WEEKLY QUESTIONS CARDIOVASCULAR SYSTEM (MODULE 11) WEEK 4 (18-22 MARCH 2012) ARTERIAL BLOOD PRESSURE (1) 1.

Choose the correct statement about the blood pressure? A. Pulse pressure is the difference between maximal pressure and minimal pressure in systemic arteries B. Systolic pressure ranging between 60-90 mmHg C. Mean pressure usually remains nearer the systolic level D. Arterial blood pressure is identical in the different arteries of the same individual 2. The following are incorrect regarding Arterial blood pressure, EXCEPT: A. At birth, baby have a very high heart rate with high arterial blood pressure B. Arterial blood pressure depend mainly on arteriolar resistance C. The blood pressure might falls progressively to approximately 0mmHg after flows through systemic circulation D. Arteriolar resistance is very important in regulation of blood pressure 3. Which one of the following is important factor affecting blood pressure? I. Rise in stroke volume increased the systolic pressure II. Increase in diastolic pressure is affected by increase in heart rate with constant stroke volume III. The resistance of peripheral circulation is directly proportional to the radius of vessel IV. The diameter of arterioles is controlled by local, nervous and chemical factors A. I & II B. I, II, & III C. I, II & IV D. All of the above 4. The following are true about the peripheral resistance EXCEPT: A. It is one of the main factor affecting the arterial blood pressure B. In polycythemia, the arterial blood pressure is increases C. Concentration of plasma protein have larger effect on the blood viscosity rather than the hematocrit value D. Vein have large resistance despite of its large size

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5. Choose the correct answer regarding the factors affecting the ABP? A. The longer the length, the greater is the resistance, the lower the ABP B. Cardiac output will not be affected by the sympathetic nervous system C. Respiratory activity did not affect the heart rate and subsequently the cardiac output D. The capillaries have the highest resistance due to its small size 6. Which of the following statement is false about the blood pressure? A. The systolic pressure is the maximal pressure in the systemic arteries occurring during the systole B. The average value of pulse pressure is 40 mmHg C. The normal range for diastolic pressure is between 60-100 mmHg D. The mean pressure is the average pressure throughout the cardiac cycle 7. Choose the correct statement about the arterial blood pressure A. It is the force exerted by the blood against any unit area of the vessel wall B. It can be affected by the changes in the blood volume C. All of the above D. None of the above 8. All of the following statements are true about the physiological variations of the arterial blood pressure except A. The diastolic pressure is usually high in obese person B. Women has slightly lower arterial blood pressure than men C. The arterial blood pressure rises slightly after meals D. During sleep, the systolic blood pressure falls about 15-20 mmHg 9. Choose the false statement about factors that affect the arterial blood pressure A. The arterial blood pressure depends primarily upon two factors that is the cardiac output and the peripheral resistance B. A rise in the stroke volume will raises the diastolic pressure because a larger amount of blood has to be accommodated in the arterial system C. The viscosity of blood is caused by two factors which are the blood cells and the plasma proteins D. Narrowing of the arterioles while the cardiac output being constant will leads to rise in the diastolic pressure

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10. Which of the following statement is false regarding the normal standards and variations of arterial blood pressure? A. The average blood pressure of normal person is 120/80 B. The arterial blood pressure may differ by 5-10 mm Hg in the corresponding arteries on both sides of the body C. The arterial blood pressure in the femoral artery is lower than in the brachial by 10-15 mmHg D. The arterial blood pressure in the popliteal artery is 15-20 mmHg lower than in the femoral artery PATHOLOGY - INFECTIVE ENDOCARDITIS 11. Choose conditions that will lead to the following effects: left atrium pressure increase systemic congestion IIIIIIIVA. B. C. D. Mitral stenosis Mitral incompetence Aortic stenosis Aortic incompetence I, II, III I, II IV II, III, IV I,II, III, IV pulmonary congestion right heart failure

12. All the following are etiologies for infective endocarditis EXCEPT I- Periodontal infection II- Skin infection; abscess III- Genitourinary procedures; catheterization IV- Cardiac catheterization V- Neutropnea A. B. C. D. E. I & II II & III III & IV IV & V None of the above

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13. All the following is the microscopically morphology of infective endocarditis EXCEPT A. Outer cap; leukocytes and platelets adhesions B. A core of dead cells and foam cells with extracellular matrix C. A zone of basophilic containing bacteria D. Deeper zone: non-specific inflammation on the cusp itself 14. Which of the following types of bacterial endocarditis is WRONGLY paired to its clinical pictures? A. SABE malaise B. ABE chills C. ABE high grade fever D. SABE low grade fever 15. Which of the following is NOT the death cause for infective endocarditis? A. Cardiac failure B. Renal failure C. Transient infection D. Embolism to vital organ E. Ruptures of mycotic aneurysm in cerebral artery Staphylococcal Infection 16. Staphylococcus aureus can be differentiated from other staphylococci by: A. Coagulase positive B. Arranged in grape-like structure C. They produece catalase D. None of above 17. All of following are toxins produce by staph. Aureus EXCEPT: A. Leucocidins B. Haemolysins C. Staphylokinase D. Toxic Shock Syndrome Toxin -1 18. Exfoliative toxin may lead to : A. Damages platelets B. Loss of motility and destruction of leukocyte C. Septic metastasis D. Desquamation of skin

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19. All the following true about Staph. Epidermis EXCEPT: A. Produce large amounts of a polysaccharide slime when bacteria grow on a solid surface B. Novobiocin resistant C. They are oppurtunistic pathogens D. They can cause endocarditis 20. Which of following are laboratory diagnosis of infective endocarditis : A. Non specific test B. Cardiology investigations C. Microbiological investigations D. All of above ARTERIAL BLOOD PRESSURE (3) 21. The pressure difference between contraction and relaxation of heart is known as A. Systolic pressure B. Diastolic pressure C. Pulse pressure D. Mean pressure 22. Which of the following lowering the ABP physiologically? A. Young age B. Stress C. Moderate exercise D. Increase in size of body 23. The mean arterial pressure at the beginning of venous system is about A. 50mmHg B. 35mmHg C. 15mmHg D. 0mmHg 24. Which of the following factors affecting the arterial blood pressure? I. Changes in blood volume II. Peripheral resistance III. Elasticity of large arteries IV. Cardiac output A. I, II and IV B. II, III and IV C. II and III D. I, II,III and IV QMU WEEK 4 CVS

25. The capillaries have the smallest diameter, and thus have the highest resistance A. True B. False 26. The total peripheral resistance is directly proportional to I. Length of vessel II. Blood viscosity III. Fourth power of radius IV. Thickness of the wall of vessel A. I and II B. I and III C. II and III D. III and IV ANATOMY VEINS OF HEAD AND NECK 27. The following are true EXCEPT A. The main veins of head and neck are internal and external jugular vein and anterior jugular vein B. The external jugular vein is formed by the union of posterior auricular vein and posterior division of retromandibular vein C. Suprascapular vein and deep cervical vein drain into external jugular vein D. The only tributary of subclavian vein is the external jugular vein 28. The following are true EXCEPT A. The anterior jugular vein which comes from the submental plexus of vein runs deep to sternomastoid muscle and terminates in external jugular vein B. Internal jugular vein runs deep to sternomastoid muscle whereas external jugular vein runs superficial to it C. The union of anterior division of retromandibular vein with anterior facial vein is one of the tributaries of internal jugular vein D. The external jugular vein pierces the deep fascia, three cm above the midaxillary line 29. The following are true EXCEPT I. Internal jugular vein join the subclavian vein to form brachiocephalic vein II. The cavernous venous sinus is connected to the internal jugular vein through superior petrosal sinus III. The internal jugular vein pass through the jugular foramen as the continuation of sigmoid sinus IV. The internal carotid artery is lateral to internal jugular vein in the carotid sheath A. I & II C. II & IV B. II & III D. III & IV QMU WEEK 4 CVS

30. The following are true EXCEPT I. Superior and inferior thyroid veins drain into internal jugular vein II. Common facial vein and lingual veins are tributaries of internal jugular vein III. Internal jugular vein has 7 tributaries IV. Internal jugular veins join the subclavian veins and form the brachiocephalic veins behind the clavicle A. I, II & III B. I & III C. III & IV D. II, III & IV State true or false 31. Superior and inferior pharyngeal veins come from the pharyngeal plexus and terminate into internal jugular vein ( ) Arteries of Upper Limb 32. Which of the following is TRUE regarding subclavian artery? A. Right subclavian artery arises from arch of aorta B. Left subclavian artery arises from brachiocephalic artery. C. Divided into 3 parts by pectoralis minor muscle D. It terminates at outer border of 1st rib to give axillary artery. 33. Which of the following are the branches of 2nd part of axillary artery? I- Subscapular artery II- Superior thoracic artery III- Lateral thoracic artery IV- Thoracoacromial artery A. I and II B. III and IV C. I,II and IV D. II,III and IV 34. Which of the following is TRUE regarding the course of ulnar artery. A. It is smaller than radial artery B. It descends in forearm lateral to ulnar nerve C. It passes deep to flexor retinaculum to enter hand. D. It will continue as deep palmar arch.

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35. Which of the following is TRUE regarding arterial supply of hand? A. Superficial palmar arch lies proximal to outstretch thumb B. Deep palmar arch formed mainly by ulnar artery C. Princeps pollicis is the main supply of thumb D. Radial indices supply ulnar side of index. 36. Which of the following branch will share in the anastomosis at surgical neck of humerus? I- Anterior circumflex humeral artery II- Ascending branch of profunda brachii III- Pectoral branch of thoracoacromial artery IV- Subscapular artery. A. I and II B. III and IV C. I,II and III D. II,III and IV Regulation of Arterial Blood Pressure 37. The nervous pressure control mechanisms are important mechanism in controlling I. Bainbridge reflex II. Marys reflex III. Changes in chemical composition IV. CNS ischemic response A. I, II and III B. I, II and IV C. II, III and IV D. I, II, III and IV 38. -Initiated by blood pressure below 50/60 mmHg -not one of mechanisms for regulating normal arterial pressure

The above statements are regarding to A. B. C. D. Vasopressin Vasoconstrictor mechanism Bainbridge reflex Central ischemic response Marys reflex

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39. Which of the following are true regarding atrial reflex in regulation of arterial blood pressure? I. Can increase the excretion of water II. Can cause vasodilatation of arterioles III. Rapidly adapting reflex IV. Responds only when the arterial pressure falls below 80mmHg A. I and II B. I and III C. II and III D. III and IV 40. The most potent vasoconstrictor mechanism is A. Norepinephnrine-Epinephrine Vasoconstrictor Mechanism B. Renin-Angiotensin Vasoconstrictor Mechanism C. Vasopressin Vasoconstrictor Mechanism D. Capillary fluid shift mechanism 41.

-This mechanism will not stop until the pressure rises back to normal - Important in regulation of blood volume -Controlled by several hormonal systems

The above statement is about A. B. C. D. Capillaries Kidney Lymphatic system Atrial reflex

Hypertension 42. Which of the following is not the constitutional risk factor of atherosclerosis? A. Sex B. Age C. Diet D. Familial predisposition

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43. All the following are minor risk factors of atherosclerosis except? A. Obesity with high caloric intake B. Behavioral pattern ( type B personality) C. High carbohydrate diet D. Physical inactivity 44. All the following are true about Monckebergs sclerosis except? A. Lesion characterized by focal calcium deposition in intima B. Commonly affected the arteries of extremities C. The calcified medial sclerosis can be visualized radiologically D. Affected arteries may also develop atherosclerosis 45. Benign hypertension characterized by? A. Occurs in 5% of hypertension patients B. Usually occurs in young adult males C. Female more affected than male from the 4th-6th decade D. Blood pressure is more than 200/ 120 mmHg 46. Which of the following is not the cause increase blood volume due to salt and water retention of secondary hypertension? A. Cushings syndrome B. Neurogenic stimulation of vasomotor center C. Primary Aldosteronism D. Rennin angiotensin sytem activation

ANTIHYPERTENSIVE DRUG 1 47. Choose the correct statement below; I II III IV A B C D Hypertension can be lowered by managing the peripheral vascular resistance Vasodilator drug can be given to manage hypertension Giving diuretics drug can increased blood pressure Decreasing cardiac output can lower increased blood pressure I, II, III II, III, IV II , IV All of the above

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48. All of the statement below are correct EXCEPT A B C D ACE inhibitors are contraindicated to pregnant woman In hypertensive patient with asthma, the best prescription is by giving B-adrenoreceptor blocker Diuretics are one of the therapeutic treatments in treating hypertension Ca2+ channel blockers can increase the possibility of lowering blood pressure back to normal

State TRUE or FALSE 49. We can manage hypertensive patient by giving the correct diet which is low in fat and high in potassium. 50. Ali is a Nigerian with the age of 54 , thus, he has low renin status. 51. Decreasing the cardiac output can decrease hypertension by giving negative chronotropic drug, negative inotropic drug, venous vasodilator drug, or even by diuretics. Congenital anomalies of the heart 52. All of the following are FALSE about development of heart EXCEPT A. B. C. D. Septum superium and left sinal valve will fuse with the atrial septum Foramens that are formed during heart development are foramen primum and secundum only Absorption of distal part of bulbus cordis forms the smooth parts of right and left ventricle Muscular part of interventricular septum is formed by proliferation of bulbar and atrioventricular cushions

53.

Failure of formation of spiral aortic-pulmonary septum Both of ascending aorta and pulmonary trunk are replaced by one vessel

Which of the following congenital anomalies of heart characterized by characteristic above? A. B. C. D. E. Cor- biloculate Dextrocardia Persitant truncus arteriosus and bulbus cordis Transposition of the great vessels Unequal division of truncus arteriosus by spiral septum

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54. All of the following are interseptal defect EXCEPT A. B. C. D. Defect in the septum primum Defect in septum secundum Defect in septum superium Patent foramen ovale

55. Which of the following are the characteristics of Fallots tetralogy? I. II. III. IV. A. B. C. D. Rogers disease Overriding of aorta Pulmonary hypertension Right ventricular hypertrophy II and IV I, II and III I, II and IV All of the above

56. Anomalies of the heart valves are mainly in form of stenosis A. B. True False

Fetal circulation and aortic arch development 57. The blood carried by umbilical vein enters the foetus through umbilical ring and A. B. C. D. Half the blood passes into liver and half enters ductus venosus All the blood enters ductus venosus Half the blood passed into pancreas and half enters ductus venosus All the blood enters the pancreas

58. Which structures below prevents the backflow of mixed oxygenated blood from left atrium into right atrium? A. B. C. D. Septum secundum Septum primum Foramen ovale Atrial septum

59. From where does non-oxygenated blood come from? A. B. C. D. Inferior vena cava and ductus venosus Superior vena cava Umbilical vein Ductus arteriosus and left ventricle QMU WEEK 4 CVS

60. Match the foetal circulation structures below to their fate after birth and choose the correct order Foramen ovale I. Closed due to adhesion between septum primum and septum secundum Ligamentum teres Medial umbilical ligament Ligamentum arteriosum

Ductus arteriosus Left umbilical vein Distal part of umbilical artery

II. III. IV.

A. B. C. D.

I, IV, II, III I, III, IV, II I, II, IV, III I, II, III, IV

61. Right subclavian artery is formed of I II III IV A. B. C. D. Right fourth aortic arch Right seventh intersegmental artery Part of dorsal aorta between right fourth aortic arch and seventh intersegmental artery Left seventh intersegmental artery I, II AND III I, II AND IV I,III AND IV All of the above

Sabar iku mustikaning laku

: Sabar merupakan inti penghayatan hidup.
~Asian Philosophy~

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ANSWERS 1 2 3 4 5 6 7 8 9 10 11 12 A 131-2 C 132-3 C 135-6 C 137 A 134-5 C 131 C 134 A 132 B 135 C 132 D 224-5 E 226-7 13 14 15 16 17 18 19 20 21 22 23 24 B 228 A 228 C 229 A C D B D C A C D 25 26 27 28 29 30 31 32 33 34 35 36 B A C 28 D 28 C 29 B 29 TRUE D 37 B 38 B 40 C 41 A 43 37 38 39 40 41 42 43 44 45 46 47 48 D C A C B C B A C B C B 49 50 51 52 53 54 55 56 57 58 59 60 TRUE FALSE TRUE A4 C 12 C 12 A 13 A 13 A 24 B 24 B LECTURE A LECTURE 61 A LECTURE

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