Week: 3 Module: Cardiovascular system (module 11) Name: Duration: EMBOLISM 1.

All of the following are true regarding Embolism EXCEPT: A. It may form as a complication of thrombus formation B. Imparction of detached thrombus in small vessel wall may results in partial or complete occlusion of the vessel C. 99% of emboli are detached thrombi D. If these emboli are septic they will lead to pyemic abscess 2. The effect of pulmonary embolism depend on: I. The size of embolus II. Nature of the blood supply III. The presence or absence of pulmonary congestion IV. The vulnerability of tissue to hypoxia A. I ONLY B. I & III C. I,II,& III D. III & IV 3. All of the answer below are correct regarding thromboembolism EXCEPT: A. In interventricular septal defect, venous emboli bypass the lung and reach the arterial circulation B. The systemic thromboembolism refer to emboli that travel through arterial circulation while pulmonary embolus from venous circulation C. The emboli may be septic or aseptic D. Systemic (arterial) thromboembolism originate in the lung, aorta or large artery 4. Choose the correct types of emboli I. Tumor emboli in benign tumors II. Detached thrombi III. Air emboli IV. Miscellaneous emboli A. I & II B. II, III & IV C. III & IV D. IV ONLY 5. Choose the correct answer regarding effect of thromboembolism: A. Septic emboli resulting from infected thrombi cause infarction B. In venous thromboemboli, there is development of pulmonary hypertension with subsequent left heart failure

C. D.

Acute heart failure in medium sized emboli Saddle embolus cause hemorrhagic lung infarct

CARDIAC OUTPUT 1 TRUE OR FALSE 6. Stroke volume is the volume of the blood pumped by each ventricle per minute(True/false) 7. End diastolic volume is affected by the venour return and stroke volume(true/false) 8. Sleep affect the cardiac output massively(true/false) 9. What happen when the Right atrium pressure increasing above 7mmHg? A Syncope B Dizziness C Regulation of body takes place D Heart stop immediately 10. Below are the factors that increase venous return EXCEPT A Increase in mean systemic filling pressure B Increase in right atrial pressure C Increase in muscle tone and contraction D No influence from gravity CARDIAC ENZYMES 11. All the following are the disadvantages of myoglobin EXCEPT A. Typical rise occurs within 2-4 hours after onset of myocardial infarction B. Myoglobin is not cardiac specific C. Cant be used as late marker D. Cant be used in diagnosis myocardial infarction in renal failure patients 12. Choose the correct advantages of Creatine Kinase as marker for myocardial infarction. IPlasma enzyme activity increase by 95% in myocardial infarction IISecond rise indicates extent of damage IIIIndicate reperfusion after thrombolytic therapy with confirmed AMI patients IVA prolonged rise may indicate cardiac ventricular aneurysm A. B. C. D. I , II, and III I, III and IV II, III and IV I, II, III and IV

13. All the following conditions can lead to increase in plasma AST concentration and increase LDH1 level EXCEPT IPrimary hepatic dysfunction IISecondary hepatic dysfunction after small MI IIICongestive heart failure without infarction or pulmonary embolism IVMyocardial infarction A. B. I & II II & III

C. D.

I & III II & IV

True or False 14. Cardiac and skeletal forms of TnI and TnT are structurally different and can be distinguished by immunological assays. (True / False) 15. Enzyme activity assay reflects the concentration of enzymes thus having the best accuracy. (True / False) CARDIAC OUTPUT 2 16. Which is not the factor that determine the venous return? A. The respiratory movements B. The capillaries diameter C. The right atrial pressure D. Voluntary muscle contraction and tone 17. Choose the false statement regarding the effect of gravity on cardiac output: A. Gravity has an effect on the venous return in lying flat position B. On standing up from lying down,400-600 ml is pooled down in the veins of lower limbs C. If the person remains standstill,cardiac output will decrease and syncope might occur D. Contraction of skeletal muscles of lower limb prevents pooling of blood in the veins 18. Which is the false statement regarding the pumping capacity of the heart: A. Is the maximum cardiac output which the heart can pump B. Resting cardiac output is the pumping rate of the normal heart during rest C. Resting cardiac output is equal to the resting venous return D. Under normal conditions, venous return is always higher than the pumping capacity 19. All the following are true regarding the factors that determine the pumping capacity of heart except: A. Regarding the preload, a denervated heart can rapidly adjust its ouput to rapid changes in venous return B. The pumping power of heart is indirectly proportionate to the preload C. Sympathetic tone to the heart increases its pumping capacity by its chronotropic and inotropic effects D. Physiological cardiac hypertrophy increases pumping capacity up to 35 L/min 20. The effects of afterload are the following except: A. When the blood pressure against the heart pumping is raised, the heart puts out less blood than it receives for several minutes B. Blood accumulates in the ventricles and the size of the heart increases and the heart beats more forcefully and output returns to its previous level C. When the blood pressure and resistance are reduced,the output rises transiently but the size decreases D. Changes in the arterial blood pressure in a normal heart have no effect on the output provided that the venous return is kept constant

ISCHEMIA AND HEMORRHAGE 21. All the following are the examples of arterial obstruction causing infarction except? A. Thrombosis B. Embolism C. External compression by tumor D. Blood vessel dilatation 22. All the following factors affect the development of an infarct except? A. Nature of blood supply B. The state of collateral circulation C. Carbon dioxide content of the blood D. Vulnerability of tissue to hypoxia 23. Which is not the cause reperfusion of the infarcted area of red infarct? A. Relief of associated vasospasm B. presence of occluded thrombus C. Dissolution of occluded thrombus D. Presence of some collateral circulation 24. All are fates of infarct except? A. Small infarct encapsulated by fibrous tissue B. Infection and abscess formation C. Large infarct encapsulated by fibrous tissue D. Superadded putrifaction leads to gangrene 25. All the following are the external hemorrhage except? A. Epistaxis B. Melena C. Hematocele D. Hematuria Drug Used In Coagulation Disorder 26. All of the following are the side effect and toxicity of heparin EXCEPT A. Spontaneous haemorrhage B. Osteoporosis with large doses even in short usage duration C. Formation of heparin-dependent antiplatelet antibodies D. Hypersensitivity 27. Which of the following are regarding heparin as a parenteral anticoagulant ? I. Has immediate effect II. Prevent fibrin formation by increase activity of antithrombin III III. Therapy is monitored by prothrombin time (PT) IV. 1 mg I.V of its antidote is required to antagonize each 100 units of heparin A. B. C. D. I and II II and III I, II and IV All of the above

28. All of the following are FALSE about anticoagulants EXCEPT A. Heparin can be given orally B. LMW Heparins cause less bleeding as it has greater activity against factor Xa C. Antidote of warfarin is protamine sulphate D. Oral anticoagulants are active either in vivo or in vitro E. Heparin can be introduced through I.V, I.M and subcutaneous administration 29. Which of the following are regarding oral anticoagulants? I. Warfarin is a coumarin derivatives II. Interfere with the formation of prothrombin and VII, IX, and X from vitamin K III. Has latent period due to rate of drug action in liver IV. It is teratogenic A. B. C. D. I and II II and III I, II and III All of the above

30. Which of the following answers not one of therapeutic or prophylactic uses of anticoagulant? A. Coronary thrombosis B. Endocarditis C. Following major surgery D. Cardiac prosthesis E. Long standing atrial fibrillation THE CARDIAC RESERVE AND THE CARDIAC WORK 31. Which of the following affect the stroke volume reserve? I. Venous return II. Sympathetic discharge III. Cardiac dilation IV. Body temperature A. II and III B. I, II and III C. I, II and IV D. I, II, III and IV 32. The following are the limit of cardiac reserve (in excessive increase in heart rate) EXCEPT A. Overstretching of myocardial fibers B. Shortening of diastolic time C. Decrease in stroke volume D. Affects coronary perfusion 33. In non-athlete , the stroke volume is increased during exercise, through: A. Cardiac dilation B. Greater end-diastolic volume C. Smaller end-systolic volume D. Increase venous return

34. In heart failure, the capacity of cardiac reserve is: A. 300%-400% B. 500%-600% C. 200% D. None of the above 35. Any factor impeding the cardiac pump capacity decrease cardiac reserve A. True B. False 36. The kinetic work, performed by the heart is about A. 6 Kg meter/ minute B. 1 Kg meter/ minute C. 0.14 Kg meter/ minute D. 7.14 Kg meter/ minute RHEUMATIC FEVER BETA-HEMOLYTIC STREPTOCOCCI (MICROBIOLOGY) 37. According to the haemolytic properties in blood agar, the streptococci can be classified into A. Alpha haemolytic streptococci B. Beta haemolytic streptococci C. Non-haemolytic streptococci D. All of the above 38. Which of the following answer is not the morphology of the beta haemolytic streptococci? A. The capsule produce by group A streptococci can impede the process of phagocytosis B. It is gram negative cocci, occurring in chains of varying length, non-motile, no sporing C. The streptococcal cell wall contains carbohydrates, proteins, peptidoglycans and lipoteichoic acid D. Hair like pili project through the capsule of group A streptococci 39. All of the following factor plays a role in the determination of the virulence of group A streptococci except A. Hyaluronic acid capsule B. M protein C. Phospholipids D. Lipoteichoic acid 40. Choose the correct answer about the hyaluronidase enzyme secreted by the group A streptococci A. It split the hyaluronic acid, an important component of the ground substance of connective tissue B. It aids in spreading of infection C. Encoded by bacteriophage gene during lysogenic conversion D. Purified hyaluronidase is used medicinally to increase the absorption of drugs that are given by injection 41. Which of the following is not true about advantages of the antigen detection tests? A. Sensitive B. Specific

C. D.

Rapid Inexpensive

INTERRELATIONSHIP BETWEEN PRESSURE, FLOW AND RESISTANCE 42. Which of the following is FALSE regarding blood flow in vessels? A. It refers to quantity of blood that passes a given point in the circulation in a given period of time. B. Most central portion of the blood stays in the center of the vessels C. It determined by pressure gradient and vascular resistance D. It is inversely proportional to the pressure difference 43. Choose the correct answers regarding resistance along the vascular system. I. Arteriolar resistance determines perfusion through an organ II. Resistance at the parallel systemic vascular beds determines distribution of the blood flow through organs III. It is the highest at the aorta. IV. It is inversely proportional to blood flow A. B. C. D. I,II I,II,III I,III,IV I,II,IV

44. Which law states this. Vessel wall tensions distending pressure x the radius of vessels A. B. C. D. Laplace law Poiseuille's law Ohm's law Newton's Law

45. Which of the following is NOT related to Poiseulle's Law? A. Pressure gradient is directly proportional to blood flow B. Blood viscosity is directly proportional to blood flow C. The wider the lumen,the the greater the blood flow D. The longer the blood vessels,the greater the resistance 46. Choose the false answers regarding total peripheral resistance. I. It is directly proportional to the blood viscosity and length of vessel II. It is controlled by arteriolar resistance III. The vessels arranged in series create more resistance than the one arranged in parallel. IV. Capillaries control perfusion through an organ and the distribution of cardiac output A. B. C. D. I,II,III I,II,IV I,III,IV II,III,IV

47. The following are TRUE examples of vasodilator substances (metabolites) EXCEPT: (pg 126) A. Histamine in injured tissue B. Adenosine in cardiac muscle C. Increase in carbon dioxide tension in brain D. Decrease the temperature in active tissues 48. The duration of reactive hyperemia depends on : (pg 127) A. Duration of block B. During exercise C. Duration take place for days D. All of above 49. What is systemic control of regulation blood flow: (pg 128) A. Autoregulation and endothelial mediated B. Myogenic and metabolic C. Hormonal and nervous mechanism D. None of above 50. Which of following endothelial mediated regulation? (pg 128) I. ADH II. Thromboxane A III. Nitric oxide IV. Kinins A. I AND II B. II AND III C. III AND IV D. I AND IV 51. Which the following have powerful vasoconstriction action? (lecture) A. ADH : Vasopressin B. Kinins C. Epinephrine D. Atrial natriuretic peptide ACUTE RHEUMATIC FEVER (PATHOLOGY) 52. The following statements are true EXCEPT A. Aschoffs nodules are characteristic only in rheumatic fever affecting the heart B. Acute rheumatic fever is a complication of streptococcal pharyngitis C. Penicillin is potent in decreasing the incidence and severity of acute rheumatic fever D. Antibody against the infecting microorganism takes 2-3 weeks to be formed 53. The following are true abut acute rheumatic fever EXCEPT A. It is an autoimmune disease causing systemic inflammation B. Most of the patients of acute rheumatic fever has decrease serum complement and antihyaluronidase antigens C. The pathogenesis involve sharing the same epitopes between the infecting microorganism and self antigen D. Aschoffs cells have large vesicular nuclei with caterpillar like chromatin mass

54. The following are true EXCEPT I. Rheumatic fever of the heart shows pancarditis II. Mural endocardium is more affected than valvular endocardium III. Mural thrombi may be found in Mac Callums patches IV. Aschoffs bodies are scattered within interstitial connective tissue, intravascular A. I & II B. II & III C. I& III D. II & IV 55. The following are correct statements regarding rheumatic fever EXCEPT I. Rheumatic chorea is due to basal ganglia involvement II. A person with polyarthritis and arthralgia with no previous history of rheumatic fever is diagnosed as having rheumatic fever III. Acute rheumatic fever shows a high mortality rate with majority of the patients died IV. Erythematous lesions are transient and migratory A. I & II B. II & III C. III & IV D. I & IV 56. The following are true EXCEPT A. Acute rheumatic fever affecting the heart is the most dangerous with high occurrence in children B. Recurrences increase the risk of chronic rheumatic heart disease C. Subcutaneous nodules are painless and localized over extensor tendons of extremities D. Pancarditis will always be transformed into chronic rheumatic heart disease

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Answer: 1.D(pg.185) 2.B(pg.174) 3.D(pg.188) 4.B(pg.187) 5.A(pg.188) 6.False 7.True 8.False 9.C 10.B 11.A 12.D 13.C 14.True 15.False 16.B(pg.114) 17.A(pg.115) 18.D(pg.115) 19.B(pg.116) 20.A(pg.116) 21.D 22.C 23.B 24.A 25.C 26.B(pg.282) 27.C(pg.281) 28.B(pg.281) 29.D(pg.283) 30.B 31.B 32.A 33.C 34.D 35.A 36.C 37.D(pg.239) 38.B(pg.239) 39.C(pg.241) 40.C(pg.241) 41.A(pg.242) 42.D 43.D 44.A 45.B 46.A 47.D 48.A 49.C 50.B 51.A 52.A 53.B 54.D 55.B 56.D