which Ventricular pressure increases without achange in its volume occurs in C .

c) The period during which Ventricular pressure decreases without achange in its volume occurs in E.

d) The period of ejection occurs during C.e) All of the above mentioned choices is correct.

Ans : D

37- The Resting potential of atrium is represented by:-

a) ST segment.b) ST segment + T wave + TP segment.c) QRS complex.d) TP segment.

Ans : B

38- Regarding the second heart sound :

a) its heard by the end of ST segment .b) its heard during QRS complex.c) An abnormal second heart sound may indicate a mitral valve

regurgitation .


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d) An abnormal second heart sound may indicate a mitral valveinsufficiency.

Ans : A

39- According to Dr. Mohammad jaafar, during the plateau phase of ventricularaction potential, which of the following is false :

a) The opening of slow Na-Ca channels maintain the membrane in adepolarized state.

b) No further slow Na-Ca channels can be opened .c) Potassium channels are closed .d) Potassium channels are partially opened .e) During the plateau, the myocyte is in an absolute refractory period.

Ans :D

40- Regarding precordial leads, which of the following is NOT correct :

a) An S wave cannot be seen in precordial lead V6.b) The greatest R wave is seen in precordial lead V6.c) A Q wave is note seen in precordial lead V1.d) An R wave is not seen in precordial lead V6.e) Precordial lead V2 is located at the level of the 4 th intercostal space left

to the sternum.

Ans : D

41- Regarding bipolar limb leads, which of the following is NOT correct :

a) Normally , the minimal voltage is recorded in lead I.b) Normally, The minimal voltage is recorded in lead III .c) Normally, The maximal voltage is recorded in lead II.d) Lead I records an ECG based on the electrical activity measured

between the red & yellow electrodes.e) To record limb lead II, the positive terminal is connected to the left leg.

Ans : A

42- Which of the following is not correct:

a) Prolonged increase in the temperature increases the heart rate.b) All waves are seen negative in unipolar lead aVR.


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c) A high concentration of Ca +2 in the extracellular fluid prolongs theplateau.

d) A high concentration of K + ions in the extracellular fluid causesBradycardia.

e) A high concentration of K + ions in the extracellular fluid causes themembrane to remain partially depolarized.

Ans : A

Biochemistry

1- Glycogenolysis :A- Conversion of glycogen to glucose.B- Conversion of pyruvate to glucose.C- Breakdown of glycogen to glucose.D- Breakdown of glycogen to pyruvate.

ans: C

2- Gluconeogenesis:A- Conversion of pyruvate to glucose.B- Conversion of glucose to glycogen.C- Is an exact reverse to glycogenolysis.D- Mainly occurs in muscles.

ans: A

3- Which of the following is TRUE about cardiac muscles:A- They perform both aerobic and anaerobic metabolism.B- They store large amounts of glycogen and lipids.C- Lipoprotein lipase is one of their enzymes.D- Glycolysis is the major pathway that provides them with energy.


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ans: C

4- All of the following are true regarding ketone bodies and their synthesis.EXCEPT:

A- They are the major fuel during starvation state.B- Synthesis increases when B-oxydation decreases.

C- Synthesized in hepatic mitochondria.D- Synthesis increases when insulin release decreases.

ans: B

5- All of the following are Ketone bodies. EXCEPT :A- Acetone.

B-

Acetate.C- Acetoacetic acid.D- B-hydroxybutyric acid.

ans: B

6- Which of the following statements regarding ketone bodies is CORRECT :1- In extrahepatic tissue, to be utilized B-hydroxbutyrate reoxidized to

acetate.

2-

Thiolase cleaves acetoacetyl-COA to form 2 molecules of acetone.3- Succinyl-COA donates COA for acetoacetate.4- Succinyl-COA:3-Ketoacid-COA transferase is highly available in the

liver.

A- All are correct.B- 1and 3.C- 1, 2 and 3.D- 2 and 3.

ans: B

7- The major source of cholesterol is :A- Diet.B- De novo synthesis in the intestine.C- De novo synthesis in the skin.


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D- LDH

ans: C

Pathology

1. Any two of the following findings can be used to diagnose infectedendocarditis except :

A. valver reguregationB. ECHO findingsC. splinter hemorrhagesD. positive blood culture for staph aureus

answ : C , all of them are major criteria except C

2. Which of the following valvular diseases is least likely to show high titersof acute phase reactents ( inflammatory markers )

A. infected endocarditisB. non bacterial thrombotic endocarditisC. libman sacks diseasesD. rheumatic heart disease

answ : B

3. A 10 years old boy presented with fever and joint pains , physicalexamination showed nodules on the extensor surface of his forearms

and uncontrollable limb movements . the history of the patient willprobably reveal : A. IV drug abuseB. previous upper respiratory tract infectionC. recurrent UTID. recent dental procedure


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ans : B, this presentation fits rheumatic fever

4. The above patient was admitted to the hospital , after one day hedeveloped symptoms of LHF , the most likely cause of these symptoms

is : A.amyloidosisB. perecarditisC. cardiac tamponadeD. mitral valve insufficiency

ans :D , rheumatic fever usually leads to mitral regurgitation

5. Which of the following is the least likely complication of Takayasu

disease : A. systemic hypertensionB. myocardial infarctionC. lower limbs ischemiaD. pulmonary hypertension

ans : C

6. A 30 years old male presented with abdominal pain , BP was 160/100and history revealed dark black stool , recent hepatitis infection andsome sort of mild itches . further analysis is most likely to show :

A. high C-ANCA titersB. high P-ANCA titersC. eosenophilic infiltrate on histological examination of his renal arteriesD. fibrnoid necrosis on histological examination of his renal arteries

ans : D, all clues point to PAN .

7. The most common cause of acquired heart diseases in newborns is : A. rheumatic feverB. atherosclerosisC. Kawasaki disease


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D. pain

ans : A.

16. This 30 years old male presented with complains of recurrent chest pain, cardiac enzymes where normal and further investigations revealed40% narrowing of his LAD , his physician suspects some sort of angina ,if it was so , the best thing to do is :

A. put the patient on Ca channels blockersB. do catheterizationC. do a bypass surgeryD. put the patient on statins

ans: A, this is mostly vasospastic angina which should be treated withCa blockers

17. The most common cause of acute MI is : A. embolismB. thrombosisC. vasospasmD. amyloidosis

ans : B

18. A Jewish patient was admitted to KAUH in Jordan , he was diagnosedwith Kaposi sarcoma , this patients history doesnt show any previoussurgery of any trip of of Jordan , the type of the Kaposi sarcoma ismostly : A. classic KaposiB. endemic Kaposi

C. epidemic KaposiD. post transplant Kaposi

ans : A

19. a person died suddenly of acute thrombosis in his coronary arterieswithout any previous chest pain , he was placed in a refrigerator and


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the next day autopsy was done on him , a histological section of hiscardiac tissue will show :

A. loss of nuclei

B. contraction bandsC. macrophages infiltrateD. non of the above

ans: D, he died suddenly , which means it is an acute cardiac deathcaused by arrhythmia , these changes happens in MI and needs timeto develop .

anatomy

1- Tranverse pericardial sinus is formed by_________, and oblique pericardialsinus is formed by ____________

a-development of arteries...development of veins

b-development of veins...development of arteries

c-development of endocardium...development of hunter's canal

d-development\folding of heart tube...development of veins

2- Azygos vein empties into:

a-inferior vena cava

b-hemiazygos vein

c-superior venous duct of Connor

d-superior vena cava


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3- Musculi pectini can be found in ___________, Trabeculae carneae can befound in ___________

a-R. renal artery... L. anastomsis of femoral sheath

b-R. atrium... R. ventricle

c-interventricular septum... L. ventricle

d-Howel's muscular trabecules...posterior atrioventricular groove

4- Where do I put my stethoscope to hear the mitral valve

a-apex of heart, 9 cm to left of midline

b-apex of heart, 8 cm to right of midline

c-anterior to root of lung, 9 cm left of midline

d-base of heart, 9 cm left of midline

5-What do vitelline veins drain?

a-body of embryo

b-head of embryo

c-both of the above

d-umbilical vesicle (yolk sac)

6-What stops the ventricles from continued dilation downward in thedeveloping embryo?

a-diaphragm

b-septum transversarum

c-bulbis cordis

d-truncus arteriosis


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11-In which paired vein and artery does blood flow in the same direction?

a-part of the great cardiac vein and circumflex artery

b-radial vein, radial artery

c-truncated vein of the Adromeda and aorta

d-none of the above

12-Vertebral artery arises from:

a-aorta

b-thoracic artery

c-subclavian artery

d-vertebrae

13-Which of these pass in Hunter's canal (adductor canal):

a-femoral artery

b-artery of Lewis

c-subclavian artery

d-radial artery

14-From what pharyngeal arches do the pulmonary trunk and arch of aorta

(and their subdivisions) arise?

a-1,2,5

b-3,4,6

c-2,6,4


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d-3,2,6

15-Endocardial space contains:

a-purkinje cells (fibers?)

b-WBCs

c-tunica media

d-ulnanis conjunctiva

16-Purkinje fibers are pale staining because they don't contain a lot of:

a-mitochondria

b-cytoplasm

c-contractile myofilaments

d-elastic lamina

17-Arterioles contain _________ layer(s) of smooth muscles

a- 2-3

b- more than 10

c- 2-10

d- 1

18-The vagus nerve is __________, while the phrenic nerve is ___________

a-posterior to root of lung...posterior to root of lung

b-posterior to vertebrae...anterior to root of lung

c-posterior to root of lung...anterior to root of lung


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d-cranial nerve X (10), cranial nerve XII (12)

1-d 2-d 3-b 4-a 5-d 6-b 7-a 8-.... 9-d 10-c 11-a 12-c

13-a 14-b 15-a 16-c 17-d 18-c

Community

1. the Framingham experiment was started:

A. 20 years ago.

B. 50 years ago.

C. 10 years ago.

D. 5 years ago.

2: the method of study in the Framingham heart study is:

A. Case control.

B. Cohort.

C. Random control.

D. Survey.

3: All of the following are risk factors for CVD except:

A. Smoking.


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B. quite personality.

C. Alchoholism.

D. hyperlipidemia.

E. DM.

4: The major cause of death in females between 25-64 years is:

A. Cancer.

B. Cardiovascular diseases.C. Congenital anomalies.

D. external incident.

ANSWERS:

BBBB

Pharma

1.Which of the following should be administered to a patient with very hightriglyceride?

A. NiacinB. Atorvastatin

C. Cholestaramine

D. Gimfibrozil

ans: D

2.Which of the following is the most important effect by which nitrates relieveangina pain?


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A.Decreased preloadB.Decreased afterloadC.Dilation of coronary arteriesD. decrease in sympathetic tone

Answer: C

3.Which of the following drugs is an alpha and beta receptor blocker that canbe used in pregnancy :A. LabetalolB. propranololC. metaprololD. atenolol

ans : A

4-Which is the LEAST likely adverse effect of nitrates when the drug is used in

angina treatment?

A. Burning under the tongue during sublingual administration

B.HypotensionC.Bronchial constriction

D. Headache

E. Palpitation

ans: C

5-Which of the drugs can be given to a patient with Congestive HF?

A.Digoxin

B.Thiazides

C.Captopril


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D.Hydralazine

E. All of the listed drug

ans : E

6-Beta-adrenoreceptor blocker:

A.Reduces the automaticity in the heart

B.Reduces myocardial contractility

C.Reduces the hepatic blood flow

D.Reduce rennin release from the kidney

E.Are characterized by all the listed action

Ans: E

7- Whats wrong about digoxin

A.long half life

B.cause cardiac arrythmiaC.must not be given with diuretics

D. works on Na-K pump

ans : C

Good luck

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CVS Trial Exam

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