Pbd Exam 4

Front 1

Nitric oxide can stimulate a vasodilatory action at the vascular smooth muscle. What is the second messenger for this action? _______________

Back 1

cGMP

Front 2

In myocardial ischemia, changes occur in which portion of
the ECG? _______. This portion of the ECG corresponds to what phase of the ventricular action potential? ______

Back 2

T wave OR ST segment OR ST;
phase 3 OR K+ efflux

Front 3

Myocardial work will increase if left ventricular pressure _______ (increases, decreases, no change) such as with the valve defect ________.

Back 3

increases;
aortic stenosis

Front 4

In a patient with restrictive cardiomyopathy, filling of the heart would: _______ (increase/decrease), which would generally cause stroke volume to _______ (increase/decrease).

Back 4

decrease, decreased

Front 5

In a normal heart, coronary flow increases with increased work. This is because of increased _________ production in the exercising cardiac muscle.

Back 5

adenosine OR lactic acid

Front 6

Infusion of a nitroprusside would cause resistance to ______________ (increase/decrease) and heart rate to ______________(increase/decrease).

Back 6

decrease,
increase

Front 7

The final stage of atherosclerosis is called the _____________ and involves migration and involvement of ____________( CELL TYPE) at the site of the plaque.

Back 7

complicated lesion,
platelets

Front 8

In a newborn with a patent ductus, most commonly the flow in the ductus will be from __________ (aorta to pulmonary artery, pulmonary artery to aorta) because pressure is greatest in the __________ (aorta, pulmonary artery).

Back 8

aorta to pulmonary artery,
aorta

Front 9

In postductal coarctaction of the aorta, brachial pressure is ________________(higher than, less than, the same as) pressure in the femoral artery, and plasma angiotensin would be _____________(increased, decreased, no change).

Back 9

greater,
increased

Front 10

Pulse in the ankle would be faint in __________ (disease name).

Back 10

Buerger’s disease OR arteriosclerosis obliterans OR coarctation of the aorta

Front 11

The valve which closes at the beginning of ventricular contraction is the _________ valve; this produces the ______ heart sound.

Back 11

mitral;
first

Front 12

Volume in the heart at the end of systole is _______ (greater than/less than) the volume at the end of diasystole.

Back 12

less than

Front 13

In a patient with chronic aortic stenosis, the pressure in the left ventricle would be ________ (increased /decreased/not changed) as compared to a person with a normal aortic valve.

Back 13

increased

Front 14

In a patient with mitral regurgitation the murmur would occur during __________ (systole, diastole).

Back 14

systole

Front 15

The channel in the heart responsible for Phase 2 of the ventricular muscle action potential is the ________ channel (Be specific).

Back 15

L type Ca2+ channel

Front 16

Torsades de pointes occurs as a result of depolarization at the _________ phase of the cardiac action potential, and causes ventricular heart rate to __________ (increase/decrease/not change).

Back 16

end of phase 2 OR start of phase 3;
increase

Front 17

A beta1 agonist would cause the threshold for Ca++ channel opening in the SA node to _______ (increase /decrease/not change), and ventricular muscle SR Ca++ release to __________ (increase/decrease/not change).

Back 17

decrease;
increase

Front 18

In the first stage of atherosclerosis, (a)___________ cells invade through the endothelial layer and take up fat from oxidized LDLs. This uptake occurs because of the presence of (b)_____________ receptors on these cells.

Back 18

monocyte;
scavenger

Front 19

Which part of the ECG is most effected by myocardial ischemia? (a)_____________. This change is primarily due to changes in
permeability to which ion? (b)___________.

Back 19

ST segment OR T Wave;
K+

Front 20

During a hemorrhage, the cardiac output would __________ (increase / decrease) and heart rate would (reflexly) ________ (increase / decrease).

Back 20

decrease;
increase

Front 21

Injection of an alpha agonist would cause blood pressure to _________ (increase / decrease / not change), which would cause heart rate AND contractility (reflexly) to __________ (increase / decrease / not change).

Back 21

increase;
decrease

Front 22

When the ductus remains patent postnatally, the most common direction of flow is _________ (left to right / right to left) because pressure in the pulmonary artery is usually ______ (less than / greater than ) pressure in the aorta.

Back 22

left to right;
less than

Front 23

Aortic stenosis could result in __________ (dilated cardiomyopathy OR hypertropic cardiomyopathy OR concentric hypertrophy), because of __________ ( poor alignment of muscle fibers OR increased left ventricular pressure).

Back 23

concentric hypertrophy;
increased left ventricular pressure

Front 24

Dilated cardiomyopathy causes contractility to _______ (increase / decrease), which would generally cause cardiac output and blood pressure to _______ (increase / decrease).

Back 24

decrease;
decrease

Front 25

A decrease in firing in the parasympathetic nerve to the heart would cause heart rate to (a) _______ (increase/decrease). This effect would result from a/an (b) _______ (increase/decrease) in Na+ entry in
phase 4 of the action potential in the SA node.

Back 25

(a) increase;
(b) increase

Front 26

An increase in epinephrine would cause contractility to (a) _______(increase/decrease) because the SR release of (b) _______ (what ion) is increased.

Back 26

(a) increase;
(b) Ca2+

Front 27

Increases in skeletal muscle activity in your legs would cause EDV to (a) _______ (increase/decrease). This results in a/an (b) _______ (increase/decrease) in stroke volume. This effect is called the (c) ____________.

Back 27

(a) increase;
(b) increase;
(c) frank-starling mechanism OR heterotropic autoregulation OR intrinsic control

Front 28

Ventricular fibrillation would cause the blood pressure to _______(increase/decrease).

Back 28

decrease

Front 29

Vasodilation can be caused by (a) _______ (name one agent), which causes resting membrane potential to (b) _______ (increase= less negative / decrease= more negative).

Back 29

(a) any dilator: NE, PGE2, NO, adenosine, prostaclycine;
(b) decrease

Front 30

If the radius of an arteriole increases then the resistance in this vessel will (a)____________ (increase/decrease/not change) and the flow in the vessel will (b)_____________ (increase/decrease/not change).

Back 30

(a) decrease
(b) increase

Front 31

The vessel with the thinnest vessel wall would be the (a)____________ (aorta, renal artery, capillary in the liver, vena cava), whereas the vessel with the greatest compliance would be the (b)________ (renal artery, capillary in the liver, vena cava, carotid artery).

Back 31

(a) capillary in the liver
(b) vena cava

Front 32

In a patient with mitral stenosis the pressure in the left atrium would be _______________ (increased/decreased/no change) as compared to a person with a normal mitral valve.

Back 32

increased

Front 33

Volume in the heart at the end of diastole is _______________ (greater than, less than) the volume at the end of systole.

Back 33

greater than

Front 34

In a patient with mitral regurgitation the murmur would occur during __________ (systole, diastole).

Back 34

systole

Front 35

During isovolumetric contraction the pressure in the left ventricle (a)_______________ (increases/decreases/does not change), and at the peak of the contraction the pressure in the left ventricle is (b)_______________ (greater than, less than ) the pressure in the aorta.

Back 35

(a) increases
(b) greater than

Front 36

The fourth heart sound would occur:
a. during ventricular relaxation
b. during atrial contraction
c. during rapid filling
d. during ventricular contraction

Back 36

B

Front 37

Treatment with a drug which stimulates α1 receptors would cause blood pressure to ____________ (increase/ decrease). This effect occurs because there is a/an _________ (increase/decrease) in activity of the Ryr receptor/channel in vascular smooth muscle cells.

Back 37

increase;
increase

Front 38

Autoregulation would cause ____________ (vasodilation, vasocontriction) as a response to decreased pressure in the artery to that tissue. This effect may be mediated by ____________ (nitric oxide, angiotensin II, norepinephrine).

Back 38

vasodilation;
nitric oxide

Front 39

In myocardial ischemia, changes occur in which portion of the ECG?_______. This portion of the ECG corresponds to what phase of the ventricular action potential? ______

Back 39

T wave or ST segment;
Phase 3 OR K+ efflux OR repolarization

Front 40

In a newborn with a patent ductus, most commonly the flow in the ductus will be from (aorta to pulmonary artery, pulmonary artery to aorta).

Back 40

aorta to pulmonary artery

Front 41

Which of the following is most likely to increase myocardial work
a) anemia
b) hemorrhage
c) increased arterial blood pressure
d) atherosclerosis

Back 41

c) increased arterial blood pressure

Front 42

The first stage of atherosclerosis is called the ________________________ and involves migration of ____________( CELL TYPE) into the vascular wall.

Back 42

foam cell;
monocytes

Front 43

Regurgitation of the mitral valve causes a murmur during ______________(systole or diastole).

Back 43

systole

Front 44

A stenotic aortic valve will cause a murmur during ______________(systole or diastole).

Back 44

systole

Front 45

Heart rate is decreased when the activity of the ___________ (parasympathetic or sympathetic) nerves to the heart increases.

Back 45

parasympathetic

Front 46

The SERCA pumps is located where in the heart?_(Cell and location in cell) _________.
Increased activity of the SERCA causes ventricular muscle cells to ___________(contract/relax) more efficiently.

Back 46

ventricular muscle cell OR sarcoplasmic reticulum;
relax

Front 47

An increase in contractility of the ventricles is can be caused by _______
The concentration of which ion in the cardiomyocyte is involved in the mechanism of contractility_______.

Back 47

sympathetic OR epinephrine;
Ca2+

Front 48

Dilated cardiomyopathy causes contractility to _______ (increase/decrease), which would generally cause cardiac output and blood pressure to _______ (increase/decrease)

Back 48

decrease;
decrease

Front 49

Re-entry results in:
a. sinus bradycardia
b. sinus tachycardia
c. atrial or ventricular tachycardia
d. long QT

Back 49

C

Front 50

Pressure in arterioles is (more/less) _______________ than pressure in the veins.

Back 50

more

Front 51

During diastole, pressure in the ventricle is (more/less) _______________ than pressure in the aorta.

Back 51

less

Front 52

The absolute refractory period in ventricular muscle cells is:
a. shorter than that in nerves
b. determined by the permeability of the L type Calcium channels
c. determined by timing of inactivation gates on the sodium channels
d. determined by potassium channel opening

Back 52

c. determined by timing of inactivation gates on sodium channels

Front 53

The first heart sound is caused by
a. closure of the AV valves
b. opening of the AV valves
c. closure of the aortic and pulmonic valves
d. opening of the aortic and pulmonic valves

Back 53

a. closure of AV valves

Front 54

If the radius of a arteriole to the small intestine increases, then resistance will (increase, decrease, not change)_______________________, and flow to the small intestine will (increase, decrease, not change)_______________________.

Back 54

decrease;
increase

Front 55

A drug is given which DIRECTLY decreases blood pressure but doesn't directly change cardiac output. This drug is most likely to be:
a. a beta agonist
b. an alpha agonist
c. nitroprusside
d. vasopressin

Back 55

c. nitroprusside

Front 56

Within seconds after administering nitroprusside, heart rate increases and cardiac output increases. This reflex response occurs because:
a. baroreceptor firing increases and causes increased
sympathetic stimulation of the SA node
b. baroreceptor firing increases and causes increased
parasympathetic stimulation of the SA node
c. baroreceptor firing decreases and causes increased
sympathetic stimulation of the SA node
d. baroreceptor firing decreases and causes increased
parasympathetic stimulation of the SA node

Back 56

c. baroreceptor firing decreases and causes increased
sympathetic stimulation of the SA node

Front 57

If a vessel in the lower leg is occluded and the skin distal to the occlusion appears blue then the occlusion is in what type of vessel? _________________

Back 57

vein

Front 58

Baroreceptors are located in the wall of the __________ and the __________ arteries

Back 58

carotid;
aortic (aortic arch)

Front 59

If a patient is given a vasodilator, then you would expect systemic vascular resistance to _____________ (increase/decrease); the heart rate would ______________(increase/decrease) as a reflex response to the change in blood pressure.

Back 59

decrease;
increase

Front 60

An increase in parasympathetic nerve firing to the heart would cause cardiac output to:
________________

Back 60

decrease

Front 61

An increase in sympathetic nerve firing to arterioles in the kidney would cause flow to the kidney to: ____________

Back 61

decrease

Front 62

In a patient with restricted cardiomypathy End Diastolic Volume would: ___________

Back 62

decrease

Front 63

An infusion of saline intravenously would cause stroke volume to: ___________

Back 63

increase

Front 64

A drug which acts by increasing IP3 generation in vascular smooth muscle would cause TONE (degree of constriction) of the vascular smooth muscle cell to: _____________

Back 64

increase

Front 65

Atrial natriuretic peptide causes the TONE (degree of constriction) of the vascular smooth muscle cell to: ___________

Back 65

decrease

Front 66

Beta 2 receptors would cause contractility to ________

Back 66

not change

Front 67

In a patient with a patent ductus arteriosus, a murmur is heard (when):____________

Back 67

continuously (systole/diastole)

Front 68

Which type of cardiomyopathy can occur in alcoholics? ________

Back 68

dilated

Front 69

If resistance in an arteriole goes up, then the flow to the tissue supplied by this arteriole must (increase or decrease) __________________.

Back 69

decrease

Front 70

The type of blood vessel with high compliance is a _______________.

Back 70

vein

Front 71

Closure of the mitral valve causes the _______ heart sound. (S1, S2, S3 or S4?)

Back 71

S1

Front 72

A stenotic aortic valve will cause a murmur during __________________ (systole or diastole).

Back 72

systole

Front 73

Heart rate is decreased by increased _____________ activity (parasympathetic or sympathetic).

Back 73

parasympathetic

Front 74

In the ventricular muscle cell:
The Phase 0 of action potential is caused primarily by influx of ________________ (K+, Na+, or Ca++).
Phase 2 is caused by influx of ___________ (K+, Na+, or Ca++) channels through ______________ (type of channels).

Back 74

Na+;
Ca2+;
L-type calcium channels

Front 75

The SERCA pumps is located where? ________ (Cell and location in cell).
It pumps what ion ? ___________.

Back 75

ventricular muscle cell OR vascular smooth muscle;
Ca2+

Front 76

If a myocardial infarct occurs, a short term response to help maintain flow would be an (increase or decrease) _________
in sympathetic nerve activity, whereas a very long term response would be an increase in myocardial ____________.

Back 76

increase;
hypertrophy (size,mass)

Front 77

When a coronary artery is occluded, the normal response in the vessel distal to the occlusion would be _________ (dilation/constriction); a factor/chemical that would be likely to cause this response is_______________.

Back 77

dilation;
adenosine

Front 78

In atherosclerosis, in the fatty streak stage the lipid deposition occurs because of uptake of fat from (what type of carrier molecule) ___________ by (what type of cell- give name before uptake)________________

Back 78

Oxidized LDL;
monocyte

Front 79

During a hemorrhage, the cardiac output would (increase or decrease) _________ and heart rate would (reflexly) (increase or decrease) _________

Back 79

decrease;
increase

Front 80

In which vessel would longitudinal smooth muscle be most abundant?
a. renal arteriole
b. skin capillary
c. leg vein
d. aorta
e. cerebral artery

Back 80

c. leg vein

Front 81

in which vessel would elastic fibers be most abundant?
a. renal arteriole
b. skin capillary
c. leg vein
d. aorta
e. cerebral artery

Back 81

d. aorta

Front 82

which of the following would you expect if the diameter of an arterial in your big toe decreases by 10%
a. toe would turn green
b. heart rate would increase
c. toe would have increased perfusion
d. your skin would get red
e. none of the above

Back 82

e. none of the above

Front 83

which of the following would be most likely to result form aortic stenosis?
a. chronic hypertensions
b. sinus bradycardia
c. diastolic murmurs
d. S3

Back 83

d. S3

Front 84

Which of the following would NOT reduce ventricular filling?
a. restrictive cardiomyopathy
b. mitral stenosis
c. constriction of venous vascular smooth muscle
d. pericardial tamponade
e. a dramatic increase in heart rate to 180 beats per minute

Back 84

c. constriction of venous vascular smooth muscle

Front 85

A defect in conduction through the AV node producing a third degree AV block would be
would be expected to cause:
a. pulse rate of 100 bprn with SA node firing of 80 bprn
b. pulse rate and SA node firing rates of 100 bprn
c. pulse rate of 60 bprn with SA node firing rate of 100 bprn
d. pulse rate and SA node firing rate of 60 bprn

Back 85

c. pulse rate of 60 bprn with SA node firing rate of 100 bprn

Front 86

Re-entry in ventricular muscle would cause:
a. sinus tachycardia
b. sinus bradycardia
c. tachycardia with ectopic beats
d. no change in heart rate

Back 86

c. tachycardia with ectopic beats

Front 87

Opening of L type Calcium channels is directly caused by:
a. binding of specific ligands such as acetylcholine to the channel
b. an increase in voltage across the plasma membrane (depolarization)
c. activation by ryanodine
d. activation by cGMP
e. none of the above

Back 87

b. an increase in voltage across the plasma membrane (depolarization)

Front 88

An increase in cardiac contractility can occur as a result of:
a. dilated cardiomyopathy
b. an increase in blood volume
c. treatment with L-type calcium channel blockers
d. sympathetic stimulation
e. all of the above

Back 88

d. sympathetic stimulation

Front 89

Hypertension may contribute to the development of:
a. aortic valve insufficiency
b. atherosclerosis
c. cardiac hypertrophy
d. myocardial ischemia
e. all of the above

Back 89

e. all of the above

Front 90

Which of the following would be most consistent with poor wound healing, leg pain and leg
ulcers in a 50 year old male smoker?
a. Buerger's disease
b. Raynaud's syndrome
c. thrombophlebitis
d. coarctation of the aorta
e. patent ductus arteriosus

Back 90

a. Buerger's disease

Front 91

Which of the following is consistent with aortic murmur, high systolic pressure measured in
the brachial artery, and pain in the leg with exercise?
a. Buerger's disease
b. Raynaud's syndrome
c. thrombophlebitis
d. coarctation of the aorta
e. patent ductus arteriosus

Back 91

d. coarctation of the aorta

Front 92

Which of the following would be found in a fatty streak?
a. lipid deposits within the endothelial cells
b. lipid deposits in the smooth muscle cells in the muscular layer of the vessel wall
c. lipid deposits in the macrophages in the intimal layer
d. lipid deposits in platelets in the intimal layer

Back 92

c. lipid deposits in the macrophages in the intimal layer

Front 93

Which of the following could be used to block progression of atherosclerosis?:
a. a drug which inhibits macrophage synthesis of cytokines
b. a drug which stimulates scavenger receptor expression
c. a drug which stimulates oxidation of LDLs
d. a drug which inhibits HDL synthesis

Back 93

a. a drug which inhibits macrophage synthesis of cytokines

Front 94

Which of the following is true concerning the mechanism of action of a Beta-1 agonist drug on
the heart:
a. B-1 agonists increase dephosphorylation of phospholamban in cardiac myocytes
b. B-1 agonists increase phosphorylation of ryanodine receptors in cardiac myocytes
c. B-1 agonists increase phosphorylation of Big K channels in cardiac myocytes
d. B-1 agonists decrease the rate of Na+ entry into SA node cells

Back 94

b. B-1 agonists increase phosphorylation of ryanodine receptors in cardiac myocytes

Front 95

Which of the following statements about control of blood flow is true:
a. The cerebral circulation autoregulates its flow over a range of pressures
b: Skeletal muscle blood flow during exercise is controlled exclusively by an
increase in sympathetic stimulation.
c. There is no autoregulation in the kidney vasculature.
d. Acetycholine causes vasoconstriction in sweat glands.

Back 95

a. The cerebral circulation autoregulates its flow over a range of pressures

Front 96

Phenylephrine is a drug which is an agonist at alpha 1 receptors. Which of the following
would you expect to occur after phenylephrine is injected ? (Be sure to consider reflexes)
a. a decrease in blood pressure and heart rate
b. an increase in blood pressure and heart rate
c. an increase in blood pressure and decrease in heart rate
d. a decrease in blood pressure and increase in heart rate
e. an increase in blood pressure but no change in heart rate

Back 96

c. an increase in blood pressure and decrease in heart rate

Front 97

Which is true about sympathetic stimulation in the cardiovascular system ?
a. in normal people it is the major factor maintaining heart rate at rest
b. in normal people it is the major factor maintaining vascular smooth muscle tone
c. in patients with myocardial ischemia, sympathetic stimulation of the SA node is
reduced
d. in patients with low blood volume due to hemorrhage, sympathetic stimulation of
the venous vasculature is reduced

Back 97

b. in normal people it is the major factor maintaining vascular smooth muscle tone

Front 98

Which of the following would you expect to be true in a normal patient after loss of 700
ml of blood?
a. Blood flow in the brain would be decreased.
b. Blood flow to the skin would be decreased.
c. Blood flow in the coronary blood vessels would be decreased.
d. Stimulation of the SA node by sympathetic nerves would be decreased

Back 98

b. Blood flow to the skin would be decreased.

Front 99

In a patient with severe hypertropic cardiomyopathy, stroke volume would
a. increase
b. decrease
c. not change

Back 99

b. decrease

Front 100

Atrial natriuretic peptide causes the tone (degree of constriction) of the vascular smooth
muscle cell to
a. increase
b. decrease
c. not change

Back 100

b. decrease

Front 101

Myocardial ischemia could be caused in a patient with coronary artery disease when Beta
stimulation of the heart:
a. increase
b. decrease
c. not change

Back 101

a. increase

Front 102

In a patient with coarctation of the aorta mean arterial pressure in the femoral artery would :
(relative to a normal person)
a. increase
b. decrease
c. not change

Back 102

b. decrease

Front 103

Cardiac hypertrophy causes the 02 demand of the heart to:
a. increase
b. decrease
c. not change

Back 103

a. increase

Front 104

In response to an occlusion in a coronary artery, autoregulation would cause the relaxation
of vascular smooth muscle in downstream arterioles to:
a. increase
b. decrease
c. not change

Back 104

a. increase

Front 105

Ventricular fibrillation would cause the blood pressure to
a. increase
b. decrease
c. not change

Back 105

b. decrease

Front 106

Increased sympathetic firing to the heart would cause permeability of calcium channels in the SA node to
a. increase
b. decrease
c. not change

Back 106

a. increase

Front 107

An increase in K' efflux out of a cardiac muscle cell causes the membrane potential of that
cell to
a. increase
b. decrease
c. not change

Back 107

b. decrease

Front 108

Vasoconstrictors cause intracellular Ca2+ levels in vascular smooth muscle cells to:
a. increase
b. decrease
c. not change

Back 108

a. increase

Front 109

Viagra decreases the breakdown of cGMP in vascular smooth muscle; this would cause the
blood flow in the vessels with vasodilator stimulation to
a. increase
b. decrease
c. not change

Back 109

a. increase

Front 111

In ventricular muscle:
the timing of this phase is delayed in the form of long QT syndrome caused by Kdr channel mutations
a. phase 0
b. phase 1
c. phase 2
d. phase 3
e. phase 4

Back 111

d. phase 3

Front 113

In the SA node:
L-type Ca2+ channels are open during this phase
a. phase 0
b. phase 1
c. phase 2
d. phase 3
e. phase 4

Back 113

a. phase 0

Front 114

In ventricular muscle:
Kto channels open during this phase
a. phase 0
b. phase 1
c. phase 2
d. phase 3
e. phase 4

Back 114

b. phase 1

Front 115

In the ventricular muscle:
Na+ activation gates open at the start and close at the end of this phase
a. phase 0
b. phase 1
c. phase 2
d. phase 3
e. phase 4

Back 115

a. phase 0

Front 116

left ventricular volume is greatest
a. end of diastole/start of systole
b. end of systole/ start of diastole

Back 116

a. end of diastole/start of systole

Front 117

greatest decrease in left ventricular pressure begins
a. end of diastole/start of systole
b. end of systole/ start of diastole

Back 117

b. end of systole/ start of diastole

Front 118

the mitral valve closes
a. end of diastole/start of systole
b. end of systole/ start of diastole

Back 118

a. end of diastole/start of systole

Front 119

the aortic valve closes
a. end of diastole/start of systole
b. end of systole/ start of diastole

Back 119

b. end of systole/ start of diastole

Front 120

nitroprusside (NO donor)
a. constriction
b. dilation

Back 120

b. dilation

Front 121

PGE2
a. constriction
b. dilation

Back 121

b. dilation

Front 122

Angiotensin II
a. constriction
b. dilation

Back 122

a. constriction

Front 123

Adenosine
a. constriction
b. dilation

Back 123

b. dilation

Front 124

An increase in parasympathetic nerve firing to the heart would cause cardiac output to:
a. increase
b. decrease
c. no change

Back 124

b. decrease

Front 125

An increase in firing in the sympathetic nerves to the veins would cause cardiac output to:
a. increase
b. decrease
c. no change

Back 125

a. increase

Front 126

In a patient with restrictive cardiomyopathy, filling of the heart would:
a. increase
b. decrease
c. no change

Back 126

b. decrease

Front 127

Atrial natriuretic peptide causes the tone (degree of constriction) of the vascular smooth muscle cell to:
a. increase
b. decrease
c. no change

Back 127

b. decrease

Front 128

In a patient with postductal coarctation of the aorta, mean arterial pressure in the femoral artery would : (relative to a normal person
a. increase
b. decrease
c. no change

Back 128

b. decrease

Front 129

Viagra decreases the breakdown of cGMP in vascular smooth muscle; this would cause the blood flow in the vessels with vasodilator stimulation to:
a. increase
b. decrease
c. no change

Back 129

a. increase

Front 130

In response to an occlusion in a coronary artery, the tone (constriction) of the downstream arterioles will
a. increase
b. decrease
c. no change

Back 130

a. increase

Front 131

Cardiac hypertrophy causes the O2 demand of the heart to:
a. increase
b. decrease
c. no change

Back 131

a. increase

Front 132

During exercise, the consumption of O2 causes blood flow to the exercising muscle to:
a. increase
b. decrease
c. no change

Back 132

a. increase

Front 133

Platelets release substances which generally cause tone of the vessel to
a. increase
b. decrease
c. no change

Back 133

a. increase

Front 134

An increase in K+outside of a cardiac muscle cell will cause the membrane potential of the cell to
a. increase
b. decrease
c. no change

Back 134

B. decrease

Front 135

An increase in K+ efflux out of a cardiac muscle cell will cause the membrane potential of that cell to:
a. increase
b. decrease
c. no change

Back 135

b. decrease

Front 136

In ventricular action potential:
Ca++ channels are open
a. phase 0
b. phase 1
c. phase 2
d. phase 3
e. phase 4

Back 136

c. phase 2

Front 137

In ventricular action potential:
absolute refractory period ends near the start of this phase
a. phase 0
b. phase 1
c. phase 2
d. phase 3
e. phase 4

Back 137

d. phase 3

Front 138

In ventricular action potential:
digitalis will cause after-depolarizations during this phase
a. phase 0
b. phase 1
c. phase 2
d. phase 3
e. phase 4

Back 138

e. phase 4

Front 139

In ventricular action potential:
inward flux of Na+
a. phase 0
b. phase 1
c. phase 2
d. phase 3
e. phase 4

Back 139

a. phase 0

Front 140

The period of the cardiac cycle during which the aortic valve is closed and the mitral valve is opened
a. isovolumetric contraction
b. systolic ejection
c. isovolumetric relaxation
d. diastolic filling

Back 140

d. diastolic filling

Front 141

The period of the cardiac cycle during which aortic pressure increases the most
a. isovolumetric contraction
b. systolic ejection
c. isovolumetric relaxation
d. diastolic filling

Back 141

b. systolic ejection

Front 142

The second heart sound occurs at the beginning of this part of the cycle
a. isovolumetric contraction
b. systolic ejection
c. isovolumetric relaxation
d. diastolic filling

Back 142

c. isovolumetric relaxation

Front 143

EDV in the ventricle would occur immediately before the start of this part of the cycle.
a. isovolumetric contraction
b. systolic ejection
c. isovolumetric relaxation
d. diastolic filling

Back 143

a. isovolumetric contraction

Front 144

Elastic fibers are abundant in which of the following vessels?
a. the aorta
b. capillaries
c. arterioles
d. small venules

Back 144

a. the aorta

Front 145

Which of the following is TRUE regarding valve defects?
a. Mitral valve stenosis results in a systolic murmur.
b. Mitral valve regurgitation results in a systolic murmur.
c. Aortic valve stenosis results in a diastolic murmur.
d. Aortic valve regurgitation results in a systolic murmur.

Back 145

b. Mitral valve regurgitation results in a systolic murmur.

Front 146

Aortic stenosis would be likely to result in:
a. left atrial dilation
b. left atrial hypertrophy
c. left ventricular dilation
d. left ventricular hypertrophy

Back 146

d. left ventricular hypertrophy

Front 147

An increase in the interval from the P wave to the QRS is likely to be caused by:
a. an increase in parasympathetic stimulation of the SA node
b. an increase in parasympathetic stimulation of the AV node
c. an increase in sympathetic firing to ventricular muscle cells
d. an increase in sympathetic firing to the SA node

Back 147

b. an increase in parasympathetic stimulation of the AV node

Front 148

Re-entry in ventricular muscle would cause:
a. sinus tachycardia
b. sinus bradycardia
c. tachycardia with ectopic beats
d. no change in heart rate

Back 148

c. tachycardia with ectopic beats

Front 149

The pacemaker potential in the heart:
a. requires sympathetic stimulation to occur
b. occurs because of conductance (flow) of Na+ ions into the cells
c. is the result of the very negative resting membrane potential of the cells
d. is increased by parasympathetic stimulation

Back 149

b. occurs because of conductance (flow) of Na+ ions into the cells

Front 150

Which of the following is NOT required in order to produce a coordinated pumping by the ventricles?
a. an intact bundle of His and Purkinje system
b. gap junctions between ventricular muscle fibers
c. a normally acting AV node
d. all of the above are required

Back 150

c. a normally acting AV node

Front 151

Which of the following is NOT TRUE of the mechanism of action of a B1 drug on the heart:
a. It works by increasing phosphorylation of phospholamban in myocytes
b. It works by increasing phosphorylation of RyR in myocytes
c. It works by increasing phosphorylation of Big K channels in myocytes
d. It works by increasing the rate of Na+ entry into SA node cells

Back 151

c. It works by increasing phosphorylation of Big K channels in myocytes

Front 152

Which of the following is likely to increase EDV?
a. infusion of saline intravenously
b. infusion of an a1 agonist
c. riding a bicycle
d. all of the above

Back 152

d. all of the above

Front 153

The ryanodine receptor (RyR) linked channel is NOT important for which of the following:
a. vascular smooth muscle cell relaxation
b. voltage-dependent Ca++ influx
c. Ca++ -stimulated Ca++ release
d. IP3 stimulated Ca++ release

Back 153

b. voltage-dependent Ca++ influx

Front 154

Which of the following changes in the ECG would occur in a patient with a defect in the delayed rectifier K+ channel?
a. longer time between P and QRS
b. wide QRS
c. QT interval increased
d. irregularly shaped P waves

Back 154

c. QT interval increased

Front 155

Which of the following changes in the ECG would occur in a patient with a right bundle branch defect?
a. longer time between P and QRS
b. wide QRS
c. ST segment elevated
d. irregularly shaped P waves

Back 155

b. wide QRS

Front 156

Which of the following would NOT reduce both ventricular filling and stroke volume?
a. atrial fibrillation
b. mitral stenosis
c. decreased venous compliance
d. pericardial effusion

Back 156

c. decreased venous compliance

Front 157

An increase in stroke volume above the normal level would be caused by which of the following:
a. infusion of a 1 antagonist (beta-blocker)
b. an increase in filling of the heart EDV
c. an increase in afterload
d. all of the above

Back 157

b. an increase in filling of the heart EDV

Front 158

Which of the following would be found in a fatty streak?
a. lipid deposits within the endothelial cells
b. lipid deposits in the smooth muscle cells in the tunica media
c. lipid deposits in the macrophages in the tunica intima
d. lipid deposits in platelets in the tunica intima

Back 158

c. lipid deposits in the macrophages in the tunica intima

Front 159

Which symptoms are consistent with Raynaud’s phenomenon?
a. edema and hyperpigmentation in the lower limb
b. a systolic murmur and elevated heart rate
c. vasospasms with exposure to cold
d. thin shiny skin and thick nails; risk of gangrene

Back 159

c. vasospasms with exposure to cold

Front 160

Which of the following is NOT true about aneurysms?
a. The risk is increased by hypertension.
b. They can be related to congenital or genetic defects.
c. The formation is related to wall tension.
d. They are likely only in small vessels.

Back 160

d. They are likely only in small vessels.

Front 161

Indomethacin or ibuprofen are used to treat infants with patent ductus arteriosus because:
a. They stimulate blood clotting to cause the ductus to close.
b. They cause pulmonary vasodilation to reduce flow form the aorta to the pulmonary artery.
c. They inhibit PGE2 production, resulting in ductal vasoconstriction.
d. They inhibit PGF2a which causes ductal dilation.

Back 161

c. They inhibit PGE2 production, resulting in ductal vasoconstriction

Front 162

Which of the following disease states or defects is least likely to cause pulmonary hypertension?
a. mitral stenosis
b. aortic regurgitation
c. dilated cardiomyopathy
d. mitral valve prolapse

Back 162

d. mitral valve prolapse

Front 163

Which sensor mechanism would be most important for the increase in heart rate you feel if you go to the top of Pike’s Peak (elevation 14,000 ft)?
a. aortic barorecepors
b. atrial B receptors
c. carotid chemoreceptors
d. ventricular stretch receptors

Back 163

c. carotid chemoreceptors

Front 164

Angiotensin has been implicated in the process of hypertrophy in the heart. Use of converting enzyme inhibitors (which reduce production of angiotensin) would be most useful in treating which of the following patients?
a. patients after myocardial infarction
b. hypertensive patients
c. patients with chronic severe aortic regurgitation
d. all of the above

Back 164

d. all of the above

Front 165

Which of the following would occur following clot formation in several vessels supplying a tissue?
a. Total peripheral resistance would decrease, and the tissue would appear blue.
b. Total peripheral resistance would not change because heart rate would increase.
c. Total peripheral resistance would increase, and the tissue would be pale.
d. Total peripheral resistance would not change, although the tissue would become necrotic.

Back 165

c. Total peripheral resistance would increase, and the tissue would be pale.

Front 166

Flow in a capillary would be _____________flow in the aorta.
a) greater than
b) less than
c) the same as

Back 166

b) less than

Front 167

In the systemic circulation, normal capillary pressure is ___________normal venous pressure
a) greater than
b) less than
c) the same as

Back 167

a) greater than

Front 168

Ventricular pressure during systole is ____________atrial pressure
a) greater than
b) less than
c) the same as

Back 168

a) greater than

Front 169

End diastolic volume is ____________end systolic volume
a) greater than
b) less than
c) the same as

Back 169

a) greater than

Front 170

In a normal heart, the rate of firing of the SA node cells is __________that of cells in the bundle of His.
a) greater than
b) less than
c) the same as

Back 170

c) the same as

Front 171

In the presence of a second degree AV block, the rate of firing of the SA node cells is ______________that of cells in the bundle of His
a) greater than
b) less than
c) the same as

Back 171

a) greater than

Front 172

At rest in a normal person sympathetic tone to the heart is ____________parasympathetic tone to the heart
a) greater than
b) less than
c) the same as

Back 172

b) less than

Front 173

In ventricular muscle, the contribution of extracellular Ca++ to muscle contraction is
_______________the contribution of sarcoplasmic reticulum stores of Ca++
a) greater than
b) less than
c) the same as

Back 173

b) less than

Front 174

In a patient with coarctation of the thoracic (postductal) aorta, arterial blood pressure in the arm would be _____________arterial blood pressure in the leg.
a) greater than
b) less than
c) the same as

Back 174

a) greater than

Front 175

In a normal person, an acute increase in blood pressure will cause heart rate to _____________
a) increase
b) decrease
c) not change

Back 175

b) decrease

Front 176

In a normal person, activation of the parasympathetic nervous system will cause heart rate to ____________
a) increase
b) decrease
c) not change

Back 176

b) decrease

Front 177

Following arteriolar vasoconstriction, capillary pressure will ____________
a) increase
b) decrease
c) not change

Back 177

b) decrease

Front 178

In a normal person, a sudden increase in pericardial fluid which resulted in cardiac tamponade would cause cardiac output to ______________
a) increase
b) decrease
c) not change

Back 178

b) decrease

Front 179

In a normal person, a change in arterial blood pressure of 5 mmHg would be expected to cause blood flow to ventricular muscle to ___________
a) increase
b) decrease
c) not change

Back 179

c) not change

Front 180

Aortic stenosis would cause ventricular pressure to ____________
a) increase
b) decrease
c) not change

Back 180

a) increase

Front 181

Infusion of a drug which is an agonist at a-1 receptors would cause reflex heart rate to __________
a) increase
b) decrease
c) not change

Back 181

b) decrease

Front 182

During hemorrhage plasma Angiotensin II levels would ___________
a) increase
b) decrease
c) not change

Back 182

a) increase

Front 183

Local release of thromboxane by platelets would cause resistance in the arteriole to _________
a) increase
b) decrease
c) not change

Back 183

a) increase

Front 184

Restrictive cardiomypathy limits cardiac function because:
a. contractility is reduced
b. mitral valve regurgitation occurs
c. diastolic filling is reduced
d. heart rate is decreased

Back 184

c. diastolic filling is reduced

Front 185

In which of these tissues is autoregulation of blood flow most important:
a, the skin
b. the stomach
c. the brain
d. the liver

Back 185

c. the brain

Front 186

Which of the following diseases tend to occur in patient with other autoimmune diseases?
a. arteritis
b. Buerger's disease
c. coarctation of the aorta
d. aortic stenosis

Back 186

a. arteritis

Front 187

Which of the following would NOT be associated with Raynaud's disease:
a. intermittent flow to fingertips and/or toes
b. thrombosis
c. thick, brittle nails ,
d. numbness

Back 187

b. thrombosis

Front 188

Afterload may contribute to the development of:
a. aortic valve insufficiency
b. cardiac hypertrophy
c. myocardial ischemia
d. all of the above

Back 188

d. all of the above

Front 189

Which of the following are NOT actions of the sympathetic nervous system on ventricular myocytes:
a. increase activity of protein kinases
b. increasing resting membrane potential
c. increase phosphorylation of L-type Ca channels
d. increase phosphorylation of phospholamban

Back 189

b. increasing resting membrane potential

Front 190

Which of the following is most important for the relaxation of the ventricular myocardium?
a. K to channels
b. Ca ATPase on plasma membrane
c. Ca ATPase on sarcoplasmic reticulum
d. L-type Ca++ channels

Back 190

c. Ca ATPase on sarcoplasmic reticulum

Front 191

Agents which inhibit activity of the Na+/K+ ATPase can increase contractility if given at the proper (therapeutic doses). This increase in contractility would occur because:
a. Intracellular K+ levels increase
b. Intracelluar Na+ levels decrease
c. Intracellular Ca++ levels increase
d. Ventricular volume increases

Back 191

c. Intracellular Ca++ levels increase

Front 192

A venous thrombosus would cause all of the following except:
a. tenderness and swelling
b. pain at the site of thrombosus
c. pale skin
d. neuralgia

Back 192

c. pale skin

Front 193

Which of the following are thought to be involved in the appearance of fatty streaks in atherosclerosis?
a. presence of platelets
b. release of cytokines by smooth muscle cells
c. uptake of oxidized LDLs
d. presence of adhesion molecules on the macrophages

Back 193

c. uptake of oxidized LDLs

Front 194

Vascular smooth muscle vasoconstriction would be increased by an agent which:
a. increases IP3 stimulation of ryanodine receptors
b. decreases phosphorylation of L-type Ca++ channel
c. increases phosphorylation of Ca++ ATPase
d. increases opening of "big" K+channels

Back 194

a. increases IP3 stimulation of ryanodine receptors

Front 195

Administration of antibiotics in patients with mitral valve prolapse is intended to:
a. reduce the risk of pericarditis
b. reduce the risk of blood clots
c. reduce the risk of endocarditis
d. prevent angina

Back 195

c. reduce the risk of endocarditis

Front 196

Mitral stenosis would be likely to cause:
a. atrial dilation
b. a murmur between SI and S2
c. increased left ventricular end diastolic pressure
d. increased cardiac output

Back 196

a. atrial dilation

Front 197

Which of the following would you expect as a consequence of early after depolarization?
a. atrial fibrillation
b. AV block
c. Torsades de pointes
d. Sinus tachycardia

Back 197

c. Torsades de pointes

Front 198

Which of the following channels is NOT voltage-dependent?
a. The Na+ channel on ventricular muscle cells
b. The Na+ channel on SA node cells
c. The ryanodine coupled Ca++ channel in ventricular muscle cells
d. The L-Type Ca++ channel on ventricular muscle cells

Back 198

c. The ryanodine coupled Ca++ channel in ventricular muscle cells

Front 199

The resting (or pacemaker) potential in the SA node cells is caused by:
a. an inward leak of Na+
b. an outward leak of Na+
c. opening of K+channels
d. opening of L-type Ca++ channels

Back 199

a. an inward leak of Na+

Front 200

Spread of contraction over the atria depends on:
a. innervation by the sympathetic nervous system of atrial myocytes
b. gap junctions between atrial myocytes
c. presence of t-tublues between myocytes
d. the bundle of His which is a high speed conduction system between the myocytes

Back 200

b. gap junctions between atrial myocytes

Front 201

Reentry can be caused by which of the following:
a. formation of a fibrotic scar
b. an abnormality in the sodium channel resulting in prolongation of the refractory period
c. ischemia in myocytes
d. both b and c

Back 201

d. both b and c

Front 202

A change in the shape of the t wave in the ECG is most likely related to a change in extracellular concentrations of which ion?
a. Na+
b. Ca++
c. cr
d. K+

Back 202

d. K+

Front 203

An increase in the interval from the p wave to the QRS is likely to be related to a change in:
a. An increase in parasympathetic stimulation of the SA node
b. An increase in parasympathetic stimulation of the AV node
c. An increase in sympathetic firing to ventricular muscle cells
d. An increase in sympathetic firing to the SA node

Back 203

b. An increase in parasympathetic stimulation of the AV node