Professional Documents
Culture Documents
8) Ca++ ATPases are present on the cardiac ____ and are ____ as numerous as in skeletal
muscle.
a) Junctional sarcoplasmic reticulum; Half
b) Junctional sarcoplasmic reticulum; Twice
c) Longitudinal sarcoplasmic reticulum; Half
d) Longitudinal sarcoplasmic reticulum; Twice
e) Terminal cisternae; Half
9) The release of calcium from the junctional sarcoplasmic reticulum is dependent on:
a) Intracellular voltage changes
b) Extracellular voltage changes
c) Intracellular calcium concentration changes
d) Extracellular calcium concentration changes
10) Which of the following is true regarding phospholamban (Plb) during periods of
sympathetic activation and increased cardiac activity? SERCA = Sarco/Endoplasmic
Reticulum Ca2+ ATPase pump, PKA = Protein kinase A, SR = Sarcoplasmic reticulum
a) Dephosphorylated Plb increases SERCA, decreasing Ca++ and leading to
decreased contraction (inotropy)
b) Dephosphorylated Plb decreases SERCA, decreasing Ca++ and leading to
decreased rate (chronotropy)
c) PKA is activated and phosphorylates Plb, which increases SERCA, increasing
Ca++ and leading to increased contraction (inotropy)
d) PKA is activated and phosphorylates Plb, which decreases SERCA, increasing
Ca++ and leading to increased rate (chronotropy)
11) Which of the following best describes the process of calcium-induced calcium release
(CICR) in cardiac muscle?
a) During the action potential plateau phase, the L-type calcium current causes an
influx of trigger calcium, which binds to calcium release channels causing the SR
to absorb calcium from the muscle cell causing an increase in contractile
activation
b) During the action potential depolarization phase, the L-type calcium current
causes an influx of trigger calcium, which directly causes an increase in
contractile activation
c) During the action potential plateau phase, the L-type calcium current causes a
release of trigger calcium in the SR leading to an increase in contractile activation
d) During the action potential depolarization phase, the L-type calcium current
causes an influx of trigger calcium, which blocks calcium release channels
causing the SR to release calcium into the muscle cell causing an increase in
contractile activation
e) During the action potential plateau phase, the L-type calcium current causes an
influx of trigger calcium, which binds to calcium release channels causing the SR
to release calcium into the muscle cell causing an increase in contractile activation
12) Ca++, IP3, and DAG are known to cause Ca++ release from the SR; a mechanism
that is most important in what type of muscle?
a) Cardiac
b) Smooth
c) Skeletal
13) SR Ca++ ATPase has a high affinity for Ca++ and has been shown to be primarily
responsible for:
a) Strength of cardiac contraction
b) Speed of cardiac relaxation
c) Initiation of cardiac contraction
d) Initiation of cardiac relaxation
e) Deactivation of TnC
14) Calsequestrin, found on the SR cisternae, along with calreticulin work to ____ the
gradient between ____ and ____ compartments, taking some workload away from the SR
Ca++ ATPase pump.
a) Increase; Extracelluar; Intracellular
b) Increase; Intracellular; Intra-SR
c) Decrease; Extracelluar; Intra-SR
d) Decrease; Extracelluar; Intracellular
e) Decrease; Intracellular; Intra-SR
15) The protein sarcolumenin may help with Ca++ storage by transferring it:
a) From the junction SR to the longitudinal SR
b) From the longitudinal SR to the cisternae
c) From the cisternae to the junction SR
d) From the junctional SR to the cisternae
e) From the longitudinal SR to the junctional SR
16) When compared to SR Ca++ ATPase, the Ca++ ATPase proteins on the sarcolemma
can handle at most ____ of the calcium which must be extruded following each beat to
maintain a constant total calcium inside the SR.
a) 3%
b) 20%
c) 45%
d) 80%
e) 95%
17) The high capacity transport system, Na+/Ca++ exchanger, moves ____ Na+ inward
for each Ca++ extruded from the cell.
a) 1
b) 2
c) 3
d) 4
e) 6
18) The activity of the Na+/Ca++ exchanger increases as the cell repolarizes, with the
Vm becoming more negative.
a) True
b) False, the activity decreases
c) False, Vm becomes more positive
19) What is the effect of cardiac glycosides (e.g. digitoxin/digoxin and ouabain)?
a) Increasing cardiac inotropy
b) Increase cardiac chronotropy
c) Decreasing cardiac inotropy
d) Decreasing cardiac chronotropy
20) Which of the following would best treat digitoxin (digitalis) poisoning by competing
and displacing digitoxin from its binding site on the Na-K-ATPase?
a) Increasing intracellular K+ concentration
b) Increasing intracellular Na+ concentration
c) Increasing extracellular K+ concentration
d) Increasing extracellular Na+ concentration
21) Digitoxin poisoning slows the activity of the Na-K-ATPase resulting in:
a) A build-up of intracellular K+
b) A build-up of intracellular Na+
c) A build-up of extracellular K+
d) A build-up of extracellular Na+
22) Which of the following is true regarding the fibrocartilage atrioventricular ring?
a) It supports the AV valves
b) It separates the atria from the ventricles mechanically
c) It separates the atria from the ventricles electrically
d) A & B
e) A, B, & C
23) Regarding the cylindrical left ventricle, ejection volume is proportional to ____ the
radius of the left ventricle.
a) The square root of
b) Half of
c) Twice
d) The square of
e) The cube of
24) Increased parasympathetic tone along the right vagus nerve would most likely:
a) Increase the heart rate at the SA node
b) Increase the heart rate at the AV node
c) Decrease the heart rate at the SA node
d) Decrease the heart rate at the AV node
25) Concerning the structure of the normal heart:
a) Atria are thick-walled, low-capacity structures
b) Right ventricular muscle mass is greater than left ventricular muscle mass
c) The bicuspid and tricuspid valves are not closed by contraction of papillary
muscles
d) The pericardium is an elastic structure that helps the heart expand to hold more
blood
26) Regarding the normal circuit for blood flow (bulk flow), pressure is lowest in the:
a) Right atrium
b) Capillaries
c) Inferior vena cava
d) Arterioles
e) Systemic arteries
27) Bulk flow of blood from the aorta to the systemic veins occurs because:
a) Pressure is low in veins
b) The oxygen content of blood is different between the two vessels
c) Blood movement is driven by gravity
35) “Diastolic run-off” occurs when the ____ valves close with ventricular pressure ____.
a) AV; Decreasing
b) AV; Increasing
c) Semilunar; Decreasing
d) Semilunar; Increasing
36) Maximal heart rate is estimated as HRmax = ____ beats/min – (one beat/min/age)
a) 100
b) 160
c) 200
d) 220
e) 260
37) What is the stroke volume during normal basal conditions?
a) 20mL
b) 70mL
c) 120mL
d) 150mL
e) 200mL
38) Which of the following describes ejection fraction?
a) (EDV – ESV) / EDV
b) (EDV – ESV) / ESV
c) (ESV – EDV) / EDV
d) (ESV – EDV) / ESV
39) Which of the following best describes cardiac output (Q)?
a) Q = Heart rate (HR) * Stroke volume (SV)
b) Q = Heart rate (HR) + Stroke volume (SV)
c) Q = Heart rate (HR) - Stroke volume (SV)
d) Q = Stroke volume (SV) - Heart rate (HR)
e) Q = Stroke volume (SV) / Heart rate (HR)
f) Q = Heart rate (HR) / Stroke volume (SV)
40) Inotropy relates to the relative contractile force of the heart given a constant:
a) End-diastolic volume (EDV)
b) End-systolic volume (ESV)
c) Preload
d) Afterload
41) Which of the following best describes increased lusitropy?
a) Faster relaxation and large dP/dt
b) Slower relaxation and large dP/dt
c) Faster relaxation and small dP/dt
d) Slower relaxation and small dP/dt
42) The stiffness and resistance to stretch seen in cardiac muscle is due to the
extracellular matrix, pericardial sac, and cytoskeletal structure of the cardiac muscle cell.
Thus, when comparing skeletal muscle to cardiac muscle, there is a drastic:
a) Decrease in active tension
b) Decrease in passive tension
c) Increase in active tension
d) Increase in passive tension
43) An extreme preload (EDV) is needed to distend sarcomeres past optimal, leading to
congestive heart failure. Which of the following would most likely result?
a) Decreased SV, decreased EDV, increase circulatory system pressure
b) Increased SV, decreased EDV, decreased pulmonary system pressure
c) Increased SV, decreased EDV, increase pulmonary system pressure
d) Decreased SV, increased EDV, decreased pulmonary system pressure
e) Decreased SV, increased EDV, increase pulmonary system pressure
44) According to Starling's Law of the heart, cardiac output is directly related to the:
a) Size of the ventricles
b) Heart rate
c) Amount of blood returning to the heart
d) End-systolic volume
e) Cardiac reserve
45) Which of the following is true about Frank-Starling's Law of the Heart?
a) Ensures sufficient calcium is available for each contraction
b) Ensures that Cardiac Outputs (CO) for the right and left ventricles are equal
c) Has its basis in optimization of thick and thin filament overlap
d) Has its basis in the rate and quantity of calcium delivered to the myofilaments
e) B & C
f) A & D
46) When presented with an increased afterload in the aortic circulatory system, which of
the following would decrease according to the Starling Law?
a) SV of the initial contraction
b) ESV and EDV
c) Contractile force of consequent contraction
d) Preload and ventricular stretch
e) The number of structurally appropriate crossbridges
47) In cardiac and smooth muscle, there is an inverse relationship between shortening
velocity and afterload. Which of the following is true when comparing skeletal muscle to
cardiac muscle?
a) Cardiac muscle has a higher Vmax and higher velocity of shortening
b) Cardiac muscle has a higher Vmax and lower velocity of shortening
c) Cardiac muscle has a lower Vmax and higher velocity of shortening
d) Cardiac muscle has a lower Vmax and lower velocity of shortening
48) Intrinsic mechanisms for altering force of cardiac contraction are primarily dependent
upon the length-tension relationship (sarcomere length). The “Garden Hose Effect”
increases contractile force as a result of:
a) EDV
b) ESV
c) Pulmonary circulation filling
d) Systemic circulation filling
e) Coronary circulation filling
49) An increase in troponin sensitivity to calcium that would increase cardiac force at a
given calcium concentration due to increased stretch of the myocardium is an:
a) Intrinsic factor
b) Extrinsic factor
d) Drugs
e) Alcohol
57) Which of the following is true regarding a premature ventricular contraction (PVC)?
a) The time after the PVC to the next heartbeat is shortened and the next heartbeat
is weaker
b) The time after the PVC to the next heartbeat is shortened and the next heartbeat
is stronger
c) The time after the PVC to the next heartbeat is lengthened and the next
heartbeat is weaker
d) The time after the PVC to the next heartbeat is lengthened and the next
heartbeat is stronger
58) In a 2nd degree AV heart block Mobitz type I (Wenckebach), the contraction interval
between the atria and ventricles lengthens until a beat is skipped. Which of the following
is true of the heartbeat immediately after the skipped beat?
a) It arises from the ventricles
b) It conducts in a backwards fashion
c) It is faster than the previous beat
d) It is weaker than the previous beat
e) It is stronger than the previous beat
59) Which of the following is NOT true regarding long-term contractility changes seen in
hypothyroidism?
a) Thyroid hormone levels decrease
b) Slow-type V3 myosin is increased
c) Fast-type V1 myosin is decreased
d) dP/dt is increased
e) Inotropy is decreased
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a) ICa decreases
b) Acetylcholine gets released
c) Inotropy increases
d) Chronotropy decreases
e) Lusitropy increases drastically
11) Which of the following would occur in a patient who is given a calcium channel
blocker, such as verapamil, nifedipine, or diltiazem?
a) Decreased length of phase 2 and decreased inotropy
b) Increased length of phase 2 and decreased inotropy
c) Decreased length of phase 2 and increased inotropy
d) Increased length of phase 2 and increased inotropy
12) During which phase of the cardiac action potential do the h-gates of the Na++
channels begin to reset, subjecting the cell to premature activation by a strong stimulus
(relative refractory period, RRP)?
a) Phase 0
b) Phase 1
c) Phase 2
d) Phase 3
e) Phase 4
13) Which of the following is most responsible for the rapid repolarization in phase 3 of
the cardiac action potential, during both the fast and slow response potentials?
a) Gradually decreasing gCa
b) Gradually decreasing gNa
c) Gradually decreasing gK
d) Gradually increasing gNa
e) Gradually increasing gK
14) During phase 4 (diastole) of the cardiac action potential, the membrane is
predominantly permeable to which ion?
a) Ca++
b) K+
c) Na+
d) Cl-
e) PO4-
15) Which of the following is primarily responsible for setting Vm (Ik1)?
a) Anomolous rectifier K+ channels
b) Transient outward K+ channels
c) Delayed rectifiers
d) Receptor operated muscarinic K+ channels
e) ATP-inhibited K+ channels
16) Which of the following hyperpolarize cardiac cells, shorten the plateau phase, and are
responsible for the bradycardic effect of the PNS?
a) Anomolous rectifier K+ channels
b) Transient outward K+ channels
c) Delayed rectifiers
d) Receptor operated muscarinic K+ channels
e) ATP-inhibited K+ channels
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a) True
b) False, it is most essential at low heart rates
c) False, it is most essential at high heart rates
d) False, it is only essential with AV stenosis
e) False, it is never essential
3) At the onset of isovolumic contraction (cardiac cycle phase 2) the Frank-Starling
mechanism exerts its maximal influence as preload is set. The ventricles contract with the
AV valves being forced shut and the ____ sound is heard.
a) S4
b) S3
c) S2
d) S1
4) On an atrial pressure curve, which of the following corresponds to the slight eversion
of the AV values under high ventricular pressure?
a) a-wave
b) c-wave
c) v-wave
d) x-descent
e) y-descent
5) 70-80% of the stroke volume is emptied from the ventricles during the rapid ejection
period, seen as which of the following on an atrial pressure curve?
a) a-wave
b) c-wave
c) v-wave
d) x-descent
e) y-descent
6) On an atrial pressure curve, which of the following is due to the continuous venous
return and increasing atrial volume after the rapid ejection phase?
a) a-wave
b) c-wave
c) v-wave
d) x-descent
e) y-descent
7) Which of the following results in 20-30% of stroke volume to be ejected and is
associated with the windkessel effect, especially during an intermittently pumping heart?
a) Reduced ventricular filling (Phase 7)
b) Atrial systole (Phase 1)
c) Isovolumic contraction (Phase 2)
d) Rapid ejection (Phase 3)
e) Reduced ejection (Phase 4)
8) During ventricular diastole (isovolumic relaxation), pressure in the ventricles drops
precipitously and approaches that of the atria, causing closure of certain heart valves and
leading to the ____ heart sound.
a) S4
b) S3
c) S2
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d) S1
9) During the rapid ventricular filling phase of the cardiac cycle, the AV valves open and
blood rapidly pours into the ventricles, leading to the ____ heart sound and causing the y-
descent on the atrial pressure waveform.
a) S4
b) S3
c) S2
d) S1
10) Which of the following phases is most shortened at high heart rates?
a) Isovolumic contraction (Phase 2)
b) Rapid ejection (Phase 3)
c) Reduced ejection (Phase 4)
d) Isovolumic relaxation (Phase 5)
e) Rapid ventricular filling (Phase 6)
11) Which of the following is NOT true?
a) Right heart pressures are lower than left heart pressures
b) Right atria contract slightly before left atria
c) Right ventricular systole starts before left ventricular systole
d) Right ventricular systole ends after left ventricular systole
e) Right ventricular ejection begins before and ends after left ventricular ejection
12) Which of the following is NOT true regarding the first heart sound (S1)?
a) Heard at the initiation of ventricular systole
b) Occurs following the shutting of the AV valves
c) The sound is mostly due to the closing of the valves
d) The sound is due to the vibrations of the ventricular wall
e) The sound amplitude is dependent upon the force of contraction
13) Which of the following would lead to splitting of the S1 sound?
a) The aortic valve closing much sooner than the pulmonic
b) The pulmonic valve closing much sooner than the aortic
c) The right AV valve closing much sooner than the left
d) The left AV valve closing much sooner than the right
e) The AV valves closing at exactly the same time
14) When compared to S1, which of the following is NOT true of S2?
a) Is of higher frequency
b) Is of slower duration
c) Is of higher amplitude
15) Splitting of S2 is most commonly heard as:
a) The aortic valve closing sooner than the pulmonic
b) The pulmonic valve closing sooner than the aortic
c) The right AV valve closing sooner than the left
d) The left AV valve closing sooner than the right
e) The AV valves closing at exactly the same time
16) Which of the following heart sounds represents tensing of the ventricles at the end of
rapid filling and is typically heard in children and adolescents?
a) S4
b) S3
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c) S2
d) S1
17) The S4 heart sound is associated with:
a) Atrial contraction
b) Atrial relaxation
c) Ventricular contraction
d) Ventricular relaxation
18) Which of the following is left ventricular stroke work (LVSW) in a normal heart?
MAP = mean arterial pressure (100mmHg), MPP = mean pulmonary pressure (18mmHg)
a) LVSW = EDV + ESV + MAP
b) LVSW = (ESV – EDV) / MAP
c) LVSW = (ESV – EDV) * MAP
d) LVSW = (EDV – ESV) / MAP
e) LVSW = (EDV – ESV) * MAP
19) Which of the following is a typical value for right ventricular stroke work (RVSW)?
a) 126 ergs
b) 700 ergs
c) 1260 ergs
d) 7000 ergs
e) 17,000 ergs
Match the following using the image here:
20) Opening of the aortic valve
21) Opening of the mitral valve
22) Closure of the mitral valve
23) Closure of the aortic valve
24) The area under the ventricular work curve can approximate:
a) Myocardial blood flow
b) Myocardial dysfunction
c) Myocardial oxygen utilization
d) Myocardial heat loss
e) Myocardial contraction force
25) Which of the following changes in the pressure-volume loop would be seen in a
patient with hypertension?
a) No change in volume, increase in pressure
b) No change in volume, decrease in pressure
c) No change in pressure, increase in volume
d) No change in pressure, decrease in volume
e) No changes to the pressure-volume loop
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e) Veins
2) In which of the following locations does pressure decrease the most (dP/dt) due to a
high elastic modulus (dP/ddiameter)?
a) Arteries
b) Arterioles
c) Capillaries
d) Venules
e) Veins
3) Which of the following does NOT change in each segment of the circulatory system?
a) Velocity
b) Flow
c) Area
d) Amount of oxygen
e) Compliance (dV/dP)
4) Which group of blood vessels contains the greatest percentage of the total blood
volume?
a) Arteries because they have the largest diameter
b) Capillaries because they have the greatest total cross-sectional area
c) Arterioles because they have the highest resistance
d) Veins because they are the most distensible
5) Arteriosclerosis (“hardening” of the arteries) would most likely cause:
a) Decreased compliance and increased palpable pulse pressure
b) Decreased compliance and decreased palpable pulse pressure
c) Increased compliance and increased palpable pulse pressure
d) Increased compliance and decreased palpable pulse pressure
6) What component of arterioles is most responsible for regulating capillary hydrostatic
pressure and delivery of nutrients to the tissue?
a) Location in body
b) Compliance
c) Number of branches
d) Length
e) Diameter
7) Regulatory factors of arterioles include sympathetic stimulation, which causes
vasoconstriction, and pre-capillary sphincters, which occlude flow. These factors and
others are important as dilation and filling of all vessels would require:
a) 1 liter of blood
b) 3 liters of blood
c) 5 liters of blood
d) 15 liters of blood
e) 30 liters of blood
8) Exchange of nutrients and waste products can occur at:
a) Arterioles
b) Venules
c) Capillaries
d) A & C
e) B & C
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9) A patient presents with burns that breaks down fenestrae within the capillaries. Which
of the following would most likely occur?
a) Tissue ischemia
b) Tissue hypoxia
c) Tissue edema
d) Arteriole backflow
e) Venous insufficiency
10) Which of the following is NOT correct regarding percent of total blood volume?
a) Veins contain about 55%
b) Venules contain about 5%
c) Pulmonary circulation contains about 10%
d) Arteries contain about 25%
e) Capillaries and arterioles contain <10%
11) Which of the following would most likely occur if a patient lost basal sympathetic
tone in the venous circulation?
a) Venous inflammation
b) Syncope
c) Varicosities
d) Venous thrombi
e) Myocardial infarction
12) Which of the following is true of flow if resistance is doubled?
a) Flow will quadruple
b) Flow will double
c) Flow will not change
d) Flow will be cut in half
e) Flow will be cut in quarter
13) In a vessel exhibiting laminar blood flow, at what location in the vessel cross-section
is velocity the highest (Vmax)?
a) At the center of the vessel
b) Halfway between the center and the walls
c) At the vessel walls
d) At all points along the cross-section
e) At no point along the cross-section due to turbulence
14) Which of the following describes laminar velocity of blood flow, with Q = P / R?
a) Velocity = (Resistance / Area) / Pressure
b) Velocity = (Resistance / Pressure) / Area
c) Velocity = (Area / Pressure) / Resistance
d) Velocity = (Area / Resistance) / Pressure
e) Velocity = (Pressure / Resistance) / Area
15) Which of the following describes the Bernoulli Equation for pressure?
a) Pressure = 4 * Density * Velocity
b) Pressure = 2 * Density * Velocity
c) Pressure = Density * Velocity
d) Pressure = 1/2 * Density * Velocity
e) Pressure = 1/4 * Density * Velocity
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16) Even though blood is a non-Netwonian colloidal suspension, its viscosity does not
change with flow.
a) True
b) False, it increases with slowed flow
c) False, it decreases with slowed flow
17) According to the Fahraeus-Lindqvist effect, which cross-sectional location would one
find large blood components such as erythrocytes?
a) At the center of the vessel
b) Halfway between the center and the walls
c) At the vessel walls
d) At all points along the cross-section
e) At no point along the cross-section due to turbulence
18) Which of the following conditions would be the most susceptible to low oxygen
availability in tissues with “plasma skimming?”
a) Diabetes
b) Hypertension
c) Epileptic
d) Anemia
e) Wilson disease
19) Decreasing which of the following will increase Reynold’s number (NR) for the
initiation of turbulent blood flow?
a) Blood velocity
b) Blood vessel diameter
c) Blood viscosity
d) Density of whole blood
20) At which of the following locations is turbulent flow most likely due to an increased
Reynold’s number?
a) Low pressure, small diameter, bifurcating vessels
b) High pressure, small diameter, straight vessels
c) High pressure, small diameter, bifurcating vessels
d) High pressure, large diameter, straight vessels
e) High pressure, large diameter, bifurcating vessels
21) According to the Poiseuille-Hagen relationship, doubling the radius of a vessel would
have what effect on blood flow?
a) Flow would increase by 2 times
b) Flow would increase by 4 times
c) Flow would increase by 8 times
d) Flow would increase by 16 times
e) Flow would increase by 32 times
22) Which of the following is true of viscosity when hematocrit rises above normal levels
(40-45%) during dehydration or polycythemia?
a) Viscosity decreases proportionally
b) Viscosity decreases more than proportionally
c) Viscosity increases proportionally
d) Viscosity increases more than proportionally
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23) Regarding a flow versus perfusion pressure curve, which of the following is true of
the critical closing pressure (CCP) and flow during sympathetic stimulation?
a) CCP will equal 20mmHg and flow will be constant
b) CCP will decreases and for a given pressure flow will decreases
c) CCP will decreases and for a given pressure flow will increase
d) CCP will increase and for a given pressure flow will decreases
e) CCP will increase and for a given pressure flow will increase
24) Which of the following is true of the pulmonary circulatory system?
a) High pressure and high resistance
b) High pressure and high compliance
c) Low pressure and high resistance
d) Low pressure and high compliance
25) Which of the following corresponds to the first audible Korotkoff sound when
auscultating the brachial artery?
a) S1 heart sound
b) S2 heart sound
c) Systolic pressure
d) Diastolic pressure
e) Atrial kick
26) Which of the following locations best coincides with brachial artery pressures?
a) Right atrium
b) Right ventricle
c) Pulmonary artery
d) Left atrium
e) Left ventricle
f) Aorta
27) If the pressure generated by the heart distended the aorta so that it contained the
entire end diastolic volume (EDV), which of the following would be true?
a) EDV = 0
b) ESV = 0
c) EDV – ESV = 0
d) ESV – EDV = 0
e) EDV + ESV = 0
28) Which of the following is NOT a determinant of central arterial blood pressure?
a) Cardiac output
b) Venous return
c) Peripheral resistance
d) Compliance
e) End diastolic volume
29) Which of the following product components of blood pressure is NOT regulated?
a) Compliance
b) Heart rate
c) Stroke volume
d) Peripheral resistance
30) A marathon runner would likely have a pulse pressure less than 40mmHg.
a) True
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b) False
31) What is the mean arterial pressure (MAP) for an individual with measured blood
pressure of 120/60?
a) 60
b) 80
c) 96
d) 100
e) 120
32) Which of the following changes very little when comparing the ascending aorta to the
saphenous artery?
a) Compliance
b) Diastolic pressure
c) Systolic pressure
d) Pulse pressure
e) MAP
33) Venous pressures are greatest at what location when lying supine or prone?
a) Neck
b) Chest
c) Abdomen
d) Pelvis
e) Extremities
34) Which of the following occurs during expiration?
a) Intrapleural pressure decreases, compressing the vena cava
b) Intrapleural pressure decreases, compressing the aorta
c) Intrapleural pressure increases, compressing the vena cava
d) Intrapleural pressure increases, compressing the aorta
35) Which of the following is the most important mechanism in returning venous blood?
a) Expiration
b) Inhalation
c) Parasympathetic tone
d) Skeletal muscle pump
e) Catecholamine release
36) If blood flow is increased, which of the following is most likely true, given that HR
and SV are the major central factors affecting MAP?
a) Peripheral resistance decreases
b) Peripheral resistance increases
c) Blood pressure decreases
d) Blood pressure increases
37) Which of the following is NOT true?
a) Decreased stroke volume decreases MAP and decreases capillary flow
b) Increased heart rate increases capillary flow
c) Increased peripheral resistance increases MAP
d) Decreased heart rate decreases MAP
e) Decreased peripheral resistance lowers capillary flow
38) Which of the following is responsible for long term control of blood flow?
a) Sympathetic nervous system
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c) Hypercapnia
d) Acidosis
e) Vasopressin (ADH)
46) Which of the following is a vasodilator (relaxes smooth muscle)?
a) Endothelin
b) Adenosine
c) Histamine
d) Hypokalemia
47) Which of the following describes the action of atrial natriuretic peptide (ANP)?
a) Vasoconstricting and decreases kidney excretion of electrolytes and water
b) Vasoconstricting and increases kidney excretion of electrolytes and water
c) Vasodilatory and decreases kidney excretion of electrolytes and water
d) Vasodilatory and increases kidney excretion of electrolytes and water
48) Reactive hyperemia would be most common in which situation?
a) During a myocardial infarction
b) During continual exercise
c) During long periods of rest
d) During increased sodium intake
e) During decreased myogenic tone
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5) At some point, there is a circulatory limit to maximal exercise. Which of the following
does NOT occur with exercise to exhaustion?
a) Hypothermia
b) HR maximizes
c) Stroke volume maximizes
d) Dehydration and fluid loss increase
e) Sympathetic drive overcomes capillary vasodilation
6) Which of the following orthostatic changes results in the most rapid decrease in
thoracic blood volume (30% change)?
a) Standing to supine
b) Standing to sitting
c) Supine to sitting
d) Sitting to standing
e) Supine to standing
7) Which of the following does NOT occur during a major orthostatic change resulting in
decreased central blood volume?
a) Blood flow and arterial pressure decrease initially
b) Baroreceptor reflex decreases parasympathetic drive
c) The cardio-inhibitory center of the medulla is inhibited
d) Total peripheral resistance decreases
e) Diastolic pressure remains nearly constant
8) Which of the following situations would NOT affect sympathetic capacities, thus not
cause syncope for a patient who undergoes an orthostatic change?
a) Syphilis
b) Congestive heart failure
c) Diabetes
d) Hypotension
e) Alpha-adrenergic receptor blockage
9) An infant presents with superventricular tachycardia (SVT). The attending physician
asks you to perform a Valsalva maneuver to increase vagal tone and hopefully terminate
the SVT without the use of drug therapy. Which of the following would be the best
option for this patient?
a) Have the patient attempt to forcefully exhale air
b) Have the patient breathe out through a straw
c) Have the patient bear down as if trying to defecate
d) Insert an IV line and administer a large bolus of normal saline
e) Place a bag of ice and cold water on the patient’s face
10) Which of the following is seen as a sign of progressive (severe) hemorrhagic shock,
but not a sign of compensated hemorrhagic shock?
a) Baroreceptor reflex
b) Angiotensin release increased
c) Anomolous viscosity (“sludge”)
d) CNS ischemic response at low pressures
e) Vasopressin release increased
11) Which of the following leads to increased capacitance and decreasing venous return?
a) Plasma hypovolemic shock
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b) Neurogenic shock
c) Anaphalactic shock
d) Septic shock
e) Hemorrhagic shock
12) Which of the following maneuvers could help improve a patient who lost
autoregulation of cerebral blood flow due to a particular potent vasodilator?
a) Increasing blood pressure
b) Decreasing blood pressure
c) Increasing breathing rate
d) Decreasing plasma volume
e) Increasing cerebral paCO2 levels
13) Cerebral circulation has excellent autoregulation between what MAP ranges?
a) 20mmHg to 100mmHg
b) 70mmHg to 120mmHg
c) 30mmHg to 130mmHg
d) 60mmHg to 160mmHg
e) 40mmHg to 220mmHg
14) Which of the following vascular locations is least regulated by sympathetic nervous
system control?
a) Brain
b) Extremities
c) Neck
d) Heart
e) Spleen
15) The Cushing phenomenon would most likely be activated in which of the following
patient presentations?
a) Adrenal deterioration
b) Myocardial infarction
c) Cerebral tumor
d) Congestive heart failure
e) Epileptic seizure
16) Which of the following explains the principle behind cerebral functional magnetic
resonance imaging (fMRI)?
a) Cortical release of 14C-2-deoxyglucose is associated with cerebral stroke
b) Neuronal uptake of Ca++ is associated with regional neural activity
c) Neuronal release of 14C-2-deoxyglucose is associated with retinal stimulation
d) Cortical blood pressure is associated with regional glucose tolerance
e) Cortical blood flow is associated with regional neural activity
17) Which of the following (local tissue factors) has the largest impact on cerebral blood
flow (can double flow)?
a) Hyperosmolarity
b) Hypoxia
c) Hyperkalemia
d) Hypercapnia
e) Inorganic phosphate
18) Which of the following would lead to the greatest amount of cerebral vessel dilation?
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9) Which of the following would NOT affect hydostatic interstitial pressure (Pi)?
a) Tissue edema
b) Capillary filtration and absorption
c) Hematocrit value
d) Tissue compliance
e) Lymph drainage
10) Which of the following locations has the lowest Reflection Coefficient, thus the
highest permeability relating to oncotic pressure?
a) Brain
b) CNS
c) Skeletal muscle
d) Kidney
e) Bone
11) During surgery, a patient’s MAP drops and the anesthesiologist hangs albumin for IV
administration. Which of the following factors is being most affected by this colloid?
a) Pc = hydrostatic capillary pressure
b) Pi = hydrostatic interstitial pressure
c) !c = oncotic capillary pressure
d) !i = oncotic interstitial pressure
12) Which of the following situations would lead to decreased arteriolar filtration and
increased venular reabsorption?
a) Arteriolar dilation
b) Dehydration
c) Increased venous pressure
d) Hypoproteinemia
e) Venous constriction
13) A patient undergoes a Swan-Ganz catheterization to measure pulmonary capillary
wedge pressure. After testing, left ventricular failure is suspected. Which of the following
would be the most likely clinical sign?
a) Venous obstruction
b) Peripheral edema
c) Exercise-induced dysrhythmia
d) Lymphatic obstruction
e) Pulmonary edema
14) Even with highly permeable capillaries, the lympatics tend to keep which of the
following values low?
a) Pc = hydrostatic capillary pressure
b) Pi = hydrostatic interstitial pressure
c) !c = oncotic capillary pressure
d) !i = oncotic interstitial pressure
15) Which of the following locations does NOT normally receive venous return from the
coronary circulation?
a) Coronary sinus
b) Right atrium
c) Left atrium
d) Right ventricle
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e) Left ventricle
16) Typically, which of the following is true when comparing the left and right coronary
artery flow to aortic pressure (flow)?
a) The left coronary artery follows aortic pressure
b) The right coronary artery follows aortic pressure
c) Both coronary arteries follow aortic pressure
d) Neither coronary artery follows aortic pressure
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7) Which of the following would be used for categorizing a person who has a VO2max of
34-42mL O2/kg/min?
a) Unfit (unfit)
b) Sedentary (average)
c) Minimally trained (good)
d) Well trained (optimal)
e) Superior (elite athlete)
8) Which of the following is NOT a component of musculoskeletal fitness?
a) Muscular strength
b) Muscular endurance
c) Muscle size
d) Flexibility
9) Postural control is a component of which of the following?
a) Cardio-respiratory fitness
b) Musculoskeletal fitness
c) Motor fitness
d) Metabolic fitness
10) Which of the following components relates to the maintenance of ATP concentrations
of about 5mM even during intense exercise?
a) Cardio-respiratory fitness
b) Musculoskeletal fitness
c) Motor fitness
d) Metabolic fitness
e) Morphological fitness
11) Which of the following mechanisms is NOT correct with regard to metabolic fitness?
a) Creatine phosphate + ADP <=>ATP + Cr
b) 2 ADP <=> ATP + AMP
c) Glucose => 2 ATP + 4 pyruvate + 2 NADH
d) Kreb cycle production of NADH, FADH2, and ATP from GTP
e) Beta-oxidation of fatty acids and use of glycerol
f) Amino acid degradation, gluconeogenesis
g) Electron transport chain use of NADH and FADH2
12) During steady-state exercise at a level less than 70-80% of VO2max, what energy
source is relied on most heavily, especially in aerobically fit individuals?
a) Beta-oxidation of fatty acids
b) Rephosphorylation of ATP via creatine phosphate
c) Kreb cycle
d) Glucose and glycogen
e) Gluconeogenesis
13) What muscle fibers are mainly responsible for locomotion and may become fatigued
as glycogen levels decrease during low to moderate exercise?
a) Type I
b) Type I and IIa
c) Type I and IIb
d) Type IIa and IIb
e) Type IIa, IIb, and IIx
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14) Which of the following techniques would be most beneficial to maintain glycogen
levels for an individual planning on running a marathon?
a) Sodium loading the day before the marathon
b) Hydration with water only, avoiding sports drinks
c) Imbibition of dilute glucose the day prior to the marathon
d) Heavy caffeine use through “energy drinks”
e) Carbohydrate depletion and loading cycles
15) Bone tensile strength is a component of:
a) Cardio-respiratory fitness
b) Musculoskeletal fitness
c) Motor fitness
d) Metabolic fitness
e) Morphological fitness
16) Which of the following principles of aerobic training and conditioning relates to the
degree of stress put on the system in question, such as increasing weight or running
longer distances?
a) Specificity
b) Overload
c) Progression
d) Warm-up/Cool-down
e) Individual differences
17) Which of the following describes training heart rate, which is approximated at 50-
60% of VO2max? (HRmax = 220 – age)
a) HRtraining = HRrest + ((HRmax – HRrest) * 70%)
b) HRtraining = HRrest + ((HRmax – HRrest) * 60%)
c) HRtraining = HRrest + ((HRmax – HRrest) * 50%)
d) HRtraining = HRmax + ((HRmax – HRrest) * 70%)
e) HRtraining = HRmax + ((HRmax – HRrest) * 60%)
18) Which of the following is the most important when considering aerobic exercise?
a) Duration of 20-40 minutes
b) Duration of >60 minutes
c) Intensity
d) Frequency of 3-4 times per week
e) Frequency of 5-7 times per week
19) Which of the following would NOT be a result of chronic aerobic training?
a) Increased left ventricular muscle mass and efficiency
b) Increased number of red blood cells and blood volume
c) Increased glycogen use and lipid sparing
d) Increased capillary and mitochondrial densities in skeletal muscle
e) Increased lactate tolerance (H+ buffering capacity)
20) During exercise, venous oxygenation (right atrium) decreases from 75% to:
a) 70%
b) 50%
c) 25% James Lamberg
d) 10%
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