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Physiology
Anatomy
Shock
Myocardial infarction
100
Which of the following is most likely to INCREASE pulse pressure? a) Increased heart rate b) Increased TPR c) Decreased aorta compliance d) Decreased venous return e) both c) and d)
c) Decreased aorta compliance
100
Which three arteries responsible for blood supply to the head and upper limbs, leave the arch of the aorta?
Brachiocephalic, left common carotid, left subclavian
100
Name at least 3 different types of shock
Hypovolemic, cardiogenic, distributive, obstructive
100
Which three coronary arteries are most likely to be involved in myocardial infarction? (in order of most to least)
LAD> RCA> Circumflex
200
In heart physiology, what does 'afterload' refer to?
The pressure/resistance against which the muscle exerts it's contractile force. e.g. the afterload in the LV is the pressure in the aorta.
200
What are the three layers of blood vessels?
Tunica adventitia, tunica media, tunica intima
200
The best single indicator of adequacy of restoration of fluid volume after injury is a. blood volume b. haematocrit c. blood gases d. urine output e. rise in blood pressure
Answer= d) urine output
200
Which of the following is NOT used in treating MI a) Organic nitrates b) Beta adrenoceptor agonists c) Calcium channel antagonists d) Statins e) Aspirin
b) Beta adrenoceptor agonists. Beta adrenoceptor Antagonists are used.
300
Put these in order of conductance in normal physiology: Bundle of His AV node SA node Purkinje Network Bundle branches
SA node AV node Bundle of His Bundle Branches Purkinje Fibres
300
From inguinal ligament to pubic symphysis, in what order are the femoral artery, femoral nerve and femoral vein?
Nerve, Artery, Vein
300
What is distributive shock (e.g. septic shock)?
Widespread systemic vasodilation and decreased cardiac output, causing decreased perfusion of vital organs.
300
Name at least two plasma markers of cardiac injury
Cardiac troponin, Creatine Kinase MB (CK-MB), Myoglobin, Lactate dehydrogenase (LDH), Glycogen phosphorylase isoenzyme BB (GPBB), ischaemia modified albumin (IMA), aspartate aminotransferase, pro-brain natriuretic peptide,
400
In cardiac myocyte action potential, which channels are responsible for the plateau?
Slow Na+/Ca2+ channels open, letting in Na+ and Ca2+. K+ channels also become less permeable, preventing re-polarization.
400
Name the three openings to the right atrium by which it receives deoxygenated blood.
Superior vena cava Inferior vena cava coronary sinus
400
What would we expect to see in a patient with class II (15-30% blood loss) hypovolaemic shock?
Tachycardia, reduced pulse pressure, possibly tachypnoea and anxiety. Urinary output usually still satisfactory.
400
Are myocardial infarctions haemorragic or anaemic? Why?
Haemorragic, as they do not have end-artery circulatory supply.
500
Describe the Frank-Starling Law. What causes it?
The Frank-Starling law says that an increase in filling volume in the heart causes a corresponding increase in cardiac contractility. This is caused by more optimal overlap on the cardiac myocyte's muscle filaments.
500
What is the venous pathway from the hemi-azygos vein to the right atrium?
Hemi-azygos vein, azygos vein, superior vena cava, right atrium.
500
A bleeding patient is dropping his blood pressure. What would be your first line to maintain his blood pressure? a. get patient to drink lots of fluids b. Give IV dextrose 5 % solution c. Give IV normal Saline d. Give fresh plasma e. Give blood transfusion
Answer = c) give IV normal saline
500
A murmur after myocardial infarction that is systolic is likely to be due to which of the following lesions: a. ventricular aneurysm b. hypertension c. mitral incompetence from papillary muscle damage d ventricular septal defect e. ventricular rupture
Answer = d) ventricular septal defect