Review of Cardiac Anesthesia with 2,100 MCQs (For all Examinations in Cardiac Anesthesia) Poonam Malhotra Kapoor
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Cardiovascular Anesthesia

Applied Anatomy and Physiology1

1. Each of the following is located in the mediastinum, except the:
  1. Aorta
  2. Esophagus
  3. Heart
  4. Pancreas
  5. Trachea
1. d
2. Which of the following is the body cavity that contains the pituitary gland?
  1. Abdominal
  2. Cranial
  3. Pleural
  4. Spinal
  5. Thoracic
2. b
3. Which of the following closes and seals off the lower airway during swallowing?
  1. Alveoli
  2. Epiglottis
  3. Larynx
  4. Uvula
  5. Vocal cords
3. b
4. Which of the following controls body temperature, sleep, and appetite?
  1. Adrenal glands
  2. Hypothalamus
  3. Pancreas
  4. Thalamus
  5. Thyroid gland
4. b
5. Which of the following is a substance that aids the transmission of nerve impulses?
  1. Acetylcholine
  2. Cholecystokinin
  3. Deoxyribose
  4. Oxytocin
  5. Prolactin
5. a
6. Where is the sinoatrial node located?
  1. Between the left atrium and the left ventricle
  2. Between the right atrium and the right ventricle
  3. In the interventricular septum
  4. In the upper wall of the left ventricle
  5. In the upper wall of the right atrium
6. e
27. Exhaled air, when compared with inhaled air, contains more:
  1. Carbon dioxide and less oxygen
  2. Nitrogen and less carbon dioxide
  3. Oxygen and less carbon dioxide
  4. Oxygen and less carbon monoxide
  5. Oxygen and less nitrogen
7. a
8. In the lungs, gas exchange occurs in tiny one-celled air sacs called:
  1. Alveoli
  2. Bronchi
  3. Bronchioles
  4. Capillaries
  5. Pleurae
8. a
9. A structure composed of two or more tissues is termed:
  1. Organ
  2. Serous membrane
  3. Complex tissue
  4. Organ system
9. a
10. The visceral pleura:
  1. Is the membrane lining surface of the lungs
  2. Is the membrane lining the wall of the thoracic cavity
  3. Is the fluid around the lungs
  4. Is the thinnest portion of the peritoneum
10. a
11. The anatomical position is characterized by all of the following except:
  1. Arms facing posterior
  2. Thumbs pointing laterally
  3. Face pointing anteriorly
  4. Body standing upright
11. a
12. Which of the following lies fully ipsilateral to the left iliac region?
  1. Epigastric region
  2. Left hypochondriac region
  3. Right inguinal region
  4. Hypogastric region
12. b
13. The “basic unit of life” is:
  1. The atom
  2. Water
  3. The cell
  4. The chemical level of organization
13. a
14. A homeostatic imbalance:
  1. Must be restored by negative feedback mechanisms
  2. Is considered the cause of most diseases
  3. Is when the internal conditions of the body become more stable
  4. Only occur when positive feedback mechanisms are overwhelmed
14. b
15. Which of the following is NOT a characteristic of life?
  1. Growth
  2. Responsiveness
  3. Reproduction
  4. Organ systems
15. d
16. The sum of all chemical reactions in the body is termed:
  1. Homeostasis
  2. Physiology
  3. Dynamic feedback
  4. Metabolism
16. d
17. A vertical plane through the body dividing it into right and left is termed:
  1. Sagittal
  2. Lateral
  3. Transverse
  4. Frontal
17. a
318. Which of the following is an example of applied physiology?
  1. Measuring the length of the femur on a fetus using ultrasound
  2. Locating an injury to a tendon in the shoulder using CT imaging
  3. Describing the process of how a toxin interferes with nerve impulse conduction
  4. Identifying the types of cells found in a biopsy sample of lung tissue
18. c
19. The elbow is __________ to the wrist:
  1. Distal
  2. Lateral
  3. Ventral
  4. Proximal
19. d
20. The heart is ____ to the lungs:
  1. Superior
  2. Dorsal
  3. Medial
  4. Lateral
20. c
21. What is the function of serous membranes?
  1. To prevent fluid loss from an organ
  2. To reduce friction between internal organs
  3. To circulate blood around the organ
  4. To conserve heat within the organ
21. b
22. Histology is the study of:
  1. Cells and membranes
  2. Skin
  3. Organs and organ systems
  4. Tissues
22. d
23. Which of the following involves the injection of radioisotopes into the body?
  1. Radiography
  2. PET
  3. Plain CT scan
  4. Echocardiograph
23. a
24. ________ occurs when carbon dioxide is eliminated faster than it is produced.
  1. Respiratory alkalosis
  2. Respiratory acidosis
  3. Metabolic acidosis
  4. Metabolic alkalosis
24. a
25. The most important ECF buffer of HCl is ________.
  1. CO2
  2. Sodium bicarbonate
  3. Heparin
  4. Progesterone
25. b
26. Molecules that can act reversibly as acids or bases depending upon the pH of their environment are called ________.
  1. Amphoteric
  2. Phosphoric
  3. Buffer
  4. Acidotic
26. a
27. Arterial blood pH below 7.35. is called ________.
  1. Alkalosis
  2. Respiratory alkalosis
  3. Acidemia or acidosis
  4. Respiratory acidosis
27. c
28. ________ reduces blood.
  1. Atrial natriuretic peptide
  2. Brain natriuretic peptide
  3. Procalcitonin
  4. Rennin
28. a
429. When the blood becomes hypertonic (too many solutes), ADH is released. What is the effect of ADH on the kidney tubules?
  1. The release of ADH causes the kidney tubules to reabsorb excess water, resulting in the excretion of concentrated urine.
  2. Excretion of dilute urine
  3. Acidosis
  4. Alkalosis
29. a
30. Only ________ muscle cells are always multinucleated.
  1. Skeletal
  2. Gastric
  3. Cardiac
  4. Neural
30. a
31. The time in which cross bridges are active is called the period of ________.
  1. Relaxation
  2. Contraction
  3. Insertion
  4. Excursion
31. b
32. Only ________ muscle cells commonly branch.
  1. Skeletal
  2. Cardiac
  3. Neural
  4. Gastric
32. b
33. A smooth, sustained contraction is called ________.
  1. Tetanus
  2. Relaxation
  3. Contraction
  4. Limping
33. a
34. The AV node is found near which two valves?
  1. MV and AV
  2. MV and TV
  3. MV and PV
  4. AV and PV
34. b
35. The blood supply to the AV node is:
  1. Branch of RCA
  2. Branch of LAD
  3. Branch of LM artery
  4. Branch of circumflex
35. b
36. The duration of action potential from the SA node to the ventricular muscle is:
  1. 1-2. ms
  2. 4-5. ms
  3. 200-300. ms
  4. 300-400. ms
36. d
37. The automatic innervations of the heart is from the:
  1. Stellagate ganglion alone
  2. Vagus nerve alone
  3. Both stellate ganglion and vagus
  4. None of the above
37. c
38. Noradrenaline binds to which receptors on pacemaker cells of SA node to enhance Ca2+ influx:
  1. α1 receptors
  2. β1 receptors
  3. α2 receptors
  4. β2 receptors
38. b
39. The AP conduction velocities in the cardiac conduction system across the different tissues of the heart is maximum for:
  1. SA Node
  2. AV node
  3. Purkinje system
  4. Bundle of HIS
39. c
540. The concentration of Ca2+ in the ECF and the SR is __________ than the concentration in cardiomyocyte cytoplasm:
  1. Greater than 10,000
  2. Less than 10,000
  3. Same
  4. None of the above
40. a
41. In a pressure volume loop relationship in a cardiac cycle, the area under the curve represents:
  1. Cardiac output
  2. Oxygen delivery
  3. Stroke work
  4. Peripheral resk
41. c
42. M1, M2, M3 receptors are related to:
  1. Epinephrine
  2. Norepinephrine
  3. Acetylcholine
  4. Dopamine
42. c
43. Under physiological conditions both noradrenaline and adrenaline mediate coronary vasodilation due to their:
  1. β1. effect
  2. β2. effect
  3. α1. effect
  4. α2. effect
43. a
44. Acetylcholine is a potent coronary:
  1. Vasodilator
  2. Vasoconstrictor
  3. Both
  4. None of the above
44. a
45. Control of microcirculation is heterogenous between different vascular microdomain and is modulated by all, except:
  1. Endothelial
  2. Metabolic
  3. Neurogenic
  4. Nonmyogenic
45. d
46. Flow dependent vasodilation of intermediate arteriols and small arteries (140-300 µm):
  1. ↑ coronary blood flow
  2. ↑oxygen supply
  3. Both the above
  4. None of the above
46. c
47. “Snow storm” appearance is a USG finding seen in:
  1. Ectopic pregnancy
  2. Hydatidiform mole
  3. PCOD
  4. Incomplete abortion
47. d
48. According to WHO, low birth weight means weight less than:
  1. 1. kg
  2. 2. kg
  3. 2.5. kg
  4. 3. kg
48. c
49. All of the following are morphologic features of apoptosis except:
  1. Cell shrinkage
  2. Chromatin condensation
  3. Inflammation
  4. Apoptotic bodies
49. c
50. All of the following are true about internal jugular vein except:
  1. Inferior thyroid vein drains into it
  2. Superior thyroid vein drains into it
  3. Vagus nerve is posteromedial to it in carotid sheath
  4. Use by the surgeon as a guide in neck dissection for lymph node removal
50. a
51. Best investigation to detect pneumoperitoneum is:
  1. Plain X-ray abdomen, erect
  2. Left lateral decubitus
  3. Plain X-ray chest, erect
  4. CT Scan
51. c
652. Beta-blocker toxicity is treated by:
  1. Glucagon
  2. Isoproterenol
  3. Atropine
  4. Dopamine
52. a
53. Blood agar is an example of:
  1. Enrichment media
  2. Enriched media
  3. Selective media
  4. Transport media
53. b
54. Myocardial oxygen demand is maximally increased with:
  1. Halothane
  2. Ether
  3. TCE
  4. N2O
54. a
55. Fast anterograde transport occurs at a rate of about:
  1. 40. mm/day
  2. 400. mm/day
  3. 1. mm/day
  4. 10. mm/day
55. b
56. The resting cardiac muscle cell is most permeable to:
  1. Na
  2. K
  3. Ca
  4. Cl
56. b
57. The membrane potential of cardiac muscle cells is most affected by even a small change in plasma concentration of:
  1. Na
  2. K
  3. Cl
  4. Ca
57. b
58. Hypokalemia would be expected to result in:
  1. Increased neuronal excitability
  2. A more negative RMP
  3. No change in RMP
  4. A decrease in firing level of neurons
58. b
59. The number of Na channels per square micrometer of membrane in myelinated mammalian neurons is maximum in the:
  1. Cell body
  2. Dendritic zone
  3. Initial segment
  4. Node of Ranvier
59. d
60. The site of origin in the nerve of conducted impulses is the:
  1. Dendritic zone
  2. Axon hillock
  3. Node of Ranvier
  4. Terminal buttons
60. b
61. In motor neurons, the portion of the cell with the lowest threshold for the production of a fullfledged action potential is:
  1. Initial segment
  2. Soma
  3. Dendritic zone
  4. Node of Ranvier
61. a
62. Action potential conduction velocity is influenced by:
  1. Axon diameter
  2. Temperature
  3. Myelination
  4. All of the above
62. d
63. In the CNS, the membranes that wrap around myelinated neurons are those of:
  1. Schwann cells
  2. Oligodendroglia
  3. Endothelial cells
  4. Astrocytes
63. b
764. When heart rate is about 75. beats/min, the duration of absolute refractory period of cardiac muscle is:
  1. 5. ms
  2. 25. ms
  3. 200. ms
  4. 250. ms
64. a
65. When heart rate is about 75. beats per minute, what is the mean duration of action potential in ventricular muscle cells?
  1. 5. ms
  2. 25. ms
  3. 200. ms
  4. 250. ms
65. d
66. The force of muscle contraction cannot be increased by:
  1. Increasing the frequency of activation of motor units
  2. Increasing the number of motor units activated
  3. Increasing the amplitude of action potentials in motor neurons
  4. Recruiting larger motor units
66. c
67. An excitable cell has an RMP of -70. mV and a firing level of - 50. mV. This cell would be inexcitable when its membrane potential is:
  1. - 30. mV
  2. - 55. mV
  3. - 70. mV
  4. - 90. mV
67. a
68. For the same conditions (as in the above question), the cell would be most excitable when its membrane potential is:
  1. - 30. mV
  2. - 55. mV
  3. - 70. mV
  4. - 90. mV
68. b
69. Although the equilibrium potential of Na is + 60. mV, the membrane potential does not reach this value during the overshoot because:
  1. The concentration gradient of Na is reversed
  2. Na channels undergo rapid inactivation
  3. K efflux commences immediately after the upstroke
  4. The membrane is impermeable to Na
69. d
70. Which one of the following statements about electrotonic potentials is incorrect?
  1. They are graded responses
  2. They are local (non-propagated) responses
  3. They may be depolarizing or hyperpolarizing
  4. They are produced by a threshold stimulus
70. b
71. Thin filaments do not contain:
  1. Actin
  2. Myosin
  3. Troponin
  4. Tropomyosin
71. b
72. The ATPase activity of which of the following proteins is altered to regulate skeletal muscle contraction?
  1. Actin
  2. Myosin
  3. Troponin
  4. Tropomyosin
72. b
73. The activity of which contractile protein is altered to regulate smooth muscle contraction?
  1. Actin
  2. Myosin
  3. Calmodulin
  4. Tropomyosin
  5. All of the above
73. c
874. Smooth muscle lacks:
  1. Actin
  2. Myosin
  3. Troponin
  4. Tropomyosin
74. a
75. An example for non-syncytial smooth muscle is:
  1. Iris
  2. Sphincter of Oddi
  3. Vas deferens
  4. Uterus
75. a
76. The twitch duration in fast type skeletal muscle fibers is about:
  1. 10. ms
  2. 50. ms
  3. 100. ms
  4. 250. ms
76. d
77. The major source of calcium for contraction of skeletal muscle is:
  1. ECF
  2. Cytosol
  3. Mitochondria
  4. Sarcoplasmic reticulum (SR)
77. c
78. Ryanodine receptor is located in the:
  1. Sarcolemma
  2. T-tubule
  3. Terminal cisterns of sarcoplasmic reticulum
  4. Cytosol
78. a
79. Which of the following blocks the ryanodine receptor?
  1. Dantrolene
  2. Curare
  3. Cocaine
  4. Hexamethonium
  5. All of the above
79. e
80. Which of the following slow the relaxation process in skeletal muscle?
  1. Slow myosin ATPase
  2. Inhibition of Ca-Mg ATPase
  3. ATP depletion
  4. None of the above
80. b
81. Rigor mortis is due to:
  1. Damage to actin and myosin
  2. Rapid sequestration of Ca in ER
  3. Increased myosin ATPase
  4. ATP depletion
81. a
82. Staircase phenomenon (Treppe) is due to:
  1. Increased availability of calcium
  2. Summation
  3. Tetanus
  4. Increased excitability
82. c
83. Which of the following statements regarding type I muscle fibers is incorrect?
  1. They are rich in myoglobin
  2. Their oxidative capacity is high
  3. Their myosin ATPase activity is high
  4. Their glycolytic capacity is moderate
83. a
84. Which of the following is incorrect about type II muscle fibers?
  1. They are called slow fibers
  2. Their myosin ATPase activity is high
  3. They contain little myoglobin
  4. They are rich in glycolytic enzymes
84. c
985. Which of the following statements is incorrect?
  1. Contraction against a constant load with approximation of the ends of the muscle is called isotonic contraction
  2. Contraction can occur without an appreciable decrease in the length of the muscle
  3. Isometric contractions do work whereas isotonic contractions do not
  4. Muscles can lengthen while doing work
85. d
86. The smallest amount of muscle that can contract in response to excitation of a single motor neuron is
  1. 1. muscle fiber
  2. A muscle fasciculus
  3. The entire muscle
  4. All muscle fibers supplied by that neuron
86. c
87. The size of the motor unit is smallest in
  1. Type II muscle fibers
  2. Single-unit smooth muscle
  3. Orbicularis oculi
  4. Soleus
87. c
88. Gradation of force in skeletal muscle is not achieved by
  1. Increasing intracellular calcium
  2. Recruitment of motor units
  3. Size principle
  4. Asynchronous firing of motor units
  5. Varying release of calcium from SR
88. b
89. Regarding the ionic basis of action potential in cardiac muscle cells, which one of the following is incorrect?
  1. Phase 0: Na influx
  2. Phase 1: K influx
  3. Phase 2: Ca influx
  4. Phase 3: K efflux
89. c
90. When heart rate is about 75. beats/min, the duration of absolute refractory period of cardiac muscle is
  1. 50. ms
  2. 100. ms
  3. 200. ms
  4. 300. ms
90. c
91. When heart rate is about 75. beats/min, the duration of ventricular systole is about
  1. 1. s
  2. 2. s
  3. 3. s
  4. 0.5. s
91. a
92. Which of the following muscle types is the ‘fastest’?
  1. Skeletal muscle
  2. Smooth muscle
  3. Cardiac muscle
92. c
93. Which of the following characteristics is exhibited only by skeletal muscle?
  1. Gradation of force production
  2. Refractoriness
  3. Beneficial effect
  4. Staircase phenomenon
  5. None of the above
93. b
94. Non-linearity of length-tension relationship is most evident in:
  1. Skeletal muscle
  2. Smooth muscle
  3. Cardiac muscle
94. c
1095. In adults, intravesical pressure rises suddenly when intravesical volume reaches about:
  1. 100. mL
  2. 200. mL
  3. 300. mL
  4. 400. mL
95. b
96. The latch-bridge mechanism in smooth muscle is responsible for:
  1. Fast muscle twitch
  2. Sustained muscle contraction
  3. Excitation-contraction coupling
  4. Unstable membrane potential
96. a
97. The minimum stimulus strength that produces a compound action potential in nerve or muscle is:
  1. Rheobase
  2. Chronaxie
  3. Twice rheobase
  4. Twice chronaxie
97. a
98. Which one of the following accelerates contraction as well as relaxation of heart muscle?
  1. Norepinephrine
  2. Calcium
  3. Digoxin
  4. Potassium
98. b
99. Which of the following statements about cardiac muscle is incorrect?
  1. Summation cannot occur
  2. It is a ‘fast’ muscle
  3. Slow myosin ATPase activity
  4. It contains myoglobin
99. c
100. Which nerve fiber type is most susceptible to conduction block by local anesthetics?
  1. Type A
  2. Type B
  3. Type C
  4. Type D
100. c