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15 Cards in this Set
- Front
- Back
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1. The normal resting potential of the ventricular cell is largely the result of the:
a. extracellular movement of sodium b. extracellular movement of potassium c. intracellular movement of negatively charged proteins d. intracellular movement of calcium |
The normal resting potential of the ventricular cell is largely the result of the:extracellular movement of potassium
The movement of K+ out of the cell and down its concentration gradient results in a net loss of positive charge from inside the cell. An electrical potential is established across the membrane with the inside of the cell being negative because anions do not accompany the K+. pg. 414 Morgan, GE, Mikhail, |
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3. After perfusing the myocardium, most of the blood returns to the right atrium via the:
a. cardiac veins b. bronchial veins c. azygous vein d. coronary sinus |
c.
After perfusing the myocardium, most of the blood returns to the right atrium via the: coronary sinus After perfusing the myocardium, most of the blood returns to the right atrium via the coronary sinus. Lesser amounts of blood also return via the anterior cardiac veins and the Thebesian veins. pg. 430 Morgan, GE, Mikhail, MS, and Murray, MJ |
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4. In the normal patient, the orifice of the mitral valve is approximately:
a. 1 - 1.5 cm2 b. 2 - 3.5 cm2 c. 4 - 6 cm2 d. 7 - 9 cm2 |
c.
In the normal patient, the orifice of the mitral valve is approximately: 4 - 6 cm2 pg. 467 Morgan, GE, |
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7. The area of the myocardium most vulnerable to ischemia is the:
a. right epicardium b. right subendocardium c. left epicardium d. left subendocardium |
c.
The area of the myocardium most vulnerable to ischemia is the: left subendocardium Because it is subjected to the greatest intramural pressures during systole, the endocardium tends to be most vulnerable to ischemia during decreases in coronary perfusion pressure. pg. 432 Morgan, GE, Mikhail, |
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8. A reduction in fibrinolysis through the inhibition of lysine binding sites on plasminogen and plasmin can be attained with the administration of:
a.aprotonin b. aminocaproic acid c. bivalirudin d. low molecular weight heparin |
c.
A reduction in fibrinolysis through the inhibition of lysine binding sites on plasminogen and plasmin can be attained with the administration of: aminocaproic acid Aminocaproic acid is a lysine analog that binds to lysine binding sites on plasminogen and plasmin thus blocking the binding of plasmin to target fibrin. Through this mechanism, aminocaproic acid is reduces fibrinolysis. pg. 1533 Hardman, JG, and Limbird, LE. Goodman & Gillman's Pharmacologic Basis of Therapeutics. New York: McGraw-Hill Medical Publishing Division, 2001. |
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An 84-year-old man with a history of severe aortic stenosis is scheduled for a cystoscopy to evaluate his hematuria. The most appropriate anesthetic technique in this patient would be:
a. a spinal anesthetic to the T10 level b. an epidural anesthetic to the L2 level c. an inhalational anesthetic with desflurane and oxygen d. a local anesthetic with narcotic/benzodiazepine sedation |
d.
a local anesthetic with narcotic/benzodiazepine sedation Spinal and epidural anesthesia are contraindicated in patients with severe aortic stenosis. If general anesthesia is necessary, an opioid-based anesthetic with a suitable nonopioid induction agent such as etomidate is required to maintain afterload. Local anesthesia with sedation is also a preferred technique. |
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During depolarization of the ventricular cell, activation of the slow calcium channels occurs during phase:
a. 0 b. 1 c. 2 d. 3 |
During depolarization of the ventricular cell, activation of the slow calcium channels occurs during phase: 2
a. During phase 2, the plateau phase, there is activation of the slow calcium channels. |
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10. During repair of a perforated colonic diverticula, the following hemodynamic parameters were obtained: mean arterial pressure = 92 mmHg, central venous pressure = 2 mmHg and cardiac output = 7.5 L/min. From this, the systemic vascular resistance can be calculated to be:
a. 550 dyn sec / cm5 b. 960 dyn sec / cm5 c. 1240 dyn sec / cm5 d. 1670 dyn sec / cm5 |
b. 960 dyn sec / cm5
Systemic vascular resistance is calculated with the following equation: SVR = 80 x (MAP - CVP) / CO The normal range of SVR is 900 - 1500 dyn . sec cm-5. |
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12. Cardiac conditions NOT associated with an increased risk endocarditis include:
a. previous bacterial endocarditis b. presence of a porcine mitral valve c. mitral valve prolapse d. hypertrophic cardiomyopathy |
mitral valve prolapse
Mitral valve prolapse has been shown to carry no greater risk for endocarditits than seen in the general population. Other cardiac conditions not associated with increased risk include: presence of a pacemaker, previous rheumatic fever without valve dysfunction, previous CABG surgery and physiologic heart murmurs. |
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13. During cardiopulmonary bypass, roller pumps:
a.-maintain output regardless of the systemic resistance encountered b. -require complete occlusion of the tubing in order to pump blood c. -are usually placed between the venous cannula and the reservoir d. -cause less trauma to the blood cells than centrifugal pumps |
maintain output regardless of the systemic resistance encountered
The constant speed of the rollers pumps blood regardless of the resistance encountered and produces a continuous nonpulsatile flow. |
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14. Electrophysiologic effects of verapamil are the result of:
a. binding to the slow L-type calcium channels b. binding to the slow T-type calcium channels c. binding to calcium channels in their resting active state d. inhibiting potassium efflux during myocardial repolarization |
binding to the slow L-type calcium channels
Calcium channel blockers are organic compounds that block calcium influx through the L-type, but not T-type channels. Verapamil preferentially binds the channel in its depolarized state and thus produces a use-dependent block. |
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16. The overall incidence of coronary artery disease in surgical patients is approximately:
2 - 4% 5 - 10% 15 - 20% 25 - 30% |
5 - 10%
Coronary artery disease is responsible for over one-third of all deaths in Western societies and is a major cause of perioperative morbidity and mortality. The overall incidence of CAD in surgical patients is estimated to be between 5 and 10%. |
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17. A potent endothelial-derived vasodilator that has also been shown to inhibit platelet aggregation is:
thromboxane A2 protein C nitric oxide thrombomodulin |
nitric oxide
Nitric oxide is synthesized from arginine by nitric oxide synthetase. Nitric oxide is a potent vasodilator and inhibits platelet aggregation. |
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19. Anatomically, the sinoatrial node is located:
a. in the right atrium at the junction of the superior vena cava b. in the left atrium at the insertion of the superior pulmonary vein c. in the septal wall of the right atrium anterior to the opening of the coronary sinus d. in the AV groove |
in the right atrium at the junction of the superior vena cava
The SA node is a group of specialized pacemaker cells in the sulcus teminalis, located posteriorly at the junction of the right atrium and the superior vena cava. |
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20. In the normal patient, the major determinant of left ventricular preload is:
a. LV contractility b. systemic vascular resistance c. heart rate d. pulmonary venous return |
pulmonary venous return
In the absence of significant valvular dysfunction, venous return is the major determinant of both right and left ventricular preload. |
