CARDIOVASCULAR PRACTICE QUESTIONS

1. Which of the following current(s) is responsible for the rapid depolarization phase of
the SA node action potential?

A. if and iNa
B. iCa
C. iNa
D. iK and if
E. iNa and iK

2. Bert is in the middle of a marathon and his heart rate is higher than when he is resting.
This raised heart rate is due to:

A) increase in if and iCa currents.

B) increase in iK currents
C) depolarization of the ventricular myocyte
D) increased contractility
E) activation of alpha 1 receptors.

3. Use the figure below to answer this question

A. The aortic valve opens at 2 and closes at 7

B. The aortic valve opens at 3 and closes at 5
C. The mitral valve opens at 2 and closes at 5
D. The mitral valve closes at 3 and opens at 5
E. The mitral valve closes at 3 and opens at 7.

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4. What is the approximate value of mean arterial pressure for the person in the above
diagram?

A. 70 mmHg
B. 85 mmHg
C. 93 mmHg
D. 105 mmHg
E. 115 mmHg

5. The left atrial pressure ‘a’ wave is due to:

A. atrial contraction
B. regurgitation of blood from the LV to the LA during systole
C. bulging of mitral valve back into the LA during systole.
D. venous return flowing into the LA during diastole.
E. stenosis of the mitral valve.

6. Use the figure below to answer this question.

If a murmur was heard during C and D which increased then decreased in volume, which
of the following valve defects is most likely to be present?
A) Aortic incompetence
B) Aortic stenosis
C) Mitral stenosis
D) Mitral incompetence

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7. Use the figure below to answer this question.

E’

E
F
LV D D’
Pressure

C’
A C
B

LV volume

ABCDEF (solid line) represents the LV pressure-volume loop during a cardiac cycle.
Which of the following changes would most likely alter the loop to ABC’D’E’F ?

A. increased arteriolar constriction

B. increased contractility
C.reduced venous compliance
D. increased venodilation
E. increased heart rate

8. Nitroglycerin, a drug used to treat angina is effective in this condition because it:

A. increases preload
B. increases afterload
C. increases contractility
D. decreases preload
E. decreases afterload
F. decreases contractility

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9. Use the figure below to answer this question.

F E

LV D
Pressure X

A C
B

LV volume

The above represents a LV pressure – volume loop. How would increased sympathetic
activity alter this loop? Sympathetic activity would

A. Shift E downwards
B. Shift C to the right
C. Shift F to the right
D. Increase X
E. Shift A downwards

10. Which point on the loop represents closure of the aortic valve?

A. A
B.B
C.C
D.D
E.F

11. At which point on this loop is the ventricular volume greatest?

A. A
B. B
C. D
D. E
E. F

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12. Laplace Law states that

A. if the pressure inside a sphere is kept constant, the wall tension increases as the radius
of the sphere increases.
B. the force of contraction of the myocardium is increased when the myocardial fibre
length is increased.
C. the resistance to blood flow is inversely proportional to the fourth power of the radius.
D. the resistance to blood flow is reduced when the vessels are in parallel.
E. the resistance to blood flow is increased when vessels are in series.

13. Which one of the following is required for cardiac but is not necessary for skeletal
muscle contraction?

A. extracellular calcium
B. calcium release from the sarcoplasmic reticulum
C. troponin C
D. actin
E. myosin

14. Use the figure below to answer this question

The line between the two arrows is flat (isoelectric) because

A. atrial myocytes are depolarized whereas the ventricular myocytes have repolarized.
B. atrial myocytes and ventricular myocytes are all depolarized.
C. the membrane potential of all the atrial and ventricular myocytes is – 85 mV.
D. the ventricular myocytes are depolarized but the atrial myocytes are resting.
E. there is no potential difference between the inside and outside of the myocytes during
this interval.

15. Use the ECG below to calculate the mean electrical axis of the heart.

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The axis is closest to

A. +30
B. -30
C. -90
D. +150
E. +90

16. Use the following ECG – recorded from a patient, to answer this question.

This patient is most likely suffering from

A. first degree block

B. second degree block Mobitz type I
C. second degree block Mobitz type II
D. third degree block
E. atrial fibrillation

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17. The oxygen consumption of a test subject was found to be 700ml/min. Pulmonary
artery oxygen content was 140 ml/L of blood and the brachial artery oxygen content was
210 ml/L of blood. His cardiac output was most likely which of the following?

A. 4.2 L/min
B. 7.0 L/min
C. 10.0 L/min
D. 12.6 L/min
E. 30 L/min

18. A 65 year old woman presents to the physician for a routine medical check up. The
physician notes that her blood pressure is 160/95 mm Hg. A drug with which of the
following actions would help reduce this woman’s blood pressure?

A. alpha 1 agonist
B. angiotensin antagonist
C. beta 1 agonist
D. muscarinic antagonist
E. a drug that increased contractility only

19. A 74 year old man was diagnosed with congestive heart failure and was prescribed
digoxin. Digoxin is beneficial in this condition because it

A. reduces the Na gradient across the myocyte membrane.

B. blocks the Ca-ATPase pump.
C. blocks the Ca-induced Ca release channels.
D. increases iCa
E. enhances expulsion of Ca out of the myocyte.

20. Activation of β1 receptors on the myocardial cells of the heart by norepinephrine

leads to all the following EXCEPT

A. increase protein kinase A

B. increase cAMP
C. increased activation of iCa
D. increased phospholipase C
E. increased uptake of calcium into the sarcoplasmic reticulum

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21. Which one of the following is most likely to lead to a decrease in contractility of the
heart?

A. exercise
B. dobutamine
C. digoxin
D. propranolol
E. prazosin

22. A 23 year old man has suffered a massive hemorrhage after being savaged by a
mongoose. Fluid is infused in order to increase venous return to the heart. This will cause
the ventricular myocardium to produce more force due in part to:

A. moving the muscle length to the descending limb of the length-tension curve
B. increased end-systolic volume
C. increased calcium sensitivity to troponin C
D. decreasing afterload
E. increasing afterload

23. The opening of the atrio-ventricular valves occurs at about the same time in the
cardiac cycle as the:

A. beginning of diastole
B. end of isovolumetric contraction
C. first heart sound
D. QRS complex of the ECG
E. beginning of systole

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