Download Primary FRCA MCQ/SBA Revision Day 23rd

Primary FRCA MCQ/SBA Revision Day 23 rd August 2014
Physiology
For each of the questions below, answer ‘True’ or ‘False’. There is no negative
marking. Each correct answer carries one mark
1) At birth:
a) The foramen ovale closes because of a reversal of the pressure gradient
between the left and right atria.
b) The ductus arteriosus closes because of a respiratory acidosis
c) Blood flow in the IVC falls
d) Hypoxia will favour a right to left shunt
e) The first breath generates a negative pressure of about 50 cmH2O
2) Left ventricular end diastolic pressure (LVEDP):
a) Gives an index of preload
b) Will be raised if left ventricular compliance increases
c) Is increased in aortic regurgitation
d) Is a determinent of myocardial oxygen consumption
e) Is measured using a pulmonary artery flotation catheter
3) An increase in right atrial pressure:
a) Decreases systemic arterial pressure
b) Will increase type A atrial stretch receptor discharge during atrial systole
c) Causes an increase in urine volume
d) Can increase the heart rate via the Bainbridge reflex
e) Can decrease the heart rate via the baroreceptor reflex
4) In diastole:
a) Myocardial relaxation is metabolically active
b) Hypercalcaemia causes positive lusitropy
c) Left atrial contraction occurs just before right atrial contraction
d) The greater part of left coronary artery blood flow occurs during diastole.
e) Diastasis shortens first with increasing heart rate
5) In the first 24 hours after major trauma:
a) Sodium is retained
b) Glomerular filtration rate increases
c) Patients will be immunosuppressed
d) Urinary nitrogen levels will rise
e) Isulin secretion is decreased
6) Afterload:
a) Equals systemic vascular resistance
b) If increased, will result in decreased LVEDV
c) Is likely to be low in heart failure
d) Will be low in a dilated ventricle
e) Is decreased in mitral regurgitation
7) Concerning the splanchnic circulation:
a) The adult liver normally receives approximately one third of its blood supply
from the coeliac axis
b) Beta 1 adrenergic receptors cause mesenteric arteriolar vasodilatation
c) Positive end expiratory pressure (PEEP) decreases portal blood flow
d) Arcades of arterioles supplying mucosal villi terminate and branch at the tip
supplying well oxygenated blood to the mucosa
e) The splanchnic venous system can contain 1/3 of the total blood volume
8) Concerning cardiac tissue:
a) Myocardial cells have a RMP of -60mV
b) Myocardial cells do not possess gap junctions
c) Conduction velocity of action potentials is greatest in the bundle branches
and Purkinje system
d) Calcium within the sarcoplasmic reticulum is released in response to rising
intracellular sodium levels
e) Both the SA and AV nodes blood supply is derived from the right coronary
artery
9) During moderate exercise:
a) Cerebral blood flow increases
b) Increased cardiac output is achieved mainly from an increased heart rate
c) Central venous pressure rises
d) Intravascular volume is usually reduced
e) Haematocrit tends to fall
10) Regarding electrolyte changes:
a) Hypokalaesmia increases automaticity
b) Hypokalaemia increases the QT interval
c) Hyperkalaemia brings the RMP closer to the threshold potential
d) Hypercalcaemia makes the threshold potential more negative
e) Hypermagnesemia prolongs the PR interval
11) Cardiac output increases with:
a) Heart rate
b) Increased systemic vascular resistance
c) A decrease in dp/dt
d) Hyperkalaemia
e) An increase in LVEDV
12) Concerning the cardiac cycle
a) aortic blood flow is lowest at the end of diastole
b) aortic pressure is highest at mid systole
c) atrial conreaction can account for 40% of ventricular filling
d) QRS complex occurs immediately before the rapid ejection phase
e) The aortic valve opens at the start of ventricular systole
13) Response to acute haemorrhage may include
a) reduced ADH secretion
b) reduced sympathetic output
c) reduced baroreceptor discharge
d) increased glucagon release
e) increased interstitial fluid formation
14) In the fetal circulation at birth
a) Pulmonary vascular resistance halves
b) SVR rises
c) Left atrial pressure rises
d) The ductus arteriosus should close within 48 hrs
e) The foramen ovale fuses
15) The following increase the fluid out of capillaries
a)
b)
c)
d)
e)
venous hypertension
decrease in oncotic pressure
arterial vasoconstriction
hypotension
decrease in hydrostatic pressure in capillaries
16) The ‘ a ‘ wave in jugular venous pulse
a) is caused by atrial filling during ventricular systole
b) is elevated in tricuspid stenosis
c) is elevated in atrial fibrillation
d) is elevated in tricuspid regurgitation
e) when enlarged are known as cannon a waves
17) In Cardiac ventricular muscle
a) cells exhibit automaticity
b) the cell membranes are largely impermeable to negatively charged ions
c) Depolarization is followed by a plateau potential lasting about 200 ms
d) Rapid depolarization is mainly due to calcium influx thro’ transient T type
channels
e) Cannot be tetanized
18) Concerning coronary blood flow
a) it is increased during hypoxia
b) is approximately about 25% of the cardiac output at rest
c) significant right coronary artery perfusion occurs during systole
d) the coronary circulation has the highest A-V O2 difference of all the
major organs
e) coronary blood flow is regulated by the baroreceptor reflexes
19) Cardiac excitation in the normal heart
a) Is initiated spontaneously in the SA node
b) transmission thro’ the atrium takes 0.4ms
c) the AV node allows rapid transmission of the electrical excitation to the
ventricle
d) the preferential route of transmission from the right to left atrium is via the
Bachmann bundle
e) the gap junctions allow the myocardium to act as a single contractile unit
20) The Valsalva Manouvre
a) at the onset of valsalva manouvre arterial pressure rises
b) the reduced arterial pressure seen during the manouvre is exaggerated in
hypovolaemia
c) heart rate changes are mediated via the aortic chemo receptors
d) the bradycardia seen after the termination of the manouvre is absent in
most long standing diabetics
e) increases the intensity of heart murmur associated with aortic stenosis