CVS - Physiology

Medi Call FCPS – 1 | Physiology - Cell Physio
PHYSIOLOGY
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7. Blood supply of heart depends upon: (Med 18 Nov 2022 (A.N)
+7 in past) - ID: 12976
CVS
Ⓐ Co2 levels Ⓑ Oxygen requirement
Ⓒ Hormones Ⓓ Neurotransmitters
Ⓑ ↑ Workload ➜ ↑ O2 demand ➜ local metabolites (adenosine)

dilates vessels ➜ ↑ coronary blood flow (fivefold during exercise)
✦ Oxford, Pg.
8. Difference in maternal and fetal Circulation is

that fetal has less? (Gynae 16 May 2022 (A.N) +2 in past) - ID:
34031
Ⓐ O2 sat Ⓑ CO2 sat

Arterial System Ⓒ Respiratory vascular resistance
1. Major venous drainage of heart (DENTAL 16 Aug 2022 (A.N) +8 Ⓓ Affinity for oxygen
in past) - ID: 37278
Ⓐ Fetal circulation is characterized by
Ⓐ Small cardiac vein Ⓑ Anterior cardiac vein ◉ Low sys. vascular resistance with high systemic blood flow
Ⓒ Coronary sinus ◉ High pulm. vascular resistance with low pulmonary blood flow
◉ HbF ☛ have High Oxygen affinity
Ⓒ Coronary veins are responsible for draining deoxygenated blood ◉ Low O2 tension ☛ allows for proper unloading of oxygen and
from myocardium into cardiac chambers important for angiogenesis
✦ N.I.H USA, Pg. ,
2. What is main determinant of coronary circulation that
produces greater effects on circulation and causes 9. Sympathetic supply of vessel is by: (Med 15 Feb 2022 (A.N)
increase coronary blood flow during exercise? (Med 23 May +3 in past) - ID: 34069
2023 (A.N) +6 in past) - ID: 9734
Ⓐ Beta 1 adrenergic Ⓑ Beta 2 adrenergic
Ⓐ Sympathetic stimulation Ⓒ Cholinergic Ⓓ Muscarinic
Ⓑ Local metabolites and oxygen demand Ⓔ Nicotinic
Ⓒ Parasympathetic output Ⓓ All of above
Ⓑ Beta-2 receptor ➜ Vasodilation
Ⓑ When myocardial oxygen consumption is increased, as during Alpha receptor ➜ Vasoconstriction
exercise, coronary vasodilation and increased oxygen delivery are ✦ Guyton, Pg. 778
critical to preventing myocardial underperfusion and ischemia. Exercise
10. From which vessel mixed venous blood sample can be
coronary vasodilation is thought to be mediated primarily by production
obtained?? (Radio 30 Nov 2021 (M) +6 in past) - ID: 149
of local metabolic vasodilators released from cardiomyocytes secondary
to an increase in myocardial oxygen consumption. Ⓐ IVC Ⓑ Rt atrium
Ⓒ Pulmonary arteries Ⓓ Pulmonary vein
3. During investigations you discover aorta of a patient
Arises from right ventricle. Whats diagnosis? (Surg 16 Nov
2022 (A.N)) - ID: 68146
Ⓒ Mixed venous blood is usually obtained through a catheter inserted
up ➜ brachial vein of forearm ➜ through subclavian vein➜ down
Ⓐ TGA Ⓑ Patent ductus arteriosus to right atrium ➜ finally, into right ventricle or pulmonary artery.
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Ⓐ In cases of transposition of great arteries, these vessels arise from
MCQ with Explanation & Reference
wrong ventricle. They are "transposed" from their normal position so
that aorta arises from right ventricle and pulmonary artery from left 11. maximum resistance is present in ☛ arterioles (Precapillary
ventricle. sphincters)
4. Which nerve loops around arch of aorta? (Med 17 Nov 2022 12. Major resistance vessels ☛ Arterioles (Peripheral resistance)
(A.N) +1 in past) - ID: 69034 13. Veins that open directly into chambers of heart, chiefly into atria ☛
Ⓐ Right recurrent laryngeal nerve Venae cordis minimae (In heart walls)
Ⓑ Left recurrent laryngeal nerve 14. Regarding coronary blood flow ☛ Increases with increase in heart
Ⓒ Phrenic nerve Ⓓ Azygous nerve rate (↑ O2 demand)
15. Distribution of blood flow is mainly regulated by ☛ Arterioles
Ⓑ LRLN ☛ originates from vagus nerve ➜ descends into thorax ➜ (Resistance)
loops under arch of aorta ➜ then ascends to innervate larynx.
RRLN ☛ also originates from vagus ➜ loops around right subclavian 16. Chemical stimuli results in transient dilatation of ☛ Arterioles
artery, not aortic arch. (Hypoxia)
17. Vascularization is associated with factor ☛ FGF (FGF3/FGF10 and
5. Tunica media with elastic fibers is maximum in (Surg 17 FGF-2)
Nov 2022 (A.N)) - ID: 83014
18. Fetal circulation ☛ Increase pulmonary pressure
Ⓐ Aorta Ⓑ Pulmonary artery
Venous System
Ⓒ Renal artery Ⓓ Veins
19. 300 ml fluid infused in body. After 5 min of
Ⓐ Aorta ☛ Muscular artery have maximum tunica media transfusion, Maximum amount of blood will be present in ?
✦ Leeds Uk, Pg. (Med 19 Sep 2019 (M) +5 in past) - ID: 13143
6. O2 amount in fetal circulation (Anesth 15 Nov 2022 (M) +2 in Ⓐ Arteries Ⓑ Veins and venules
past) - ID: 38351
Ⓒ Capillaries Ⓓ Heart
Ⓐ Pulmonary artery ＞ pulmonary vein
Ⓑ Right hard more O2 than left heart Ⓑ Distribution of Blood in circulatory system
Ⓒ Umbilical artery more oxygenated ✦ Veins and Venules ☛ 64 %
✦ Arteries ☛ 13% ✦ Heart ☛ 7%
Ⓐ EXPLANATION ✦ Arterioles and Capillaries ☛ 7%
✦ Pulmonary circulation ☛ 9%
Medi Call FCPS – 1 | Physiology - C.V.S
✦ Guyton, Pg. 169, 170 factor to decrease in her skeletal muscles during exercise
is (Radio 15 Aug 2022 (A.N) +1 in past) - ID: 54500
20. 8% blood lost in 30 minutes. BP remains normal.
Which of following lost maximum amount of blood? (Med 25 Ⓐ Arteriolar resistance Ⓑ Carbon dioxide concentration
May 2023 (M) +23 in past) - ID: 16495 Ⓒ Lactic acid concentration Ⓓ Sympathetic nervous activity
Ⓐ Artery Ⓑ Capillaries
Ⓒ Vein Ⓓ Venules
Ⓐ Exercise ➜ ↑ oxygen demand of skeletal muscles ➜ ↓ arteriolar
resistance ➜ arteriolar dilation to fulfill O2 demand.
Ⓒ ➤ Veins carry most of blood ( approx 64 % ) ➜ any gain or loss will 32. Layers of blood vessel wall (Radio 23 May 2023 (M) +1 in
affect this blood reservoir most past) - ID: 68708
✦ Guyton, Pg. 169
Ⓐ Tunica adventitia Ⓑ Tunica media
21. First reservoir of transfused blood ☛ Veins and venules (Transfused Ⓒ Tunica intima
through veins)
22. Middle pulmonary vein drains into ☛ Inferior pulmonary vein Ⓐ Vessel wall ☛ consists of three layers ➜ tunica intima ( innermost
), tunica media and tunica adventitia.
23. A portal anastomosis is a capillary network in between ☛ Two
veins (Vein - Capillaries - Vein ) 33. SVC and IVC drain into ☛ Right atrium
24. Blood vessel valve present in: ☛ Medium size veins (Prevent 34. Main factor to keep blood supply to tissues: ☛ Arterial smooth
backflow) muscle
25. Veins are big reservoir of blood because of ☛ Increase blood 35. Size of RBC in veins ☛ greater than in Arteries
volume capacity (Larger cross-sectional area)
36. Septal blood supply ☛ Anterior Interventricular Artery (Perforators
Microvasculature and septal arteries)
26. Which one is common in pulmonary and skeletal 37. Increased filtration thru capillary is facilitated by ☛ Increase
capillaries? (Med 18 Nov 2022 ( M) +8 in past) - ID: 31297 hydrostatic pressure of capillaries
38. Branches of arteries that can't be seen with naked eyes ☛ 0.3mm
Ⓐ Hydrostatic pressure Ⓑ Protein filtration
Ⓒ Oncotic pressure 39. Flow through lumen is dependent on ☛ Viscosity
40. Which changes occur first in fetal circulation soon after birth ☛
Ⓑ ✪ Hydrostatic pressure ☛ Pulmonary capillary pressure is low, Decrease pulmonary vasculature + increase LA pressure
about 7 mm Hg, in comparison with a considerably higher functional
41. Post ventricular branches 2 in number and supply ☛ Diaphragmatic
capillary pressure in peripheral tissues of about 17 mm Hg.
surface heart
✪ Oncotic pressure ☛ Colloid osmotic pressure of pulmonary
interstitial fluid is about 14 mm Hg, in comparison with less than half 42. Receptor causes Vasodilation ☛ Beta 2
this value in peripheral tissues 43. Cause of heat loss ☛ Vasodilation
✪ Capillaries of both Lungs and peripheral tissues alow small AA to
44. First line of defense In bleeding ☛ Blood Vessels
filter across membrane and doesn't allow large protein
✦ Guyton, Pg. 513 45. First branch of abdominal aorta ☛ celiac trunk
27. Largest total cross-sectional and surface area is of Hemodynamics

(CPSP Demo +22 in past) - ID: 9148
Blood Flow
Ⓐ Artery Ⓑ Arterioles
Ⓒ Capillaries Ⓓ Venules 1. Role of lymphatic’s: (Gynae 1 Dec 2021 (M) +4 in past) - ID:
34068
Ⓒ Vessel Cross-Sectional Area (cm2) Ⓐ Dissemination of infection
✦ Aorta 2.5 ✦ Arteries 20 ✦ Arterioles 40 Ⓑ Removal of extravascular fluid
✦ Capillaries 2500 ✦ Venules 250 ✦ Veins 80 ✦ VC 8 Ⓒ To present antigen to lymphocytes
✦ Guyton, Pg. 170
28. Where does pericytes are found? (Med 16 Aug 2022 (E) +12 Ⓑ ✪ Lymphatics serve to collect plasma and its constituents that have
in past) - ID: 13883 exuded from capillaries into interstitial space.
✪ They drain from body tissues via a system of vessels that coalesce
Ⓐ Bones Ⓑ Heart and eventually enter right and left subclavian veins at their junctions
Ⓒ Small blood vessels Ⓓ Ciliary bodies with respective internal jugular veins
✦ Ganong, Pg. 538
Ⓒ Pericytes
✪ Present around Capillaries and postcapillary venules 2. Vascular resistance in response to surgical stress is due
✪ Have long processes ✪ Contractile to: (Gynae 22 Feb 2023 (M) +12 in past) - ID: 33718
✪ Release vasoactive agents and extracellular matrix
Ⓐ Cortisol Ⓑ ACTH
✦ Ganong, Pg. 538
Ⓒ Catecholamine’s Ⓓ Aldosterone
29. Pericytes, which are seen in capillary bed are ☛ Pluripotent cells
lining capillaries Ⓒ Stress due to surgery ➜ Release of catecholamines from adrenal
medulla ➜ Vasoconstriction
----- ✦ Guyton, Pg. 212
30. In determining rate of flow through an orifice depends 3. During excercise blood supply decreases to (Med 17 Nov
on which of following properties of gas (Anesth 15 Feb 2022 (M) 2022 (A.N) +10 in past) - ID: 12403
+2 in past) - ID: 35994
Ⓐ Brain Ⓑ Skin
Ⓐ Conductivity Ⓑ Critical temperature Ⓒ Kidney Ⓓ Splanchnic circulation
Ⓒ Density Ⓓ Radioactivity
Ⓔ Viscosity Ⓓ Overall normal Blood supply to GIT ＞ Kidneys
◉ During exercise Blood flow to GIT is decreased ( 25% - 50% )
Ⓒ EXPLANATION
more than it is decreased to Kidneys ( upto 25% )
31. A healthy 22-year-old female medical student has an ◉ Muscles , Skin and Barin receive more blood during Exercise
exercise stress test at a local health club. most likely ✦ N.I.H USA, Pg. , ✦ Guyton, Pg. 246

4. Blood supply of heart is regulated by ? (Med 18 Nov 2022 ( 17. Force of heart contraction depends on ☛ Pre-existing length of
M) +11 in past) - ID: 18799 muscle fiber
Ⓐ Vagus nerve Ⓑ Local metabolites 18. Blood supply to brain decreases by ☛ Hyperventilation (↓ PaCO2 )
Ⓒ Pitutary gland Ⓓ Hypothalamus Stroke Volume
Ⓑ Regulation of blood flow occurs primarily through local intrinsic 19. Stroke volume increases…what decreases (Surg 1 May
regulation, most likely . production of vasodilating metabolites in 2018 +4 in past) - ID: 15331
response to minimal degrees of ischaemia.
Ⓐ ESV Ⓑ EDV
5. Which of following decreases blood supply to brain? (Med
17 June 2021 (E) +5 in past) - ID: 24725 Ⓐ ✪ It is volume of blood pumped from left ventricle per beat. Stroke
volume is calculated using measurements of ventricle volumes from an
Ⓐ I/V epinephrine Ⓑ Inhalation of 17%CO2 echocardiogram and subtracting volume of blood in ventricle at end of a
Ⓒ Seizures Ⓓ Hyperbaric O2 beat (called end-systolic volume)
✦ Guyton, Pg. 115
Ⓓ ✪ ↓ O2 almost immediately causes vasodilation, returning brain
blood flow and transport of O2 to cerebral tissues to near normal 20. Inc. SV without changing other parameters ? (Med 31 Aug
2021 (E) +4 in past) - ID: 22472
✪ Hyperbaric O2 ➜ ↓ CO2 and Inc O2 ➜ Vasoconstriction ➜ ↓
Cerebral perfusion Ⓐ Inc. pulse pressure and inc. MAP
✦ Guyton, Pg. 788 ✦ First Aid, Pg. 501
Ⓑ Dec. systolic and diastolic BP
6. Exercising muscle (Med 23 Feb 2023 (M)) - ID: 83565 Ⓒ Inc. systolic and diastolic BP
Ⓓ Inc. systolic
Ⓐ Decrease vascular resistance
Ⓐ PP = DBP- SBP
Ⓐ EXPLANTION MAP = DBS + 1/3rd of PP
✪ ↑ SV ➜ ↑ CO ➜ ↑ SBP ➜ ↑ PP
7. Single factor independent of others causing thrombus
✪ ↑ SV ➜ ↑ PP ➜ ↑ MAP
formation in old age patients developed coronary artery ✦ Ganong, Pg. 514
thrombi is due to: (Gynae 16 Nov 2022 (M)) - ID: 83971
21. Increasing stroke volume, while keeping TPR and
Ⓐ Hypocoagubility Ⓑ Endothelial retraction diastolic pressure constant, would result in (Med 17 May 2022
Ⓒ Turbulence of blood flow Ⓓ Endothelial injury (M) +16 in past) - ID: 13944
Ⓒ Turbulence of blood flow ☛ key factor in thrombus formation Ⓐ Increase MAP and decrease Pulse pressure
(Virchow's triad) particularly in old age patients with coronary artery Ⓑ Increase MAP and increase Pulse pressure
disease. Ⓒ Decrease MAP and Decrease Pulse pressure
Ⓓ No change in MAP and pulse rate
8. Blood flow directly proportional to (Med 18 Nov 2022 ( M)) -
ID: 83110 Ⓑ ✪ Pulse pressure is directly proportional to Stroke volume so it will
Ⓐ Surface area of capillaries Ⓑ Peripheral resistance increase
Ⓒ Length of vessels MAP = CO X TPR
↑ stroke volume ➜ ↑ C.O ➜ ↑ MAP
✦ Ganong, Pg. 514, 514
Ⓐ Blood flow is strongly proportional to ☛ vessel radius ( surface area
22. extra systolic beat would produce: (Med 17 Nov 2022 (A.N)
9. Decrease CO2 in blood causes (Med 19 Nov 2022 (A.N)) - ID:
+9 in past) - ID: 31277
82915
Ⓐ Increase pulse pressure because contractility is increased.
Ⓐ Decrease blood flow to brain
Ⓑ Increase pulse pressure because HR is increased
Ⓑ Increase blood flow to brain
Ⓒ Decrease pulse pressure because SV is decreased
Ⓒ No effect on brain blood flow
Ⓓ Decrease pulse pressure because PR interval is increased
Ⓐ ↓ CO2 ➜ Cerebral vasoconstriction ➜ ↓ Cerebral blood flow
✦ Ganong, Pg. 623 Ⓒ When heart contracts ahead of schedule ➜ ventricles will not have
filled with blood normally ➜ stroke volume output during that
10. Which of following will cause decreased lymphatic contraction is ↓ or almost absent ➜ ↓ CO ➜ ↓ Pulse pressure
ﬂow? (Gynae 16 Nov 2022 (A.N) +32 in past) - ID: 13848 ✦ Guyton, Pg. 158
Ⓐ Hemorrhage and Shock 23. Sudden rise in pulse pressure is due to: (Surg 17 Nov 2022
Ⓑ Increased hydrostatic pressure (A.N) +15 in past) - ID: 31317
Ⓒ Increased oncotic pressure Ⓓ Increased venous
Ⓐ Increase in arterial compliance
return
Ⓑ Decrease in arterial compliance
Ⓒ Increase stroke volume
Ⓐ A＞C
Ⓓ Increase heart rate at constant cardiac output.
Shock ➜ ↓ Tissue perfusion ➜ ↓ Capillaries hydrostatic pressure ➜ ↓
Fluid leakage to interstitium ➜ ↓ Lymph flow
Ⓒ ✪ PP directly proportional to SV and Inversely proportional to
✦ Guyton, Pg. 200
Arterial compliance
11. Adenosine ☛ ↑ K+ out of cells ➜ hyperpolarizing cell and ↓ ICa, ✦ Sudden ↑ in SV ➜ ↑ CO ➜ ↑ systolic BP ➜ sudden ↑ pulse
decreasing AV node conduction. pressure
✪ Drug of choice in diagnosing/terminating certain forms of SVT. ✦ Aging ➜ Gradual ↓ Arterial compliance ➜ Gradual ↑ in Pulse
pressureNote :- Stem is asking sudden rise PP, Arterial compliance e.g
12. Cerebral blood flow at rest ☛ 50 ml/100g/min (Average rate)
aging nerver sudden
13. Upper and lower limits of cerebral blood flow auto regulation. ☛ 65- ✦ Ganong, Pg. 546 ✦ First Aid, Pg. 285
140 mmHg (Lost above and below this)
24. Mean stroke volume is defined as ? (Gynae 16 Nov 2022 (M)
14. Inverse relation to blood flow: ☛ Resistance +13 in past) - ID: 20418
15. Coronary blood flow is mainly maintained by ☛ Myocardial O2
demand / consumption (Local metabolites) Ⓐ Cardiac output divided by heart rate (sv=co/hr)
Ⓑ Urine out put divided by cardiac input
16. Negative inotropic effect is by ☛ Adenosine (↓ force of Ⓒ Both a and b Ⓓ None of above
contraction)

Medi Call FCPS – 1 | May 2023 Papers
Ⓐ ✪ Cardiac Output (ml/min)= Stroke Volume (ml) x Heart Rate Ⓑ ✪ initial management of multiple-trauma patient includes following
(beats per minute). So, stroke volume= Cardiac output / heart rate. steps in sequence
✦ Ganong, Pg. 514 ● Aims of initial evaluation of trauma patients: -
● Stabilise patient
25. In moderate exercise, which of following increases?
● Identify life-threatening conditions in order of risk and initiate
(Gynae 22 Feb 2023 (A.N)) - ID: 84190
supportive treatment
Ⓐ Stroke volume Ⓑ Venous compliance ● Organise definitive treatments or organise transfer for definitive
Ⓒ Stress Ⓓ Cholesterol treatments. Since this patient is hemodynamically unstable so
the best initial step is fluid replacement.
Ⓐ Moderate exercise ☛ body needs to pump more blood to supply ✦ CMDT, Pg. 506
muscles with oxygen and nutrients ➜ achieved by increasing stroke
35. Venous return increases. When increase in venous
volume.
compliance? (Med 24 May 2023 (A.N) +1 in past) - ID: 83215
26. Athletes have enlarged heart comparatively and
Ⓐ Inc vagal tone Ⓑ Inc TPR
increased stroke volume instead their muscles need same
Ⓒ Inc Right atrial pressure
amount of energy and having cardiac output
approximately same as that in normal individuals. What
Ⓐ Parasympathetic outflow Increases (Vagal tone ) ➜ Increase venous
can be reason for this phenomenon? (Med 25 May 2023 (A.N)
compliance ➜ Decrease TPR
+44 in past) - ID: 12879
✦ Ganong, Pg. 559
Ⓐ Dec. stroke vol.
36. A person was injured in RTA, presented to you in ER
Ⓑ Increased stroke vol. and dec. heart rate
with bleeding from site of injury. His bp was 90/70 and HR
Ⓒ Inc BP Ⓓ Inc. cardiac output
of 100. When he stands up from supine position heart rate
is 120. This increase is due to: (Gynae 24 May 2023 (M) +10 in
Ⓑ ✪ Well-trained athlete’s heart is often larger and considerably
past) - ID: 12972
stronger than that of a normal person, which allows athlete’s heart to
pump a large stroke volume output per beat even during periods of rest Ⓐ Decrease venous return Ⓑ Increased venous
✦ Guyton, Pg. 155 return
Ⓒ Increased EDV Ⓓ Increased cardiac output
27. In stroke patient doppler showed increase perfusion,
by which metabolite ? (Med 25 May 2023 (A.N) +1 in past) - ID:
82848
Ⓐ ✪ Pt is already hypovolemic now Due to sudden posture change (
From Supine to Standing ) ➜ Arterial pressure drop due to gravity ➜
Ⓐ Decrease pco2 Ⓑ Decrease po2 Change in arterial pressure immediatly sense by baroreceptors ➜ ↑
Sympathatic outflow ➜ ↑ HR
Ⓑ Hypoxemia ☛ increases CPP only if Po2 ＜ 50 mm Hg ✦ Guyton, Pg. 221
✦ Davidson ✦ First Aid, Pg. 501
37. Increase in venous return does NOT result in an
28. Stroke volume is 70 and ESV is 50ml, calculate EDV ☛ 120ml (EDV increase in one of following: (Surg 22 Feb 2023 (M)) - ID: 84220
= SV + ESV)
Ⓐ Cardiac output Ⓑ End-diastolic volume
29. Effect on heart rate or arterial competence when SV increases with Ⓒ Left ventricular tension Ⓓ Pulmonary pressure
no changes in total peripheral resistance ☛ Increase arterial Ⓔ Stroke volume
competence with increase CO
30. Increase stroke volume is due to ☛ Large blood volume (Frank Ⓓ Increased venous return ➜ leads to :
Starling Law ) 1. Inc. end-diastolic volume (more blood filling heart before it
31. Stroke volume will decrease by ☛ Decrease EDV (↓ Venous return) contracts)
2. Inc. stroke volume (more blood being pumped out with each beat
Venous Return due to Frank-Starling )
32. A boy fell from a height of 12 feet. He got injured and 3. Inc. cardiac output (blood pumped in a minute).
bleeding occurs continuously 5 minutes. severe bleeding Pulmonary pressure ☛ primarily affected by lung volume, pulmonary
will develop following state ? (Med 19 Nov 2019 (M) +7 in past) - blood volume, tone of pulmonary arterioles, rather than systemic
ID: 20154 venous return.
Ⓐ Hypotension, tachycardia and low CVP 38. In a man performing exercise, venous return from legs
Ⓑ Hypotension, tachycardia and raised CVP is facilitated mainly by (Med 22 Feb 2023 (A.N) +3 in past) - ID:
54945
Ⓒ Hypertension Ⓓ Lower ICP
Ⓐ Contraction of leg muscles Ⓑ Increased abdominal pressure
Ⓐ ✪ Signs of significant blood loss ➜ ◉ Tachycardia ◉ Ⓒ Increased arterial blood pressure
Hypotension ( BP is normal untill 30% blood loss) ◉ Low CVP ◉ Ⓓ Valves in veins
Oiguria ◉ Confusion ◉ Thready pulse ◉ MOD ◉ Death
✦ SRB Surgery, Pg. 120
Ⓐ ✪ During exercise calf muscles (gastrocnemius and soleus) contract
33. A man wearing a tight collar shirt and feels faint and compress intramuscular and deep veins raising venous pressure
whenever he turns his head, reason? (Med 25 May 2023 (M) +11 and propelling blood in deep venous system to flow toward heart
in past) - ID: 36481 while one-way valve function prevents reflux thereby preventing blood
from pooling
Ⓐ Increase TPR Ⓑ Increase venous compliance ✦ Ganong, Pg. 515
Ⓒ Increase CO Ⓓ Venous return
39. Preload depends on: (Med 19 Nov 2022 (M) +1 in past) - ID:
Ⓑ Tight collar ➜ Pressure on baroreceptors ➜ Parasympathetic outflow 84034
➜ Increase venous compliance ➜ Decrease TPR ➜ Faint Ⓐ Venous return Ⓑ Stretch of ventricle fibers
✦ Ganong, Pg. 559
Ⓒ TPR Ⓓ Stretch of Atrium
34. Patient brought in ER with redioulnar and femoral
fractures. BP90/60 mm of Hg, Pulse = 120 bpm. What is Ⓐ ✪ Venous return (VR) is flow of blood back to heart.
best initial management? (Surg 24 May 2023 (A.N) +20 in past) - ✪ ↑ pulmonary venous return to left atrium leads to ↑ filling (preload)
ID: 16499 of left ventricle, which in turn ↑ left ventricular stroke volume
by Frank-Starling mechanism.
Ⓐ Fracture fixation Ⓑ Volume replacement ▶ Preload is left ventricular end-diastolic pressure , amount of
Ⓒ Radiography of limbs Ⓓ Refer to ortopaedic surgeon ventricular stretch at end of diastole

✦ Ganong, Pg. 508 and propelling blood in deep venous system to flow toward heart
while one-way valve function prevents reflux thereby preventing blood
40. Female when stand from sitting feel dizziness,
from pooling
presented with B.P 90/50 along with Tachycardia. there is
✦ Ganong, Pg. 515
compensation by which underlying mechanism? (Radio 15
Nov 2022 (M) +10 in past) - ID: 16076 47. Pregnant lady faints on chair during tooth extraction in
supine or Right lateral position. Pregnant ladies are
Ⓐ Dec. stroke vol Ⓑ Dec. after load
always advised to lie on left lateral position to avoid
Ⓒ Dec. pre load Ⓓ Decreased venous return
compression of (Gynae 15 June 2021 (M) +13 in past) - ID: 23308
Ⓓ ✪ Orthostatic hypotension ☛ is defined as a ↓ in systolic blood Ⓐ IVC obstruction Ⓑ Hypertrophy of Veins
pressure of 20 mm Hg due to a change in a person's position. On Ⓒ Amniotic Embolism Ⓓ Placental Abruption
moving from sitting to standing, or from lying down to standing, gravity
acts on vascular system to ↓ volume of blood returning to heart and Ⓐ Supine hypotensive syndrome ➜ Caused when gravid uterus
blood pools in leg compresses inferior vena cava when a pregnant woman is in a supine
✦ American Academy, Pg. position, leading to decreased venous return centrally ➜ Symptoms
41. On standing suddenly which of following will include pallor, dizziness, low blood pressure, sweating, nausea and
increases? (Surg 17 Nov 2022 (M) +6 in past) - ID: 21332 increased heart rate
✪ These are transient symptoms which resolve with maternal position
Ⓐ Pulsepressure Ⓑ Coronary blood flow change, such as leftward tilt
Ⓒ Renal blood flow Ⓓ Venous compliance All ONE LINERS Below and other CONTROVERSIAL MCQs
are present on MediCall App in Full MCQ form !
Ⓓ ✪ On standing abruptly from sitting or lying position would cause
Just search relevant Keyword in App search bar and
venous pooling of blood and in turn increasing venous compliance
✦ Ganong, Pg. 262, 515 find Full MCQ with Explanation & Reference
42. Under normal circumstances which of following have 48. Starling Effect causes ☛ Increase venous return (↑ Preload)
equal supply? (Med 17 Nov 2022 (A.N) +2 in past) - ID: 72364 49. In aircraft, during ascent pilot have his blood pooled in veins of
lower limbs ☛ Arterial pressure will decrease (Increased HR)
Ⓐ Venous return and pulmonary blood flow
Ⓑ Cardiac output and venous return 50. Venous return to heart during quiet standing is NOT facilitated by
☛ Gravitational increase in arterial pressure (↓ Venous return )
Ⓑ Under steady-state conditions, venous return must equal cardiac 51. A person standing at same place for 1hour ☛ Central venous
output (CO) when averaged over time because cardiovascular system is pressure will decrease (Gravity)
essentially a closed loop. Otherwise, blood would accumulate in either
52. Venous return decreases in ☛ Skeletal muscle paralysis (Soleus)
systemic or pulmonary circulations.
✦ Guyton, Pg. 245 53. Venous return ☛ Increases when right atrium pressure decreases
(↓ venous resistance)
43. Under normal physiological condition Which one of
54. Venous return increased by ☛ Dec. total peripheral resistance
following is equal (Med 17 Aug 2022 (A.N) +2 in past) - ID: 9706
(Vasodilation )
Ⓐ Venous return and coronary flow 55. In exercise, venous blood returns to heart by ☛ Muscle pump in
Ⓑ Venous return and renal flow calves (Soleus muscles)
Ⓒ Cerebral flow and coronary flow
56. Venous return: ☛ Will become zero when all circulatory responses
Ⓓ Venous return and pulmonary flow
abolish
Ⓓ ✪ In normal conditions VR must be equal to cardiac output ( Right 57. During inspiration. JVP drops due to ☛ Increase venous return
ventricle ➜ Pulmonary flow ) ( Frank–Starling mechanism)
✦ Guyton, Pg. 245
58. Position changes from upright to supine, results in ☛ Increase
44. Venous return is measured by (Med 1st Dec 2021 (A.N) +4 in venous return
past) - ID: 15707 59. Venous return to right heart affected mostly by ☛ TPR
Ⓐ Preload Ⓑ Afterload 60. In jogging individuals most likely ☛ Contraction of leg muscles
Ⓒ TPR Ⓓ Stroke volume Peripheral Resistance
Ⓐ ✪ Venous return (VR) is flow of blood back to heart. 61. Which of following will decrease in strenuous
✪ ↑ pulmonary venous return to left atrium leads to ↑ filling (preload) exercise? (Surg 22 Feb 2023 (A.N) +13 in past) - ID: 26304
of left ventricle, which in turn ↑ left ventricular stroke volume
by Frank-Starling mechanism. Ⓐ CO ⒷSv
▶ Preload is left ventricular end-diastolic pressure , amount of Ⓒ TPR Ⓓ MAP
ventricular stretch at end of diastole
✦ Ganong, Pg. 508 Ⓒ ↓ in TPR is result of ↓ vascular resistance in skeletal muscle
vascular beds ➜ leading to ↑ blood flow to cardiac and skeletal muscle
45. Lymphatic flow decrease in (Surg 17th Feb 2021 (M) +4 in ➜ exercise hyperemia
past) - ID: 2351 ✦ Guyton, Pg. 206
Ⓐ Increase venous pressure Ⓑ Increase arterial pressie 62. Brochoconstriction +syncopy (Med 18 Nov 2022 (A.N)) - ID:
Ⓒ Increase protein leakage Ⓓ Decreased venous pressure 83243
Ⓐ As all lymph from body finally drains into systemic veins so venous Ⓐ Vasovagal attack Ⓑ Asthma attack
pressure should be overcome before lymph can flow in to veins. Ⓒ Panic attack Ⓓ Anaphylactic shock
✦ Ganong, Pg. 538
Ⓐ Strong emotional response or pain ➜ activates vagus nerve ➜ slows
46. Which of following Increase venous return to heart? heart rate and dilates blood vessels ➜ leads to fainting (syncope) and
(Med 30 Sep 2020 (A.N) +4 in past) - ID: 16127 bronchoconstriction.
Ⓐ Anemia Ⓑ Calf muscle contraction 63. Which of following is an index for total peripheral
Ⓒ Due to Valve in veins Ⓓ Inc Intra thoracic pressure resistance (TPR)? (Med 18 Nov 2022 (A.N) +8 in past) - ID: 33927
Ⓑ ✪ During exercise calf muscles (gastrocnemius and soleus) contract Ⓐ Mean Arterial Pressure (MAP) Ⓑ Diastolic BP
and compress intramuscular and deep veins raising venous pressure Ⓒ Systolic BP Ⓓ Stroke Volume

Ⓑ ✪ DBP depends on TPR Ⓔ Beat index of afterload ☛ total peripheral resistance that left
✪ SBP depends on CO ventricle needs to overcome to eject blood during systole. It's an
✦ Ganong, Pg. 604 important determinant of cardiac workload and can affect cardiac
function.
64. Increased TPR and arterial pressure is due to (Med 17
Aug 2022 (A.N) +6 in past) - ID: 12207 71. Laminar flow relationship with (Anesth 23 May 2023 (M) +1
Ⓐ Parasympathetic activity
Ⓑ Sympathetic stimulation via Alpha 1 receptors Ⓐ Pressure gradient Ⓑ Inverse to radius
Ⓒ Sympathetic stimulation of B2 receptors Ⓒ Direct to length Ⓓ Inverse to viscosity
Ⓓ Increasing stroke volume
Ⓐ Laminar flow is directly proportional to ☛ pressure gradient (F ∝
Ⓑ ↑ vasoconstriction of arterioles, resulting from increased P).
sympathetic outflow. As a result, TPR and arterial pressure will increase ✦ Ganong, Pg. 540
✦ Guyton, Pg. 178
72. Rise in systemic filling pressure, right atrial pressure,
65. TPR is directly related to (Med 17 June 2021 (A.N) +9 in past) and decreased venous resistance in which conditions? (Med
- ID: 507 24 May 2023 (A.N) +2 in past) - ID: 36564
Ⓐ Capacitance Ⓑ HR Ⓐ Hemorrhage Ⓑ Exercise

Ⓒ Vasomotor tone Ⓓ Vessel compliance Ⓒ Sympathetic
Ⓒ ✪ Vasomotor tone is mainly estimated by TPR. Ⓑ EXPLANATION

✪ ↑ vascular tone ➜ vasoconstriction ➜ narrower lumen ➜ blood
have to overcome more resistance to pass through narrow lumen which 73. During moderate exercise, there is a decrease in (Med 25
May 2023 (A.N) +4 in past) - ID: 54977
is TPR.
✦ Guyton, Pg. 217
Ⓐ Arteriovenous oxygen difference
66. Turbulence in vessels increased by increase in? (Gynae 2 Ⓑ End diastolic volume Ⓒ Pulse pressure
Dec 2021 (M) +4 in past) - ID: 9966 Ⓓ Total peripheral resistance (TPR)
Ⓐ Diameter Ⓑ Radius Ⓓ ✪ Exercise ➜ ↑ Metabolic demand ➜ Release local metabolites ➜

Ⓒ Viscosity Ⓓ Velocity Vasodilation ➜ ↓ TPR ➜ ↑ Blood flow
✦ Guyton, Pg. 206
Ⓓ As Velocity ↑ ➜ Re ↑ ➜ Turbulence
✦ Ganong, Pg. 540 74. Exercising man will have which of following ? (Radio 28
Aug 2021 (E) +6 in past) - ID: 24829
67. Turbulent flow through a tube is inversely related to:
(Med 21 Feb 2023 (A.N) +2 in past) - ID: 34837 Ⓐ Increased Pulmonary Resistance
Ⓑ Decreased Cardiac Output Ⓒ Decreased minute
Ⓐ Velocity Ⓑ Viscosity ventilation
Ⓒ Pressure Ⓓ Blood Ⓓ Decreased Urine out put
Ⓔ Decreased Vascular Compliance
Ⓑ Reynolds number ( Re ) ➤
✪ Re directly proportional to Density and Velocity Ⓔ Happenings During Exercise
✪ Re inversly proportional to Viscocity ↑ O2 consumption ➜ ↑ CO2 production + ↑ Temp ➜ Right shift of
As Velocity ↑ ➜ Re ↑ ➜ Turbulence ODC ➜ ↑ ventilation to meet O2 demand
✦ Ganong, Pg. 540
↑ cardiac output ➜ ↑ pulmonary blood flow to highly comliant
68. A pt fainted during dental surgery, Trendelenburg Pulmonary vesculature ➜ overall response is a large decrease in
position was maintained and some irritant solution was pulmonary vascular resistance (PVR)
snored in order to stimulate some area in brain, which Local metabolites ➜ Dilates skeletal vasculture but
nerve carries that? (Med 18 Nov 2022 (A.N)) - ID: 82994 Nervous system response ➜ ↑ Constriction of overall blood vessels
➜ ↑ resistance ➜ ↓ Compliance ➜ ↑ Arterial pressure
Ⓐ Vagus nerve Ⓑ Spinal injury ↑ Arterial Pressure ➜ ↑ GFR ➜ ↑ Diuresis ( counters reduced
Ⓒ CHF kidney blood supply factor during exercise )
✦ First Aid, Pg. 670, 117 ✦ Guyton, Pg. 227, 248
Ⓐ Emotional Disturbance ➜ Vasodilatory center of anterior
hypothalamus ➜ muscle vasodilator system becomes activated + vagal 75. A student fall down while watching a surgery due to:
(Radio 30 Nov 2021 (A.N) +7 in past) - ID: 35059
cardioinhibitory center transmits strong signals to heart ➜ slow heart
rate markedly + arterial pressure falls rapidly (↓ ↓ TPR) ➜ reduces Ⓐ Increase TPR Ⓑ Decrease TPR
blood flow to brain ➜ lose consciousness ( Vasovagal Syncope ) Ⓒ Increase CO Ⓓ Decrease VR
✦ Guyton, Pg. 218, 218
69. In which phenomena increase C02, decrease TPR and Ⓑ ✪ Neurogenic shock ☛ also called vasovagal syncope and acute
increase vasodilation in skeletal muscle is: (Med 16 Aug 2022 cerebral anemia ➜ most common systemic complication in dentistry.
(A.N) +1 in past) - ID: 84081 ✪ Pathophysiology ☛ Emotional Disturbance ( fear /stress ) ➜
Vasodilatory center of anterior hypothalamus ➜ muscle vasodilator
Ⓐ CO poisoning Ⓑ Cyanide Poisoning system becomes activated + vagal cardioinhibitory center transmits
Ⓒ Hypoxia Ⓓ Exercise strong signals to heart ➜ ↓ heart rate markedly + arterial pressure
falls rapidly ➜ ↓ blood flow to brain ➜ lose consciousness.
Ⓓ ✪ Exercise ➜ ↑ Metabolic demand ➜ Release local metabolites ➜ ✪ Signs and symptoms ☛ Pallor, forehead sweating, nausea,
Vasodilation ➜ ↓ TPR ➜ ↑ Blood flow lethargy, weakness, bradycardia, hypotension and loss of
✦ Guyton, Pg. 206 consciousness.
70. Beat index of afterload is: (Gynae 17 Nov 2022 (M)) - ID: ✪ Treatment ☛ stop dental procedure and monitor vital signs.
83987 ✦ Guyton, Pg. 218, 218 ✦ N.I.H USA, Pg. ,
Ⓐ Left ventricular mean systolic pressure 76. 3rd year student attending surgery for 1 st time
Ⓑ Left ventricle end-diastolic volume suddenly collapse, BP 90/60mmHg. what will be reason?
(Med 25 May 2023 (M) +11 in past) - ID: 19723
Ⓒ Inotropic state of heart Ⓓ Mean arterial pressure
Ⓔ Total peripheral resistance Ⓐ Dec Heart rate Ⓑ Dec peripheral resistance
Ⓒ Inc capillary permeability Ⓓ Dec venous return

103. Woman cut her finger by mistake, immediate effect ☛ Ⓑ ✪ Starling law ☛ “the strength of heart's systolic contraction is
vasoconstriction directly proportional to its diastolic expansion with result that under
normal physiological conditions heart pumps out of right atrium
Cardiac Output
all blood returned to it without letting any back up in veins”. In a
1. Cardiac output is decreased in (Med 22 Feb 2023 (A.N) +4 in nutshell venous return is directly proportional to cardiac output
past) - ID: 6640 ✦ Guyton, Pg. 119
Ⓐ Beriberi Ⓑ Hyperthyroidism 8. A young healthy male of 25yrs has decreased cardiac

Ⓒ Anemia Ⓓ Heart Failure rate 50 beats/min and cardiac output is high these
findings present in (Med 17 May 2022 (A.N) +1 in past) - ID: 79487
Ⓓ ✪ When heart failure occurs cardiac output decreases and heart is
Ⓐ Parasympathomimetic drugs Ⓑ Exercise
unable to pump sufficiently to maintain blood flow to fulfil body needs
Ⓒ Athlete Ⓓ Rest
✦ Guyton, Pg. 405
Ⓔ Sympathomimetic drugs
2. Athlete are different from normal person in regards to
(Med 23 Feb 2023 (M) +7 in past) - ID: 2764 Ⓒ ✪ Heart becomes enlarged/ hypertrophic, due to Intense
cardiovascular workouts ☛ Heart becomes enlarged/ hypertrophic ➜
Ⓐ High resting cardiac output Ⓑ Low oxygen consumption
creating an ↑ in SV, an enlarged left ventricle (and right ventricle) ➜
Ⓒ Decrease muscle mass Ⓓ Increase resting heart
↓ in resting pulse along with irregular rhythms ➜ ↑ both HR and SV
rate
✪ Most athletes have a resting heart rate between 40-60 BPM giving
them bradycardia diagnosis.
Ⓐ ✪ Heart becomes enlarged/ hypertrophic, due to intense
cardiovascular workouts, creating an ↑ in SV, an enlarged left All ONE LINERS are present on MediCall App in Full MCQ
ventricle (and right ventricle), and a ↓ in resting pulse along with form ! Just search related Keyword in App and find Full
irregular rhythms. . This type of exercise also ↑ both HR and SV MCQ with Explanation & Reference
✦ Guyton, Pg. 155 ✦ Ganong, Pg. 519
9. Dye used to measure cardiac output is ☛ Cardio green (Indicator
3. Cardiac output measured by thermo dilution method is dilution method)
called (Med 23 Feb 2023 (A.N) +3 in past) - ID: 9131
10. Cardiac output Increases more in ☛ Exercise (Fast heart beats)
Ⓐ Fick’s law Ⓑ Graham,s law 11. Cardiac output increase by ☛ Increase Blood volume
Ⓒ Starling method Ⓓ Indicator dilution technique
12. measurement of cardiac output by thermodilution ☛ Maybe
inaccurate due to respiratory changes in pulmonary artery temperature
Ⓓ ✪ Indicator dilution method uses a thermal indicator (cold or heat)
injected into right side of heart and detected either in pulmonary 13. Cause of decreased cardiac output ☛ IVC obstruction
arterial or arterial blood, thus cardiac output 14. Increase cardlac output Is augmented by ☛ Sympathetic
✦ Ganong, Pg. 514
15. Cardiac output is augmented by ☛ Venous constriction ( ↓ Venous
4. Cardiac output depends upon: (Gynae 16 Nov 2022 (M)) - ID: Compliance ➜ ↑ VR ➜ ↑ Preload ➜ ↑ CO )
83972
16. Wheatstone bridge principle is used to measure ☛ Cardiac output
Ⓐ Stroke volume (Millivolts output per volt input)
Ⓑ Left ventricular end-diastolic volume 17. Cardiac output in heavy exercise is augmented by ☛ Sympathetic
Ⓒ Left ventricular end-diastolic pressure stimulation (↑ heart rate, BP)
Ⓓ Ejection fraction
18. Cardiac Output is maximum ☛ just after delivery (Uterine
contraction )
Ⓐ Cardiac output ☛ calculated as product of stroke volume ( volume
of blood pumped from one ventricle with each beat) and Heart rateLeft 19. If heart rate is 70 beats/min, then cardiac output of this ventricle is
ventricular end-diastolic volume ☛ volume of blood in left ventricle closest to ☛ 5.25 1/min
at end of filling, or diastole. It influences stroke volume and cardiac 20. Coronary blood supply ☛ 5% of Cardiac Output
output, it's not direct factor.
21. Cardiac output and cerebral flow equal ☛ At Rest
5. Cardiac output depends on which of following (Dent 25 Feb 22. Cardiac output is decreased in ☛ Standing or sitting from lying
2020 (A.N) +4 in past) - ID: 34203 position (Gravity)
Ⓐ Heart rate Ⓑ Venous return 23. CO when HR is 72 BPM and SV is 70 ml ☛ 5000 ml (CO = SV ✖
Ⓒ Stroke volume Ⓓ Ejection fraction HR )
24. Regarding exercise tolerance test we need to observe ☛ Cardiac
EXPLANATION out will increase to level Of metabolic demand (Otherwise Angina)
✦ Guyton, Pg. 119
25. During exercise cardiac output increases due to ☛ Increased
6. Mean arterial pressure depends upon ? (Med 23 Feb 2023 (M) ventricular contraction (↑ Sympathatic flow )
+11 in past) - ID: 21035
26. Cardiac output of left and right sides of heart is ☛ 100% (Equal)
Ⓐ CO Ⓑ Venous return 27. Chronic anemia causes ☛ Inc. Cardiac Output (Compensatory
Ⓒ CO and TPR Ⓓ TPR response)
Ⓒ Mean arterial pressure = DBP + 1/3rd PP 28. Cardiac output measured by dye dilution method in ☛ Aorta
✪ ↑ CO ➜ Inc SBP ➜ ↑ PP ➜ ↑ MAP (Injected into a large vein or rt atrium)
✪ ↑ TPR ➜ ↑ DBP ➜ ↑ MAP 29. Thermo dilution method is also called ☛ temperature change
✦ Guyton, Pg. 184 method (Determines cardiac output )
7. Starling’s law is (Med 16th Feb 2021 (E) +4 in past) - ID: 9193 30. Hypovolumic Shock ➜ ◉ Pale and Cold ◉ ↓ CVP ◉ ↓ CO ◉ ↑
PVR ◉ ↑ HR ◉ ↓ Preload
Ⓐ Cardiac out put (C.O) decrease when parasympathetic system
activates Heart Rate
Ⓑ Cardiac output increase when venous return increases
1. Patient came for routine checkup, Heart Rate 58, no
Ⓒ Cardiac output increases when sympathetic activity increases.
other symptoms, cause? (Med 17 May 2022 (A.N)) - ID: 79316
Ⓓ Cardiac output decreased with increase in venous return Ⓐ Trained athlete Ⓑ HF

Ⓒ Heart block

Ⓐ In athlete ☛ ↑ ↑ SV and ↓ HR 9. Effect of vagus on heart rate (Med 23 Feb 2023 (A.N) +2 in
✦ Guyton, Pg. 155 past) - ID: 1618
2. At which right atrial pressure there is distension of Ⓐ Chronotropic Ⓑ Ionotropic

veins at lower neck but not in upper neck. (Med 24 May 2023 Ⓒ Negatively chronotropic Ⓓ Positive chronotropic
(A.N)) - ID: 84379
Ⓒ Vagus nerve directly innervates sinoatrial node. when activated, it
Ⓐ +10 Ⓑ +8
serves to lower heart rate, thus exhibiting a Negative Chronotropic
Ⓒ +22 Ⓓ 25
effect ( Guyton )
Ⓑ At +8 right atrial pressure ☛ there is enough pressure to distend 10. In Hemorrhage after compensation, which one of
lower neck veins but not enough to distend upper neck veins. following decreases (Anesth 28 Aug 2021 (E) +7 in past) - ID: 5769
At +10 level of right atrial pressure, you might expect to see distension
in both lower and upper neck veins Ⓐ Venous Compliance Ⓑ H.R
Ⓒ Cardiac out put Ⓓ Urine output
3. Brain bridge reflex: (Gynae 24 May 2023 (M) +1 in past) - ID:
84210 Ⓑ ✪ Hemorrhage ➜ If ＞ 10% Blood Loss ➜ ↓ ↓ Cardiac Output ➜
↓ ↓ Pressures ➜ Aretrial Baroreceptors and stretch receptors ➜ initiate
Ⓐ Causes reactive hypertension in shock
powerful sympathetic reflexes ➜ ● ↑ ↑ Heart Rate ● ↓ Vascular
Ⓑ Increases heart rate due to stretch of sinus in right atrium
compliance ● ↓ Urine output ➜ COMPENSATION
Ⓒ Is used for balance Ⓓ Maintains posture
✪ After Compensation ( Volume replacement ) Heart Rate will
Ⓔ Means bradycardia on occlusion of AN fistula
Decrease to normal while CO, Urine Output and Venous compliance will
Ⓑ ✪ Brainbridge reflex ☛ ↑ Atrial Volume ➜ ㊉ Strech receptors ➜ Increase
✦ Guyton, Pg. 295 ✦ CMDT, Pg. 507 ✦ Ganong, Pg. 559
Through vagus ( Both afferent and Efferent ) ➜ ↑ HR and Contraction
✦ Guyton, Pg. 223 11. Heart rate is 75 . ventricular phase takes 0.3 sec to
complete. If heart rate increased to 225 then in how much
4. Beta stimulation is associated with ? (Med 17 May 2022 (M)
+7 in past) - ID: 21473 time ventricular phase will be completed (Gynae 16 Feb 2022
(M)) - ID: 72354
Ⓐ Dec. heart rate Ⓑ Dec. cardiac output
Ⓐ 0.9 sec Ⓑ 0.05 sec
Ⓒ Cardiac inhibition
Ⓒ 0.1 sec
Ⓓ Increase HR. and force of contraction
Ⓓ ✪ epinephrine and norepinephrine ➜ Activation of beta1 adrenergic Ⓐ Duration of 1 cardiac cycle ☛ is reciprocal of heart rate
✪ When HR 75 ☛ one cardiac cycle is 0.8 sec (60/75)
receptors ➜ Inc. activity of adenylyl cyclase ➜ Inc. intracellular cAMP in
✪ If ventricular phase takes 0.3 sec ➜ roughly 37.5% of cycle
SA node ➜ Which then Causes 2 Effects:
✪ If heart rate triples to 225 ➜ one cycle is 0.27 sec (60/225) ➜
➊ Increases conductance of funny sodium channels and L-type calcium
Ventricular phase would be approx 0.1 sec (37.5% of 0.27).
channels ➜ Inc influx of cations during depolarization ➜ faster
attainment of threshold potential during phase 4 ➜ Inc. Heart Rate 12. most important subjective cause of a person feeling
(positive chronotropic) exhaustion during exercise: (Surg 30 Nov 2021 (A.N) +6 in past) -
➋ Activation of protein kinase ➜ Phosphorylation of L-type Ca2+ ID: 25719
channels in AV node ➜ increased Ca2+ entry ➜ increased contraction
and conduction (positive dromotropic and inotropic) ( Guyton ) Ⓐ Increase O2 saturation
Ⓑ Lactic acid release causing increased pH
5. Parasympathetic M receptor causes which effect? (Med 23 Ⓒ Increase heart rate Ⓓ Dehydration
Feb 2023 (A.N) +1 in past) - ID: 83370
Ⓒ ✪ Exercise ➜ ↑ Body demand ➜ ↑ Sympathatic flow ➜ ↑ HR ➜
Ⓐ Mydriasis Ⓑ Vasodilation
Can compensate for short time ➜ If prolonged ➜ Exhuastion b/c heart
Ⓒ Bronchodilation Ⓓ Dec Heart rate (HR)
can't meet demand
✦ Ganong, Pg. 559
Ⓓ EXPLANATION
13. A person who does heavy exercises regularly, his
6. Depress parasympathetic nerve will cause (Med 17 Nov
resting HR will be (Anesth 16th Feb 2021 (M) +5 in past) - ID: 26
2022 (A.N) +1 in past) - ID: 83017
Ⓐ Less than 60 Ⓑ 80
Ⓐ Increase heart rate Ⓑ Decrease heart rate
Ⓒ 80-100 Ⓓ 100-150
Ⓒ Heart block Ⓓ Prolonged PR interval
Ⓐ Depress parasympathetic ➜ Increase sympathetic overflow ➜ Ⓐ ✪ Normal resting HR adults ☛ 60 to 100 bPM
✪ Athletes ☛ has a larger stroke volume which means a greater
Increase heart rate
✦ Ganong, Pg. 259 ✦ Duane Neurosceince, Pg. 438 volume of oxygen is delivered to body per heart beat ➜ normal resting
HR : 40 to 60 bpm ( lower than usual )
7. In postural hypo-tension raising patient from supine ✦ Guyton, Pg. 155 ✦ Ganong, Pg. 519
position or sitting to standing position leads to ? (Surg 23 Feb
2023 (M) +15 in past) - ID: 21041 14. Heart rate increased by ☛ Brain Bridge reflex (↑ Atrial Volume)
15. Fetal heart rate is ☛ 120-160 beats per minute (In in utero period)
Ⓐ Dec. HR Ⓑ Inc. BP
Ⓒ Inc. HR Ⓓ Arrhythmia 16. Cardiac tissues consumes O2 maximally when ☛ heart rate
increases (Exercise)
Ⓒ ✪ Due to sudden posture change ( From Supine to Standing ) ➜ 17. Parasympathetic effect is ☛ Decreases HR
Arterial pressure drop due to gravity ➜ Change in arterial pressure
18. Heart rate between 40-60 BPM ☛ Most Athletes (Bradycardia)
immediatly sense by baroreceptors ➜ ↑ Sympathatic outflow ➜ ↑ HR
✦ Guyton, Pg. 221 19. Increased amount of myocardial oxygen is consumed in ☛
Increased heart size (Law of Laplace)
8. In well trained athletes, what is permanently increased
(Med 17 Nov 2022 (M) +1 in past) - ID: 82938
20. Receptors mediate increase heat rate ☛ Beta-1
21. Inc cardiac output and dec HR present In ☛ From standing to lying
Ⓐ Arterial pressure Ⓑ Stroke volume position
Ⓒ Cardiac output Ⓓ Skeletal muscle perfusion
22. ✪ Increase HR ➜ O2 demand of heart ↑ ➜ Release of local
Ⓑ In athlete ☛ ↑ ↑ SV and ↓ HR metabolites ( Adenosine ) ➜ Coronary vasodilation ➜ ↑ blood flow
✦ Guyton, Pg. 155
Pressures

Ⓐ ✪ Mean systemic filling pressure ☛ It is pressure measured

Arterial Pressures everywhere in systemic circulation after blood flow has been stopped by
1. Difference between systemic and pulmonary circulation clamping large blood vessels at heart
is (Med 22 Feb 2023 (A.N) +2 in past) - ID: 79517 ✪ mean systemic filling pressure, although almost impossible to
measure in living animal
Ⓐ More blood flow in pulmonary circulation
Ⓑ Low resistance in pulmonary circulation ✦ Guyton, Pg. 252
Ⓒ High resistance in pulmonary circulation
8. Increase MAP but no resistance in venous return ☛ Exercise
Ⓓ Variable circulation in pulmonary
9. Jugular pulse is differentiated from carotid pulse on basis of ☛
Ⓑ ✪ Pulmonary artery mean pressure is about 16 mmHg abdominal pressure (Hepatojugular reflex)
✪ Aorta mean pressure is about 100 mmHg ( 6 times greater than in 10. True about systolic pressure ☛ Depends on venous return (↑ CO)
pulmonary artery )
11. Pulmonary artery pressure raised in ☛ Moderate exercise
✪ Pulmonary resistance is about 10 times less than that in systemic
circulation. 12. Most pressure from systole fall dissipated at ☛ Arterioles-capillaries
✪ PaO2 pulmonary Arteries ➜ 40 mmHg jucntion (Contract and dilate)
✪ PaO2 systemic Arteris ➜ 80 - 100 13. Pressure ☛ highest in aorta (100 mm Hg)
✦ Guyton, Pg. 170, 527
14. Max Blood velocity in ☛ Pulmonary artery (V = F/A)
2. arterial pulse which is palpable on radial artery is due to 15. Pulmonary Arterial pressure increases with ☛ Hypoxia
(Surg 17 Nov 2022 (A.N) +4 in past) - ID: 9982
(Vasoconstriction)
Ⓐ Pulse pressure which pushes arterial wall 16. Normal Pulmonary artery wedge pressure is ☛ 6-12 mmHg (＞18 ➜
Ⓑ Systolic pressure of left ventricle Edema)
Ⓒ Diastolic pressure of left ventricle
17. Pressure in arteries and veins if human hearts stops for a while ☛
Ⓓ None of above
Mean Systemic Pressure (Clamping large vessel)
Ⓐ pulse we feel is pressure blood is exerting on vessel wall. In 18. Values less in pulmonary circulation than in systemic circulation ☛
superficial vessels we can feel that pressure even by our mere hands mean arterial pressure, arterial oxygen level and vascular resistance.
✦ Ganong, Pg. 510
19. Maximum arterial pressure dissipation at: ☛ Arteriolar capillary
3. Mean Arterial pressure is? (Surg 16 June 2021 (A.N) +5 in junction (Site of resistance )
past) - ID: 9976 20. Mean arterial pressure when systolic BP 132 mmHq and diastolic BP
66 ☛ 88 (MAP = DP + 1/3(PP) )
Ⓐ Diastolic +1/3pulse pressure
Ⓑ Difference btween systolic and diastolic pressure 21. Pulse wave velocity can be used to ☛ Detect blood flow to
Ⓒ Remain always constant extremity
Ⓓ Systolic and diastolic pressure 22. BP checked by invasive method from dorsalis pedis artery differs
from BP checked from radial artery ☛ Pulse pressure is higher
Ⓐ Mean arterial pressure is calculated by formula Diastolic blood
23. Condition that increases pulse pressure ☛ Thyrotoxicosis (Less
pressure plus 1/3rd of pulse pressure
✦ Guyton, Pg. 544 common)
24. Pulse pressure ☛ Greater in Femoral Artery than Aorta ( greater
4. Pulse pressure is? (Gynae 18 Sep 2019 (M+E) +7 in past) - ID:
proportion of elastin fibers in aorta ) (Aorta: highest compliance )
9978
25. Pulse pressure ☛ difference of systolic and diastolic pressures
Ⓐ Measured only in diastole Ⓑ Determined by stroke volume (Force generated by heart)
Ⓒ Decreased in old age Ⓓ Measured only in systole
26. Initial clinical sign of patient in shock ( hypotensive, shivering,
tachypneic ) ☛ Increase pulse rate (Class I and II)
Ⓑ ✪ Pulse pressure is difference between systolic and diastolic blood
pressure. 27. Blood flow to tissue is maintained by ☛ Mean arterial pressure
✪ ↑ SV ➜ ↑ CO ➜ ↑ SBP ➜ ↑ PP (Perfusion pressure )
✦ Guyton, Pg. 180
28. Pulse Pressure ☛ Depends upon compliance of arterial system
5. Which organ has a highest arteriovenous O2 difference? (Compliance=volume change /pressure change)
(Med 23 Feb 2023 (A.N) +5 in past) - ID: 9746 29. Left heart catheterisation ☛ involves accessing arterial
circulation, usually through radial artery, to allow catheterisation of
Ⓐ Liver Ⓑ Lungs
aorta, LV and coronary arteries
Ⓒ Heart Ⓓ Kidneys
30. Exercise ☛ Systolic BP rises moderately while diastolic remain
Ⓒ Heart is organ which has highest arteriovenous difference at resting unchanged or fall
state Venous Pressures
✦ Ganong, Pg. 570
31. Increased Central venous pressure is due to? (Gynae 16
6. Pulmonary Wedge Pressure is (Dent Sep 2018 +5 in past) - May 2022 (A.N) +6 in past) - ID: 20564
ID: 9995
Ⓐ Decrease heart rate Ⓑ Decrease urine output
Ⓐ Direct measures left atrial pressure
Ⓒ Increase heart rate Ⓓ Decrease CO
Ⓑ Indirectly measures left atrial pressure,
Ⓒ Measures venricular pressure Ⓓ Measures rt. atrial
Ⓐ ✪ CVP is ↑ by either an ↑ in venous blood volume or by a ↓ in
pressure
venous compliance.
✪ ↓ heart rate ➜ ↓ in cardiac output ➜ Blood backing up into venous
Ⓑ Pulmonary capillary wedge pressure (PCWP) provides an indirect
circulation ➜ ↑ venous volume ➜ ↑ CVP
estimate of left atrial pressure (LAP). Although left ventricular pressure ✦ Guyton, Pg. 184
can be directly measured by placing a catheter within left ventricle, it is
not feasible to advance this catheter back into left atrium. 32. Regarding CVP measurement (Anesth 17 May 2022 (M)) - ID:
✦ Guyton, Pg. 510 79505
7. Mean systemic filling pressure determine by (Dent June Ⓐ Reliable indicator of left ventricle function
2021 +6 in past) - ID: 34649 Ⓑ Normal CVP exclude diagnose of pulmonary edema
Ⓒ Unaffected by therapeutic vasoconstriction atrium
Ⓐ Venous return Ⓑ Cardiac output
Ⓓ CVP of 5mmHg is higher than reading of 5cm water

Ⓓ 1.36 cm water = 1.0 mm Hg Ⓐ 25 mmHg Ⓑ 120 mmHg

5 mmHG = 5 ✖ 1.36 = 6.8 cm water Ⓒ 8 mmHg Ⓓ 80 mmHg
33. Central venous pressure is increased by ☛ Increasing venous Ⓒ ✪ Right Atrial pressure ☛ Almost Zero
volume (↓ in CO ) ➤ Pulmonic valve opens at ☛ 8 mmHg
34. Venous pressure inc by 8mm, capillary pressure would be ☛ ✦ Jaypee, Pg. 538
Increase by 8mm
6. Pulmonary valve opens when right ventricular pressure
35. Indication of CVP insertion is ☛ Infusion of irritant substances, CVP exceeds (Med 15 Nov 2022 (A.N) +24 in past) - ID: 26092
monitoring, Advanced haemodynamic monitoring, Central venous
oxygenation monitoring and Temporary cardiac pacemaker Ⓐ 25 mmHg Ⓑ 8 mmHg
Ⓒ 80 mmHg Ⓓ 4 mmHg
36. CVP ☛ Give accurate measurement when catheter in right atrium
(No valve) Ⓑ Normal RV pressure
37. Standing ↓ VR due to gravity pooling effect thus venous pressure Systolic ☛ 25mmHg Diastolic ☛ 8 mmHg
minimal in SVC＞ IVC RV Pressure exceeds 8 mmHg ➜ ventricular pressures push semilunar
valves open during Systole✪ Right Atrial pressure ☛ Almost Zero
-----
✪ Aorta Pressure ☛ 80 mmHg
38. Atrial Pulse (Med 18 Nov 2022 ( M)) - ID: 83106 ✪ Aortic Valve opens at ☛ 80 mmHg
✪ Left ventricular Pressure ☛ 120 mmHg
Ⓐ Pressure wave along arterial wall ✦ Guyton, Pg. 115
Ⓑ Pressure wave along Venous wall
7. In which phase of Cardiac cycle pressure increased but
Ⓐ Arterial pulse ☛ pressure wave that travels along arterial wall, volume remains constant? (Med 17 Nov 2022 (A.N) +1 in past) -
created by alternating expansion and contraction of elastic arteries after ID: 82660
each systole of left ventricle. Ⓐ Isovolumetric contraction Ⓑ Isovolumetric relaxation
39. Valsalva's Maneuver Initiator Is ☛ Increase Int >Thoracic Pressure Ⓒ Rapid ejection Ⓓ Passive filling
40. About chambers of heart ☛ Right ventricle pressure 25/5 mmHg Ⓐ Isovolumic contraction ☛ volume of ventricle does not change
41. Torr is a unit of: ☛ Pressure because all valves are closed ➜ pressure inside ventricle increases to
equal pressure in aorta (80 mm Hg) ➜ Pressure in aorta remain lowest
Cardiac Cycle till valve is closed and begin to rise during rapid ejection phase and
Systole onwards
Click and view Cardiac Cycle Graph on MediCall App
1. Ventricular contraction causes which wave in JVP (Eye 30 ✦ Guyton, Pg. 114, 117
Nov 2021 (M) +6 in past) - ID: 10001
8. Max blood in ventricle during? (Med 17 May 2022 (E) +2 in
ⒶA ⒷC past) - ID: 37459
Ⓒ A and c ⒹP
Ⓐ Isovolumetric contraction Ⓑ Isovolumetric relaxation
Ⓑ C wave ☛ corresponds to right ventricular contraction Ⓒ Slow ejection Ⓓ Rapid ejection
causing tricuspid valve to bulge towards right atrium during RV
isovolumetric contraction
Ⓐ EXPLANATION
✦ Guyton, Pg. 114 9. Semilunar valve open during which stage of cardiac
2. Hypercalcemia may cause (Med 25 May 2023 (M) +3 in past) - cycle (Radio 30 Nov 2021 (M) +5 in past) - ID: 15624
ID: 83284
Ⓐ Rapid ejection Ⓑ Slow ejection
Ⓐ Systolic arrest Ⓑ Diastolic arrest Ⓒ Isovolumic contraction Ⓓ Isovolumic relaxation
Ⓒ QT Prolongation Ⓓ Tachycardia
Ⓐ Ventricular pressure rises during contraction ➜ semilunar valves
Ⓐ Hypercalcemia ☛ Affects heart ➜ shortened QT interval ➜ shortens (aortic and pulmonary) open ➜ Rapid ejection of blood
systolic phase ➜ heart not contracting effectively during systolic phase. ✦ Guyton, Pg. 115
3. Which of following event occurs just before opening of 10. Right ventricular pressure can exceed upto? (Med 31
August 2021 (A.N) +8 in past) - ID: 16230
aortic valve? (Med 25 May 2023 (M) +2 in past) - ID: 35226
Ⓐ 10 mmHg Ⓑ 25 mmHg
Ⓐ Beginning of diastole Ⓑ Beginning of systole
Ⓒ 35 mmHg Ⓓ 40 mmHg
Ⓒ Rapid filling Ⓓ Isovolumetric relaxation
Ⓑ Isovolumetric contraction ☛ period between mitral valve closing Ⓑ ◉ Left Ventricle pressure ☛ 120 mmHg
◉ Right Ventricle pressure ☛ 25 mmHgRVP ( Systolic ) ☛ 25 mmHg
and aortic valve opening; period of highest O2 consumption
RVP ( Diastolic ) ☛ 0 – 8 mmHg
4. Aortic Pressure highest in which Phase of Cardiac Cycle? ✦ Jaypee, Pg. 538
(Surg 25 May 2023 (M) +23 in past) - ID: 12287
11. . Dicrotic notch on aortic pressure curve is seen in:
Ⓐ Slow Ejection Phase Ⓑ Rapid Ejection Phase (Radio 30 Nov 2021 (A.N) +15 in past) - ID: 15203
Ⓒ Isovolumetric Contraction Ⓓ Isovolumetric relaxation
Ⓐ Closure of aortic valve Ⓑ Open of aortic
Ⓒ Closure of mitral Ⓓ Open of mitral
Ⓐ Ventricular Contraction ejection Phase
➊ First third ☛ Rapid ejection ➜ ventricular pressure rises and 70% of
Ⓐ Immediately before Aortic valve closes➜ short period of backward
blood is intensively ejected
flow of blood ➜ small and brief increase in arterial blood pressure ➜
➋ Last two thirds ☛ Slow ejection ➜ 30% of remaining ejected ➜
Dicrotic notch on waveform
Max Pressure 120 mmHg✪ Max pressure in ventricle ☛ Rapid ejection
phase ✦ Ganong, Pg. 542
✪ Max pressure in Aorta ☛ Slow ejection phase
✦ Guyton, Pg. 115 ✦ BRS Physiology, Pg. 112 12. During which phase of cardiac cycle Ventricular filling
occurs ? (Dent June 2021 +6 in past) - ID: 18818
5. pressure in RT atrium at which pulmonary valve opens?
(Gynae 1 Dec 2021 (E) +5 in past) - ID: 12549 Ⓐ Atrial systole Ⓑ Ventricular systole
Ⓒ Aortic Opening

2. First Heart sound is produced due to ? (Gynae 22 Feb 2023 Aortic area ☛ right second intercostal space, just lateral to sternum
(M) +15 in past) - ID: 18060 ➜ aortic valve sounds best heard
✦ Reference, Pg.
Ⓐ Hpovolumic contraction Ⓑ Isovolumic contraction
Ⓒ Isovolumic relaxion Ⓓ Hypovolumic relaxation 11. Second heart sound is heard during: (Radio 23 May 2023
(A.N) +25 in past) - ID: 24828
Ⓑ Isovolemtric contraction ➜ left ventricular pressure to rise above
Ⓐ Isovolumetric contraction Ⓑ Isovolumetric relaxation
atrial pressure ➜ Closure of A-V valves ➜ S1
✦ Guyton, Pg. 116, 114
Ⓒ Atrial systole Ⓓ Rapid ejection
3. In which case first heart sound is louder ? (Med 17 Aug Ⓑ ✪ Isovolumetric relaxation ➜ Closure of pulmonic and aortic
2022 (E) +10 in past) - ID: 19958 valve ➜ S2
✪ Isovolemtric contraction ➜ Closure of A-V valves ➜ S1
Ⓐ Upper limit of PR interval Ⓑ Lower limit of PR interval
✦ Guyton, Pg. 115, 114
Ⓒ Q-T segment Ⓓ Midsystole
12. S2 is best appreciated in (Gyn 16 Aug 2022 (M)) - ID: 62056
Ⓑ ✪ First Heart Sound ☛ contraction of ventricles first causes
sudden backflow of blood against A-V valves (tricuspid and Ⓐ 3rd left intercostal space Ⓑ 2nd right intercostal space
mitral) ➜ valves close and bulge toward atria ➜ vibration of taut valves Ⓒ 4th left intercostal space Ⓓ 5 left intercostal space
and walls produce 1st heart sound
✪ A short PR interval ☛ Atria have less time to empty into Ⓑ S2 is best appreciated in 2nd right intercostal space, close to
ventricle ➜ more forceful atrial contraction and maximal separation sternum. This is because S2 is produced by closure of aortic and
of AV valves ➜ Louder S1 upon valvular closure pulmonic valves, and 2nd right intercostal space is best location to hear
✦ Guyton, Pg. 283 ✦ Medscape, Pg. aortic component of sound (Bates, 13th Edition, p. 290).
4. On auscultation first heart sound is variable in ☛ Atrial 13. Specific in S1 ☛ Increase duration
fibrillation (Degree of LV filling) 14. Second heart sound ☛ has high pitch (AV valve stronger)
5. Period between S1 and S2 heart sounds ☛ Ventricular systole 15. S2 ☛ Caused by closure of aortic and pulmonary valve
6. S1 heart sound is due to ☛ Closure of av valve 3rd Heart Sound
2nd Heart Sound
16. A soft, low pitched third heart sound auscultated in
7. Splitting of 2nd heart sound during Inspiration is due many normal individuals due to vibrations set up by (Eye 15
Aug 2022 (M) +1 in past) - ID: 36028
to? (Med 31 August 2021 (A.N) +17 in past) - ID: 19326
Ⓐ Early closure of aortic Ⓐ Closure of Aortic Valve Ⓑ Closure of AV valve

Ⓑ Late closure of pulmonary valve Ⓒ Flow of blood into aorta Ⓓ Opening of semilunar valves
Ⓒ Early closure of Mitral valve Ⓔ Rapid inflow of blood into ventricles
Ⓑ During inspiration ➜ more blood is present in right ventricle ➜ so Ⓔ Third heart sound ( ventricular gallop ) ☛ usually abnormal sound
aortic valve closes earlier as compared to pulmonary valve ➜ A2 and P2 ➜ due to Rapid passive ventricular filling ➜ occurs in dilated CHF,
are not synchronized normally ➜ causing S2 split. severe hypertension, M.I, or mitral incompetence ➜ occurs just after S2
➤ Prolonged or fixed S2 splitting ➜ can be a sign of ASD or RBBB when mitral valve opens, allowing passive filling of left ventricle.
Remember ! If you have to choose between Early closure of Aortic and ➤ S3 can be a normal finding in children, pregnants and athletes
✦ Davidson, Pg. 459 ✦ Davidson, Pg. 459
Delayed Closure of Pulmonic valve then Split is specifically caused due
to Delayed Closure of Pulmonic 17. Rapid ventricular filling when Contraction of atria over
✦ Ganong, Pg. 540 incompetent valve is accompanied by ? (Radio 23 May 2023
(A.N) +35 in past) - ID: 19615
8. 2nd heart sound is produced due to (Surg 16 Feb 2022 (E)
+10 in past) - ID: 9106 Ⓐ 1st heart sound Ⓑ 2nd heart sound
Ⓐ Closure of aortic and pulmonary valves Ⓒ 3rd Heart Sound Ⓓ Arrhythmia
Ⓑ Opening of aortic and pulmonary valves
Ⓒ Third heart sound ( ventricular gallop ) ☛ usually abnormal sound
Ⓒ Opening of tricuspid valve Ⓓ Closure of tricuspid valve
➜ due to Rapid passive ventricular filling ➜ occurs in dilated CHF,
Ⓐ End of systole ➜ semilunar (aortic and pulmnary) valves close severe hypertension, M.I, or mitral incompetence ➜ occurs just after S2
rapidly ➜ 2nd Heart sound produced when mitral valve opens, allowing passive filling of left ventricle.
Two components ➜ split on inspiration and single on expiration ➤ S3 can be a normal finding in children, pregnants and athletes
✦ Davidson, Pg. 459
➊ Aortic closure sound (A2)
➋ Pulmonic closure sound (P2) 18. S3 heart sound ☛ Hypervolemia
✦ Jaypee, Pg. 545 ✦ Guyton, Pg. 116
19. 3rd heart sound vibration goes up by ☛ CHF (Filling pressures)
9. Second heart sound produced by: (Med 15 Aug 2022 (A.N)) - 20. S3 corresponds to ☛ Audible in Exercise
ID: 84096
4th Heart Sound
Ⓐ Closure of Mitral valve Ⓑ Close of Tricuspid Valve
Ⓒ Closure of Aortic + Pulmonary Valve 21. fourth heart sound is produced by ☛ Vibration of ventricular wall
Ⓓ None during atrial contraction (Atrial gallop)
-----
Ⓒ ✪ Isovolumetric relaxation ➜ Closure of pulmonic and aortic
valve ➜ S2 22. Sound of mitral valve is best heard at (Med 15 Nov 2022
✪ Isovolemtric contraction ➜ Closure of A-V valves ➜ S1 (A.N) +17 in past) - ID: 9111
✦ Guyton, Pg. 115, 114
Ⓐ Left 5th Intercostal space in midclavicular line
10. In Auscultation 3rd intercostal space left to sternum: Ⓑ Right 5th intercostal apace Ⓒ 2nd intercostal space
(Gyn 16 Aug 2022 (M) +1 in past) - ID: 84071 Ⓓ 3rd intercostal space
Ⓐ Aortic A2 Ⓑ Aortic A1 Ⓐ Mmitral valve ☛ best heard at apex of heart which lies over left
Ⓒ Pulmonary valve sound Ⓓ Mitral valve ventricle ( midclavicular line in 5 left intercostal space )
✦ Guyton, Pg. 284
Ⓒ Pulmonary area ☛ left second intercostal space, just lateral to
sternum ➜ sounds from pulmonary valve are best auscultated 23. Murmur of aortic valve can be best auscultated at: (Med
23 May 2023 (A.N) +10 in past) - ID: 15199

7. Slowly depolarizing prepotential ☛ SA node (Slow L-type Ca

Ⓐ 4th intercostal space channels)
Ⓑ 3rd intercostal space at midclavicular line
Ⓒ 3rd intercostal space at midaxillary line 8. Normal ECG do not record electrical activity of : ☛ SA node (Too
Ⓓ Second intercostal space at right side of sternum small)
9. Lowest Resting membrane Potential ☛ SA Node (-55 mV)
Ⓓ peaking of murmur moves toward S2 as valve area narrows. 10. Vagal stimulation of myocardium Acts predominantly at ☛ SA node
Classically, aortic stenosis murmur is heard best at right upper sternal causing altered K+ permeability
border 2nd ICS (where it is harsh and noisy).
✦ Goljan, Pg. 276 11. SA Node ☛ automatically generates impulses, creating rhythmic
heartbeat
24. Dx of a 25yr female with atypical chest pain, dyspnea on exertion
A.V Node
and palpitations, pulse rate 80/min, B.P 130/80mmhg, grade 2 systolic
murmur at 4th sternal border. ECG and chest X-Ray= normal ☛ Normal 12. Increased time for ventricular filling, cause is (Eye 30
heart (Normal ECG and CXR) Nov 2021 (M) +12 in past) - ID: 12876
25. S4 is produced by ☛ Ventriclar filling
Ⓐ AV nodal delay Ⓑ SA node
26. In 4th intercostal space (ICS) at left lower sternal border ☛ Ⓒ Purkingi fibers Ⓓ Bundle of his
Tricuspid valve is heard (Mitral Valve ☛ 5th ICS)
Ⓐ AV Node delays impulses by ➜ approximately 0.13 sec ➜ extremely
Conduction System important ➜ ensures that atria have ejected their blood into ventricles
S.A Node first before ventricles contract
✦ Guyton, Pg. 125
1. SA node acts as pacemaker (Surg 1 Sep 2021 (M) +10 in past)
- ID: 14275 13. What are effects of sympathetic stimulation on heart?
(CPSP Demo +8 in past) - ID: 4550
Ⓐ Contractile muscle Ⓑ Located in Right Atrium
Ⓐ Decreased rate Ⓑ Coronary vasoconstriction
Ⓒ Located on Top of Ventricle Ⓓ Above opening of SVC
Ⓒ Hyperpolarization of SA node Ⓓ Decreased AV nodal
Ⓑ SA Node ☛ specialized for automaticity ➜ located in superior delay
posterolateral wall of Right Atrium immediately below opening
Ⓓ Sympathetic stimulation ➜ ↑ Nodal firing rate ➜ ↑ speed ➜ ↓
of superior vena cava
Delay
✦ Almost No Contractile muscle in SA Node
✦ Ganong, Pg. 521
✦ Guyton, Pg. 123
14. Slowest conduction occur in which part of Conducting
2. SA node acts as a pacemaker because which of
System? (Med 23 Feb 2023 (M) +14 in past) - ID: 12278
following cause ? (Eye 30 Nov 2021 (M) +21 in past) - ID: 20470
Ⓐ AV node Ⓑ Inter-nodal pathway
Ⓐ Produces impulses at a faster rate
Ⓒ Purkinje Fibers Ⓓ SA Node
Ⓑ Generate impulses spontaneously
Ⓒ Rich sympathetic innervations
Ⓐ Conduction Speed ☛ Purkinje (4 m/s) ＞ Bundle of His (1 m/s) ＞
Ⓓ Due to Automaticity
Atria (1 m/s) ＞ Ventricles (1 m/s) ＞ AV Node (0.05 m/s).
Ⓐ SA , AV , Purkinje All are capable of generating spontaneous ☢ AV node ☛ diminished gap junctions ➜ Slowest
✦ Ganong, Pg. 522
Impulses
◉ SA Node ☛ Lowest Pre-potential ( -55 mV ) ➜ 15. AV Bundle ( Bundle of His ) ☛ Only transmission pathway from
fastest Impulse generation rate ➜ 70 - 80 bpm atria to ventricles (Divides into Right Left)
◉ AV Node ☛ 40 - 60 bpm
16. Maximum conductivity of AV node is. ☛ 230 Impulse/min (2:1 or
◉ Atrial Muscle ☛ 40 - 60 bpm
greater AV block)
◉ Ventricular Muscle ☛ 20 - 40 bpm
◉ Purkinje ☛ 15 - 40 bpm Purkinje
✦ Guyton, Pg. 127, 124
17. Conducting system of heart comprise of : (Gynae 1 Dec
3. Parasympathetic Action of vagus on SA node is due to: 2021 (E) +5 in past) - ID: 15366
(Med 2 Dec 2021 (A.N) +5 in past) - ID: 14997
Ⓐ Cardiac syncitium
Ⓐ Potassium Ⓑ Calcium Ⓑ SA node, atrioventricular purkinje fibers.
Ⓒ Sodium Ⓓ Potassium and Sodium Ⓒ Adrenergic receptor
Ⓓ Cardiac myocytes, SA node, AV node, bundle of His, Crura and
Ⓐ Cholinergic vagal fibers to nodal tissue stimulated ➜ Purkinje fibers
acetylcholine increases K+ conductance of nodal tissue ➜ membrane
becomes hyperpolarized ➜ ↓ slope of prepotentials ➜ slows opening of Ⓓ Conduction Pathway :
Ca2+ channels ➜ ↓ firing rate SA node ➜ Atrial Muscle + Internodal fibers ➜ AV node (delay) ➜ AV
✦ Ganong, Pg. 521 Bundle (bundle of His) ➜ Bundle brances ("crura" of Bundle)➜ Purkinje
system ➜ Ventricular muscles.
4. Which of following normally has most prominent
✦ Ganong, Pg. 520
prepotential (Med 25 May 2023 (A.N) +29 in past) - ID: 34240
18. Purkinje Conducting pathway of heart is present in ?
Ⓐ Bundle of His Ⓑ Sinoatrial node (Anesth 29 Aug 2021 (A.N) +24 in past) - ID: 22579
Ⓒ Purkinje fibers Ⓓ Ventricular muscle cells
Ⓐ Myocardium Ⓑ Neurocardium
Ⓑ Prepotential / Pacemaker potential ☛ Predominantly SA node ＞ Ⓒ Pericardium Ⓓ Sub Endocardium
AV node
✦ Atrial and ventricular muscle fibers do not have prepotentials, and Ⓓ SA node ☛ located in wall (myocardium) of right atrium
they discharge spontaneously only when injured or abnormal AV node ☛ located in RA Subendocardium
✦ Ganong, Pg. 521 Purkinje ☛ located in subendocardium
✦ GRAY'S, Pg. 1014
5. Parasympathetic act on SA node via neurotransmitters ☛ ACH (Binds
to M2) 19. Fastest conducting fibers in heart are? (Med 17 Aug 2022
(A.N) +20 in past) - ID: 9159
6. Sympathetic activity on heart causes: ☛ Increase SA node
rate (Norepinephrine)

Ⓐ Purkinje Ⓑ Atria ✦ Guyton, Pg. 389 ✦ Goljan, Pg. 129

Ⓒ Bundle of His Ⓓ Left bundle branch
26. Plateau in Cardiac AP is due to ? (Med 25 May 2023 (A.N)
+24 in past) - ID: 22490
Ⓐ Conduction Speed :
Purkinje (4 m/s) ＞ Bundle of His (1 m/s) ＞ Atria (1 m/s) ＞ Ventricles Ⓐ Influx of calcium and efflux of potassium
(1 m/s) ＞ AV Node (0.05 m/s). Ⓑ Influx of sodium Ⓒ Efflux of potassium only
✪ AV node ☛ Diminished gap junctions ➜ Slowest Ⓓ Efflux of calcium and influx of potassium
✪ Purkinje fibers ☛ Abundant CXN 40 Gap junctions ➜ Fastest
✦ Ganong, Pg. 522 Ⓐ Phase 2 -Plateau
Ca channels open and fast K+ channels close ➜ brief initial
20. Purkinje fibers are fastest in transmitting impulse repolarization then plateau
because (Gynae 17 Nov 2022 (M) +21 in past) - ID: 14719 ✦ Guyton, Pg. 111
Ⓐ Gap junctions Ⓑ Few Myofibrils 27. In SA node, phase 4 depolarization ( pacemaker potential ) is
Ⓒ Both a and b Ⓓ Wider diameter attributable to ☛ An increase in Na+ conductance (Reduce negativity)
28. Time period of absolute refractory resting period of heart ☛ 200 -
Ⓒ Purkinje fibers ☛ specific Gap junctions with more CXN 40 protein
270 miliseconds (0.2 - 0.27 seconds)
➜Faster ion transmission ➜ 6x Faster than ventricular muscle and 150x
Faster than A-V nodal fibers 29. Ion having profound effect in ECF ☛ Potassium (Arrhythmia)
☢ Gap Junctions ☛ also present in AV Node and Mayocardium but 30. Depressed cardiac activity due to citrate is reversed by ☛ Ca
Purkinje has special ones ion (Binds citrate )
☢ Purkinje are v large fibers but this is not main reason of faster
conduction
-----
☢ Few Myofibrils ( Contract less during conduction ) 31. Cause of atrial Fibrillation after acute MI ? (Med 15 Aug
✦ N.I.H USA, Pg. ✦ Guyton, Pg. 126 2022 (A.N)) - ID: 82539
21. Ventricular muscle receives impulses directly from? Ⓐ Option A Ⓑ Option B

(Surg 24 May 2023 (A.N) +3 in past) - ID: 9166
Ⓒ Option C Ⓓ Conduction system effected
Ⓐ Purkinje system Ⓑ Bundle of his
Ⓒ Right and left bundle branches Ⓓ AMI rapidly changes electrophysiological properties of myocardium
Ⓓ Av node and promote electrical disturbances in conduction and repolarization
32. Artificial pacemaker placed in due to defect in

Ⓐ Conduction Pathway : conduction of which of following? (Med 17 Nov 2022 (M) +1 in
SA node ➜ Atrial Muscle + Internodal fibers ➜ AV node (delay) ➜ past) - ID: 72394
bundle of his ➜ purkinje system ➜ ventricular muscles.
✦ Ganong, Pg. 522 Ⓐ Moderators band Ⓑ AV Node
Ⓒ SA Node Ⓓ Purkinje Fiber
22. Right bundle branch of conducting system of heart is Ⓔ Right atrium
present in (Surg 24 May 2023 (A.N) +6 in past) - ID: 72411
Ⓐ Septomarginal trabeculae Ⓑ Chorda tendinea Ⓒ SA node is natural pacemaker of heart that initiates electrical
Ⓒ Supraventricular crest Ⓓ Septal papillary muscles impulses that regulate heartbeat. If it fails to function properly, an
Ⓔ Chris ta terminalis artificial pacemaker is placed.
(Reference: Harrison's Medicine, 20th Edition, page 2237)
Ⓐ Right bundle branch ☛ In right ventricle, moderator band 33. Receptors in SA node and smooth muscle ☛ Beta adrenergic 1 beta
(septomarginal trabecula) contains right bundle branch.
adrenergic 2
✦ Kaplan Anatomy, Pg. 92
34. Super excitability (hyperexcitability) of heart is ☛ Ventricles are
23. Order of stimulation after reaching Purkinje fibres ☛ Septum , hyperexcitable
Endocardium , Epicardium. (Depolarize interventricular septum)
35. SA Node located at ☛ Upper part of sulcus terminalis
Cardiac Action Potential
E.C.G
24. Action Potential of pacemaker is due to influx through:
(Med 2 Dec 2021 (A.N) +4 in past) - ID: 9163 P wave
Ⓐ Fast Na+ channel Ⓑ Rapid repolarization 1. Patient's ECG has no p Wave, but has a normal QRS
Ⓒ Slow Ca++ channel Ⓓ Decrease in K+ permeability complex and a normal T wave. His pacemaker would be
located in which of following ? (Med 19 Nov 2022 (M) +11 in
Ⓒ ◉ Phase1 and 2 ☛ Absent in SA Node past) - ID: 13125
◉ Phase 3 ☛ Outward K+ current ➜ causes Repolarization
Ⓐ Ventricles Ⓑ AV node
◉ Phase 4 :
Ⓒ SA node Ⓓ Bundle of his
➤ Inward Na+ current ➜ Slow Na+ channels ➜ trigger
depolarization ➜ Potential reaches about -50 mV
Ⓑ ✪ Absent P wave ☛ Mean Atria not depolarizing ➜ so pacemaker
➤ Inward Ca2+ current ➜ vis Fast T Channels ➜ further depolarize to
can not be in SA Node
about -40 Mv
✪ Pacemaker in AV Node ☛ cause QRS and T wave (Normal
◉ Phase 0 ☛ Once threshold potential is reached ➜ L-type Slow Ca++
Depolarization and Repolarization of Ventricles)
channels open ➜ calcium influx ➜ complete depolarization
✪ Pacemaker in AV Bundle ☛ cause Abnormal sequence and
☢ SA and AV Nodes ☛ Lack fast Na+ channels ➜ upstroke of action
Abnormal QRS
potential is by Ca2+ current rather than Na+ ✦ Guyton, Pg. 114
✦ Ganong, Pg. 521 ✦ Kaplan Physiology, Pg. 43
2. Atrial depolarization is represented by ☛ P wave (Followed by atrial
25. Which of following has profound effect on heart?
contraction)
(DENTAL 16 Aug 2022 (A.N) +9 in past) - ID: 33592
3. P wave coincides with ☛ A-C wave in JVP curve
Ⓐ Potassium Ⓑ Calcium
Ⓒ Sodium Ⓓ Glucose PR interval/segment
4. Type 1 AV block? (Med 17 May 2022 (E)) - ID: 79412
Ⓐ Changing level of serum K+ has very profound effect on heart i.e
both hyperkalemia and hypokalemia can lead to arrhythmia , can be Ⓐ Absent QRS Ⓑ QT Prolongation
fatal if severe Ⓒ Prolong PR interval

Ⓒ Prolonged PR interval ☛ indicates delayed conduction to ventricles Ⓐ Dec number of QRS complexes
➜ first-degree AV block. Ⓑ Increases number of QRS complexes
✦ Ganong, Pg. 494 ✦ Guyton, Pg. 157 Ⓒ Speeds up heart rate via sympatheticS
5. A wave in jugular venous pulse (JVP) corresponds to : Ⓐ Carotid sinus massage ☛ stimulates baroreceptors in carotid sinus
(Med 17 Nov 2022 (A.N) +6 in past) - ID: 24708
➜ sends signals to brain (medulla) ➜ results in increase in
Ⓐ QT interval Ⓑ PR segment parasympathetic and decrease in sympathetic activity mediated by
Ⓒ QRS complex Ⓓ PR interval vagus nerve ➜ leads to decrease in heart rate ➜ slows down SVT
Decreasing QRS complexes is a consequence of slowing heart rate,
Ⓓ ◉ Normally ☛ visible A wave is A and C waves together due to v ventricles are contracting less frequently
short A-C Interval
16. QRS complex is formed during which of following
◉ A - C interval ☛ reflects PR interval on ECG
activities ? (Dent 23 May 2023 (A.N) +20 in past) - ID: 16289
◉ Prolonged P-R ☛ A and C separately visible (first-degree block)
✦ Guyton, Pg. 114 ✦ Medscape, Pg. Ⓐ Ventricular systole Ⓑ Venticular diastole
6. AV conduction is slowed down due to Vagal stimulation Ⓒ Atrial systole Ⓓ Ventricular Depolarization
of heart. it is reflected as (Gynae 16 Nov 2022 (M) +23 in past) -
ID: 14824 Ⓓ QRS complex ☛ formed when electrical impulse spreads through
ventricles ➜ ventricular depolarization ( QRS complex starts just before
Ⓐ Increased heart rate Ⓑ Increase PR interval ventricular contraction )
Ⓒ Increase contraction Ⓓ Increased cardiac output ✦ Guyton, Pg. 114
Ⓑ Parasympathetic Stimulation of Heart 17. High QRS complex shows ☛ Left Ventricular Hypertrophy (Larger
➊ SA node stimulation ☛ Lengthens depolarization ➜ ↓ H.R mass of myocardium)
➋ AV node stimulation ☛ ↑ ↑ AV Nodal delay ➜ ↑ PR interval 18. In ECG: ☛ QRS complex precedes ventricular contraction (Just
✦ Ganong, Pg. 521, 494 ✦ Guyton, Pg. 157 before)
7. On ECG, PR Interval represents? (Gynae 22 Feb 2023 (A.N) 19. Time taken by nerve Impulse to transmit from Endocardium to
+24 in past) - ID: 26423 Epicardium, is shown on ECG as ☛ QRS Complex
Ⓐ Conduction from atrium to ventricle 20. Q wave appearance in v 4 which artery involved ☛ LAD
Ⓑ AV Nodal Delay Ⓒ Ventricular depolarization 21. Normal sinus rhythm ☛ P-wave ➜ QRS complex ➜ T-wave
Ⓓ Atrial depolarization
QT interval
Ⓑ PR interval (0.16 sec) ☛ time from onset of P wave to start of QRS 22. Hypoglycemia in ECG is represented by: (Med 26th Nov
complex ➜ reflects conduction through AV node ➜ Signal slows down 2020 (M) +6 in past) - ID: 33977
passing through AV ➜ Allow ventricles to fill
Ⓐ PR Interval shortening Ⓑ ST Elevation
✪ Prolonged PR interval ☛ indicates delayed conduction to ventricles
Ⓒ Inverted T wave Ⓓ QT Prolongation
➜ first-degree AV block.
✪ Short PR interval ☛ AV node delay is bypassed ➜ such as in Wolff-
Ⓓ Hypoglycemia ☛ ✦ ST wave changes with ✦ lengthening of QT
Parkinson-White syndrome or Lown-Ganong-Levine syndrome.
✦ Ganong, Pg. 494 ✦ Guyton, Pg. 157
interval and ✦ cardiac repolarization
✦ Medscape, Pg.
8. Part of ECG from END of P wave to start of R wave ☛ PR segment
23. time taken for impulse to travel from endocardium to epicardium
9. PR interval in ECG corresponds to jugular pulse as ☛ A_C represented on ECG ☛ QT Interval (Complete ventricular contraction )
interval (1st Heart sound + Ventricular filling)
24. End of Atrial Depolarization to End of Ventricular Repolarization in
10. Increase PR interval will decrease ☛ Ventricular filling cardiac cycle is represented on ECG as ☛ QT interval (Total
11. Increased heart rate ☛ Decreased PR interval Contraction)
12. Atrial systole on ECG is represented by ☛ PR segment (and 25. Hypercalcemia causes on ECG ☛ Short QT (Or Hyperkalaemia )
ventricular depolarization) 26. Patient with twitching in muscles of upper limbs and carpopedal
QRS complex spasm, ECG shows QT prolongation, dx☛ Hypocalcemia
ST segment
13. Low voltage QRS complex is seen in ?? (Med 1st Dec 2021
(A.N) +10 in past) - ID: 16453 27. At which point in ECG more Ca ions enter in ventricular
Ⓐ Old MI Ⓑ Bundel branch block muscle cell (Med 16 June 2021 (A.N) +5 in past) - ID: 159
Ⓒ Hypertension Ⓓ LHD Ⓐ P wave Ⓑ R wave
Ⓒ S-T segment Ⓓ P-R intervel
Ⓐ After myocardial infarction ➜ Normal myocardium is replaced by
fibrous tissue ➜ Slow down or Blocks Conduction ➜ Less depolarization Ⓒ Just after QRS complex ➜ max Ca++ ions enter muscle ➜
current in ventricles ➜ Small QRS complexes. Ventricular contraction occurs ➜ shown by ST segment
✦ Guyton, Pg. 147
✦ Guyton, Pg. 132
14. During cardiac cycle, QRS complex begins slightly prior 28. T-wave on ECG represents: (Dentistry Aug 2021 (E) +8 in
to onset of (Psyc 30 Nov 2021 (M) +1 in past) - ID: 54979 past) - ID: 9195
Ⓐ Atrial systole Ⓑ Contraction phase Ⓐ Ventricular repolarization Ⓑ Ventricular depolarization

Ⓒ Ventricular systole Ⓓ Rapid inflow Ⓒ Atrial Repolarization Ⓓ Refractory period
Ⓒ QRS complex ☛ formed when electrical impulse spreads through Ⓐ T wave ☛ Ventricular Repolarization stage ( ventricles begin to relax
ventricles ➜ ventricular depolarization ( QRS complex starts just before ) ➜ occur slightly before end of contraction
ventricular contraction ) ✦ Guyton, Pg. 114
✦ Guyton, Pg. 114
29. What are ECG findings in hyperkalemia? (Med 18 Nov 2022
15. Patient with supraventricular tachycardia, doctor ( M) +4 in past) - ID: 18337
offered a carotid massage, mechanism how it works? (Med
23 Feb 2023 (A.N)) - ID: 83540 Ⓐ Disappeared QRS complexes Ⓑ Inverted P wave
Ⓒ Short T wave
Ⓓ Sinusodial pattren of Tall T wave

Ⓓ In hyperkalemia, most common ECG finding is tall T wave, Broad ✪ U wave (after T wave) ➜ shows purkinje repolarizarion
QRS complexes, and flatted P wave is also seen is severe hyperkalemia. ✪ Slightly prolonged PR interval.
▶ Clinical signs ➜ Palpitations , Muscular Weakness , Cramping ,
30. A patient has received multiple blood transfusions. Constipation , Hypoventilation , Hypotension
Now his cardiac rhythm is irregular and ECG shows tall T ✦ Ganong, Pg. 535
waves. What is cause ? (Surg 18 Nov 2022 (M) +23 in past) - ID:
20643 36. Changes seen on ECG in a patient taking K sparing diuretics and
beta blockers ☛ Tall T wave (Hyperkalemia)
Ⓐ Hyperkalemia Ⓑ Hypercalcemia
37. ST Segment ☛ Isoelectric interval between ventricular
Ⓒ Hyponatremia Ⓓ Hypokalemia
depolarization (S wave) and repolarization (T wave) ➜ both ventricles
Ⓐ Hyperkalemia effects on Heart : are completely depolarized but repolarization is not yet started
✪ Tall, Peaked T waves U wave
✪ Atrial Paralysis and prolonged QRS
✪ severe arrhythmias and Heart stops in diastole 38. Most prominent Feature of hypokalemia in ECG (Med 18
Nov 2022 (A.N) +14 in past) - ID: 13968
☢ Hyperkalemia is a common complication in transfusion of stored
blood because Potassium in stored blood contains more than 60 mEq/L Ⓐ Inc. PR interval Ⓑ Dec. PR interval
of potassium due to decrease in ATP production and increased leak of Ⓒ U wave Ⓓ Tall p wave
potassium into plasma by 35 days
✦ Ganong, Pg. 535 Ⓒ Hypokalemia (＜ 3 mEq/L) ☛ Elevation of U wave (comes after T
31. Which of following represents interval between end of wave) ➜ shows purkinje repolarizarion
✦ Ganong, Pg. 535
ventricular depolarisation and start of ventricular
repolarization ? (DENTAL 16 Aug 2022 (A.N) +7 in past) - ID: 21207 39. Slow papillary Re-polarisation wave is represented by ☛ U
wave (After T wave)
Ⓐ PR segment Ⓑ PR interval
Ⓒ QT segment Ⓓ ST segment 40. U wave of ECG denoted repolarization of ☛ Purkinje fibers
Electrophysiology
Ⓓ ST Segment ☛ Isoelectric interval between ventricular
depolarization (S wave) and repolarization (T wave) ➜ both ventricles 41. Systolic phase of cardiac cycle correspond to following
are completely depolarized component of ECG (Med 23 Feb 2023 (A.N) +4 in past) - ID: 72245
✦ Guyton, Pg. 132
Ⓐ QRS complex Ⓑ QT interval
32. Acute myocardial infarction changes on ECG? (ENT 23 Ⓒ ST segment Ⓓ PR Segment
May 2023 (M) +10 in past) - ID: 16658 Ⓔ QT/RT interval
Ⓐ ST segment depression Ⓑ Prolong QRS complex
Ⓐ QRS complex represents ventricular depolarization and contraction,
Ⓒ T wave depression Ⓓ ST-segment elevation
which occurs during systolic phase of cardiac cycle.
(Reference: Ganong's , 26th Edition, page 287)
Ⓓ ✪ Acute M.I ☛ First peaked T waves ➜ then ST elevation ( 25 –
40% ) ➜ then negative T waves ➜ finally pathologic Q waves 42. Regarding electrical isolation of circuit with use of ECG monitoring
✪ Prolong QRS complex ☛ shows slower spread of ventricular for placing a CVP line ☛ Use of transducer for converting electrical
depolarization ➜ may be due to disease of His-Purkinje network signals to light
✪ Absent P wave ☛ Fine Atrial fibrillation
43. Electrical potential change in ECG is due to ☛ Partial depolarized
✪ T wave depression ☛ Hypokalemia
state (Otherwise zero voltage)
-----
33. Which of following show complete Ventricular
depolarization (systole) in cardiac phase (Surg 24 May 2023
(M) +24 in past) - ID: 1806 45. Which part of ECG is associated with "A" wave of
jugular venous pressure (JVP)? (Med 23 Feb 2023 (A.N)) - ID:
Ⓐ QRS complex Ⓑ PR segment 83546
Ⓒ PR interval Ⓓ ST Segment
Ⓐ QRS complex Ⓑ P wave
Ⓓ QRS is begining of ventricular depolarization ➜ contraction occurs Ⓒ T wave Ⓓ ST segment
after QRS ➜ depolarization ends at begining of T wave ( repolarization
wave ) ➜ completion of Systole Ⓑ "A" wave of JVP is caused by atrial contraction, which occurs
✦ Guyton, Pg. 114, 132 during P wave on ECG. P wave represents depolarization of atria, which
leads to atrial contraction and generation of "A" wave of JVP
34. ECG change characteristic of acute myocardial
infarction is: (Eye 23 May 2023 (M) +16 in past) - ID: 36464 46. Ventricular filling in which ECG segment: (Surg 18 Nov
2022 (M)) - ID: 83952
Ⓐ Displacement of ST-segment Ⓑ Disappearance of Q-
wave Ⓐ TP Ⓑ QT
Ⓒ Inverted T-wave Ⓓ Tall T wave Ⓒ ST Ⓓ QRS
Ⓐ ✪ ECG in Acute M.I ☛ First peaked T waves ➜ then ST Deviation( Ⓐ Ventricular filling ☛ primarily occurs during TP segment of ECG,
25 – 40% ) ➜ then negative T waves ➜ finally pathologic Q waves. which represents period of diastole.
✦ Davidson, Pg. 497 QRS ☛ represents ventricular depolarization and beginning of
ventricular contraction, not filling.
35. Patient presented with weakness, constipation,
Palpitations and sinking heart. His ECG shows narrow 47. Low amplitude ECG (Med 18 Nov 2022 (A.N)) - ID: 83249
depressed T wave, with prominent U wave and prolonged
Ⓐ Old MI Ⓑ Hypokalemia
PR interval. What could be reason ? (Med 25 May 2023 (M) +31
Ⓒ Pericarditis
Ⓐ Hypokolemia Ⓑ Hyponatremia Ⓐ After myocardial infarction ➜ Normal myocardium is replaced by

Ⓒ Hypernatremia Ⓓ Hyperphosphatemia fibrous tissue ➜ Slow down or Blocks Conduction ➜ Less depolarization
current in ventricles ➜ Small QRS complexes.
Ⓐ Hypokalemia ＜ 3 mEq/L cause : ✦ Guyton, Pg. 147
✪ Sagging of ST segment
48. Infant brain EEG finding will be (Med 23 Feb 2023 (A.N) +1
✪ Depression / Inversion of T wave in past) - ID: 83384

Ⓐ Atrial flutter Ⓑ Ventricular fibrillation

Ⓐ B wave dyssynchronized Ⓑ Delta wave Ⓒ Atrial fibrillation Ⓓ Atrial Flutter
Ⓒ Alpha wave Ⓓ Beta waves
Ⓒ EXPLANATION
Ⓐ EXPLANATION
6. Patient has mitral stenosis develops Atrial fibrillation.
49. Electrocardiogram of a patient shows prolonged PR Most suitable finding (Med 17 Aug 2022 (A.N) +11 in past) - ID:
interval and QRS complexes after every three P waves (3:1 3853
rhythm). He is most likely having AV heart block of type?
(Surg 22 Feb 2023 (M)) - ID: 84215 Ⓐ P mitrale Ⓑ Irregular R-R interval
Ⓒ Regular P waves Ⓓ QRS absent
Ⓐ Complete Ⓑ First degree
Ⓒ Mobitz I Ⓓ Mobitz II Ⓑ ✪ A FIB ☛ Irregularly Irregular RR intervals
Ⓔ Partial ✪ P Mitrale ☛ left atrial enlargement ➜ Upright P waves
Ⓒ Mobitz I (Wenckebach) heart block
2nd degree heart block ➜ progressive PR interval lengthening (not seen 7. Cardiac tissue is most vulnerable to ventricular
in Mobitz II) until a P wave is not followed by a QRS complex (a fibrillation at which point (Med 17 Aug 2022 (A.N) +9 in past) -
"dropped beat"). ID: 3248
50. Old man collapse and his ECG show atrial rate of 75 Ⓐ At start of action potential
and ventricular rate of 35 bpm, P and QRS are dissociated Ⓑ When action potential is about to end
(Med 23 May 2023 (A.N) +1 in past) - ID: 83469 Ⓒ At end of action potential
Ⓓ At peak of action potential
Ⓐ Stokes Adams Ⓑ Atrial Fibrillation
Ⓒ Sinus Bradycardia Ⓓ Ventricular Tachycardia Ⓑ When action potential is about to end ☛ Relative refractory period ➜
most vulnerable
Ⓐ Stokes-Adams syndrome ☛ sudden unconsciousness due to ✪ Absolute refractory period ☛ beginning of phase 0 until part way
decrease in blood flow (cardiac output), most often resulting from through phase 3 ➜ impossible for cell to produce another action
certain forms of heart block. potential.
Disparity between atrial and ventricular rates might suggest a form of ✪ Relative refractory period ☛ Absolute is immediately followed,
heart block, leading to decreased perfusion and episodes of syncope. until end of phase 3, by a relative refractory period ➜ due to leaking of
potassium ions ➜ makes membrane potential more negative
51. In CVP trace right atrial filling with a closed tricuspid valve is
(hyperpolarised) ➜ this resets sodium channels, opening inactivation
signified by ☛ A wave
gate, but still leaving channel closed ➜ possible to initiate an action
52. CM5 configuration ☛ Left lead on left arm potential, but a stronger stimulus than normal is required
✦ Guyton, Pg. 112
Arrhythmias
8. Atrial fibrilation (Med 17 May 2022 (E)) - ID: 79448
Flutter
Ⓐ ＞350 HR Ⓑ ＞150
1. Characteristic ECG changes in atrial flutter (Med 1st Dec
2021 (A.N) +6 in past) - ID: 12475
Ⓒ ＞100 Ⓓ ＜120
Ⓐ Dec. complexes Ⓑ Tall T waves Ⓑ A-fib ☛ QRS complexes irregular e no P-Waves, HR 120-160
Ⓒ Saw tooth Ⓓ WPS pattern ✦ ECG Made Easy, Pg. 113 ✦ Davidson, Pg. 565
9. Emboli frim Atrial fibrillation will lodge in ? (Med 23 Feb

Ⓒ Atrial flutter ☛ characteristic “sawtooth” P waves
2023 (M)) - ID: 83358
✦ Ganong, Pg. 530
Ⓐ MCA Ⓑ ACA
2. A pt presented to CCU with sudden onset of
unconsciousness. Feeble pulse. ECG shows an atrial rate
Ⓐ Middle Cerebral Artery (MCA) ☛ most common site for embolic
200-350/min. 3:1 A-V block and saw-tooth-shaped P
stroke. Emboli, particularly originating from a cardiac source such as
waves. most likely diagnosis is (Surg 18 Nov 2022 (M) +28 in
past) - ID: 54553
atrial fibrillation, lodge in MCA because of its direct continuation with
internal carotid artery and its large diameter.
Ⓐ Atrial fibrillation Ⓑ Atrial flutter
Ⓒ Complete A-V block Ⓓ Ventricular fibrillation 10. ECG of a 65yo shows absent P waves, narrow QRS
complex, ventricular rate of 120bpm and irregular R-R
Ⓑ ✪ Atrial flutter ☛ a “Re.entrant” circuit ➜ depolarize atrium at a interval. What is most probable dx? (Med 19 Nov 2022 (M) +3 in
past) - ID: 57207
rate of about 200 to 350 bpm ➜ Sawtooth P waves + Rhythm 2 : 1 or 3
:1 Ⓐ A-fib Ⓑ A-flutter
✦ Guyton, Pg. 165 Ⓒ SVT
3. Atrial flutter ☛ Heart beat is between 200 and 350/min (Sawtooth P Ⓓ Mobitz type 1 2nd degree heart block
waves)
Ⓐ In Atrial fibrillation fibrillatory f waves replaces p waves and R – R
Fibrillation interval are irregular
4. A patient had arrhythmia and P waves were absent, 11. In Patient with atrial fibrillation which wave will be
which part of cardiac cycle is affected: (Med 17 Aug 2022 (M) absent in JVP? (Med 25 May 2023 (A.N) +2 in past) - ID: 9687
+3 in past) - ID: 33798
ⒶA ⒷC
Ⓐ Atrial Systole Ⓑ Ventricular Relaxation
ⒸV Ⓓ None of above
Ⓒ Ventricular Contraction Ⓓ Atrial relaxation
Ⓐ ✪ A wave ☛ represents Atrial systole ➜ Absent in AFib
Ⓐ Atrial fibrillation ☛ Irregular QRS complexes with no P-WAVE
✪ C wave ☛ represents closer of tricuspid valve ➜ most prominent in
tricuspid lesions
5. A 25.year old man has irregularly irregular pulse on ✪ V wave ☛ represents isovolumic relaxation of ventricles
examination. Which of following conditions you consider ✦ Guyton, Pg. 114
as 1st possibility? (Med 17 Aug 2022 (M) +2 in past) - ID: 37835

12. A patient's ECG is showing absent P wave along with 19. Mechanism behind ECG of a patient taking routine medication
pulse deficit. what do you suspect ? (Dent 23 May 2023 (A.N) showing 2-P wave followed by one QRS ☛ Drug induced frst degree
+18 in past) - ID: 19931 block (CCBs and B-Blockers)
Ⓐ Atrial fibrillation Ⓑ Atrial flutter 2nd Degree Block
Ⓒ Both a and b Ⓓ None of above
20. Type 2 heart block is best explained by which of
following statements ? (Gynae 1 Dec 2021 (A.N) +8 in past) - ID:
Ⓐ Atrial fibrillation ☛ atria contract independently ➜a v rapid,
19319
irregular heart rate ➜ each ventricular contraction may not be
sufficiently strong to transmit an arterial pulse wave through peripheral Ⓐ Ventricle rate slower than Atrial rate
artery ➜ causes an apex-radial pulse deficit Ⓑ Stroke volume is decreased
✔ Absent P wave with a flat baseline Ⓒ More chance of ventricle arrhythmia/fibrillation
✔ Irregularly Irregular RR intervals Ⓓ Heart rate is increased
✔ Irregularly irregular QRS complex
✦ ECG Made Easy, Pg. 113 ✦ Davidson, Pg. 565 Ⓐ Mobitz type 2 ☛ disease of distal conduction system (bundle of His-
Purkinje System)
13. Patient had rheumatic fever, now presented with SOB, and has
➤ Dropped Beat without PR Interval lengthening ➜ poor conduction to
atrial fib, murmurs 11 b heard at ☛ Systolic murmur at aortic area
ventricles ➜ ventricular rate (38 bpm) is slower than atrial rate (75
14. Commonest cause of sudden death is ☛ Ventricular fibrillation bpm) ➜ P to QRS Ratio is 2:1 , 3:1 , 4:1
(50% of MI) ✦ Davidson, Pg. 477
1st Degree Block 21. A 62yo man has slow palpitations and following ECG.
15. Increase PR Interval with BP 120/80 (Med 16 Aug 2022 (E) What is most likely dx? (Med 15 Feb 2022 (A.N)) - ID: 56476
+8 in past) - ID: 36342
Ⓐ Sinus bradycardia Ⓑ 1st degree heart block 428
Ⓐ First degree block Ⓑ Unifascicular block Ⓒ Mobitz type 1 block Ⓓ Mobitz type 2 block
Ⓒ Bifasclcular block Ⓓ Hypokalemia
Ⓔ Complete heart block Ⓐ Sinus bradycardia Slow palpitation ( HR ＜ 60)
22. Progressive PR prolongation followed by missing a

Ⓐ PR interval (0.16 sec) ☛ time from onset of P wave to start of QRS
beat on ECG is diagnostic of (Med 23 Feb 2023 (M) +12 in past) -
complex ➜ reflects conduction through AV node ➜ Signal slows down
ID: 12844
passing through AV ➜ Allow ventricles to fill
✪ Prolonged PR interval ☛ indicates delayed conduction to ventricles Ⓐ Atrial flutter Ⓑ 2nd degree block
➜ first-degree AV block. Ⓒ Mobitz type2 Ⓓ Mobitz type 1
✪ Short PR interval ☛ AV node delay is bypassed ➜ such as in Wolff-
Parkinson-White syndrome or Lown-Ganong-Levine syndrome. Ⓓ Second-Degree Block ☛ 2 Types :
✦ Ganong, Pg. 494 ✦ Guyton, Pg. 157 ➊ Mobitz type 1 (Wenckebach) ☛ progressive PR lengthening until a
beat is dropped
16. A patient with ECG of prolong PR interval, left axis
➋ Mobitz type II ☛ dropped beats without PR lengthening
deviation and no left hypertrophy. what Is diagnosis ? (Med
✪ Causes ➜ Drugs ( Digoxin, beta blocker, CCBs ) , Increased vagal
16 Aug 2022 (E) +3 in past) - ID: 18422
tone , Sinoatrial conduction disease , Right coronary infarction
Ⓐ Trifasicular block Ⓑ Biifasicular block ✦ Davidson, Pg. 477, 477
Ⓒ RBBB Ⓓ None of above
23. During second degree heart block what happens? (Med
16 Aug 2022 (A.N) +3 in past) - ID: 71168
Ⓐ ✪ Bifasicular block ☛ RBB + either right or left Axis deviation
(depending upon fascicle involed) Ⓐ Increased risk of ventricular Tachycardia
✪ Trifascicular block ☛ combination of first degree block (Prolonged Ⓑ Atrial rate greater than ventricular rate
PR) + Left axis deviation + RBB Ⓒ Stroke volume decrease Atrioventricular dissociation
✦ ECG Made Easy, Pg. 268 Ⓓ Atrial contraction less than ventricle
17. HTN Patient taking Beta blocker presented with
Ⓑ 2nd degree heart block ☛ problem in heart's electrical conduction
prolong PR interval . (Med 17 Aug 2022 (M) +12 in past) - ID:
system ➜ some signals from atria do not reach ventricles ➜ irregular
34226
heart rhythm ➜ atrial rate becomes greater than ventricular rate due to
Ⓐ Drug Induced First degree block missed beats.
Ⓑ Unlfascicular block Ⓒ Blfasclcular block
24. In ECG u will find out 2 P wave and one QRS complex
Ⓓ Hypokalemia
rhythm where pacemaker lies does (Med 23 May 2023 (A.N) +2
Ⓐ Drugs commonly cause first-degree AV block
Class Ia antiarrhythmics (quinidine, procainamide) Ⓐ SA node Ⓑ AV node
Class Ic antiarrhythmics (flecainide) Ⓒ Purkinje
Class II antiarrhythmics (beta-blockers)
Ⓐ In 2nd degree heart block pacemaker is still SA node
18. A 60 year old lady has severe chest pain. ECG shows ✦ Davidson, Pg. 477
changes of inferior wall - myocardial infarction. ECG also
shows progressive prolongation of PR - interval until a 25. Constant PR intervals with QRS-T after every 2 beats
QRS complex is dropped. What is SINGLE most likely - (Med 25 May 2023 (M) +1 in past) - ID: 79230
diagnosis ? (Med 17 Aug 2022 (E)) - ID: 66269
Ⓐ Mobitz Type II
Ⓐ Atrial fibrillation Ⓑ Ventricular tachycardia
Ⓒ Supraventricular tachycardia Ⓓ Mobitz type I AV block Ⓐ Mobitz type 2 ➤ Dropped Beat without PR Interval lengthening ➜ P
Ⓔ Mobitz type II AV block to QRS Ratio is 2:1 , 3:1 , 4:1
Ⓓ Mobitz type I AV block ☛ a.k.a Wenckebach block ➜ progressive 26. ECG shows 2 P wave and 1 QRS complex pattern.
prolongation of PR interval until a beat is dropped (QRS complex is Diagnosis is? (Med 25 May 2023 (M) +7 in past) - ID: 12229
absent).
Mobitz type II AV block ☛ not progressive PR prolongation. Ⓐ Mobitz type 2 Ⓑ Mobitz type 1
Ⓒ Atrial fibrillation Ⓓ Atrial flutter

Ⓐ Mobitz type 2 ➤ Dropped Beat without PR Interval lengthening ➜ P 35. ECG shows norrnal P waves but wide QRS. Heart rate
to QRS Ratio is 2:1 , 3:1 , 4:1 is 25. Pace maker in? (Med 23 May 2023 (A.N) +6 in past) - ID:
✦ Davidson, Pg. 477 24707
27. Second degree heart block ☛ Ventricular depolarization pattern is Ⓐ AV node Ⓑ SA node
disturbed (↑ PR interval) Ⓒ Bundle Of His Ⓓ Purkinie fibers
28. Most probable dx of a 60yr lady with severe chest pain. ECG shows
Ⓓ ✪ P wave normal ☛ Sinus rhythm present
changes of inferior wall MI, progressive prolongation of PR interval until
✪ AV Block ☛ Poor conduction from Atria to Ventricles ➜ slower
a QRS complex is dropped ☛ Mobitz type I 2nd degree heart block
spread of ventricular depolarization ➜ Widening of QRS complex ➜
(Conduction defect)
Ventricular escape Rhythm➤ Pacemaker is at AV node or bundle of his
29. Second-degree heart block ☛ Progressive prolongation of PR ➜ 40-60 b/min
interval ➤ Pacemaker in ventricles or purkinje ➜ 20-40 b/min
3rd Degree Block ✦ Guyton, Pg. 157
30. Atrial Repolarization is evident in which of following 36. Third degree AV block on ECG ☛ Complete heart block (Nerve
condition? (Med 30 Aug 2021 (E) +12 in past) - ID: 12455 impulse doesnt propagate)
37. Ventricular rate:＜ 40 bpm ☛ Complete heart block (Atrial rate:
Ⓐ 1st degree heart block Ⓑ 3rd degree heart block
100 bpm)
Ⓒ Mobitz 1 Ⓓ 2nd degree block
38. In complete heart block ☛ Fainting occur because of low cardiac
Ⓑ ✪ Normally ☛ Atrial repolarization is masked by ventricular output (Low O2 to brain )
depolarization (QRS) ➜ Invisible 39. In 3rd degree block ☛ Atrium beat independently of ventricles (PR
✪ 3rd degree block ☛ Complete block ➜ no communication between interval variable )
atria and ventricles ➜ Atrial Repolarization becomes evident
✦ N.I.H USA, Pg.
Tachycardia
31. Independent P wave and QRS complex shows ? (Radio 16 40. A woman had Ml and after 48 hours later she died on
FEB 2021 (M) +4 in past) - ID: 21750 ECG there are irregular low voltage waves What can be
pathophysiology? (Med 17 June 2021 (A.N) +4 in past) - ID: 9714
Ⓐ Slow AV conduction Ⓑ Bundle of kent
Ⓒ 3rd degree complete AV block Ⓐ Decrease CO Ⓑ Decrease ejection fraction
Ⓒ Increaase in absolute refractory period
Ⓒ Complete AV block ➜ ventricles establish their own Ⓓ Re entry of impulses
signal,originating in A-V node or A-V bundle distal to blocK ➜
independent P waves from QRS-T Ⓓ Re-entry ventricular arrhythmia ➜ type of paroxysmal
✦ Guyton, Pg. 157 tachycardia occurring in ventricle where cause of arrhythmia is due
to electric signal not completing normal circuit, ➜ rather an alternative
32. In complete heart block when ECG of a patient shows P circuit looping back upon itself.
waves and QRS complex dissociation, artificial pace maker ✪ There develops a self-perpetuating rapid and abnormal activation.
is to be placed in which defective conductive tissue of ✪ Most tachyarrhythmias are caused by re-entry
heart? (Surg 17 Nov 2022 (M) +9 in past) - ID: 15436 ✦ Davidson, Pg. 468
Ⓐ AV node Ⓑ Atrium 41. Mean electrical axis of heart is deviated to left if (Eye 30
Ⓒ SA node Ⓓ Rt Ventricle Nov 2021 (M) +7 in past) - ID: 9117
Ⓓ Complete AV Block ➜ SA Node working fine for Atria But No Ⓐ Shifting of apex to right side
impulse Passing naturally from SA Node to Ventricles ➜ Ventricular Ⓑ Right bundle branch block Ⓒ Left bundle branch
Escape ➜ Arrythmias block
Treatment ➜ Place Pacemaker beneath skin, with electrodes usually Ⓓ Left sided MI
connected to right ventricle ➜ Regular Impulse Generation and spread
to whole Ventricles Ⓒ ✪ Left bundle branch ☛ spreads depolarization to left ventricle
✦ Guyton, Pg. 158 ==➤ Left BBB ☛ depolarization of corresponding ventricle is delayed
➜ Left deviation of electrical axis to side of block.✪ Left MI ☛ Fibrosis
33. A 70 year old man is found collapsed at a shopping ➜ electrical current can not pass through fibrous tissue ➜ electrical axis
mall. An ECG reveals no connection between P waves and of heart deviates to opposite Rt side.
QRS complexes with a rate of 35 beats/minute and atria ✪ Hypertrophy ☛ more myocardium to side of hypertrophy ➜ more
and ventricles beat independently. Neck vein shows depolarization ➜ shifts axis to side of hypertrophy
cannon waves. What is most likely diagnosis ? (Med 17 Nov ✦ Guyton, Pg. 146
2022 (M)) - ID: 66198
42. An 70 year old patient brought to ER, in critical
Ⓐ Third degree heart block Ⓑ Ventricular tachycardia condition, his arterial rate was ＞350b/m and ventricular
Ⓒ First degree heart block Ⓓ Mobitz type II AV block rate was 135-150 b/min, QRS was widely displaced and p
dissociation. What is most probable dx? (Med 17 May 2022 (M)
Ⓐ 3rd degree block ☛ Complete block ➜ no communication between +1 in past) - ID: 55794
atria and ventricles ➜ Atrial Repolarization becomes evident
✦ N.I.H USA, Pg. Ⓐ Atrial fibrillation Ⓑ Ventricular tachycardia
Ⓒ SVT
34. In 3rd degree heart block which of following is present Ⓓ Mobitz type1 2nd degree heart block
? (Med 21 Feb 2023 (A.N) +4 in past) - ID: 18274
Ⓐ Cannon A waves. Ⓑ Inc PR interval

Ⓑ ✪ VT ☛ Wide QR complex tachy.
✪ SVT ☛ Narrow complex Tachy.
Ⓒ Sinus tachycardia
✪ A-fib ☛ P-wave absent.
Ⓐ 3rd degree (complete) block ☛ Atria and ventricles contract ✪ Mobitz 1, 2nd-degree heart block ☛ Progressive prolongation of P-R
simultaneously ➜ Blood will be pushed against AV valve ➜ Very large interval.
pressure wave runs up ➜ cannon atrial waves ➜ seen occasionally in 43. Wide QRS complex with Short PR interval is caused by:
jugular vein (Med 22 Feb 2023 (A.N) +6 in past) - ID: 12999
✦ Guyton, Pg. 477
Ⓐ Mi Ⓑ Angina
Ⓒ Wolf Parkinson White syndrome
Ⓓ Hypokalemia

Ⓒ WPW syndrome ☛ most common ventricular preexcitation Ⓒ Ectopic pacemaker in atrium Ⓓ Left budle Branch
syndrome ➜ abnormal extra conduction pathway between atria and block
ventricles (bundle of Kent) ➜ conducts more rapidly
WPW ECG Feature : Ⓑ Accessory pathway (bundle of Kent) ➜ Allows electrical impulses
✪ Short PR interval (＜120 ms ) to bypass normal route from atria to ventricles ➜ Leads to abnormal
✪ Slow rise of upstroke of QRS complex ( delta wave ) electrical conduction and potential arrhythmias ➜ Causes WPW
✪ widened QRS complex ( total duration ＞ 0.12 seconds ) syndrome.
✦ Ganong, Pg. 531
BP Regulation
44. Wolf man parkinson syndrome (Med 19 Nov 2022 (M)) - ID:
82923 Autoregulation
Ⓐ Mobitz type 1 Ⓑ Wide QRS 1. During moderate level of exercise.blood flow to brain
Ⓒ Prolong PR Ⓓ U wave (Anesth 23 May 2023 (M) +10 in past) - ID: 9742
Ⓐ Remain unchanged Ⓑ Increases

Ⓑ WPW syndrome ☛ most common ventricular preexcitation
Ⓒ Decreases Ⓓ None of above
syndrome ➜ abnormal extra conduction pathway between atria and
ventricles (bundle of Kent) ➜ conducts more rapidly
Ⓐ ✦ There is an excellent autoregulation system in both cardiac and
WPW ECG Feature :
cerebral blood flow ,
✪ Short PR interval (＜120 ms )
✦ Sympathetic stimulation during exercise does not cause significant
✪ Slow rise of upstroke of QRS complex ( delta wave )
affect on cerebral blood vessels to affect it's perfusion
✪ widened QRS complex ( total duration ＞ 0.12 seconds ) ✦ Guyton, Pg. 295
✦ Ganong, Pg. 531
2. Blood pressure is constant but resistance is changed in ☛
45. Re-entry circuit occurs in (Med 22 Feb 2023 (A.N) +9 in past)
Autoregulation (Local regulation)
- ID: 485
3. Increase Heart rate to keep BP constant is a ☛ Autoregulation (Local
Ⓐ Ventricular hypertrophy Ⓑ Atrial fibrillation regulation)
Ⓒ Conduction block
4. Autoregulation is seen in ☛ kidney mesentery, muscles, brain, and
Ⓓ Paroxysmal nodal ventricular tachycardia
liver (not in skin)
Ⓓ Reentrant activity in AV node propagates back down to ventricle, 5. First mechanism in body as a defense in pt with skin laceration☛
producing paroxysmal nodal tachycardia Vasoconstriction (to prevent blood loss )
✦ Ganong, Pg. 529
Baroreceptors
46. Normal ventricular contraction after Extra systole will
6. Baroreceptors are most sensitive to (Gynae 24 May 2023 (M))
cause? (Surg 24 May 2023 (A.N) +7 in past) - ID: 445 - ID: 84494
Ⓐ Decrease pulse pressure due to decrease stroke volume Ⓐ Blood loss Ⓑ Inc arterial pressure
Ⓑ Increase pulse pressure due to increased contractility Ⓒ Dec arterial pressure
Ⓒ Increase pulse pressure due to increase stroke volume
Ⓓ Increased pulse pressure due to decrease in compliance of Ⓑ Baroreceptors are most sensitive to changes in arterial pressure ➜
veins When arterial pressure increases, baroreceptors increase their rate of
firing and trigger reflexes to reduce BP
Ⓑ ✪ Extra systole ➜ Diastolic time reduces ➜ Effective cardiac filling Note : Baroreceptors respond to decreases in arterial pressure, they
doesnt occur ➜ Reduced stroke volume + Reduced pulse pressure + are more sensitive to increases.
Extra Calcium movement into cell
✪ After Extra Systole ➜ Normal Systole ➜ More intracellular Calcium 7. A pt was brought to ER In state of massive hemorrhage
present ➜ Increased Contractility ➜ Stroke volume and pulse pressure because of trauma and leaded hypotension baroreceptor
both increases responsible lead to (Med 25 May 2023 (M) +6 in past) - ID: 35698
✦ BRS Physiology, Pg. 77
Ⓐ Increase parasympathetic activity
47. Extra systole means: ☛ Extra Beat (Not sinus origin) Ⓑ Increase arteriole tone Ⓒ Increased venous compliance
48. Extra Systole is associated with ☛ Low stroke volume (Ineffective Ⓓ Decrease venous compliance
cardiac filling )
Ⓓ Hypotension ➜ ↓ Firing frequency of baroreceptors ➜ ↓
49. Palpitations on exercise can occur in ☛ Sinus tachycardia (Sinus parasympathetic ↑ sympathetic stimulation ➜Vasoconstriction
arrhythmia) ↑ SV HR, , and BP
50. In arrhythmia, Hemodyanamiclly unstable patient is managed by ☛ ✦ Guyton, Pg. 7
Electrical cardioversion (Restores sinus rhythm)
8. Short term response to blood pressure (Med 25 May 2023
51. Sinus Arrhythmia due to ☛ problem in SA node (Iirregularity in (A.N) +6 in past) - ID: 36042
rhythm)
Ⓐ Baroreceptor Ⓑ RAAS
52. Ventricular extra systole causes ☛ Arrhythmia (Premature
Ⓒ CNS Ischemic Response Ⓓ ADH
ventricular contraction )
----- Ⓐ Short-term regulation of BP ☛ controlled by ANS ➜ changes in BP
detected by baroreceptors ➜ located in arch of aorta and carotid sinus.
53. Major factor in causing increased force of contraction
in cardiac muscles? (Med 15 Aug 2022 (A.N)) - ID: 84106 9. Baroreceptor reflex is important in case of (Med 31 Aug
2021 (E) +5 in past) - ID: 10010
Ⓐ Gap junctions Ⓑ SA node depolarizing
Ⓒ Increase preload Ⓓ Interested disc Ⓐ Septic shock Ⓑ Hypovolemic shock
Ⓒ Cardiogenic shock Ⓓ Neurogenic shock
Ⓒ Force of contraction ☛ primarily influenced by degree of
ventricular filling just before contraction (preload) Ⓑ ✪ Hypovolemia ➜ Baroreceptors ➜ ↑ Sympethatic outflow ➜ ↑
HR ➜ ↑ CO ➜ ↑ BP
54. WPW syndrome is caused by (Med 17 May 2022 (E)) - ID: ✦ Harsh Mohan, Pg. 98
62398
10. In which condition Baroreceptors respond Maximally
Ⓐ Bundle Branch Block by decreased firing frequency? (Surg 24 May 2023 (M) +18 in
Ⓑ Right sided accessory pathway past) - ID: 12816

19. Temperature of skin reaches 52 degree centigrade, receptors

Ⓐ Rapidly Increasing BP Ⓑ Rapidly Decreasing BP stimulated ☛ Nociceptive receptors (Thermoreceptors)
Ⓒ Cushing syndrome Ⓓ None of these
20. Dehydration increases ☛ ADH, AG2 and Aldosterone (↓
Ⓑ carotid sinus/aortic arch/atria/venae cavae ➜ Stretch-sensitive baroreceptor firing)
nerve endings ➜ Most sensitive for Decrease in BP 21. Adrenaline/ Epinephrine cause decrease in ☛ Baroreceptor firing
Rapid Fall in BP ➜ Decreased firing frequency of baroreceptors ➜ 22. Boy standing after lying BP normalizes by ☛ Baroreceptor
Decreased signaling to brain stem (vasomotor center) ➜ Dec
parasympathetic stimulation + Inc sympathetic innervation ➜ Renin Angiotensin
vasoconstriction ➜ Inc HR+ Inc SV + Inc BP 23. Lung Activate which of following (Eye 23 May 2023 (M) +5
✦ Guyton, Pg. 219, 219
11. elevation of renin level is due to: (Surg 17 Feb 2022 (A.N)
Ⓐ Renin Ⓑ Angiotensin-II
+2 in past) - ID: 33967
Ⓒ Erythropoitin Ⓓ Angiotensin-I
Ⓐ High parasympathetic activity
Ⓑ Hypoxia Ⓑ Angiotensinogen is produced by liver, converted to Angiotensin-I in
Ⓒ Decrease stretch over atrial baroreceptors Kidneys and then to Angiotensin-II in lungs.
Ⓓ High brain bridge reflex
24. In hypovolemic shock, increased thirst is due to
stimulation of hypothalamic thirst center by (Surg 24 May
Ⓒ ↓ ECF volume ➜ ↓ VR ➜ ↓ Strech of atrial wall ➜ ↓ ANP
2023 (M) +5 in past) - ID: 55357
release ➜ Hypovolemia also sensed by JGA ➜ ↑ Renin ➜ RAAS ➜
↑ ECF volume Ⓐ Adrenaline Ⓑ Angiotensin II
✦ Guyton, Pg. 364 Ⓒ Antidiuretic hormones Ⓓ Cortisol
12. Patient presented in shock decreased MAP and
Ⓑ Angiotensin ll
decreased which one of following parameter will decrease
◉ Powerfully Constricts Only Arterioles (specially efferent)
to increase BP (Med 17 Aug 2022 (A.N) +5 in past) - ID: 36034
◉ Inhibit Renin due to Negative feedback
Ⓐ Veins Compliance Ⓑ Resistance ◉ Powerful stimulus to Thirst and sodium appetite
Ⓒ Firing of baroreceptor Ⓓ Firing of chemoreceptor ✦ Guyton, Pg. 212 ✦ N.I.H USA, Pg.
25. Which of following is best known metabolic function of

Ⓒ EXPLANATION lung? (Radio 17 May 2022 (A.N) +1 in past) - ID: 9042
13. BP drops from I00mmHq to 70mmHq. it will result in Ⓐ Inactivation of serotonin
(Gynae 22 Feb 2023 (A.N) +3 in past) - ID: 163
Ⓑ Conversion of angiotensin I to angiotensin II
Ⓐ Decrease in carotid sinus nerve activity Ⓒ Inactivation of bradykinin
Ⓑ Increased sympathetic efferent effect on heart Ⓓ Metabolism of basic drugs by cytochrome P450 system
Ⓒ Increase in carotid sinus nerve activity
Ⓑ ✪ Angiotensin converting enzyme ☛ found in endothelial cells of
Ⓐ ↓ in blood pressure causes ↓ baroreflex activation and causes heart pulmonary vessels.
rate to ↑ and to restore blood pressure levels. ✪ While blood flows through small vessels of lungs ➜ two amino acids
✦ Guyton, Pg. 219 are split from angiotensin I ➜ 8-amino acid peptide angiotensin II
formed ( catalyzed by ACE ).
14. A person with decreased BP. role of carotid sinus by ✦ Guyton, Pg. 235 ✦ Kaplan Physiology, Pg. 289
barorecptor reflex will be to : (Surg 22 Feb 2023 (A.N) +7 in past)
- ID: 15171 26. Which of following causes an increase in renin level?
(Surg 18 Nov 2022 (M) +4 in past) - ID: 83937
Ⓐ Increase Heart rate Ⓑ Decrease stroke vol
Ⓒ Dec. output Ⓓ Decrease rate Ⓐ Increase plasma osmolarity
Ⓑ Increase sodium delivery to macula densa
Ⓐ Hypotension ➜ ↓ Firing frequency of Ⓒ Decrease stretch on cardiac receptor
baroreceptors ➜ ↓ parasympathetic ↑ sympathetic stimulation ➜ ↑ Ⓓ Exercise
HR, SV, and BP
✦ Guyton, Pg. 7 Ⓒ State of hypoperfusion ➜ decreased blood volume or decreased
BP ➜ Signal for Renin secretion by juxtaglomerular cells of kidney
15. A patient loses 2L blood. Mechanism which maintain
➜renin increase angiotensin II and aldosterone ➜ leading to
blood pressure and MAP, Rapidly after moderate
vasoconstriction and sodium reabsorption respectively ➜ raise BP.
hemorrhage (Eye 21 Feb 2023 (M) +37 in past) - ID: 16284
27. Renin release from juxtaglomerular apparatus is
Ⓐ Renin system Ⓑ Chemoreceptor system
inhibited by: (Med 22 Feb 2023 (A.N)) - ID: 84204
Ⓒ Baroreceptor mechanism Ⓓ Sympathetic system
Ⓐ Aldosterone Ⓑ Beta-adrenergic agonists
Ⓒ Baroreceptors ☛ sensitive to change in mean pressure Ⓒ Increased pressure within afferent arterioles
Blood Loss ☛ ↓ MAP ➜ ↓ Firing of Baroreceptors ➜ Immediate and Ⓓ Prostaglandins
Short term increase in ➜ HR, SV, and BP Ⓔ Stimulation of macula densa
✦ Guyton, Pg. 7
Ⓒ Renin ☛ released by cells of juxtaglomerular apparatus in response
16. main variable controlled by Baroreceptor reflex is?
(Radio 21 Feb 2023 (M) +16 in past) - ID: 36891
to various stimuli, including reducedBP and sympathetic nervous
system activation. Increased pressure in afferent arterioles ➜ inhibits
Ⓐ Mean Arterial Pressure Ⓑ Pulse Pressure release of renin ➜ mechanism to prevent further elevation of BP
Ⓒ Blood Pressure Ⓓ Stroke Volume
28. A young patient's blood pressure is 150/95. His serum
Ⓐ Baroreceptors ☛ sensitive to change in mean pressure Renin level is higher than normal. Which of following is
Blood Loss ☛ ↓ MAP ➜ ↓ Firing of Baroreceptors ➜ Immediate and most powerful stimulus for renin release ? (CPSP Demo +23 in
past) - ID: 3901
Short term increase in ➜ HR, SV, and BP
✦ Guyton, Pg. 7 Ⓐ Essential hypertension
17. Carotid sinus responds to ☛ Change in BP (Baroreceptors ) Ⓑ Increased delivery of sodium to Renal tubules
Ⓒ Increased sympathetic stimulation via Renal nerves
18. Carotid bodies ☛ Chemorcceptors
Ⓓ Increased blood flow to kidneys

Ⓒ Drop in ECF volume ➜ Reflex increase in renal nerve discharge and All ONE LINERS Below and other CONTROVERSIAL MCQs
↓ renal ➜ arterial pressure ➜ Sympathetic Stimulation ➜ Double are present on MediCall App in Full MCQ form !
Effect ➜ JG Cells ➜ ↑ Renin Release ➜ ㊉ RAAS ➜ Retention of Na+ Just search relevant Keyword in App search bar and
and Water ➜ ↑ ECF volume
✦ Ganong, Pg. 674
36. Long term arterial Blood Pressure control by ☛ Renin Angiotensin
29. Short-term, Immediate and Transient potent action of
(Renal)
Angiotensin 2 ( AT2). (Gynae 22 Feb 2023 (A.N) +20 in past) - ID:
12794 37. Hypertensive with renal artery thrombosis, renin is released, cause
☛ Increased peripheral by angiotensin II
Ⓐ Vasoconstriction Ⓑ Vasodilatation
Ⓒ Diuresis Ⓓ Aldosterone release 38. Most powerful Na+ retaining hormone ☛ AG2
39. Primary control of secretion from Zona glomerulosa is by ☛
Ⓐ Angiotensin II ☛ is an extremely potent Vasoconstrictor. IV Angiotensin 2 (Aldosterone)
infusion results in a pressor response within 15 seconds that lasts for 3
40. Angiotensin 1 is converted to Angiotensin 2 in ☛ Lung capillary
to 5 minutes.
endothelium (ACE)
Aldosterone release takes about 30-45 minutes
✦ Guyton, Pg. 235 41. Max feedback gain in controlling BP ☛ Renin Angiotensin
system (Vasoconstrictor effects)
30. Which of following is immediate effect of renin
42. Increase renin is associated with ☛ Chronic hypertension
angiotensin system? (Med 17 Nov 2022 (A.N) +8 in past) - ID:
13699
(↑ Salt and water retention )
43. In hemorrhage patient aldosterone level increased by ☛ AG2 (↑
Ⓐ Arteriolar constriction Ⓑ Thirst stimulation Renin )
Ⓒ Aldosterone Ⓓ ADH
44. Renin release ☛ angiotensin ll
Ⓐ angiotensin II constricts glomerular arterioles, having a greater -----
effect on efferent arterioles than afferent. As with most other capillary
beds in body, constriction of afferent arterioles increases arteriolar 45. CNS ischaemia increase (Med 17 May 2022 (E)) - ID: 79392
resistance
Ⓐ ICP Ⓑ Cerebral perfusion
31. When Total circulatory volume decreases, what will be Ⓒ Vasoconstriction
Most important change in kidney to preserve blood volume
is (Surg 16 Nov 2022 (A.N) +5 in past) - ID: 749 Ⓑ Hypoxemia ☛ increases CPP only if Po2 ＜ 50 mm Hg
✦ First Aid, Pg. 501
Ⓐ Decrease ADH secretion
46. Patient with massive blood loss, B.P. 50 mm Hg. Which
Ⓑ Increase blood flow to meduallry interstitium
response will be most active , important and Potent below
Ⓒ Increased renin secretion Ⓓ Decrease renin release
60 mm hg? (Surg 24 May 2023 (A.N) +49 in past) - ID: 15738
Ⓒ When there is any halt to blood volume kidneys respond by Ⓐ Renin-angiotensin reflex Ⓑ Bain-bridge reflex
increasing release of renin which through renin angiotensin pathway Ⓒ CNS ischemic response Ⓓ Barorecptors
preserve blood volume mechanism
32. Renin is inhibited by: (Med 23 Feb 2023 (M) +6 in past) - ID:
35041 Ⓒ Most potent ( below 60) ☛ CNS ischemic response
Severe Drop in BP (below 60) ➜ Decreased Blood to medulla ➜
Ⓐ Angiotensin Ⓑ Increase sodium Cerebral Hypoxia ➜ CNS ischemic response ➜ Vasomotor centre
Ⓒ Increase Adlosterone Ⓓ Bradykinin activated ➜ Powerful Vasoconstriction ➜ BP MaintainedBP ＞ 60
mmHg ☛ Baroreceptor Reflex most active
Ⓑ Renin secretion is inhibited by ☛ ↑ Na+ ＞ ↑ afferent arteriolar ✦ Guyton, Pg. 223
pressure ＞ AG2
✦ Ganong, Pg. 703 47. A patient presented with one litre blood loss within 5
minutes which of following will occur? (Med 25 May 2023 (M)
33. Kidney conserves blood volume by increase in (Gynae 16 +12 in past) - ID: 22962
Nov 2022 (A.N) +1 in past) - ID: 83198
Ⓐ Increased venous tone Ⓑ Decrease BP
Ⓐ Renin secretion Ⓑ Afferent vasoconstriction Ⓒ Decrease TPR Ⓓ Decrease diastolic pressure
Ⓒ AG1 Ⓓ Cortisol
Ⓐ Compensatory mechenisms
Ⓐ ✪ ↓ Blood Volume ➜ sense by JGA ➜ Release Renin ➜ activate ◉ Neuro- Hormonal System ➜ cause Widespread Vasoconstriction ( ↑
RAAS ➜ AG2 act on zona glomerulosa of adrenal cortex ➜ Release Tone of vessels )
Aldosterones ➜ Retention od Na+ and Water ◉ Kidney ➜ conerve Fluid conservation
✦ Guyton, Pg. 363 ✦ Harsh Mohan, Pg. 111
34. Which one of following directly stimulates thirst center 48. most important immediate event following bleeding
in hypothalamas? (Med 15 Feb 2022 (A.N) +34 in past) - ID: 19333 (Med 15 Aug 2022 (A.N) +15 in past) - ID: 9988
Ⓐ ADH Ⓑ Angiotensin 2 Ⓐ Activation of plasminogen Ⓑ Formation of fibrin

Ⓒ Aldosterone Ⓓ Oxytocin Ⓒ Formation of thrombomodulin
Ⓓ Constriction of blood vessels
Ⓑ ✪ Angiotensin (ANG) II is a powerful and phylogenetically
widespread stimulus to thirst and sodium appetite. Ⓓ ✪ Compensatory mechanisms to maintain adequate cerebral
✪ When it is injected directly into sensitive areas of brain, it causes an perfusion in early stage of Hge by activation of various neurohormonal
immediate ↑ in water intake followed by a slower ↑ in NaCl intake. mechanisms causing ◉ widespread vasoconstriction ◉ fluid
✦ Guyton, Pg. 384 conservation by kidney
✦ Harsh Mohan, Pg. 111
35. Vasoconstriction in mucles? (Med 19 Nov 2022 (M)) - ID:
82917 49. Renin is increased by which of following? (Med 18 Nov
2022 ( M) +12 in past) - ID: 22974
Ⓐ Aldosteron Ⓑ Renin
Ⓒ AG2 Ⓓ Cortisol Ⓐ Increased potassium Ⓑ Decreased potassium
Ⓒ Increased magnessium Ⓓ Increased Sodium
Ⓒ AG2 ☛ VAsoconstriction

Ⓑ Renin secretion is inversely proportional to plasma K+ , i.e ↓ K+ ➜ 56. Patient bp 180/90 severe headache anxiety
↑ Renin secretion . and VICE VERSA palpitations most relevant test (Med 17 May 2022 (E)) - ID:
HYPOs ( Na / k ) stimulate Renin 79407
✦ Ganong, Pg. 673
Ⓐ TSH Ⓑ ECG
- ID: 55485
Ⓑ ECG ☛ can help determine whether a heart problem might be
Ⓐ Acidotic breathing Ⓑ Bradycardia
causing secondary hypertension.
Ⓒ Motor weakness Ⓓ Tachycardia
57. Kidney releases renin in response to following ? (Surg 19
Ⓑ Acute elevations of ICP ➜ Cushing reflex ➜ Cushing’s triad of ✔ Feb 2019 (A-N) +5 in past) - ID: 20202
Hypertension ✔ bradycardia ✔ Irregular Respirations ➜ save brain
Ⓐ Hyponatremia Ⓑ Hypokalemia
tissues during periods of poor perfusion
✦ Guyton, Pg. 223 Ⓒ Hypercalcemia Ⓓ Hyperglycemia
51. Systolic bp 45mmhg, diastolic not recordable? What Ⓐ Hyponatremia ➜ kidneys ➜ DCT ➜ Macula Densa ➜ JG cells (
will activate? (Gynae 22 Feb 2023 (M) +1 in past) - ID: 83130 Specialized cells to sense Hyponatremia ) ➜ release Renin
✦ Ganong, Pg. 674
Ⓐ CNS ischemic Ⓑ Baroreceptor
58. Organ with always vasoconstriction with less than
Ⓐ Most potent ( below 60) ☛ CNS ischemic response 20% of cardiac output (Surg 16 Feb 2022 (E)) - ID: 77909
Severe Drop in BP (below 60) ➜ Decreased Blood to medulla ➜
Ⓐ Heart Ⓑ Kidney
Cerebral Hypoxia ➜ CNS ischemic response ➜ Vasomotor centre
Ⓒ Skin
activated ➜ Powerful Vasoconstriction ➜ BP MaintainedBP ＞ 60
mmHg ☛ Baroreceptor Reflex most active
Ⓒ Skin is organ that always has vasoconstriction with less than 20% of
✦ Guyton, Pg. 223
cardiac output.
52. Most potent response in shock as a whole which (Reference: Ganong's , 26th edition, page 203)
Preserve organism ? (Med 23 Feb 2023 (A.N) +16 in past) - ID:
1672 59. A patient on hypertensive drugs develops postural
hypotension due to acute fall of arterial BP. His heart rate
Ⓐ Baroreceptor Ⓑ Heart is increased . To maintain MAP ,Increase heart rate while
Ⓒ CNS ischemic response Ⓓ Sympatho-Adrenal standing up is mediated by ? (Surg 1 Sep 2021 (M) +7 in past) -
system ID: 3116
Ⓓ Sympathoadrenal system ☛ physiological connection between Ⓐ Decrease firing rate of baroreceptors

SNS and adrenal medulla ➜ stimulation of β-adrenergic receptors by Ⓑ Decrease sympathetic stimulation
Adrenaline and Noradrenaline ➜ crucial in response in emergency or Ⓒ Inc vagal tone Ⓓ Inc vasomotor tone
shock ➜ saves life by maintaining Vital functions of Heart and Brain ➜
raising Blood and energy supply.
Ⓐ Hemorrhage / Hypotension ➜ Baroreceptors detect Dec. BP as a
✦ Guyton, Pg. 295 decrease in tension (standing up) ➜ ↓ Firing frequency baroreceptors
➜ ↓ signaling to brain stem (vasomotor center) ➜ ↓ parasympathetic
53. An Increased ICP causes blood pressure increase and stimulation and Inc. sympathetic innervation ➜ vasoconstriction ➜ Inc.
decrease in Heart Rate to regulate cerebral blood flow . HR, SV, and BP
This condition is known as? (CPSP Demo +30 in past) - ID: ✦ Guyton, Pg. 7
21632
60. What happens after birth ☛ Increased left atrial pressure
Ⓐ CNS ischemic response Ⓑ Baroreceptor reflex
61. Increase mean systemic filling pressure with ☛ Decreased venous
Ⓒ Cushing reflex Ⓓ Chemoreceptor response
resistance
Ⓒ Acute elevations of ICP ➜ Cushing reflex ➜ Cushing’s triad of ✔ 62. Maximum feedback gain in controlling cardiac pressure ☛ Renal
Hypertension ✔ bradycardia ✔ Irregular Respirations ➜ save brain volume pressure mechanism
tissues during periods of poor perfusion 63. Nerve taking afferents from carotid sinus baroreceptors is ☛
✦ Guyton, Pg. 223 Glossopharyngeal (aortic arch: vagus nerve)
54. To measure accurate BP, cuff size (width) should be 64. When nerves from arterial baroreceptor are cut mean arterial
how much times of arm circumference (Anesth 15 Nov 2022 (M) pressure ☛ Would be variable without proper control (Loss of control
+1 in past) - ID: 35993 system )
Ⓐ 0.5 - 1.5 Times diameter Ⓑ 1.0-1.5 Times diameter 65. Healthy adult 25 yrs old losses blood. (500ml) ☛ B.P remains
Ⓒ 1.5 - 2.0 times diameter normal
Ⓓ 2.0 — 3.0 times diameter 66. Most potent response in massive hemorrhage ☛ CNS ischemic
Ⓔ 6.0 - 10.5 times diameter response (Only below 60 mmHg )
67. Baroreceptors ☛ formed by small nerve endings present in
Ⓐ ideal cuff bladder width is ≥ 40 percent of patient's arm
Adventitia of large arteries (Adventitial-medial border)
circumference.
68. Decrease NaCl to macula densa cause ☛ Release of renin (Macula
55. RTA, GFR decrease in patient came with excessive densa sensetizes)
bleeding, BP 80/40 Tachycardia and Low urinary output
69. During exercise High Na retention due to ☛ RAAS (↑ Na
after catheterization. Renin was increased due to decrease
reabsorption)
in (Surg 17 Nov 2022 (M) +2 in past) - ID: 24777
Circulation Control
Ⓐ Decrease In Arterial Blood Flow
Ⓑ Decrease In Arterial Blood Pressure Autoregulation
Ⓒ Increase Arterial Blood Flow
Ⓓ Increase Arterial Blood Pressure 1. Blood flow to which organ is primarily controlled by
Sympathetic nervous system rather than by Local
Ⓑ ↓ Arterial Pressue ➜ ↓ GFR ➜ ↓ delivery of NaCl to JG Cells ( Metabolites ? (Med 18 Nov 2022 (A.N) +15 in past) - ID: 23230
Macula Densa ) ➜ ↑ Renin ➜ ↑ Aldosterone ➜ ↑ Na and Wter
Ⓐ Heart Ⓑ Brain
reabsorption ➜ BP Stablized
Ⓒ Skin
✦ Guyton, Pg. 234, 344
Ⓓ Skeletal muscle during exercise

Ⓒ Sympathetic nervous system ☛ controls blood supply of Skin. that radiates into neck. most likely diagnosis is (Med 25 May
2023 (M)) - ID: 54718
2. During exercise skeletal muscle blood flow is increased
by ? (Med 25 May 2023 (A.N) +24 in past) - ID: 21190 Ⓐ Aortic regurgitation Ⓑ Aortic stenosis
Ⓒ Mitral stenosis Ⓓ Pulmonary stenosis
Ⓐ Sympathetic supply Ⓑ Local metabolites
Ⓒ O2 consumption Ⓓ CO2 loss Ⓑ Aortic stenosis ☛ Crescendo-decrescendo systolic ejection
murmur. LV ＞＞ aortic pressure during systole. Loudest at heart base.
Ⓑ ✪ Metabolic byproducts ☛ adenosine, hydrogen ions and CO2 ➜ radiates to carotids
produced by muscles ➜ Expand capillaries within muscle ➜ ↑ blood ✦ Davidson, Pg. 562
flow ➜ delivers oxygenated blood.
✪ Sympathetic Activity ☛ control flow to Non Exercising Muscles. 4. A 68 yr man presented to you with complains of angina
life, dyspnea, palpitations and bp 125/90, gets repeated
3. During exercise Blood flow to non exercising skeletal attacks of syncope. On x-ray left heart border was
muscle is Maintained through which Mechanism (Med 25 May prominent he is having : (Surg 17 Nov 2022 (M) +1 in past) - ID:
2023 (M) +10 in past) - ID: 15586 59395
Ⓐ Local metabolism Ⓑ O2 requirements Ⓐ Atrial fibrillation Ⓑ Mitral stenosis

Ⓒ Adrenergic stimulation Ⓓ Vasodilation Ⓒ Aortic stenosis Ⓓ HOCM
Ⓔ None
Ⓒ Blood flow Regulation:
✪ Non-exercising muscles ☛ by sympathetic stimulation via α1 and Ⓒ Aortic stenosis ☛ Syncope, Angina, and Dyspnea on exertion
β2 receptors. (SAD). Most commonly due to agerelated calcification in older patients (
✪ Exercising Muscles ☛ Local metabolites causing vasodilation ＞ 60 years old) or in younger patients with early-onset calcification of
( Guyton + First Aid ) bicuspid aortic valve.
4. Total peripheral resistance during exercise decreases mostly because
of ☛ Local metabolites cause arteriolodialation 5. Dx of pt with heart murmur along with QRS deviated at 120 degree
5. After losing 750-1500 ml blood, skin is calm and cold due to ☛ and QRS of 0.18s ☛ Aortic stenosis (Left Ventricular Hypertrophy)
Vasoconstriction (Tachycardia) 6. Aortic stenosis murmur ☛ Radiates to carotid (Crescendo-
----- decrescendo systolic ejection murmur)
7. LVF occurs due to ☛ Aortic stenosis (Left ventricular hypertrophy )
8. Cardiovascular system organized to maintain constant
(Med 17 Nov 2022 (M)) - ID: 82960 8. Systolic Ejection murmur @ 4th ICS is due to ☛ Aortic stenosis
(Loudest at heart base)
Ⓐ Blood pressure Ⓑ Oxygen delivery
Aortic Regurgitation
Ⓒ Cardiac output Ⓓ Pulse pressure
9. Examination of young patient.Diastolic murmur and
Ⓑ CVS ☛ Maintain constant O2 delivery to tissues collapsing pulse were noticed.Most likely diagnosis (Med
24th Nov 2020 (E) +7 in past) - ID: 2194
9. Bainbridge reflex (Surg 24 May 2023 (M)) - ID: 84359
Ⓐ AR Ⓑ Aortic stenosis
Ⓐ Inc atrial stretch Ⓑ Decreased atrial stretch
Ⓒ VSD Ⓓ Mitral stenosis
Ⓒ Decreased ventricular stretch
Ⓓ Increased ventricular stretch Ⓐ Aortic Regurgiation ➜ Volume overload of left ventricle (LV) ➜
hyperactive left ventricular dilatation (LVD) ✔ very short, early diastolic
Ⓐ Bainbridge reflex, a.k.a atrial reflex ☛ physiological process that
decrescendo murmur ✔ As pressure increases throughout pulmonary
increases HR in response to increased venous return
circuit, patient develops dyspnea and pulmonary edema ✔ pulse has a
Increased venous return ➜ increased stretch of tatria ➜ stimulates
rapid rise and fall (water-hammer pulse or Corrigan pulse)
receptors in atria ➜ send signals via tvagus nerve to cardiac center in ✦ Davidson, Pg. 623
medulla ➜ increased HR to pump additional blood quickly
10. Aortic regurgitation's most significant finding is: (Med
10. True regarding brainbridge reflex ☛ Rapid infusion of fluids lead to 15 Aug 2022 (A.N)) - ID: 84097
increase in heart rate
Ⓐ Bounding pulse Ⓑ Pansystolic murmur
Valvular Disorders Ⓒ Slow pulse Ⓓ Early diastolic murmur
Ⓔ Ejection systolic murmur
Aortic Stenosis
1. Angina like symptoms occur in which of following (Med 31 Ⓓ Aortic insufficiency ➜ a percentage of blood regurgitates back ➜
Aug 2021 (E) +4 in past) - ID: 15 Increased end diastolic volume ➜ Increased systolic blood pressure +
Decreased Diastolic Pressure in aorta ➜ increase in Aortic pulse
Ⓐ Aortic stenosis Ⓑ AR pressure ( Systolic - Diastolic ) ➜ Ventricular Hypertrophy ( to raise
Ⓒ Mitral regurgitation Ⓓ Mitral stenosis compliance ) ➜ Increased Ventricular end-diastolic volume ➜ Soft,
high-pitched, early diastolic decrescendo Murmur ( Austin Flint Murmur
Ⓐ Three cardinal symptoms of AS ☛ ● Exertional dyspnea ● Angina )
pectoris ● Syncope ✦ CMDT, Pg. 358
✦ Harsh Mohan, Pg. 451
11. A patient with left ventricular hypertrophy with
2. Which is most common heart valve to get calcified? significantly increased end diastolic volume with increase
(Radio 21 Feb 2023 (M) +1 in past) - ID: 79546
systolic and decreased diastolic value 145/45 and
Ⓐ Pulmonary Ⓑ Aortic increased aortic pressure. There was early diastolic
Ⓒ Tricuspid Ⓓ Mitral murmur which was due to: (Surg 17 Nov 2022 (A.N) +11 in past) -
ID: 25734
Ⓑ Aortic valve, which is main valve or “front door of heart”, regulates Ⓐ Tricuspid insufficiency Ⓑ Aortic Regurgitation
all of blood that leaves heart and is valve that calcifies most frequently. Ⓒ Mitral Stenosis Ⓓ Aortic Stenosis
3. A 77-year-old man collapsed while shopping. On
regaining consciousness he complains of chest pain. Last Ⓑ Aortic insufficiency ➜ a percentage of blood regurgitates back ➜
year he had several episodes of collapse and chest pain on Increased end diastolic volume ➜ Increased systolic blood pressure +
exertion. On lying his blood pressure is 120/95 mmHg and Decreased Diastolic Pressure in aorta ➜ increase in Aortic pulse
he has an ejection systolic murmur at left sternal edge pressure ( Systolic - Diastolic ) ➜ Ventricular Hypertrophy ( to raise

compliance ) ➜ Increased Ventricular end-diastolic volume ➜ Soft, Ⓐ Biphasic p wave in lead 2 Ⓑ P. Pulmonale in lead 2
high-pitched, early diastolic decrescendo Murmur ( Austin Flint Murmur Ⓒ P Mitrale in lead 4 Ⓓ P mitrale in lead 2
)
✦ CMDT, Pg. 358 Ⓐ Mitral stenosis ➤ Pressure overload ➜ Progressive Left atrial
dilation ➜ A-fib ➜ Irregularly irregular rhythm and P-Mitrale
12. Aortic insufficiency is found in: (Med 16 Aug 2022 (E) +9 in
P Mitrale ☛ broad, notched (bifid) P waves in lead II ➜ sign of left
past) - ID: 31249
atrial enlargement, classically due to mitral stenosis
Ⓐ Ankyloses spondylitis Ⓑ Reiter’s syndrome ✦ Davidson, Pg. 617 ✦ Reference, Pg.
Ⓒ Both Ⓓ None of above
20. 22-year-old pregnant woman known case of mitral
stenosis, having normal bp, tachycardia, shortness of
Ⓐ Causes of AR ☛ RHD ,IE , Degenerative , Syphilitic aortitis , Marfan
breath, and feels dizzy. She doesn't take her meds
syndrome ,RA and Ankylosing spondylitis
because she is scared it will affect her baby. Which drug is
✦ Robbins, Pg. 423
it likely to be? (Gyn 16 Aug 2022 (M)) - ID: 84064
13. Collapsing pulse Is a known feature of. (Surg 24 May 2023
(M)) - ID: 59419 Ⓐ Digoxin Ⓑ Captopril
Ⓒ Phcnytoin Ⓓ Propanolol
Ⓐ Aortic stenosis Ⓑ Aortic Regurgitation
Ⓒ Mitral stenosis Ⓓ Mitral regurgitation Ⓑ Mitral stenosis ☛ increases left atrial pressure ➜ pulmonary
Ⓔ Polycythemia, congestion ➜ tachycardia, shortness of breath, and dizziness
Captopril ☛ ACE inhibitor ➜ reduces preload and afterload ➜ relief of
Ⓑ Collapsing pulse can be thought of as a palpably widened pulse symptoms ➜ fear of fetal harm, common in pregnancy due to known
pressure; in context of aortic regurgitation or PDA it is often possible to potential teratogenic effects of ACE inhibitors.
feel a markedly water hammer pulse on lifting arm up Digoxin ☛ used in mitral stenosis, especially when there is
concomitant atrial fibrillation, but it doesn't directly alleviate increased
14. Early Diastolic Murmur at left lower sternal border
pressures caused by stenosis. It would be a reasonable treatment if
with low preload, left ventricular hypertrophy and
arrhythmia were part of clinical picture.
pulmonary oedema features are seen in ? (Radio 23 May 2023
(M) +9 in past) - ID: 19837 21. Low cardiac output failure (Gynae 16 Nov 2022 (M) +1 in
past) - ID: 82886
Ⓐ Aortic stenosis Ⓑ Tricuspid stenosis
Ⓒ Pulmonary stenosis Ⓓ Aortic regurgitation Ⓐ Anemia Ⓑ Mitral stenosis
Ⓒ Thiamine deficiency Ⓓ Thyrotoxicosis
Ⓓ Aortic Regurgiation ➜ Volume overload of left ventricle (LV) ➜
hyperactive left ventricular dilatation (LVD) : Ⓑ Mitral stenosis ☛ obstructs blood flow from left atrium to left
✔ very short, early diastolic decrescendo murmur ventricle ➜ fail to pump sufficient blood ➜ low cardiac output
✔ As pressure increases throughout pulmonary circuit, patient develops Thiamine deficiency ☛ cause beriberi ➜ can lead to typically high-
dyspnea and pulmonary edema. output, not low-output heart failure
✦ CMDT, Pg. 358 ✦ Davidson, Pg. 623
22. A patient known case of mitral stenosis is having
15. Pulse pressure increases in ☛ Aortic regurgitation (↓ in diastolic BP irregularly irregular pulse most common finding on JVP:
in aorta) (Med 19 Nov 2022 (A.N)) - ID: 84053
Mitral Stenosis Ⓐ Giant a wave Ⓑ Absent a wave
16. S1 is louder in ? (Med 14 June 2021 (E) +1 in past) - ID: 20044 Ⓒ Absent c wave Ⓓ Gaint v wave
Ⓐ Aortic stenosis Ⓑ mitral Stenosis Ⓓ Mitral stenosis ☛ impaired flow from left atrium to left ventricle
Ⓒ Aortic regurgitation during ventricular diastole ➜ cause a backlog of blood into pulmonary
veins and subsequently right atrium ➜ leading to 'giant v wave' (more
Ⓑ Increased left atrial pressures in early mitral stenosis ➜ force mobile common finding)
portion of mitral valve leaflets far apart ➜ At onset of ventricular 'v' wave ☛ represents venous filling of right atrium.
systole ➜ they are forced closed from a relatively far distance ➜ A wave in JVP ☛ represents right atrial contraction, is Not typically
Resulting in a loud S1 absent. In fact, if atria are contracting forcefully due to increased
✦ Davidson, Pg. 560 pressure gradient caused by stenotic mitral valve, a wave could be
17. A patient came with Loud S1, opening snap and newly more prominent.
developed mid diastolic rumbling murmur at apex he Absent 'a' wave in JVP ☛ typically seen when there's no effective
gives history of having rheumatic fever in childhood, what atrial contraction, such as atrial fibrillation, which is not associated with
is cause: (Med 25 May 2023 (M) +12 in past) - ID: 33659 mitral stenosis.
Ⓐ Mitral stenosis Ⓑ Aschoff bodies 23. Patient with mitral valve stenosis. Indication of mitral
Ⓒ Papillary muscle damage Ⓓ Aortic Regurgitation valve replacement surgery (Med 23 Feb 2023 (A.N) +2 in past) -
ID: 82394
Ⓐ ✪ Mitral valve is most commonly affected valve by rheumatic heart Ⓐ Floppy valve Ⓑ Papillary muscle rupture
disease Ⓒ Rupture pectinate muscle Ⓓ Dilated
✪ MS is almost always rheumatic origin cardiomyopathy
✪ Mid-diastolic murmur , Opening snap and Loud S1 are features of MS
✦ Davidson, Pg. 616 Ⓐ Mitral valve prolapse ☛ also known as click-murmur syndrome,
18. In which a wave of JVP is absent (Med 25 May 2023 (A.N) +7 Barlow's syndrome or floppy valve syndrome ➜ surgery may be
in past) - ID: 37980 recommended if it causes severe mitral valve regurgitation ➜ mitral
valve repair or mitral valve replacement.
Ⓐ Mitral stenosis Ⓑ Mitral regurgitation
Ⓒ Tricuspid stenosis Ⓓ Tricuspid regurgitation 24. Mitral stenosis. (Med 21 Feb 2023 (A.N)) - ID: 83320
Ⓐ Increased contractility of ventricle

Ⓐ MS ➜ A-fib ➜ Absent A-Wave on JVP
Ⓑ Decreased filling of left atrium
Ⓒ Decreased left ventricular preload
19. A patient with Mitral stenosis , ECG shows (Med 25 May Ⓓ Decreased left atrial pressure
2023 (A.N) +3 in past) - ID: 82425
Ⓐ Mitral stenosis ☛ narrowing of mitral valve opening ➜ obstructs
blood flow from left atrium to left ventricle ➜ increased pressure in left

atrium as blood backs up.Early stages of mitral stenosis, ventricle Ⓑ ischaemic mitral regurgitation > raised pulmonary capillary pressure
can contract more forcefully to pump this blood, which could be seen as > pulmonary oedema. Inferior myocardial infarction causes left
increased contractility. ventricular remodeling, which displaces posterior papillary muscle away
from its normal position, leading to ischemic mitral regurgitation
25. Mid diastolic murmurs with irregular R-R interval most
likely findings would be (Med 23 Feb 2023 (A.N) +6 in past) - ID: 39. Ischemia then Mitral regurgitation and papillary
36050 damage artery involved (Radio 15 Nov 2022 (M)) - ID: 82845
Ⓐ P-Pulmonale Ⓑ P-Mitral Ⓐ Left circumflex artery Ⓑ Right coronary artery
Ⓒ Pulsus Paradox Ⓓ CHF
Ⓑ PDA ➜ Arises from RCA (60%) ➜ Posteriomeidal papillary muscle ➜
Ⓑ P mitrale ☛ ECG finding of P wave shaped like an M or a notch Severe MR
which occurs when left atrium is markedly enlarged, such as in mitral ✦ First Aid, Pg. 307
stenosis (delay of left atrial activation)
40. Blood supply of Posterior papillary muscle in mitral
26. Which of following is clinical feature of mitral valve (Radio 15 Nov 2022 (A.N)) - ID: 82807
stenosis? (Med 17 May 2022 (E) +1 in past) - ID: 18332
Ⓐ LAD Ⓑ LCX
Ⓐ Bloody vomit Ⓑ None of these Ⓒ Posterior descending Ⓓ Posterior interventricular
Ⓒ Opening snap and stolic murmur
Ⓓ Opening snap and diastolic murmur Ⓒ PDA ➜ Arises from RCA (60%) ➜ Posteriomeidal papillary muscle ➜
Severe MR
Ⓓ Mid-diastolic murmur , Opening snap and Loud S1 are features of MS ✦ First Aid, Pg. 307
All ONE LINERS Below and other CONTROVERSIAL MCQs 41. Patient has MX, Now on echocardiography patient has
are present on MediCall App in Full MCQ form ! mitral valve regurgitation which artery is most likely
Just search relevant Keyword in App search bar and involved? (Radio 15 Nov 2022 (M)) - ID: 84000
Ⓐ RMA Ⓑ LAD
27. Pregnant lady with mild diastolic murmur, valve involved ☛ Mitral Ⓒ LCX Ⓓ Posterior interventricular
(MS) Ⓔ LCA
28. Murmur of mitral stenosis is best heard at ☛ Apex (Nearly mid-
diastolic) Ⓓ Posterior interventricular (posterior descending artery, PDA) ☛
mainly supply posterior portion of mitral valve, and if occluded, it can
29. Dx of pt with mid diastolic murmur, pulmonary HTN and pulmonary cause mitral valve regurgitation.LAD ☛ supply anterior wall of left
edema ☛ Right ventricular hypertrophy (Mitral stenosis ) ventricle and interventricular septum. it is not primary artery involved
30. MS murmur best heard at ☛ At apex of heart in mitral valve regurgitation
31. Autopsy of alveoli in long standing Pulmonary congestion due to 42. What would be Cause of pansystolic murmur in axilla
mitral stenosis ☛ Heart failure macrophages (Heart failure cells) (Med 17 Nov 2022 (M) +7 in past) - ID: 23403
32. Mitral valve stenosis can lead to ☛ Exercise can induce acute
Ⓐ Tricuspid stenosis Ⓑ Mitral regurgitation
pulmonary edema (Fluid buildup in lungs)
Ⓒ Aortic stenosis Ⓓ VSD
33. Most probable cause of dyspnea and orthopnea in pregnant lady
with MS ☛ Pulmonary hypertension (Back pooling of blood) Ⓑ Mitral regurgitation ☛ typically is a holosystolic (pansystolic)
34. Pregnant lady developed severe breathlessness. O/e pulse murmur heard best at Apex, and may radiate to AxillaTypes of
irregularly irregular, mild diastolic murmur, inv ☛ P.mitrale on ECG and Murmur
Raised pressure gradient across mitral valve (Mitral stenosis ) ✪ Mitral regurgitation ☛ Pansystolic murmur
✪ Mitral stenosis ☛ Mid diastolic murmur
35. Mitral stenosis ☛ Malar flush, Atrial fibrillation, Tapping,
✪ Aortic regurgitation ☛ End diastolic murmur
undisplaced apex beat, (R) ventricular heave (No pan-systolic
✪ Aortic stenosis ☛ Ejection Systolic murmur
murmur )
✪ Pulmonary regurgitation ☛ Diastolic murmur
36. Intensity ( How loud it is ) of diastolic murmyr will tell us severity of ✪ Pulmonary stenosis ☛ Systolic murmur
stenosis i. Grade 5 and 6 will be more severe than Grade 1 and 2 ✪ Throtoxicosis ☛ Innocent murmur
Mitral Regurgitation ✪ Decrease hematocrit ☛ Continuous murmur
37. Following is related to myxoid degeneration (Med 17 May
2022 (E) +7 in past) - ID: 3785 43. Patient coronary angiography trying but can’t be
performed due to posterior descending art blocked. He is
Ⓐ Mitral valve prolapse Ⓑ Libman sac endocarditis given managed. After 2 weeks new pan systolic murmur
Ⓒ Subacute endocarditis Ⓓ None of above (Surg 25 May 2023 (M) +1 in past) - ID: 82978
Ⓐ ✪ Mitral valve prolapse is a condition in which two valve flaps Ⓐ Ventricular septal rupture Ⓑ Mitral regurgitation
of mitral valve do not close smoothly or evenly, but instead bulge Ⓒ Aortic stenosis Ⓓ Pulmonary stenosis
(prolapse) upward into left atrium.
✪ Mitral valve prolapse is also known as click-murmur syndrome, Ⓑ PDA ➜ Arises from RCA (60%) ➜ Posteriomeidal papillary muscle ➜
Barlow's syndrome or floppy valve syndrome. Severe MR
✪ It is caused by congenital anomalies or degenerative myxomatous
changes, and is sometimes a feature of connective tissue disorders 44. A pansystolic murmur developing in a patient recovering from acute
such as Marfan’s syndrome myocardial infarction, due to ☛ Valvular prolapse (Start at S1 and
✦ Davidson, Pg. 618 extend up to S2.)
38. A 67yo man had successful thrombolysis for an inf MI 45. Need surgery ☛ Prolapsed Mitral valve
1 month ago and was discharged after 5days. He is now 46. Patient with a mid-systolic murmur. echo shows a leaflet of mitral
readmitted with pulmonary edema. What is most probable valve displaced upward and aortic insufficiency. Defect in ☛ Collagen
dx? (Med 17 May 2022 (E)) - ID: 56695
-----
Ⓐ Aortic regurgitation
Ⓑ Ischemic mitral regurgitation 47. A 59-y.o man presents for a well person check. A
Ⓒ Mitral valve prolapse Ⓓ Pulmonary stenosis cardiovascular, respiratory, gastrointestinal and
neurological examination is performed. No significant
findings are found, except during auscultation a mid

systolic click followed by a late systolic murmur is heard at

apex. patient denies any symptoms. most likely diagnosis
is: (Surg 16 Nov 2022 (M) +1 in past) - ID: 57948
Ⓐ Barlow syndrome Ⓑ Austin Flint murmur

Ⓒ Patent ductus arteriosus Ⓓ Graham Steell murmur
Ⓐ Mitral valve prolapse ☛ two valve flaps of mitral valve don't close
smoothly or evenly, ➜ prolapse upward into left atrium ➜ click-
murmur syndrome, Barlow's syndrome or floppy valve syndrome.
48. Pan systolic murmur in aortic area, left ventricular

hypertrophy (LVH), and atrial fibrillation (Afib), most
likely Diagnosis? (Med 23 May 2023 (A.N) +3 in past) - ID: 12233
Ⓐ Mitral regurgitation Ⓑ Aortic regurgitation

Ⓒ Tricuspid regurgitation Ⓓ Aortic stenosis
Ⓐ Pansystolic murmur in aortic area is indicative of mitral

regurgitation
49. A 50. year old patient has a heart murmur resulting

from inability to maintain constant tension on cusps of AV
valve, downward traction of her AV valves cannot be made
which structure is damaged? (Med 25 May 2023 (A.N) +13 in
past) - ID: 58089
Ⓐ Chordae tendineae Ⓑ Trabeculae carneae

Ⓒ Purkinje fibers Ⓓ Annulus fibrosis
Ⓐ Papillary muscles ➜ pull on AV valves downward ➜ via chordae

tendineae ➜ slowing their closure and preventing trauma.
50. A 6 week old baby has a pansystolic murmur at sternal

border. He feeds poorly and has poor - weight gain. baby
is acyanotic. What is SINGLE most likely diagnosis? (Med 18
Nov 2022 ( M) +1 in past) - ID: 66238
Ⓐ Tetralogy of Fallot Ⓑ Atrial septal defect

Ⓒ Ventricular septal defect Ⓓ Patent ductus arteriosus
Ⓔ Transposition of great arteries
Ⓒ VSD☛ causes a pathognomonic holo- or pansystolic murmur ➜

auscultation is generally considered sufficient for detecting a significant
VSD.
51. Carcinoid heart disease ☛ Thickening of tricuspid valve (Tricuspid

stenosis)
52. Most common heart valve involves in disease ☛ Mitral valve
53. Cause of death of pt whose mitral valve is myxedematous with
chordae tendiniae broken ☛ Mitral valve prolapse (Barlow's syndrome )
54. Increased A wave amplitude in JVP occurs due to: ☛ Tricuspid
stenosis (Intrinsic tricuspid )
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Medi Call FCPS – 1 | Physiology - Cell Physio

All ONE LINERS are present on MediCall

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 7

Ⓑ ↑ Workload ➜ ↑ O2 demand ➜ local metabolites (adenosine)

8. Difference in maternal and fetal Circulation is

Ⓐ O2 sat Ⓑ CO2 sat

27. Largest total cross-sectional and surface area is of Hemodynamics

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 22

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Ⓐ Capacitance Ⓑ HR Ⓐ Hemorrhage Ⓑ Exercise

Ⓒ ✪ Vasomotor tone is mainly estimated by TPR. Ⓑ EXPLANATION

Ⓐ Diameter Ⓑ Radius Ⓓ ✪ Exercise ➜ ↑ Metabolic demand ➜ Release local metabolites ➜

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 26

Ⓐ Beriberi Ⓑ Hyperthyroidism 8. A young healthy male of 25yrs has decreased cardiac

Ⓓ Cardiac output decreased with increase in venous return Ⓐ Trained athlete Ⓑ HF

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2. At which right atrial pressure there is distension of Ⓐ Chronotropic Ⓑ Ionotropic

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Ⓐ ✪ Mean systemic filling pressure ☛ It is pressure measured

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Ⓓ 1.36 cm water = 1.0 mm Hg Ⓐ 25 mmHg Ⓑ 120 mmHg

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Ⓐ Early closure of aortic Ⓐ Closure of Aortic Valve Ⓑ Closure of AV valve

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7. Slowly depolarizing prepotential ☛ SA node (Slow L-type Ca

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Ⓐ Purkinje Ⓑ Atria ✦ Guyton, Pg. 389 ✦ Goljan, Pg. 129

21. Ventricular muscle receives impulses directly from? Ⓐ Option A Ⓑ Option B

32. Artificial pacemaker placed in due to defect in

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 35

Ⓐ Atrial systole Ⓑ Contraction phase Ⓐ Ventricular repolarization Ⓑ Ventricular depolarization

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Ⓐ Hypokolemia Ⓑ Hyponatremia Ⓐ After myocardial infarction ➜ Normal myocardium is replaced by

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Ⓐ Atrial flutter Ⓑ Ventricular fibrillation

9. Emboli frim Atrial fibrillation will lodge in ? (Med 23 Feb

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22. Progressive PR prolongation followed by missing a

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Ⓐ Cannon A waves. Ⓑ Inc PR interval

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Ⓐ Remain unchanged Ⓑ Increases

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19. Temperature of skin reaches 52 degree centigrade, receptors

25. Which of following is best known metabolic function of

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 42

Ⓐ ADH Ⓑ Angiotensin 2 Ⓐ Activation of plasminogen Ⓑ Formation of fibrin

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Ⓓ Sympathoadrenal system ☛ physiological connection between Ⓐ Decrease firing rate of baroreceptors

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Ⓐ Local metabolism Ⓑ O2 requirements Ⓐ Atrial fibrillation Ⓑ Mitral stenosis

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Ⓐ Increased contractility of ventricle

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 46

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