Deck 4: Cardiovascular Function

Question 1

Cardiac cells are able to generate an impulse to contract even without an external stimulus. This is called:

A) excitability.
B) action potential.
C) automaticity.
D) chronotropic effect.

Answer 1

C

Question 2

The QRS wave of an electrocardiogram (EKG) is produced by:

A) depolarization of the atria.
B) repolarization of the atria.
C) depolarization of the ventricles.
D) repolarization of the ventricles.

Answer 2

C

Question 3

Stimulation of alpha receptors results in:

A) vasoconstriction (alpha 1) and vasodilation (alpha 2).
B) vasodilation (alpha 1) and vasoconstriction (alpha 2).
C) bronchodilation and increased heart rate.
D) increased heart rate (alpha 1) and increased contractility (alpha 2).

Answer 3

A

Question 4

A healthy 40-year-old man was sitting and having his blood drawn for routine labs. He suddenly becomes faint and his heart rate and blood pressure drop. He quickly awakens. What caused these symptoms?

A) His vagus nerve was stimulated.
B) His blood sugar dropped.
C) He had a seizure.
D) He had an episode of postural hypotension.

Question 5

Factor(s) that affect stroke volume include:

A) preload.
B) heart rate.
C) contractility.
D) afterload.
E) preload, contractility, and afterload.

Question 6

The renin-angiotensin-aldosterone pathway:

A) is activated by renin.
B) acts to decrease loss of sodium in urine.
C) increases in activity in response to blood loss.
D) can be blocked to help lower blood pressure.
E) All of these are correct.

Question 7

What is the mechanism of death following cardiac tamponade?

A) Impaired cardiac contraction due to inflammation surrounding a myocardial infarction
B) Compression of the heart by the blood on the pericardial sac, which impairs filling in diastole
C) Overdistension of the ventricles due to heart failure
D) Venous pressure rises and pulse pressure widens

Question 8

A 62-year-old man had a left ventricular myocardial infarction 6 weeks ago. He arrives at the emergency room complaining of chest pain that is sharp and came on suddenly. The pain is in the front of his chest. He states when he breaths in it hurts more and sitting up and leaning forward decreases the pain. A 12-lead electrocardiogram will most likely reveal:

A) ST segment elevation in the left ventricle leads.
B) ST segment depression in the left ventricle leads.
C) diffuse ST segment elevation.
D) new Q waves with reciprocal changes.

Question 9

Which of the following statements related to infective endocarditis (bacterial endocarditis) is not correct?

A) It is a complication of valvular heart disease.
B) Fibrin-platelet thrombi form on rough valve surface; bacteria implant in the thrombus and incite inflammation.
C) Microorganisms never implant on a normal heart valve.
D) Part of valve vegetations may break loose and be carried into the circulation as emboli.

Question 10

A patient presents to the emergency department complaining of severe chest pain. On examination, you note a temperature of 102.5ºF, a white blood count of 20,000/μL, and a friction rub near the lower left sternal border when the breath is held. What is the likely diagnosis?

A) Pleuritis
B) Pneumonia
C) Myocarditis
D) Pericarditis

Question 11

With mitral valve prolapse, the leaflets:

A) are narrow impeding forward blood flow during systole.
B) prolapse into the right atrium causing altered flow.
C) collapse into the left atrium during systole.
D) calcify, which prevents proper opening.

Question 12

A 70-year-old woman comes in after a syncopal episode. She said she fainted while she was gardening. She said she's been feeling a bit fatigued and short of breath but attributes this to not sleeping well. On examination, a systolic murmur is heard. Based on these findings, a common valvular disorder, and the most likely, is:

A) mitral regurgitation.
B) mitral stenosis.
C) aortic regurgitation.
D) aortic stenosis.

Question 13

An 80-year-old patient in the intensive care unit with an overwhelming systemic infection begins to exhibit splinter hemorrhages under her fingernails, hematuria, and petechia. What would be a likely cause?

A) Cardiac tamponade
B) Infective endocarditis
C) Dilated cardiomyopathy
D) Pericarditis

Question 14

A 55-year-old man has been complaining of feeling short of breath, which he feels has been worsening over the past 4-5 months. He smokes one pack of cigarettes per day for the last 30 years, and he is a recovering alcoholic. He reports being sober for the past 6 months. A transthoracic doppler reveals systolic dysfunction. Which type of cardiomyopathy is most likely present?

A) Restrictive cardiomyopathy
B) Hypertrophic cardiomyopathy with obstruction
C) Hypertrophic cardiomyopathy without obstruction
D) Dilated cardiomyopathy

Question 15

A 19-year-old athlete went out for his first day of football practice. He experienced sudden cardiac death. The cause of death was determined to be cardiomyopathy. It was most likely __________ cardiomyopathy.

A) dilated
B) hypertrophic
C) restrictive
D) dystrophic

Question 16

A 40-year-old man has a family history of one brother who died of heart disease at the age of 30 and a cousin who had a heart attack at the age of 40. He doesn't know his history on his father's side, and his mother is 75 years old and is healthy other than hypertension. He had a transthoracic echocardiogram that reveals thick, stiff ventricular walls particularly in the interventricular septum. There is reduced relaxation during ventricular filling and diastolic dysfunction. These findings are consistent with:

A) dilated cardiomyopathy.
B) hypertrophic cardiomyopathy.
C) restrictive cardiomyopathy.
D) dystrophic cardiomyopathy.

Question 17

A 62-year-old woman is complaining of palpitations and feeling dizzy. She said this happened yesterday, and she sat down and it went away. She has a history of hypertension and is taking irbesartan (an angiotensin receptor blocker). Her vital signs are as follows: temperature, 98.8 ºF; pulse irregular, 110 beats per minute; respiratory rate, 20 per minute; and blood pressure, 110/70 mm/Hg. An electrocardiogram will likely reveal:

A) ventricular tachycardia.
B) sinus tachycardia.
C) atrial fibrillation.
D) second-degree atrioventricular block.

Question 18

Patients with atrial fibrillation are commonly prescribed anticoagulation to:

A) decrease the heart rate.
B) prevent myocardial infarction.
C) prevent heart failure.
D) prevent ischemic stroke.

Question 19

The CHA₂DS₂-VASc criteria used to determine the risk for thromboembolism with atrial fibrillation includes:

A) diabetes insipidus.
B) hypertension.
C) gender.
D) age.
E) hypertension, gender, and age.

Question 20

Which of the following is a characteristic of ventricular remodeling in heart failure?

A) Results in left ventricle dilation and hypertrophy
B) Causes beta adrenergic desensitization with decrease in heart rate
C) Causes preload reduction and subsequent fluid retention
D) Results in improved contractility due to decreased myocyte loss

Question 21

A patient with a history of myocardial infarction is told he has stage C heart failure, and he wants to know what this means. The description provided will include:

A) stage C means you are at risk for heart failure.
B) stage C means your heart failure was due to coronary disease.
C) staging is used to determine the severity of heart failure, and stage C means you are showing clinical signs of heart failure.
D) stage C refers to your functional capacity and ability to do things with activity.

Question 22

An infant is diagnosed with a small patent ductus arteriosus (PDA). Which of the following is accurate pertaining to this case?

A) The infant has an opening between the right and left atria.
B) The infant will likely have difficulty breathing and difficulty with feeding and gaining weight.
C) The infant has an opening between the pulmonary artery and aorta.
D) The infant will be cyanotic.

Question 23

An infant is diagnosed with a small ventricular septal defect (VSD). Which of the following is accurate pertaining to this case?

A) The infant will most likely be asymptomatic.
B) Pulmonary blood flow is usually decreased.
C) The infant will have a murmur and cyanosis.
D) Shunting goes from the right ventricle to the left ventricle.

Question 24

A patient with a history of stable angina states that he has recently experienced an increase in the number of attacks, which occur at times when he is walking. What should you suspect?

A) The patient continues to have stable angina.
B) The patient has developed unstable angina.
C) The patient has experienced an acute MI.
D) The patient has a subendocardial necrosis.

Question 25

Why do cardiac enzymes rise after an acute myocardial infarction?

A) White cells are attracted to the site of muscle injury.
B) Injured fibers increase their synthesis of cardiac muscle enzymes.
C) Cardiac enzymes leak from the damaged muscle fibers into the bloodstream.
D) Blood flow to the injured muscle is increased.

Question 26

A 12-lead EKG is conducted on a 65-year-old woman with a history of type 2 diabetes mellitus. Which of the following findings represent an area that is electrically dead?

A) ST segment depression
B) ST segment elevation
C) Pathologic Q waves
D) Prolonged ST segment

Question 27

A fever; dry, cracked lips; a reddish tongue; and a rash on the extremities is characteristic of which vascular disorder in children?

A) Raynaud disease
B) Kawasaki disease
C) Eisenmenger syndrome
D) Buerger disease

Question 28

In a patient with acute coronary syndrome, what is the goal time from presentation to hospital to opening of the artery (i.e., door-to-balloon time)?

A) 30 minutes or less
B) 60 minutes or less
C) 90 minutes or less
D) 120 minutes or less

Question 29

The most likely place for a thrombosis to form postoperatively is:

A) the lungs.
B) the left side of the heart.
C) the legs.
D) anywhere in the body.

Question 30

A severely obese patient presents to the clinic with edema of the right lower extremity that is impairing ambulation. On inspection, the healthcare provider notes that the edema does not indent with pressure, the skin on the right lower extremity is thick and rough, and distal pulses are present and equal bilateral. The healthcare provider should expect which of the following?

A) Peripheral vascular disease
B) Congestive heart failure
C) Deep vein thrombosis
D) Lymphedema

Question 31

Which of the following individuals is the most likely to have a silent myocardial infarction (MI)?

A) A young male who smokes
B) A middle-aged female who has hypertension
C) A 40-year-old pregnant female
D) An obese male diagnosed with diabetes mellitus

Question 32

Preeclampsia develops as a result of:

A) placental vascular alterations stimulating the maternal inflammatory response.
B) increased placental perfusion as a result of shunting from the mother.
C) development of antibodies against the placenta.
D) fluid overload from physiological volume increases in pregnancy.

Question 33

Which of the following clinical manifestations is a compensatory mechanism to the initial stage of shock?

A) Decreased mean arterial pressure
B) Elevated body temperature
C) Vascular vasodilation
D) Increased heart rate

Question 34

Septic shock is commonly caused by:

A) gram-positive bacteria.
B) gram-negative bacteria.
C) fungal organisms.
D) viral organisms.

Question 35

Which of the following strategies is implemented when sepsis is suspected?

A) Administer anticoagulants.
B) Administer fluids if lactate levels are low.
C) Administer broad spectrum antibiotics.
D) Administer glucocorticoids to reduce inflammation.