Personal information

Student Date Of Birth Batch No

Mahboob Alam 14-Mar-01

Academic Session Subject Exam

2022-23 First Year Formative Assessment (CVS-I) - ( 2309-1 )

Marks

Total Marks Marks Obtain

70 42

Paper Question & Answers Detail`s

Which one of the following routes is the best for passing a A 4th intercostal space
needle to perform drainage of pericardial effusion 0 B 6th intercostal space at the left paravertebral angle
(Pericardiocentesis)?
C Second intercostal space in mid-clavicular line

D second intercostal space to the right of sternal angle

E Subcostal angle [T]

The nerve supply of fibrous pericardium and parietal layer of A Internal intercostal nerve
0
serous pericardium is from which of the following nerves? B Vagus nerve

C Phrenic nerve [T]

D Cardiac plexus

E Cervical sympathetic ganglia

A 40 years old man comes to the OPD with complaints of A Right Atrium [T]
shortness of breath and palpitation. The physician advises B Right ventricle
him an X ray chest PA view. on this film the right border of 1
C Superior vena cava
the heart is represented by which of the following
structures? D Left atrium

E Left ventricle

the sympathetic nerve fibers to the heart pass through which A First and second cervical ganglia
1
of the following sympathetic chain ganglia? B First, second cervical and stellate ganglia

C All cervical and first four or five thoracic ganglia [T]

D All thoracic ganglia

E All thoracic and lumbar ganglia

stimulation of sympathetic nerves to the heart causes which A It causes dilatation of coronary vessels [T]
0
one of the following effects? B It causes narrowing of coronary vessels

C it decrease the heart rate

D It participates in cardiovascular reflexes

E it decreases the force of heart contraction

Which one of the following options is correct regarding the A Smaller part of left atrium is smooth walled
1
gross features of heart chambers? B Larger part of left atrium is smooth walled [T]

C Coronary sinus is opened within left atrium

D Fibrous skeleton of the heart provide attachment to atrial muscles only

E The wall of right ventricle is thicker than left ventricle.

Regarding musculature of the left ventricle, how many A Two [T]

1
papillary muscles arise form the wall of left ventricle? B Three

C Four

D Five

E Six
Which one of the following surfaces of the heart is A Sternocostal surface
1
predominantly formed by left atrium? B Posterior surface (base) [T]

C Diaphragmatic (inferior)

D Right pulmonary

E Left pulmonary

Which of the following structure is an extension of cardiac A sarcolemma

muscle cell membrane that penetrates into the interior of the B sarcoplasm
1
cell and permits rapid transmission of action potential to
regulate intracellular calcium concentration? C t-tubule [T]

D sarcoplasm reticulum

E mitochondrion

The internal walls of atria are smooth whereas those of A Crista terminalis
ventricles are modified into ridges and columns of cardiac B auricles
muscles which ensures that the heart pumps blood 0
efficiently. What are these muscles ridges found in internal C Trabecular carneae [T]
walls of ventricles called? D Sulcus terminalis

E Musculi pectinati

Cardiac muscle cells are connected by complex structures A Gap junctions [T]
called intercalated discs. Which of the following cell B Zonula adherens
1
junctions in the intercalated disc is responsible for electrical
communication between cardiac muscle cells C Zonula occludens

D Desmosomes

E Macula adherens

Intercalated discs are complex structures that connect A Macula adherens

adjacent cardiac muscle cells. Which of the following cell B Zonula adherens
1
junctions in the intercalated disc is responsible for electrical
communication between cardiac muscle cells ? C Zonula occludens

D Desmosomes

E Gap junctions [T]

The right ventricle of the heart is formed primarily from A Primitive ventricle [T]
1
which embryonic structure? B Primitive atrium

C Bulbus cordis

D Sinus venosus

E conus cordis

In developing heart regarding cardiac looping, which of the A formed in 4th week
0
following options is mainly involved? B arterial and venous ends of the loop are fixed

C heart tube is dorsal to pericardial cavity

D bubous cordis and primitive ventricle grow rapidly in limited space ***
[T]

E tube gradually invaginate into pericardial cavity in a “U”- shape manner

Heart tube formation take place in which week of A 2nd week

1
development B 3rd week [T]

C 4th week

D 5th week

E 6th week

During development of inter ventricular septum, the A Neural crest cells [T]
membranous part of I.V septum is derived from endocardial B Paraxial mesoderm
0
cushions. From which of the following germ layers these
endocardial cushions are developed: C Intermediate mesoderm

D Somatic mesoderm

E Splanchnic mesoderm
Regarding development of ventricles, which one of the A Endoderm
following germ layer derivatives give rise to musculature of 1 B Neural crest
the heart:
C Somatic mesoderm

D Splanchnic mesoderm [T]

E Intermediate mesoderm

Depolarization phase of action potential in S.A node is due to A Fast sodium channels.
1
opening of B chloride channels

C Slow Calcium-sodium channels. [T]

D Slow potassium channels.

E Sodium-Potassium pump

The duration of a normal cardiac cycle with a heart beat of A 0.4 sec
1
75/min is B 0.8 sec [T]

C 1.2 sec

D 1.6 sec

E 2 sec

Closure of semi-lunar valves occurs at the onset of which A Isovolumic contraction

0
phase of cardiac cycle? B Isovolumic relaxation. [T]

C Protodiastole.

D Rapid ejection.

E Rapid filling

In which of the following conditions cardiac out put is most A Anemia

0
likely low? B Arterio-venous shunt

C Beri beri

D Hypothyroidism [T]

E Pregnancy

Which of the following statements is most likely regarding A Is a result of anaphylactic reaction
1
hypovolemic shock? B Is associated with high blood pressure

C Is caused by sever diarrhea and vomiting [T]

D Is caused by vasovagal reflex

E Is improve by raising head end of patient

What is the most likely cause of edema in congestive cardiac A Decrease in plasma oncotic pressure
1
failure? B Increase in capillary hydrostatic pressure [T]

C Increase in cardiac output

D Increase in peripheral resistance

E Increase in tissue oncotic pressure

Increase in which of the following substances will most A Calcium ions [T]
1
likely cause vasoconstriction? B Carbon dioxide

C Hydeogen ions

D Magnesium ions

E Potassium ions

In which of the following vessels endothelial cells act as a A Lymphatic capillaries [T]
one way minute valve facilitate inward flow while opposes 0 B Sinusoidal capillaries
outward flow and exhibit flap valve mechanism?
C Systemic capillaries

D Veins

E Venules

A 10 years old boy was brought to the emergency A Angiotensin II

department of Northwest Teaching hospital with a painful, B Epinepheine
red and swollen ankle joint after a sudden twist of ankle joint
0 C Histamine [T]
while walking down stairs.. Which of the following
substances is most likely responsible for the redness and D Leukotrienes
swelling of the joint?
E Serotonin
A 7 years old boy is stung by a bee while playing in the park. A Decreased capillary filtration
After sometime the area of the sting becomes red and B Interaction with the muscuranic receptors on the blood vessels.
0
swollen. Which of the following physiological mechanism
best describes the redness and swelling? C Vasodilation of the arterioles

D Vasodilation of the arterioles and increased capillary permeability [T]

E Vasodilation of the veins

A 14 year sold boy had a road traffic accident. He lost lots of A Decreased peripheral resistance
blood. He was brought to emergency department of B Vasoconstriction and venous pooling
1
Northwest teaching hospital with cold clammy skin. What is
the most likely cause for his cold extremities? C Vasocontriction [T]

D Vasodilation

E Venous pooling and sweating

A 48 years old woman had a hystrectomy for an ovarian cyst A Anaphylactic shock
at a local hospital. She was brought to emergency B Cardiogentic shock
department of Northwest teaching hospital 7 days post-op
with fever, pneumonia and low blood pressure. C/s report 0 C Hypovolumic shock
showed Gram negative rods. Suddenly her condition D Neurogenic shock
deteriorated deteriorated and went into circulatory shock.
E Septic shock [T]
Which Type of shock is this?

A 25 years old man is running on treadmil for last 10 A Adenosine increases and lactic acid decreases
minutes, which of the following physiological changes will 1 B Cardiac output increases [T]
most likely occur in his body relevant to circulation?
C Cardiac output increases and venous return decreases

D Oxygen demand decreases in tissues

E Total peripheral resistance increases

Failure of the ductus arteriosus is a common developmental A Above normal arterial PCO2
defect. Which of the following would most likely be present 1 B Below normal arterial PCO2
in a 12 months old infant with patent ductus arteriosus?
C Below normal arterial PO2 [T]

D Greater than normal arterial blood pressure

E Lower than normal Pulmonary arterial pressure

Which of the following is most likely true regarding the Frank A Does not operate in heart failure
1
Starling law of the heart? B Does not operate during exercise

C Does not operate during infarction

D Explains the increase in heart rate produced by exercise

E Explain the increase in cardiac output that occurs when venous return
is increased [T]

Which of the following components of excitatory conducting A A-V nodal region

system of myocardium has the fastest velocity of 1 B Bundle of His
conduction?
C Internodal pathway

D Purkinje fibers [T]

E Ventricular muscle fibers

Which of the following events most likely occurs at the end A Aortic valve opens
0
of isovolumic contraction? B Aortic valve closes

C A-V valve opens [T]

D A-V valve closes

E Pulmonary valve closes

A patient running high grade fever visited a local dispenser. A Allergen-Reagin reaction
The patient was given injection Penicillin by the dispenser B Myocardial depression caused by penicillin
without test dose. The patient suddenly collapsed. Pulse was
0 C Release of heparin from mast cells & basophils
very weak and thready. Blood pressure was not recordable.
What is the most likely cause of his sudden circulatory D Sudden vasodilatation and decreased peripheral resistance [T]
shock?
E Toxins released by bacteria
A 30 years old man was seriously injured in a road traffic A Infusion of balanced electrolyte solution
accident. He was brought unconscious to the emergency B Infusion of a sympathomimetic drug
department of Northwest Teaching hospital. His clothes are
C Infusion of dextran solution [T]
very bloody, and his arterial pressure is decreased to 60/40.
0
His heart rate is 140 per minute, and his respiratory rate is D Infusion of plasma
30/min. After securing hemostasis the doctor advised
E Iinjection of corticosteroids
immediate blood transfusion. Which therapy would be best
to recommend for the time being till blood is arranged?

Which of the following substance of likely released during A Adenosine

anaphylactic shock which causes generalized vasodilatation 0 B Bradykinin
and increased capillary permeability?
C Heparin

D Histamine [T]

E Nitric oxide

Kidneys play important role in regulation of blood pressure. A Causes renal vasodilation
Pressure diuresis is an important mechanism for lowing B Increases baroreceptor firing
1
blood pressure when it increases above normal. Pressure
C Lowers blood volume [T]
diuresis lowers arterial pressure because it:
D Lowers renal release of renin

E Lowers systemic vascular resistance

At the onset of exercise, the mass sympathetic nervous A Decreased cerebral blood flow
system strongly discharges. Which of the following would be 0 B Decreased coronary blood flow
the most likely effect?
C Decreased peripheral resistance

D Increased cardiac output [T]

E Venous dilation

Before inactivation by enzyme angiotensinase Angiotensin II A 1to 2 minutes [T]

1
remains active for: B 5 to 10 minutes

C 15 to 20 minutes

D 30 minutes

E 60 minutes

Kidneys regulate rise in blood pressure most likely by which A Decreasing urinary output of salt and water
0
of the following mechanism? B Increased urinary output of water alone

C Increasing blood volume

D Increasing urinary output of salt and water [T]

E Releasing rennin to result in formation of Angiotensin II

A19 year old patient was brought to ER and presented with A hypernatremia
abdominal pain and severe hyperglycemia.A diagnosis of B hypocalcemia
diabetic keto acidosis was made.Along with insulin and 1
dextrose infusion,calcium gluconate inj was given to prevent C hypokalemia [T]
cardiac arrhythmias due to; D hypercalcemia

E hyponatremia

A 63year old man presented with sudden onset of severe A High Na+,Low K+
dyspnea ,orthopnea,raised JVP (jugular vein pressure)and B Low Na+,High K+
bilateral basal crackles 3days after an episode of Myocardial
0 C Low Na+,Low K* [T]
infarction.A diagnosis of acute congestive cardiac failure
was made and IV furosemide was started for this D High Na+,High K+
patient.What electrolyte abnormality is expected?
E Low Na+,Normal K+

Enzyme alcohol dehydrogenase requires Zn for its activation A alpha ketoglutarate

0
to oxidize ethanol to: B acetaldehyde [T]

C Acetyl CoA

D aceto acetyl CoA

E Succinyl CoA

The earliest relaible indication of MI is A CPK-1

0
B CPK-2 [T]

C Troponin-I

D Troponin T

E CK-MB
A patient with severe chest pain was admitted to CCU. His A CKMB
labs included all relevant tests. Which of the following is B CPK
highly sensitive and specific for damage to the cardiac 0
C cTn [T]
tissue, appearing in plasma within 4 hours, and remaining
for 10 days? D LDH

E SGOT

Sensitive and specific marker for MI is A CPK

1
B Myoglobin

C SGPT

D SGOT

E Troponin [T]

Hypomagnesemia can result from decreased absorption or A Cardiac [T]

increased excretion of Mg2+. Symptoms include hyper B Hepatic
1
excitability of skeletal muscles or nerves in which of the
C Optical
following systems?
D Pulmonary

E Renal

Ketone body that is quantitatively prodominant in blood and A Acetone

1
urine in ketosis is? B Acetoacetate

C Acteyldehyde

D Aceytylcholine

E beta hydroxy butyrate [T]

THe major end product of beta oxidation of odd chain carbon A Acetyl CoA [T]
0
fatty acid chain is: B malonyl CoA

C Propionyl CoA

D Mevaloic acid

E Succinyl CoA

Wahat is the term associated with ketone bodies in urine? A Ketonemia

1
B ketonuria [T]

C ketoacidosis

D ketonosis

E ketosuria

The lipoprotein responsible for revrse cholestrol transport A chylomicrons

1
is: B HDL [T]

C IDL
D LDL

E VLDL

The tissue incapable of using ketone body is: A Brain

0
B cardiac muscle

C Renal cortex

D Red blood cell [T]

E Skeletal muscle

We have a 50-year-old man with asymptomatic A Captopril

hyperuricemia, and we are about to start therapy for newly B Hydroclorthiazide [T]
diagnosed essential hypertension (BP 136/90 mm Hg, based
1 C Labetalol
on repeated measurements with the patient supine and at
rest). Which of the following antihypertensive drugs D Losartan
decreases the blood pressure by producing a diuretic effect?
E Verapamil

A 56-year-old has not received any medical care nor seen a A Atherosclerosis [T]
physician for years. He reports reduced exercise tolerance B Congestive Heart Failure
over the past 5 years. On occasion in the past year he has
noted chest pain after ascending a flight of stairs. He C Deep venous thrombosis
smokes 2 packs of cigarettes per day. He is found to have a D Medial calcific sclerosis
0
blood pressure of 155/95 mm Hg. His body mass index is 30.
E Pulmonary Embolism
Laboratory findings include a total serum cholesterol of 245
mg/dL with an HDL cholesterol that is 22 mg/dL. Which of the

f ll i l b liti i t lik l t b hi
following vascular abnormalities is most likely to be his
most serious health risk?

A person attended the clinic for routine medical check-up. A normal

His blood pressure was found to be 155/80. the doctor 1 B High normal
should categorize his BP as
C Mild hypertension [T]

D Moderate hypertension

E Severe hypertension.

A dead body of a young male is brought to the mortuary for A Cardiovascular System [T]
autopsy to find the cause in a sudden unexpected death. The B Central Nervous System
1
most probable cause of death lies in the failure of the
C Respiratory System
following system:
D Reproductive System

E Gastrointestinal System

67 years old man presented to ER with dyspnea,palpitations A Hypercalcemia

and dizziness.ECG was done which showed polymorphic B Hyperkalemia
1
ventricular tachycardia.What is associated with development
C Hyperthyroidism
of this disease
D Hyponatremia

E Hypocalcemia [T]

Acrodermatitis enteropathica is inherited defect in the A calcium

0
transport of B copper

C magnesium

D sodium

E zinc [T]

What is the most likely effect of renin? A Angiotensin I formation [T]

1
B Decreased phosphate reabsorption

C Decreased Sodium reabsorption

D Increased sodium reabsorption

E Increased water reabsorption

which one is most likely to cause Right ventricular failure ? A Decrease in aldosterone secretion
1
B Heptomegaly (liver enlargement) [T]

C Pulmonary edema

D Reduce systemic arterial pressure

E Warm ,moist hands

Which one is most likely to support Left ventricular failure ? A Heptomegaly (enlargment of liver)
1
B Increased mean arterial pressure

C Pulmonary edema [T]

D Raised central venus pressure

E Warm ,moist hands

which one is most likely justify to the thickness of left A It has to eject almost all blood in the ventricle
1
ventricle wall than the right ventricle ? B It has to eject a greater stroke volume

C It has to eject blood against high pressure [T]

D It has to eject blood through a narrow orifice

E It is to eject blood at a high velocity

which one is most likely percentage of blood in capillaries ? A 5 percent of the total blood volume [T]
1
B 10 percent of the total blood volume

C 15 percent of the total blood volume

D 20 percent of the total blood volume

E 25 percent of the total blood volume

Which one is least likely in the blood vessel to affect the A Blood pressure
1
resistance to blood flow? B Velocity of blood [T]

C Viscosity of blood

D Radius of blood vessels

E water content

which section of blood vessel is most likely to occupy A Aorta

1
largest cross sectional area in human body? B Artery

C Artiole

D Capillary [T]

E Vein

Which one is least likely regarding capillaries function ? A They accommodate 5% of total blood volume
0
B They are fenestrated in endocrine ,intestinal villi and glomerulus

C They are permeable to plasma protein [T]

D The hydrostatic pressure decrease towards venules

E Their total wall area in an adult body exceeds 6300 meter square

which one is ,most likely characteristic of a cardiac muscle A Rapid depolarization -plaleau-rapid depolarization
1
fiber trans membrane action potential? B Rapid depolarization -plaleau-slow depolarization [T]

C Rapid depolarization-plateau-rapid repolarization

D Slow depolarization -plateau- rapid depolarization

E Slow depolarization-plateau-slow depolarization

Which one is most likely to be presented by QRS segment of A Depolarization of atria

1
ECG ? B Depolarization of ventricle [T]

C Repolarization of atria

D Repolarization of right and left atrium

E Repolariztion of ventricle