Bioscience Quiz 2
Review of material for test 2 in bioscience covering the cardiovascular system.
- 1.
The cells of the heart are self-excitatory in nature, and thus make the heart a highly efficient pump.
- A.
True
- B.
False
Correct Answer
A. True -
- 2.
Which of the following slows down conduction of electrical activity across the heart and thus allow for ‘atrial kick’?
- A.
AV node
- B.
SA node
- C.
Purkinje Fibers
- D.
Internodal Pathway
Correct Answer
A. AV node -
- 3.
The only direct connection between the atria and ventricles is the…
- A.
SA Node
- B.
AV node
- C.
Sinus of Valsava
- D.
Purkinje Fibers
Correct Answer
B. AV node -
- 4.
Where can the point of maximal impulse (and best auscultation of S1) be found on a normal patient?
- A.
4th right intercostals space
- B.
3rd left intercostals space
- C.
5th left intercostals space
- D.
3rd right intercostals space
Correct Answer
C. 5th left intercostals space -
- 5.
Congestive heart failure may result in what type of displacement of the point of maximal impulse?
- A.
No displacement at all
- B.
Right displacement
- C.
Cephalad displacement
- D.
Lateral displacement
Correct Answer
D. Lateral displacement -
- 6.
Which of the following has the thickest myocardial layer?
- A.
Left ventricle
- B.
Right Ventricle
- C.
Left Atria
- D.
Right Atria
Correct Answer
A. Left ventricle -
- 7.
A patient with pulmonary hypertension may also experience ________ due to increased resistance to blood flow.
- A.
Left ventricular hypertrophy
- B.
Right ventricular hypertrophy
- C.
Left Atrial thickening
- D.
None of above
Correct Answer
B. Right ventricular hypertrophy -
- 8.
Which layer of the cardiac musculature provides strength during contraction?
- A.
Epicardium
- B.
Endocardium
- C.
Myocardium
- D.
Pericardium
Correct Answer
C. Myocardium -
- 9.
Which layer of the cardiac musculature consists of an endothelium and a layer of connective tissue?
- A.
Epicardium
- B.
Pericardium
- C.
Myocardium
- D.
Endocardium
Correct Answer
D. Endocardium -
- 10.
Will a patient with tricuspid valve area of 7cm2 exhibit any signs of tricuspid insufficiency?
- A.
No, because that’s the normal area
- B.
No, not enough narrowing to exhibit symptoms yet
- C.
Yes
Correct Answer
A. No, because that’s the normal area -
- 11.
Which of the following would be a normal surface area for the mitral valve?
- A.
7 cm2
- B.
5 cm2
- C.
3 cm2
- D.
8 cm2
Correct Answer
B. 5 cm2 -
- 12.
What is the function of the sinus of Valsalva?
- A.
It is a Specialized conduction pathways readily spreads electrical activity from one atrium to the other
- B.
It is the fixation point for cardiac musculature and plays an important role in the structure, function, and efficiency of the heart
- C.
Acts as a reservoir for oxygenated blood from pulmonary veins
- D.
Allows aortic valve to open fully without compromising blood flow to myocardium.
Correct Answer
D. Allows aortic valve to open fully without compromising blood flow to myocardium. -
- 13.
After perfusing the myocardium, blood returns to the right atrium via the…
- A.
Coronary Sinus
- B.
Internodal Pathways
- C.
Left circumflex artery
- D.
Sinus of Vasalva
Correct Answer
A. Coronary Sinus -
- 14.
The AV node receives its blood supply from what artery in the majority of patients?
- A.
Left Anterior descending artery
- B.
Right Coronary Artery
- C.
Circumflex Artery
- D.
Coronary Sinus
Correct Answer
B. Right Coronary Artery -
- 15.
Which of the following is not one of three major venous drainage routes in the heart?
- A.
Coronary Sinus
- B.
Anterior Cardiac Veins
- C.
Obtuse marginal vein
- D.
Thebesian veins
Correct Answer
C. Obtuse marginal vein -
- 16.
A patient with decreased diastolic BP may experience which of the following?
- A.
Supraventricular tachycardia
- B.
Decreased right ventricular perfusion
- C.
Increased aortic pressure
- D.
Decreased left ventricular perfusion
Correct Answer
D. Decreased left ventricular perfusion -
- 17.
Which layer of the cardiac musculature is most vulnerable to ischemia during episodes of decreased coronary perfusion?
- A.
Endocardium
- B.
Myocardium
- C.
Epicardium
- D.
Pericardium
Correct Answer
A. Endocardium -
- 18.
An increase in myocardial oxygen demand will have what effect on heart rate?
- A.
No effect, as myocardium can extract more oxygen from hemoglobin
- B.
Increased heart rate to increase coronary blood flow
- C.
Decrease heart rate to allow greater filling time
- D.
All the above are possible
Correct Answer
B. Increased heart rate to increase coronary blood flow -
- 19.
Volatile anesthetic agents will cause coronary vasoconstriction and decrease myocardial oxygen demand.
- A.
True
- B.
False
Correct Answer
B. False -
- 20.
Atrial kick contributes how much to ventricular filling?
- A.
10-15%
- B.
40-50%
- C.
20-30%
- D.
35-40%
Correct Answer
C. 20-30% -
- 21.
Which of the following does not directly affect ventricular performance?
- A.
Preload
- B.
Afterload
- C.
Heart Rate
- D.
Coronary Perfusion
Correct Answer
D. Coronary Perfusion -
- 22.
End diastolic left ventricular volume is also known as what?
- A.
Preload
- B.
Afterload
- C.
SVR
- D.
Cardiac Index
Correct Answer
A. Preload -
- 23.
Acute ETOH intoxication will have what effect on ventricular performance?
- A.
Increase contractility
- B.
Decrease contractility
- C.
Cause irregular ventricular rate
- D.
Decrease heart rate
Correct Answer
B. Decrease contractility -
- 24.
Which of the following would be a normal cardiac output?
- A.
3 L/min
- B.
950 dynes
- C.
6 L/min
- D.
10 L/min
Correct Answer
C. 6 L/min -
- 25.
How would Mitral valve stenosis affect cardiac output?
- A.
Decrease CO by increasing afterload
- B.
Increase CO through incomplete closure of valve
- C.
No change on CO
- D.
Decrease CO through decrease in preload
Correct Answer
D. Decrease CO through decrease in preload -
- 26.
How would Aortic stenosis effect cardiac output?
- A.
Decrease CO by increasing afterload
- B.
Increase CO through incomplete closure of valve
- C.
No change on CO
- D.
Decrease CO through decrease in preload
Correct Answer
A. Decrease CO by increasing afterload -
- 27.
For a patient with aortic stenosis, would you want a slower or faster heart rate?
- A.
Faster
- B.
Slower
- C.
Maintain baseline heart rate
Correct Answer
B. Slower -
- 28.
You are the SRNA for Mr. Cora today who has a past history of HTN, CHF, CAD, PVD, Bil BKA, and DM. When inducing this patient your preceptor asks you how the anesthesia will affect this pt. What do you say?
- A.
This pt may have an exaggerated response to induction agents and to stimulation
- B.
This pt has a low cardiac output which will only be worsened when anesthesia decreases the preload and afterload
- C.
Anesthesia can cause a decrease in circulating catecholamine and this may lead to acute cardiac decompensation.
- D.
Be a super star and say all the above.
Correct Answer
D. Be a super star and say all the above. -
- 29.
A patient who has arteriosclerosis is also likely to be more prone to all of the following except what?
- A.
Arrythmias
- B.
HTN
- C.
Insufficient perfusion to tissues
- D.
Aneurysms
Correct Answer
A. Arrythmias -
- 30.
Hypertension is a significant cause of cardiomyopathy and CHF due to increased…
- A.
Atherosclerosis
- B.
Afterload
- C.
Preload
- D.
Cardiac Output
Correct Answer
B. Afterload -
- 31.
You are doing a pre-op for a pt who will be coming in next Tuesday for spinal surgery. This patient has a history of HTN and wants to know when he should stop taking his medication for the surgery. What do you say?
- A.
Take your last dose the night before since you must remain NPO for 8 hours prior to surgery.
- B.
Take a double dose of medication the night before, this way it will last until surgery.
- C.
Wait until you come to the hospital that morning, then take your medication only after we have measured your BP.
- D.
Take your morning pill as scheduled with a small sip of water in the AM.
Correct Answer
D. Take your morning pill as scheduled with a small sip of water in the AM. -
- 32.
You are the SRNA for a pt about to undergo repair of a L wrist fracture. This pt has a past history of HTN and after you have induced the pt becomes profoundly hypotensive. You are at a little over MAC on sevoflurane. The surgeon will make his incision in about 5 minutes, what do you do?
- A.
Just wait, hypotension for a few minutes wont hurt
- B.
Turn down your VAA, to help bring up the pressure
- C.
Give some pressors for now but maintain VAA at current level
- D.
Turn to your preceptor and beg for help… making decisions is stressful!
Correct Answer
C. Give some pressors for now but maintain VAA at current levelExplanation
you don’t want to turn down VAA prior to incision as this is most common event precipitating intra-op HTN. Just give pressors and after incision if BP does not go up turn down gas.Rate this question:
-
- 33.
What is the function of the pericardium?
- A.
To protect heart against inflammation and infection
- B.
Is highly vascularized and provides bloodflow to coronary arteries
- C.
Provides ‘atrial kick’ to the ventricles
- D.
Stabilizes heart to its anatomic position
Correct Answer
D. Stabilizes heart to its anatomic position -
- 34.
You are caring for Mr. Tisci today. He came in several days and was diagnosed with an acute MI. He was treated in cath lab and is now a patient on your floor. Within the past day he has developed and just now started complaining of chest pain. He says it came on suddenly and is frightened he is having another heart attack, he is currently sitting up in bed and leaning forward which he states helps some. You auscultate his chest and hear a creaking, scratching noise in his chest. His ECG shows ST elevation in the precordial leads, but when you send cardiac enzymes they come back normal. What do you think is wrong with Mr. Tisci?
- A.
Acute Pericarditis
- B.
Cardiac tamponade
- C.
Acute heart failure
- D.
Early phase of new MI
Correct Answer
A. Acute Pericarditis -
- 35.
Which of the following is more likely to cause symptoms with a smaller fluid volume?
- A.
Chronic constrictive percarditis
- B.
Acute pericarditis
- C.
Both conditions require only a small amount of excess fluid to cause symptoms
Correct Answer
B. Acute pericarditis -
- 36.
Which of the following is not true regarding anesthetic management of a patient chronic constrictive pericarditis who is going in for pericardiectomy?
- A.
You should have an A-line or large bore IV for these pts
- B.
Positive pressure ventilation is contraindicated for these patients
- C.
The patient should be given metoprolol prior to surgery to decrease HR and preload
- D.
CABG pump should be ready and on stand-by during procedure
Correct Answer
C. The patient should be given metoprolol prior to surgery to decrease HR and preload -
- 37.
You are SRNA for Ms. Tathum who came in after a MVA. She had trauma to her chest and is coming in for an emergent procedure. She already has an A-line and central line in place, but you are taking a quick peek at her before the procedure. She is currently hypotensive and the SBP goes even lower with inspiration (by 15 mm Hg). You see she has JVD and her heart sounds are muffled., while her CXR shows an enlarged cardiac silhouette. What is Ms. Tathum’s diagnosis?
- A.
Acute Pericarditis
- B.
Cardiomyopathy
- C.
Cardiac ischemia
- D.
Cardiac Tamponade
Correct Answer
D. Cardiac Tamponade -
- 38.
Which of the following is not a compensatory mechanism associated with Heart failure?
- A.
Decreased preload
- B.
Increased sympathetic tone
- C.
Increased afterload due to release of AVP
- D.
Ventricular hypertrophy
Correct Answer
A. Decreased preload -
- 39.
What are the two most important preoperative risk factors for predicting CV complications following noncardiac surgery? (two answers)
- A.
History of DVT or PE
- B.
History of recent MI
- C.
Uncontrolled HTN
- D.
Evidence of CHF
Correct Answer(s)
B. History of recent MI
D. Evidence of CHF -
- 40.
Which of the following patients is not eligible to undergo an elective arthroscopy?
- A.
Mrs. F who had an MI 3 months ago
- B.
Mr. H who has a history of CHF, but is currently well controlled
- C.
Mrs. E who has severe aortic stenosis
- D.
Mr. Q who is currently in a-fib
Correct Answer
C. Mrs. E who has severe aortic stenosis -
- 41.
Unstable angina frequently occurs after an MI.
- A.
True
- B.
False
Correct Answer
B. False -
- 42.
You are caring for a pt with CAD and are asked what muscle relaxant would be a good choice for this patient. How do you respond?
- A.
Vecuronium would be a good choice
- B.
Succinylcholine would be a good choice
- C.
Choice of muscle relaxants does not matter
- D.
Muscle relaxants are contraindicated due to pt condition
Correct Answer
A. Vecuronium would be a good choice -
- 43.
What type of anesthetic management would you choose for a patient with severe CAD and an EF of 20%, this patient is having removal of a lung mass?
- A.
Volatile anesthetic based technique, to maintain favorable myocardial supply-demand.
- B.
Manage with opiod based anesthetic due to depressed ventricular function.
- C.
Perform regional anesthesia with moderate sedation
- D.
Cancel the case.
Correct Answer
B. Manage with opiod based anesthetic due to depressed ventricular function. -
- 44.
With any type of valvular regurgitation you want your HR to be ______ while with any type of stenosis your want you HR to ______.
- A.
Slow, Fast
- B.
Equivalent to baseline, rapid
- C.
Fast, Slow
- D.
Rapid, equivalent to baseline
Correct Answer
C. Fast, Slow -
- 45.
Which of the following is not a true of anesthetic management for a patient with Mitral Stenosis?
- A.
Avoid hypovolemia
- B.
Epidural is preferable to regional anesthesia
- C.
Avoid giving too much fluid
- D.
Ideal HR is 80-100 bpm.
Correct Answer
D. Ideal HR is 80-100 bpm. -
- 46.
A patient will generally have symptoms of mitral stenosis once the valve surface area has been reduced to…
- A.
2 cm2
- B.
6 cm2
- C.
8 cm2
- D.
4 cm2
Correct Answer
A. 2 cm2 -
- 47.
A patient with aortic stenosis (but not CHF) will generally have all of the following except what?
- A.
Dyspnea on exertion
- B.
A-fibrillation
- C.
Left Ventricular hypertrophy
- D.
Angina
Correct Answer
B. A-fibrillation -
- 48.
A patient with acute aortic regurge is likely to have all of the following except:
- A.
Decreased Stroke Volume
- B.
Pulm Edema
- C.
Eccentric Hypertrophy
- D.
Low SVR
Correct Answer
C. Eccentric Hypertrophy -
- 49.
You are caring for 19 yr old Mr. Gerrad today who has a past history of heart transplantation at age 5. During surgery he becomes slightly bradycardic. Which of the following medication would be best to increase his HR?
- A.
Phenylephrine
- B.
Atropine
- C.
Glycopyrolate
- D.
Isuprel
Correct Answer
D. Isuprel -
- 50.
Which of the following has the greatest effect on SVR?
- A.
Constriction of arterioles
- B.
Constriction of veins
- C.
Constriction of capillaries
- D.
Constriction of conducting arteries
Correct Answer
A. Constriction of arterioles -
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Dec 26, 2012Quiz Edited by
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