PPA EXAM 2
A vasoconstrictor drug causes ____ of arterioles, which can lead to a(n) _______ in flow?
Constriction, increase
Constriction, decrease
Dilation, increase
Dilation, decrease
Which one of the following changes would result in an increase of blood flow to kidney?
Increased renal artery pressure
Decrease cardiac output
Increased renal vein pressure
Increased renal vascular resistance
Which one of the following mechanisms is responsible for the prolonged plateau phase in the ventricular action potential?
Opening of the transient outward potassium channels once the myocyte is completely depolarized
A long relative refractory period as a result of inactivation of Na+ channels
A sustained by a balance in phase 2 between influx of Na+ and efflux of K+
The influx of Ca2+ to trigger depolarization
SA Node firing is primarily initiated by which of the following?
Calcium Influx
Calcium Efflux
Sodium influx
Potassium Efflux
In the case of a patient with a third degree AV block, the patients pulse reflects the rate of firing of cells location in the:
Bundle of His
An ectopic focus in the left ventricle
AV node
SA node
Exercise induced tachycardia results primarily from a sympathetic nervous system effects to:
Decrease the efficiency of calcium restorage in the sarcoplasmic reticulum
Decrease the conduction rate in the Purkinje fibers
Increase in rate of calcium entry into the sinus node myocytes
Increase the duration of sodium channel inactivation in ventricular muscle
Ingestion of a very salty diet causes an increase in blood volume. In these patients which intrinsic adaptations occur in the heart for this increase in volume?
An increase in contractility through increased sympathetic stimulation
An increase in venous compliance through increased wall stretch
An increase in force of contraction through increased cardiac wall tension
An increase in heart rate through stretch on the SA node
Relaxation of the ventricle is important for filling. A factor that would increase relaxation of the ventricular wall would be:
Increased sympathetic stimulation of the ventricle
Increased fibrosis of the ventricular wall
Increased eIncreased end diastolic pressurend diastolic pressure
Decreased phosphorylation of phospholamban
Afterload can be increased by:
An increase in venous compliance
An increase in vascular resistance
An increase in ventricular compliance
A decrease in the size of the heart
A valve disease resulting in a systolic murmur with an increase in atrial pressure and size, with risk of pulmonary edema would be:
Mitral stenosis
Mitral insufficiency
Aortic stenosis
Aortic insufficiency
A valve disease resulting in a systolic murmur with increased ventricular pressure and an increased risk of left heart failure with reduced ejection fraction is:
Aortic stenosis
Mitral stenosis
Mitral insufficiency
Aortic insufficiency
A third heart sound is:
Always abnormal
Indicates a large atrium
Always normal
Indicates a large or hypertrophic ventricle
If the radius of an arteriole in your skin decreases, then which of the following would result?
The flow to that area of skin increases
The pressure in the capillaries supplied by that arteriole increases
The pressure in the capillaries in that area of skin decreases
The skin is likely to look red
Which of the following will increase the Volume work of the left ventricle?
Hypertension
Mitral stenosis
Mitral regurgitation
Aortic stenosis
A fourth heart sound is most likely to occur:
During the rapid filling phase in a patient with aortic stenosis.
During atrial contraction in a patient with aortic stenosis.
During the rapid filling phase in a patient with mitral stenosis.
During atrial contraction in a patient with mitral stenosis.
When the parasympathetic nervous system tone is high, cardiac output is decreased. The major reason for this effect is:
HR is decreased
Venous tone is decreased
SV is decreased
Arteriolar resistance is decreased
In a third degree AV block the origin of the ventricular wave of depolarization is in:
Ventricular cardiomyocytes
Sinoatrial node cells
Atrioventricular node cells
Purkinje fibers
In ventricular tachycardia, the origin of the ventricular wave of depolarization is:
Ventricular cardiomyocytes
Sinoatrial node cells
Atrioventricular node cells
Purkinje fibers
Cardiac output would be decreased during all of the following except:
A reduction in venous compliance
Acute aortic regurgitation
Loss of blood
Decreased firing in sympathetic nerves to the ventricular muscle
Which of the following causes a disorder of diastolic function (rather than systolic function) of the heart?
Aortic stenosis
Mitral regurgitation
Dilated cardiomyopathy
Restrictive cardiomyopathy
Administration of a specific α1 agonist drug would result in which of the following:
Immediate increase in blood pressure, followed by a reflex increase in heart rate
Immediate increase in blood pressure followed by a reflex decrease in heart rate
Immediate decrease in blood pressure, followed by a reflex increase in heart rate
Immediate decrease in blood pressure followed by a reflex decrease in heart rate
Which one of the following changes would result in an increase of blood flow to kidney?
Increased parasympathetic nerve activity to the heart
Increased sympathetic nerve activity to the heart
Increased sympathetic nerve activity to the kidney
Increased parasympathetic nerve activity to the kidney
Which one of the following conditions would cause vasoconstriction in the brain?
Decreased oxygen
Decreased adenosine
Decreased arterial pressure from 120 mmHg to 60 mmHg
Decreased sympathetic nerve activity
During a severe hemorrhage, the delivery of blood flow to the brain is maintained even though cardiac output is decreased. Which of the following allows blood flow to the brain to be maintained under these conditions?
Increased parasympathetic tone to increase arterial driving pressure
Autoregulation causes vasoconstriction in the brain arterioles due to low oxygen
Increased sympathetic tone causes vasoconstriction in the skin and GI tract
Increased renin causes concentration of the urine
Administration of _____ would result in an increase in blood pressure.
Renin inhibitor
AT1 receptor agonist
Vasopressin receptor antagonist
Alpha 1 receptor antagonist
In atherosclerosis, how can vascular resistance be increased?
Increased generation of nitric oxide
Increased vascular smooth muscle fiber number
Decreased vessel radius
Decreased thromboxane production
With what is deep red to blue-purple skin most likely to be associated?
Arterial thrombosis
Aneurysm
Low cardiac output
Venous thrombosis
What is coronary perfusion during exercise dependent upon?
Local generation of nitric oxide
Increased ATP levels in the heart
High heart rates
Sympathetic vasodilation of the coronary arterioles
An increase in fluid returning to the circulation in the capillaries would result from _____________________.
Increased lymphatic flow
Decreased protein intake
Increased arteriolar constriction
Increased venous pressure
In a patient with an atherosclerotic plaque occluding 80% of the left main coronary artery, which of the following symptoms would you expect?
Angina while walking around their home
Fatigue and dyspnea while watching television
No symptoms
Angina after bike riding 3 miles
What is cardiac ischemia likely to result from?
Respiratory disease due to the flu
An increase in heart rate to 120 bpm in a normal person
A decrease in blood pressure to 80/50
Long-term aortic stenosis
With what are abnormal ST segments closely associated?
Dilated cardiomyopathy
Afterdepolarizationa
Cardiac ischemia
Cardiac reentry arrhythmias
In the normal adaptation to dehydration, increased vasoconstriction in the kidney in response to dehydration helps to do which of the following?
Reduce the production of angiotensin
Allows for greater release of vasopressin
Shunt blood flow to the kidney
Shunt blood flow to the heart and brain
During shock, the sympathetic response to severe volume loss is maladaptive because it results in which of the following?
Dramatically improved brain blood flow
Reduced renin production
Accumulation of damaging toxins
Excessive increase in cardiac contractility
The ability of which of the following to act as vasodilators or constrictors would NOT be affected by endothelial damage?
Adenosine
Vasopressin
Bradykinin
Acetylcholine
Which of the following processes contributes to the early stage of atherosclerosis?
Monocytes invade the intimal layer through the endothelial barrier.
Smooth muscle cells migrate into the intimal layer.
Lipid deposits in hemorrhagic areas within the subintimal layer
Infections occur within the vessel wall
Which of the following would NOT be likely to increase your risk of myocardial ischemia?
Atherosclerosis
Hypertension
Lymphatic disease
Aortic valve insufficiency
Which of the following would be most likely in patient with coronary arterial atherosclerosis with 80% occlusion?
Elevated serum troponin I
Elevated ST segments with exercise
Angina at rest
A fourth heart sound
Which of the following statements about lymphatic flow is TRUE?
Lymphatic flow is independent of interstitial hydrostatic pressure.
Lymphatic flow is generally decreased by local muscle activity.
Lymphatic flow is increased by beta agonists.
Lymphatic flow is decreased with increased venous pressure.
A 50 year old woman is brought to the ED after having collapsed at home in what her family describes as a “faint”. They report that she was put on a new drug the previous day by her physician, although they are not sure what the drug is. The patient is confused, with a blood pressure of 85/50 and a heart rate of 145. She reports no pain, and has a normal ECG. Her face and body are red, with some swelling in her face, and her skin is clammy to the touch. What is her most likely diagnosis?
Cardiac arrest
Hypovolemic shock
Anaphylactic shock
Stroke
Coarcation of the aorta decreases flow to the lower body below the narrowing in the abdominal aorta. In these patients there is hypertension measured in the upper body, although blood flow to the lower body (beyond the narrowing is reduced). Which of the following mechanisms contribute to the upper body (eg brachial artery) hypertension in these patients?
Increased carotid baroreceptor activation increase sympathetic stimulation, resulting in vasocontriction
Decreased carotid baroreceptor activation increases parasympathetic stimulation, resulting in increased cardiac output
Increased renal baroreceptor activation increases sympathetic stimulation, resulting in vasoconstriction
Decreased renal baroreceptor activation increases renin-angiotensin system activation, resulting in vasoconstriction
A 60 year old visits his physician complaining of indigestion and that he has been feeling sluggish. On exam his blood pressure is 138/95 and he is tachypnic. There are no extra heart sounds but his heart rate is 98 bpm. His total cholesterol is 250. He reports he jogs 2 miles 3 times a week, but he has been getting short of breath lately. He is sent for an exercise test with ECG which shows some abnormal T waves. Given this information, which of the following statements best explain this patients situation?
He has reduced ability to exercise because his resting heart rate is high.
He has reduced ability to exercise because atherosclerosis blocked the blood flow to the muscles during exercise.
He has reduced ability to exercise because normal increases in myocardial blood flow with exercise are compromised.
He has reduced vasodilation in his skin during exercise.
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