Cardio - Phy3171

Front 1

When arterial pressure decreases there will be a reflex increase in vagal input to the heart.

True or False?

Back 1

False

Front 2

When arterial pressure increases the arterial baroreceptors will fire at a lower frequency

True or False?

Back 2

False

Front 3

What is the formula for MAP?

Back 3

MAP = SV x HR X TPR

-> SV x HR is also CO

Front 4

Application of a negative pressure (suction) to the lower half of the body ...

Back 4

Increases heart rate

Front 5

The vagus nerve contains parasympathetic nerves that project to the heart. These arise from which of the following brainstem nuclei

Back 5

The nucleus ambiguus

Front 6

Parasympathetic postganglionic neurons release the neurotransmitter

Back 6

acetylcholine

Front 7

Which of the statements below could accurately finish the following sentence? In response to the cold pressor test...

A. sympathetic and parasympathetic outflow is increased.

B. sympathetic outflow increases and parasympathetic outflow decreases.

C. the baroreceptors decrease their firing rate.

D. para-sympathetic activity is increased.

E. the hypothalamus signals the nucleus ambiguus, allowing heart rate to increase.

Back 7

B + E

Front 8

Enhanced sympathetic responses in young men to mental stress are associated with...

Back 8

elevated systolic blood pressure with aging

Front 9

During Head-up tilt the legs become a darker colour. Why?

Back 9

Hydrostatic pressure increases in the venous circulation in the lower limbs

Front 10

In response to head-up tilt, patients with pure autonomic failure...

Back 10

have a fall in arterial pressure

Front 11

Which of the following are true for muscle sympathetic nerve activity….

A. it falls in a patient with autonomic failure during head-up tilt

B. it increases in response to mental stress

C. it decreases in response to head-down tilt

D. it increases in response to painful stimuli

E. it decreases in patients with postural tachycardia syndrome in response to head-up tilt

Back 11

B, C + D

Front 12

Which BP classifications is for the values below?

Systolic BP - 140-159
Diastolic BP - 90-99

Back 12

Normal - sys: <120 & dia: <80

Prehypertension - sys: 120-139 & dia: 80-89

Stage 1 hypertension - correct answer

Stage 2 hypertension - sys: >/=160 & dia: >/=100

Front 13

Which causes of hypertension is the most common?

Back 13

Primary/essential hypertension

Front 14

Identify 3 causes of hypertension

Back 14

Any of:

- sleep apnea

- chronic kidney disease

- renovascular disease

-chronic steroid therapy + cushing's syndrome

- drug-induced/related causes

- primary aldosteronism

Front 15

Identify 3 drug-induced hypertension prescriptive medicines

Back 15

Any of:

- steroids

-estorgens

-ketamine

-antidepressants -> causes hypertension in most cases ->eg. venlafaxine

-NSAIDS

- erythropoietin

Front 16

Identify 3 drug-induced hypertension street drugs/herbal products

Back 16

Any of:

-cocaine

-nicotine

-anabolic steroids

-ketamine

-st john's wort

Front 17

What are the 4 Vignettes?

Back 17

1. Snake venom

2. The rule of halves

3. The culprit

4. Up close and personal

Vicious Snakes Rule Cities Up close and Personal

Front 18

What is a by product of Angiotensinogen in the RAS?

Back 18

Renin

Front 19

What is the result of the RAS pathway?

Back 19

Either:

- vasoconstriction

- Sodium Retention

- Vascular growth

Front 20

What is the effect of drugs which act on different parts of the pathway (RAS)?

Back 20

Combination works for greater effect

Front 21

Benefits of low dose concentrations?

Back 21

Lower risk of side effects and better benefits

Front 22

What is the dominant role of the kidney?

Back 22

- matching fluid output + intake

-Renal transplantation studies ->BP follows the kidney

-mono-genetic forms of hypertension ->all renal defects

Front 23

Resistance to blood flow is proportional to:

Select one:

a. The reciprocal of the radius of the blood vessel.

b. The radius of the blood vessel.

c. The radius of the blood vessel squared.

d. The reciprocal of the radius of the blood vessel to the 4th power.

e. The length of the blood vessel squared.

Back 23

d. The reciprocal of the radius of the blood vessel to the 4th power.

Front 24

Which of the following is CORRECT? Disease of the wall of an artery that is severe and greatly reduces the diameter of the lumen of the artery will:

Select one:

a. decrease resistance to blood flow to the organ downstream

b. increase blood flow to the organ downstream

c. Increase blood pressure beyond the diseased segment

d. Decrease blood flow to the organ downstream e. Increase oxygen delivery to the organ downstream

Back 24

d. Decrease blood flow to the organ downstream e. Increase oxygen delivery to the organ downstream

Front 25

Vascular resistance increases MOST when:

Select one:

a. vessel diameter increases

b. viscosity decreases

c. vessel radius is halved

d. hematocrit decreasese. vessel length increases

Back 25

c. vessel radius is halved

Front 26

In response to an acute increase in central blood volume caused by a blood transfusion which of the following is CORRECT

Select one:

a. Urinary salt and water excretion decreases.

b. Secretion of atrial natriuretic peptide decreases.

c. Central venous pressure decreases.

d. Cardiac baroreceptor firing increases.

e. Decreased sympathetic drive to the kidney increases renin release from the juxtaglomerular cells.

Back 26

d. Cardiac baroreceptor firing increases.

Front 27

Which of the following is NOT a cause of hypertension?

Select one:

a. Disease of the adrenal cortex that increases aldosterone secretion

b. Synthetic steriod abuse/Synthetic steroid abuse

c. Renal vascular diseases

d. Renal denervation

e. Cocaine abuse

Back 27

d. Renal denervation

Front 28

atrial natriuretic peptide

Back 28

Is a powerful vasodilator

Front 29

Increased activity of the sympathetic nervous system during mild haemorrhage ...

Select one:

a. Increases heart rate

b. Decreases heart rate

c. Causes vasodilatation within skeletal muscle

d. Inhibits sodium reabsorption within the kidney.

e. Stimulates the release of angiotensin converting enzyme from the kidney.

Back 29

a. Increases heart rate

Front 30

During the late phase of acute mild haemorrhage, arterial pressure has been restored to normal levels.

The most important mechanism by which this is achieved is:

Select one:

a. Increased cardiac output due to the actions of hormones on heart rate and cardiac contractility

b. Increased total peripheral resistance (vasoconstriction) due to increased circulating levels of atrial natriuretic peptide

c. Increased cardiac output due to salt and water retention by the kidney.

d. Autoregulation of blood flowe. Increased total peripheral resistance (vasoconstriction) due to reflex increases in sympathetic vasomotor drive.

Back 30

c. Increased cardiac output due to salt and water retention by the kidney.

Front 31

In a normal healthy adult in response to blood transfusion, which one of the following DOES occur?

Select one:

a. Urinary salt and water excretion decreases

b. Secretion of atrial natriuretic peptide decreases.

c. Increased sympathetic drive to the kidney increases renin release from the juxtaglomerular cells.

d. Cardiac baroreceptor firing increases. Blood volume increases, increasing venous return, increasing the filling of the heart, increasing SV and thus CO and MAP- the will be sensed by the baroreceptors resulting in an increased firing rate.

e. Central venous pressure decreases.

Back 31

d. Cardiac baroreceptor firing increases. Blood volume increases, increasing venous return, increasing the filling of the heart, increasing SV and thus CO and MAP- the will be sensed by the baroreceptors resulting in an increased firing rate.

Front 32

The liver secretes angiotensinogen which:

Select one:

a. Is an enzyme that catalyses the conversion of angiotensin I to its active metabolite, angiotensin II.

b. Is an enzyme that catalyses the formation of angiotensin I.

c. Acts at the adrenal cortex to promote aldosterone secretion.

d. Is a prohormone that acts indirectly on blood vessels to cause vasoconstriction.

e. Is a hormone that catalyses the breakdown of angiotensin II.

Back 32

d. Is a prohormone that acts indirectly on blood vessels to cause vasoconstriction.

Front 33

According to the World Health Organisation, hypertension is defined asSelect one:

a. A systolic pressure greater than 140 mmHg.

b. A systolic pressure greater than 120 mmHg.

c. A diastolic pressure greater than 90 mmHg.

d. Both b and d.

e. Either a or c.

Back 33

e. Either a or c.

Front 34

Which of the following would be expected to shift the pressure-natriuresis curve to the right?Select one:

a. decreased levels of angiotensin II in the blood

b. increased levels of atrial natriuretic peptide in the blood

c. Increased levels of aldosterone in the blood.

d. Decreased firing rate of the renal sympathetic nerves

e. None of the above

Back 34

c. Increased levels of aldosterone in the blood.

Front 35

Circulating levels of the following hormone fall during mild haemorrhage in mammals:

Select one:

a. Arginine vasopressin (also known as antidiuretic hormone).

b. Atrial natriuretic peptide.

c. Adrenaline.

d. Angiotensin II.

e. Both a and c

Back 35

b. Atrial natriuretic peptide.

Front 36

hich of the following is NOT true of blood pressure?

Select one:

a. is maximal during ventricular systole

b. decreases as the blood moves away from the heart

c. increases with increasing vascular resistance

d. decreases with increasing vessel diameter

e. increases when parasympathetic activity increases

Back 36

e. increases when parasympathetic activity increases

Front 37

A young man visits the doctor and is told that his blood pressure is 168/85. To which of the following categories (definitions) does this blood pressure reading belong?

Select one:

a. Optimal blood pressure

b. Normal blood pressure

c. High-normal blood pressured. mild hypertension

e. Isolated systolic hypertension

Back 37

e. Isolated systolic hypertension

Front 38

What are the steps of RAS? (renin angiotensin system)

Back 38

1. Angiotensinogen

2. Renin (by-product)

3. Angiotensin I

4. ACE (by-product) - Angiotensin-converting enzyme

5. Angiotensin II

6. AT1R / AT2R

Trying to achieve vasoconstriction, sodium retention, vascular growth

Produced by the liver

Front 39

What are the underlying causes of CVD? (cardiovascular disease) - in relation to arteries

Back 39

-Aneurysm (bulging)

-Atherosclerosis -> plaque in artery wall

- Arterioles - hypertrophy (thickening) especially in prolonged high BP

- Capillaries - including reduction in numbers ("rarefaction")

- Veins - clots, thrombus, varicose veins

Front 40

Cardiovascular disease is predominantly?

Back 40

A disease of the blood vessels

Front 41

CVD leads to damage to the?

Back 41

- Heart (myocardium) - "heart attack"

- Brain - stroke (ischaemia and haemorrhage)

- Any other organ/tissue downstream from a diseased artery (e.g. peripheral vascular disease)

Front 42

What is the common treatment for most cases of CVD?

Back 42

Bypassing the blocked coronary arteries, through balloon angioplasty and a stent

Front 43

What is the leading cause of death in 2013?

Back 43

Ischaemic Heart Disease (blocked or partially blocked arteries which affect the supply of blood to the heart)

Front 44

Do socioeconomic factors play a role in the incidence rates of CVD?

Back 44

Yes, greater socioeconomic (less disadvantage) areas for both women and men lower the incidence rates.

Front 45

What is the difference between essential and secondary human hypertension?

Back 45

Essential is all unknown causes while secondary are known.

Front 46

What is the leading cause of stroke?

Back 46

Smoking

Front 47

What is dyslipidaemia?

Back 47

High cholesterol levels

Front 48

Most common amount of risk factors for stoke is?

Back 48

3 with around 30%

Front 49

What are the levels of reducing a burden for a disease?

Back 49

1. Tertiary (late stage of disease -> treatment / rehab)

2. Secondary (early stage of disease/recurrence)

3. Primary (Specific risk factors)

4. Primordial (underlying conditions leading to causation)

Front 50

What are the two strategies for primary prevention?

Back 50

High risk individual strategy and Population strategy (Mass)