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49 Cards in this Set
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The precordial thump is indicated at the time of cardiac arrest...
A. in all patients with arrest B. only in pediatric patients C. since it can do nothing but good D. only in those with unmonitored arrhythmias E. and should be delivered to the midpart of the sternum |
The correct answer is E
The precordial thump is administered to the midpart of the sternum with the fleshy part of the fist from a distance of about 8 to 12 in. It is recommended in monitored situations. It is not recommended in children. Indiscriminate use may lead to worse arrhythmias. (1:1485; 2:265; 4:657; 5:2929–35) |
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All of the following may be seen in the patient with hypovolemia EXCEPT
A. increased heart rate B. wide pulse pressure C. decreased urine volume D. flat neck veins E. pale mucous membranes |
The correct answer is B
In hypovolemic states, the pulse pressure is narrowed. Heart rate is increased to maintain cardiac output, and the neck veins are flat. Urine volume is decreased to preserve volume. The mucous membranes are pale, reflecting lower blood flow to peripheral areas. (1:116; 2:706; 5:1326) |
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The tetralogy of Fallot includes: (1) atrial septal defect (ASD) (2) VSD (3) PDA (4) pulmonary outflow obstruction
A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is C
The tetralogy of Fallot includes a VSD, pulmonary outflow obstruction, overriding of the aorta, and right ventricular hypertrophy. An ASD or PDA is not part of the complex. (1:919; 2:433; 4:1712; 5:2009; 6:53) |
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A pacemaker with the letter code AVTPN (1) paces the atrium (2) senses the ventricle (3) triggers a pacemaker spike on sensing an impulse (4) is not programmable
A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is A
There is a standard code for pacemakers—first letter: the chamber paced; second letter: the chamber sensed; third letter: mode of response; fourth letter: programmable features; and fifth letter: dysrhythmia treatment. When treating a patient who has a pacemaker, it is important to know what kind of pacer is involved. (1:1514; 5:1431; 6:72) |
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Pacemaker threshold changes that can occur by various agents and chemical changes include (1) an increase with stress (2) a decrease with decrease in carbon dioxide (3) an increase with increase in potassium (4) an increase with hypoxia,,,
A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is C
The pacemaker threshold can respond to many bodily changes, including decreased threshold with stress. This may be related to hyperventilation and decrease in carbon dioxide, which also decreases the threshold. Increased potassium values cause a lowered threshold. Hypoxia increases the threshold. |
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Coronary artery circulation is influenced by: (1) oxygen saturation of the blood (2) cardiac output (3) autoregulation (4) adenosine,,,
A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is E
Coronary circulation is influenced by oxygen saturation and cardiac output. The coronary flow is autoregulated to maintain flow in the pressure range of 50 to 120 mmHg. Autoregulation is through oxygen levels, but functions through the action of adenosine as an intermediary. |
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Goals for the anesthetic management of a patient with coronary artery disease are to: (1) maintain high afterload (2) maintain contractility (3) maintain high heart rate (4) maintain sinus rhythm...
A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 an d 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is C
Goals for anesthetic management of the patient with coronary artery disease include maintaining contractility and maintaining sinus rhythm. One wants to avoid a high afterload and a high heart rate. These factors apply to the patient for cardiac or noncardiac surgery. |
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The coronary sinus (1) represents a minor drainage system of the heart (2) receives the entire coronary venous blood flow (3) drains into the pulmonary artery (4) contains blood with an oxygen saturation of less than 30%
A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is D
The coronary sinus receives blood that is very desaturated, having passed through the myocardial tissues that extract most of the oxygen. The sinus is the major venous drainage system of the heart. It receives about 75% of the coronary blood flow. The blood from the coronary sinus drains into the right atrium. |
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During the Valsalva's maneuver, there is (1) decreased blood return to the right ventricle (2) increased venous pressure in the head (3) decreased cardiac output (4) a reflex increase in heart rate when the aortic pressure falls...
A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is E
The maneuver was described by Valsalva as a means to force air into the middle ear via the Eustachian tubes. The maneuver causes a decrease of blood return to the right ventricle due to increased intrathoracic pressure. This also leads to an increased venous pressure in the head. Cardiac output falls during the intrathoracic pressure increase. There is a reflex increase in heart rate when the blood pressure falls. |
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Hypoxic vasoconstriction is prominent in the:
A. lungs B. brain C. heart D. liver E. skin |
The correct answer is A
The vasoconstrictor response of the pulmonary circulation differs from that of other tissues in order to match lung perfusion to ventilation. |
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Nitroglycerin causes vasodilation that is markedly potentiated by:
A. metoprolol B. remifentanil C. labetalol D. magnesium sulfate E. sildenafil |
The correct answer is E
Nitroglycerin is metabolized to nitric oxide, an activator of guanylate cyclase in vascular smooth muscle. The enzyme produces intracellular cyclic-GMP. The cyclic-GMP is degraded by a specific phosphodiesterase that is inhibited by sildenafil. Profound hypotension can occur when a sublingual dose of nitroglycerin is given within several hours of an oral dose of sildenafil. Intravenous nitroglycerin must be slowly titrated in that setting. |
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Coronary perfusion pressure (CPP) is increased as a result of:
A. increased diastolic blood pressure (DBP) B. increased left ventricular end-diastolic pressure (LVEDP) C. systolic hypertension D. tachycardia E. hypocapnia |
The correct answer is A;
Coronary perfusion occurs for the most part during diastole. CPP = DBP – LVEDP. As DBP rises or LVEDP falls, the flow will increase. Tachycardia decreases time of perfusion, since diastole is shortened. Systolic hypertension decreases perfusion, since the ventricle contracts harder, allowing less perfusion during systole. |
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The intrinsic rhythmicity of the sinoatrial node is affected by the metabolism of the pacemaker cells themselves and may be increased by:
A. digoxin B. hypothyroidism C. increased body temperature D. hyperkalemia E. calcium |
The correct answer is C
Intrinsic rhythmicity may be altered by anything that affects diastolic depolarization. Increased temperature increases heart rate. Digoxin decreases rhythmicity. Hypothyroidism does not increase rhythmicity. Calcium does not alter the resting membrane potential but does alter the threshold potential. Hyperkalemia decreases rhythmicity. |
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The intrinsic rate of the sinoatrial node is generally:
A. 20 to 40 beats per minute B. 40 to 60 beats per minute C. 70 to 80 beats per minute D. 80 to 100 beats per minute E. 100 to 120 beats per minute |
The correct answer is C
The intrinsic rate of the sinoatrial node is generally 70 to 80 beats per minute. Since it has a faster rate, it is the dominant pacemaker. The more caudal a pacemaker cell is located in the conduction system, the slower its intrinsic rate. The atrioventricular node has an intrinsic rate of 40 to 60 beats per minute. |
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The standard ECG records the correct electrical potentials when leads are placed such that:
A. lead I reads left arm-left leg B. lead I reads right arm-right leg C. lead II reads right arm-left leg D. lead III reads right arm-left leg E. lead II reads right arm-left arm |
The correct answer is C
The correct lead placement is right arm-left leg in lead II. The other leads are right arm-left arm in lead I and left arm-left leg in lead III. |
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The cardiac conduction system includes all of the following EXCEPT:
A. the sinoatrial node B. atrial conduction pathways C. right bundle branch D. left bundle branch E. coronary sinus |
The correct answer is E
The conduction system includes the sinoatrial node, the principal pacemaker. The impulse is transmitted through the atrial conduction pathways to the atrioventricular node and then to the bundle of His before dividing into the right and left branch bundles. The coronary sinus is not involved in impulse conduction but receives the venous drainage of the heart |
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Hypovolemia may occur during abdominal aneurysm procedures as a result of all of the following EXCEPT:
A. blood loss B. inadequate fluid replacement C. use of vasodilators D. loss of fluid into the bowel E. expansion of the vascular bed during aortic cross-clamping |
The correct answer is E
The expansion of the vascular bed that occurs follows the release of the clamps. It is due to a reactive vasodilatation. Other factors, such as blood loss, inadequate fluid replacement, vasoactive drugs, and extravasation of fluid, are all important. |
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LVEDP is most closely approximated by:
A. arterial blood pressure B. central venous pressure (CVP) C. pulmonary artery systolic pressure D. pulmonary capillary wedge pressure E. right atrial pressure |
The correct answer is D
Pulmonary capillary wedge pressure is the best estimate of LVEDP. By measuring changes in cardiac output and pressures, a ventricular function curve can be drawn and therapeutic interventions evaluated. Right heart pressures do not necessarily provide accurate estimates of left heart pressures and function. Therefore, CVP gives the worst approximation of left side function. |
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The average unit of packed red cells, processed by centrifugation, has a hematocrit of:
A. 40% B. 50% C. 60% D. 70% E. 90% |
The correct answer is D
Most units of red cells have a hematocrit of 70%. |
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When an adult patient is on total cardiopulmonary bypass:
A. arterial pressure is usually maintained between 40 and 60 mmHg B. blood is pumped from the venae cavae and drains by gravity into the aorta for circulation C. the level of blood in the venous reservoir of the pump reflects the central venous pressure of the patient D. venous pressure elevation is of no consequence E. viscosity of blood decreases with progressive hypothermia |
The correct answer is A
When the patient is on bypass, the pressure is usually kept between 40 and 60 mmHg. Lower pressures can be tolerated, but there is no agreement on any specific perfusion pressure. As the patient gets more hypothermic, viscosity of blood increases, which makes hemodilution an important part of cardiopulmonary bypass with hypothermia |
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During transesophageal echocardiography, the velocities of blood flow are measured by means of the:
A. Bernoulli equation B. Venturi effect C. Stewart-Hamilton equation D. Doppler effect E. continuity equation |
The correct answer is D
The Doppler effect is the change in frequency that occurs when an echo is coming from a reflector that is moving toward or away from the probe. The frequency shift is directly proportional to the velocity of the reflector in the radial direction. The Doppler-measured velocity of a jet of blood can be converted to an estimate of pressure gradient by means of the Bernoulli equation. The Stewart-Hamilton equation pertains to thermodilution cardiac output measurement. |
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The transplanted heart:
A. has an abnormal Frank-Starling mechanism B. responds as does an innervated heart to atropine C. bears functional alpha and beta adrenoceptors D. does not respond to isoproterenol E. does not increase cardiac output with increased preload |
The correct answer is C
The transplanted heart has intact - and -adrenoceptors. The Frank-Starling effect is intact. Atropine will not have any effect since there is no autonomic innervation nor circulating cholinergic agonist. |
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Increased sympathetic tone in congestive heart failure may be indicated by:
A. memory loss B. weakness C. fatigue D. confusion E. anxiety |
The correct answer is E
The anxiety seen in patients with congestive heart failure is due to increased sympathetic activity. The increased sympathetic activity is a compensatory mechanism, and it is not directly related to the low flow state, as are the other options. Memory loss, weakness, fatigue, and confusion are directly caused by low output. |
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After the tube has been correctly positioned, a bronchoscope is used. By opening at 4 and looking down the lumen of 2 one should see:
A. the left upper lobe with a right-sided tube B. the carina with a right-sided tube C. the trachea with a right-sided tube D. the carina with a left-sided tube E. the left upper lobe with a left-sided tube |
The correct answer is D
Through position 4, one is looking down the right lumen. From the right lumen, no left lung segmental bronchi can be seen with any type of properly positioned double-lumen tube. The right lumen will be the tracheal lumen on a left-sided tube, in which case the carina can be seen. |
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Defibrillation is:
A. indicated in all instances of cardiac arrest B. delivered at an energy level of 400 J in all patients C. always successful if used early D. the initial step in resuscitation of the unwitnessed arrest E. initially attempted with an energy level of 200 J for ventricular fibrillation in an adult |
The correct answer is E;
The current recommendation is to attempt defibrillation with an energy level of 200 J in an adult. If that is unsuccessful, a second attempt is made with 200 to 300 J; if that is unsuccessful, a third attempt with 360 J is made. It is not always indicated and it is not always successful. |
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In advanced life support:
A. epinephrine is used primarily for its beta adrenergic effect B. bretylium is preferable to lidocaine because of its less severe side effects C. atropine is a first-line drug used to reduce vagal tone D. isoproterenol is used first for the treatment of bradycardia E. sodium bicarbonate should be started immediately |
The correct answer is C
Atropine is the first-line drug for reducing vagal tone. Epinephrine is used for its alpha -adrenergic effect. Lidocaine is preferred over bretylium because of lidocaine's fewer side effects. Isoproterenol is not used first in cases of bradycardia |
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When monitoring the CVP:
A. a waveform should be evaluated for the most accurate reading B. the catheter should be placed in the right atrium C. an accurate reflection of fluid status is obtained in all patients D. analysis of waveforms is no better than a digital readout E. a flow-directed pulmonary artery catheter should always be used, since it will give the CVP and other information |
The correct answer is A
The most accurate interpretation of CVP is by analysis of waveform. The catheter should not be placed in the right atrium, since perforation may occur. CVP gives an indication of fluid status but is not accurate in all patients, especially in those with disparate right and left ventricular function. It is not necessary to use a flow-directed catheter in every patient. Some can be monitored by CVP alone, and the extra risk is not warranted. |
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A heart lesion associated with high pulmonary flow is:
A. pulmonic stenosis B. tetralogy of Fallot C. coarctation of the aorta D. ventricular septal defect (VSD) E. tricuspid atresia |
The correct answer is D
VSD is associated with high pulmonary flow. The options of pulmonic stenosis, tetralogy of Fallot, and tricuspid atresia are associated with decreased blood flow to the pulmonary circuit. Coarctation of the aorta is not associated with a change in pulmonary flow. |
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The patient with aortic stenosis has:
A. a rapid downhill course once symptoms are present B. a large left ventricular cavity C. low electrocardiographic voltages D. protection against ischemia due to the large ventricle E. a very compliant ventricle |
The correct answer is A
The patient with aortic stenosis has a rapid course once angina, syncope, and congestive heart failure occur. The size of the ventricular muscle mass increases, but the cavity size does not change. The increased size also renders the muscle more prone to ischemia. Fast heart rates will cause a low cardiac output, since ventricular filling will be compromised. In addition, coronary perfusion will suffer. Low heart rates can also be devastating, since the stroke volume is fixed. The most common problem is that of tachycardia. |
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Agents which may reduce right-to-left shunt in tetralogy of Fallot include...
(1) sodium nitroprusside (2) labetalol (3) propranolol (4) phenylephrine A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is D
Increased peripheral resistance may reduce cyanosis in tetralogy of Fallot. |
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The transplanted, denervated heart responds to:
(1) circulating catecholamines (2) circulating acetylcholine (3) adrenergic blocking agents (4) muscarinic blocking agents A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is B
Because of esterase activities of the blood, there is no circulating acetylcholine. betaAdrenergic receptor antagonists slow the transplanted heart, but antimuscarinic agents do not speed the transplanted heart. |
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Pulmonary capillary wedge pressure will be decreased by:
(1) right ventricular failure (2) left ventricular failure (3) severe pulmonary vasoconstriction (4) severe mitral stenosis A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is B
Left ventricular failure and mitral stenosis tend to increase the wedge pressure. |
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The coronary circulation is composed of the right and left coronary arteries:
(1) the right supplying the right ventricle (2) which are remarkably constant in their configuration and areas they supply (3) the left dividing into the left anterior descending and the circumflex (4) both of which empty into the right ventricle A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is B
There are many variations of the blood supply to the heart, but the usual configuration is for a right coronary artery supplying the right side, and a left coronary that divides into the left anterior descending and the circumflex. Most of the venous drainage empties into the coronary sinus, but there are also direct connections of the thebesian veins into all chambers. |
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Determination of cardiac output with the thermodilution technique:
(1) requires a pulmonary artery catheter with a thermistor (2) uses the same principle as the dye-dilution technique (3) requires the use of an exact amount of fluid with a known temperature (4) requires the measurement of the temperature in the pulmonary artery A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is E
Cardiac output determination with the thermodilution technique uses a dilution calculation just as does the dye-dilution technique. A thermistor measures the change in temperature in the pulmonary artery. In the dye-dilution technique, changes in dye concentration are determined. Attention to detail is important, including the injection of an exact amount with a known temperature |
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Cardioplegia solution is an important adjunct in heart surgery since:
(1) oxygen consumption increases with ventricular fibrillation (2) oxygen consumption is reduced to one-fourth with arrest (3) a quiet field is provided (4) myocardial oxygen consumption varies with rhythm A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is E;
Cardioplegia has improved the success rate of cardiac procedures, since it provides a relaxed heart. This factor leads to a decrease in oxygen consumption. Oxygen consumption approximately doubles in the presence of ventricular fibrillation. |
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Air embolism seen with cardiopulmonary bypass:
(1) is common after aortic valve procedures (2) is alleviated with the use of ventricular venting (3) is alleviated by the use of an aortic vent (4) comes in part from air that accumulates in the pulmonary veins during bypass A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is E;
Air embolism is a factor in many procedures but is most problematic in procedures on the aortic valve. Vents that are placed in the ventricle and aorta allow the air to escape. Some air accumulates in the pulmonary veins. This air can be evacuated by expansion of the lungs while the vents are still in place. |
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Hemodilution performed before bypass may cause:
(1) bradycardia (2) decreased cardiac output (3) decreased myocardial oxygen consumption (4) improved blood flow to tissues A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is D
Hemodilution may lead to improved tissue flow. It does not lead to bradycardia or to decreased cardiac output or decreased myocardial oxygen consumption. |
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Anesthetic considerations for Marfan's syndrome (arachnodactyly) include
(1) increased risk of aortic dissection (2) aortic stenosis (3) frequently difficult intubation (4) mitral regurgitation A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is B
Marfan's syndrome is associated with aortic changes, making dissection more common. Hypertension should be avoided. The high-arched palate may make intubation more difficult. Aortic stenosis is not seen, but aortic insufficiency is common. |
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During cardiopulmonary resuscitation (CPR):
(1) a central line is preferable for drug administration (2) peripheral intravenous lines are not suitable for administration of epinephrine (3) lidocaine, atropine, and epinephrine may be administered via the endotracheal tube (4) intracardiac injections should be attempted before an attempt is made to secure a central line A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is B
Injection of medications at the time of cardiac arrest usually is problematic. If a deep line is in place, it should be used. If no line is in place, an antecubital line should be attempted first. This will allow drug administration and not interrupt resuscitation procedures. If no line is available, lidocaine, atropine, and epinephrine can be administered through the endotracheal tube. |
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The pericardium:
(1) serves as a buffer to the heart at times of acceleration (2) contains nerve fibers that, when stimulated, will slow the heart rate (3) minimizes cardiac dilatation (4) is not essential to cardiac function A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is E
The pericardium is not necessary for life, as is evidenced in the many patients who function after open heart surgery without one. The function of the pericardium is to buffer the heart from sudden movement, provide lubrication between the myocardium and adjacent structures, and minimize cardiac dilatation. |
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The right lung:
(1) is the smaller of the two (2) has three lobes (3) has a single fissure (4) contains a middle lobe A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is C
The right lung is the larger of the two. It has three lobes (upper, middle, and lower) and two fissures (horizontal and oblique). |
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An increase in mean diastolic ventricular pressure will:
(1) not be reflected in the pulmonary circulation (2) necessarily increase cardiac output (3) follow the use of diuretics (4) be transmitted to the atrium and proximal vascular structure A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is D
An increase in mean diastolic ventricular pressure is usually reflected in the pulmonary circulation, assuming the mitral valve is competent. The increases may not have an effect on cardiac output depending on where the patient is on the Starling's curve; an increase may lead to decompensation. Treatment with a diuretic leads to a decrease in volume. The increase usually is transmitted to the atrium and proximal vascular structures. |
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Ventricular hypertrophy:
(1) helps by decreasing oxygen demand (2) improves perfusion (3) allows a decrease in left ventricular filling pressure (4) makes the ventricle more susceptible to ischemia A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is D
Ventricular hypertrophy presents additional problems to an already injured heart. Hypertrophy increases oxygen demand. Perfusion is decreased since diastolic pressure is decreased. The enlargement of the chamber requires an increased filling pressure. The ventricle becomes more susceptible to ischemia even in the absence of coronary artery disease. |
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A 24-year-old female was admitted for evaluation of chest pain. The pain was sharp and aggravated by breathing. A chest x-ray showed an enlarged heart, ECG showed decreased voltage, and there was a pericardial friction rub. Pericardiocentesis demonstrated purulent fluid. Serial x-rays showed widening of the cardiac shadow, and the patient was scheduled for pericardial drainage.
In monitoring this patient, the (1) arterial blood pressure is of no help (2) Swan-Ganz catheter is mandatory (3) x-ray evaluation is of utmost importance (4) CVP will provide useful information A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is D
Monitoring this patient does not require a pulmonary artery catheter. The right side of the heart should be monitored, and this can be done with a central venous catheter. An arterial line would be helpful. X-ray, once the diagnosis is established, is of little value. |
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A 24-year-old female was admitted for evaluation of chest pain. The pain was sharp and aggravated by breathing. A chest x-ray showed an enlarged heart, ECG showed decreased voltage, and there was a pericardial friction rub. Pericardiocentesis demonstrated purulent fluid. Serial x-rays showed widening of the cardiac shadow, and the patient was scheduled for pericardial drainage.
A pulsus paradoxus is a pulse that (1) reduces in amplitude on inspiration (2) shows alternate strong and weak beats (3) is merely an exaggeration of the normal respiratory effect on the arterial pulse (4) is stronger on inspiration A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is A
Pulsus paradoxus is an exaggeration of the normal variation in the pulse with inspiration. The pulse reduces in amplitude on inspiration. In the exaggerated state of pericardial effusion, the pulse may show alternate strong and weak beats. |
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Myocardial oxygen consumption is
(1) increased by propranolol (2) decreased by digoxin (3) increased by nitroglycerin (4) increased by isoproterenol A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is D
Myocardial oxygen consumption is increased by isoproterenol, due in part to increased rate and in part to increased inotropy. Consumption is increased by digoxin and decreased by nitroglycerin. |
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Coronary artery circulation is influenced by
(1) oxygen saturation of the blood (2) cardiac output (3) autoregulation (4) adenosine A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is E
Coronary circulation is influenced by oxygen saturation and cardiac output. The coronary flow is autoregulated to maintain flow in the pressure range of 50 to 120 mmHg. Autoregulation is through oxygen levels, but functions through the action of adenosine as an intermediary. |
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Calculation of SVR requires determination of:
(1) mean arterial pressure (2) mean CVP (3) cardiac output (4) pulmonary artery pressure A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are correct D. if only 4 is correct E. if all are correct |
The correct answer is A
The calculation requires mean arterial pressure, mean CVP, and cardiac output. Pulmonary pressure is not needed. Q=Stroke Volume x Heart rate |
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Stimulation of the vagus
(1) slows the heart (2) decreases contractile force (3) slows conduction (4) increases excitability A. if only 1, 2, and 3 are correct B. if only 1 and 3 are correct C. if only 2 and 4 are co rrect D. if only 4 is correct E. if all are correct |
The correct answer is B
Stimulation of the vagus slows the heart but does not affect contractility, since the vagus does not affect the ventricle directly. Vagal stimulation slows conduction and decreases excitability. |
