quiz cardiovascular part 1 of 3

Cardiovascular – Part 1 14Mar2009

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Cardiology #1 – Physiology: Cardiac Muscle & Contractility

1) Which of the following is true regarding intercalated discs within cardiac myocytes?

a) Areas of high resistance allowing for ion fluxes (mostly Na+) with signals

being conducted from cell-to-cell giving an all or nothing response

b) Areas of high resistance allowing for ion fluxes (mostly K+) with signals being

conducted from cell-to-cell giving a gradient response

c) Areas of low resistance allowing for ion fluxes (mostly Na+) with signals being

conducted from cell-to-cell giving an all or nothing response

d) Areas of low resistance allowing for ion fluxes (mostly K+) with signals being

conducted from cell-to-cell giving a gradient response

2) Which of the following are associated with Z-lines in cardiac muscle and allow for a

more rapid activation of the myocardium?

a) Connexin proteins

b) Troponins

c) Actin & myosin

d) Vimentin

e) Transverse tubules

3) Cardiac cells have a more complex cytoskeleton which aides the sarcomeres in

maintaining short lengths even in the face of high preloads.

a) True

b) False

4) Which of the following sarcolemmal channels differs the most in quantity between

striated and cardiac muscle?

a) Na+

b) Cl-

c) K+

d) Ca++

5) What is the function of cardiac “feet” proteins?

a) Current sensing

b) Voltage sensing

c) Current modulating

d) Voltage modulating

e) K+ acquisition

6) Which of the following is true regarding the ratio of T-tubules to terminal cisternae in

the cardiac sarcoplasmic reticulum?

a) 1 T-tubule: 1 terminal cisterna

b) 2 T-tubules: 1 terminal cisterna

c) 1 T-tubule: 2 terminal cisternae

d) 2 T-tubules: 2 terminal cisternae

e) 3 T-tubules: 3 terminal cisternae

7) Which of the following is true regarding the ratio of “feet” proteins to junctional

sarcoplasmic Ca++ release channels?

a) 1 “feet” protein: 1 Ca++ release channel

b) 2 “feet” proteins: 1 Ca++ release channel

c) 1 “feet” protein: 2 Ca++ release channels

d) 2 “feet” proteins: 2 Ca++ release channels



8) Ca++ ATPases are present on the cardiac ____ and are ____ as numerous as in skeletal

muscle.

a) Junctional sarcoplasmic reticulum; Half

b) Junctional sarcoplasmic reticulum; Twice

c) Longitudinal sarcoplasmic reticulum; Half

d) Longitudinal sarcoplasmic reticulum; Twice

e) Terminal cisternae; Half

9) The release of calcium from the junctional sarcoplasmic reticulum is dependent on:

a) Intracellular voltage changes

b) Extracellular voltage changes

c) Intracellular calcium concentration changes

d) Extracellular calcium concentration changes

10) Which of the following is true regarding phospholamban (Plb) during periods of

sympathetic activation and increased cardiac activity? SERCA = Sarco/Endoplasmic

Reticulum Ca2+ ATPase pump, PKA = Protein kinase A, SR = Sarcoplasmic reticulum

a) Dephosphorylated Plb increases SERCA, decreasing Ca++ and leading to

decreased contraction (inotropy)

b) Dephosphorylated Plb decreases SERCA, decreasing Ca++ and leading to

decreased rate (chronotropy)

c) PKA is activated and phosphorylates Plb, which increases SERCA, increasing

Ca++ and leading to increased contraction (inotropy)

d) PKA is activated and phosphorylates Plb, which decreases SERCA, increasing

Ca++ and leading to increased rate (chronotropy)

11) Which of the following best describes the process of calcium-induced calcium release

(CICR) in cardiac muscle?

a) During the action potential plateau phase, the L-type calcium current causes an

influx of trigger calcium, which binds to calcium release channels causing the SR

to absorb calcium from the muscle cell causing an increase in contractile

activation

b) During the action potential depolarization phase, the L-type calcium current

causes an influx of trigger calcium, which directly causes an increase in

contractile activation

c) During the action potential plateau phase, the L-type calcium current causes a

release of trigger calcium in the SR leading to an increase in contractile activation

d) During the action potential depolarization phase, the L-type calcium current

causes an influx of trigger calcium, which blocks calcium release channels

causing the SR to release calcium into the muscle cell causing an increase in

contractile activation

e) During the action potential plateau phase, the L-type calcium current causes an

influx of trigger calcium, which binds to calcium release channels causing the SR

to release calcium into the muscle cell causing an increase in contractile activation

12) Ca++, IP3, and DAG are known to cause Ca++ release from the SR; a mechanism

that is most important in what type of muscle?

a) Cardiac

b) Smooth

c) Skeletal



13) SR Ca++ ATPase has a high affinity for Ca++ and has been shown to be primarily

responsible for:

a) Strength of cardiac contraction

b) Speed of cardiac relaxation

c) Initiation of cardiac contraction

d) Initiation of cardiac relaxation

e) Deactivation of TnC

14) Calsequestrin, found on the SR cisternae, along with calreticulin work to ____ the

gradient between ____ and ____ compartments, taking some workload away from the SR

Ca++ ATPase pump.

a) Increase; Extracelluar; Intracellular

b) Increase; Intracellular; Intra-SR

c) Decrease; Extracelluar; Intra-SR

d) Decrease; Extracelluar; Intracellular

e) Decrease; Intracellular; Intra-SR

15) The protein sarcolumenin may help with Ca++ storage by transferring it:

a) From the junction SR to the longitudinal SR

b) From the longitudinal SR to the cisternae

c) From the cisternae to the junction SR

d) From the junctional SR to the cisternae

e) From the longitudinal SR to the junctional SR

16) When compared to SR Ca++ ATPase, the Ca++ ATPase proteins on the sarcolemma

can handle at most ____ of the calcium which must be extruded following each beat to

maintain a constant total calcium inside the SR.

a) 3%

b) 20%

c) 45%

d) 80%

e) 95%

17) The high capacity transport system, Na+/Ca++ exchanger, moves ____ Na+ inward

for each Ca++ extruded from the cell.

a) 1

b) 2

c) 3

d) 4

e) 6

18) The activity of the Na+/Ca++ exchanger increases as the cell repolarizes, with the

Vm becoming more negative.

a) True

b) False, the activity decreases

c) False, Vm becomes more positive

19) What is the effect of cardiac glycosides (e.g. digitoxin/digoxin and ouabain)?

a) Increasing cardiac inotropy

b) Increase cardiac chronotropy

c) Decreasing cardiac inotropy

d) Decreasing cardiac chronotropy



20) Which of the following would best treat digitoxin (digitalis) poisoning by competing

and displacing digitoxin from its binding site on the Na-K-ATPase?

a) Increasing intracellular K+ concentration

b) Increasing intracellular Na+ concentration

c) Increasing extracellular K+ concentration

d) Increasing extracellular Na+ concentration

21) Digitoxin poisoning slows the activity of the Na-K-ATPase resulting in:

a) A build-up of intracellular K+

b) A build-up of intracellular Na+

c) A build-up of extracellular K+

d) A build-up of extracellular Na+

22) Which of the following is true regarding the fibrocartilage atrioventricular ring?

a) It supports the AV valves

b) It separates the atria from the ventricles mechanically

c) It separates the atria from the ventricles electrically

d) A & B

e) A, B, & C

23) Regarding the cylindrical left ventricle, ejection volume is proportional to ____ the

radius of the left ventricle.

a) The square root of

b) Half of

c) Twice

d) The square of

e) The cube of

24) Increased parasympathetic tone along the right vagus nerve would most likely:

a) Increase the heart rate at the SA node

b) Increase the heart rate at the AV node

c) Decrease the heart rate at the SA node

d) Decrease the heart rate at the AV node

25) Concerning the structure of the normal heart:

a) Atria are thick-walled, low-capacity structures

b) Right ventricular muscle mass is greater than left ventricular muscle mass

c) The bicuspid and tricuspid valves are not closed by contraction of papillary

muscles

d) The pericardium is an elastic structure that helps the heart expand to hold more

blood

26) Regarding the normal circuit for blood flow (bulk flow), pressure is lowest in the:

a) Right atrium

b) Capillaries

c) Inferior vena cava

d) Arterioles

e) Systemic arteries

27) Bulk flow of blood from the aorta to the systemic veins occurs because:

a) Pressure is low in veins

b) The oxygen content of blood is different between the two vessels

c) Blood movement is driven by gravity



d) Pressure is higher in the capillaries than the aorta

28) Failure of the right ventricle to pump blood adequately can lead to:

a) Pulmonary edema

b) Decreased pressure in the right atrium

c) Pulmonary hypertension

d) Systemic edema

29) Which is the following statements concerning cardiac output is NOT true?

a) Cardiac output is approximately 5 L/min in the average adult individual

b) If cardiac output is 4 L/min, then flow through the capillaries is also 4 L/min

c) The entire blood volume transits the body once every 5 minutes in the average

adult

d) Total blood volume is approximately 8% of body weight

e) The approximate blood volume in an adult is 80ml/kg body weight

30) Failure of the left heart would lead to:

a) Decreased blood volume in the pulmonary circulation

b) Decreased pressure in the pulmonary system

c) Exudation of fluid from systemic capillaries into tissues

d) Minimal initial affect on the pulmonary circulation

e) Pulmonary capillary congestion

31) Rupture of the chordae tendinae of the heart could lead to:

a) Reflux of blood from the aorta to the left ventricle

b) Shunting of blood from the right to left atrium

c) Reflux of blood from the pulmonary artery to the right ventricle

d) Reflux of blood from the right ventricle to the right atrium

e) Edema palpable at least at the ankle and/or tibia

32) Which of the following most directly determines sarcomere length, acting as a direct

determinant of the force of cardiac contraction?

a) End-diastolic volume (EDV)

b) End-systolic volume (ESV)

c) Preload

d) Afterload

33) Which of the following is typically equal to the diastolic pressure in aortic or

pulmonary artery?



c) Preload

d) Afterload

34) The windkessel effect converts the kinetic energy of blood flow to potential energy

and then back to kinetic energy, allowing for the continuous forward flow of blood while

preventing excessive rises in blood pressure during systole. This is reliant on what

characteristic of the aortic and pulmonary arteries?

a) Rigidity

b) Diameter

c) Wall thickness

d) Curve angle

e) Compliance



35) “Diastolic run-off” occurs when the ____ valves close with ventricular pressure ____.

a) AV; Decreasing

b) AV; Increasing

c) Semilunar; Decreasing

d) Semilunar; Increasing

36) Maximal heart rate is estimated as HRmax = ____ beats/min – (one beat/min/age)

a) 100

b) 160

c) 200

d) 220

e) 260

37) What is the stroke volume during normal basal conditions?

a) 20mL

b) 70mL

c) 120mL

d) 150mL

e) 200mL

38) Which of the following describes ejection fraction?

a) (EDV – ESV) / EDV

b) (EDV – ESV) / ESV

c) (ESV – EDV) / EDV

d) (ESV – EDV) / ESV

39) Which of the following best describes cardiac output (Q)?

a) Q = Heart rate (HR) * Stroke volume (SV)

b) Q = Heart rate (HR) + Stroke volume (SV)

c) Q = Heart rate (HR) - Stroke volume (SV)

d) Q = Stroke volume (SV) - Heart rate (HR)

e) Q = Stroke volume (SV) / Heart rate (HR)

f) Q = Heart rate (HR) / Stroke volume (SV)

40) Inotropy relates to the relative contractile force of the heart given a constant:



c) Preload

d) Afterload

41) Which of the following best describes increased lusitropy?

a) Faster relaxation and large dP/dt

b) Slower relaxation and large dP/dt

c) Faster relaxation and small dP/dt

d) Slower relaxation and small dP/dt

42) The stiffness and resistance to stretch seen in cardiac muscle is due to the

extracellular matrix, pericardial sac, and cytoskeletal structure of the cardiac muscle cell.

Thus, when comparing skeletal muscle to cardiac muscle, there is a drastic:

a) Decrease in active tension

b) Decrease in passive tension

c) Increase in active tension

d) Increase in passive tension



43) An extreme preload (EDV) is needed to distend sarcomeres past optimal, leading to

congestive heart failure. Which of the following would most likely result?

a) Decreased SV, decreased EDV, increase circulatory system pressure

b) Increased SV, decreased EDV, decreased pulmonary system pressure

c) Increased SV, decreased EDV, increase pulmonary system pressure

d) Decreased SV, increased EDV, decreased pulmonary system pressure

e) Decreased SV, increased EDV, increase pulmonary system pressure

44) According to Starling's Law of the heart, cardiac output is directly related to the:

a) Size of the ventricles

b) Heart rate

c) Amount of blood returning to the heart

d) End-systolic volume

e) Cardiac reserve

45) Which of the following is true about Frank-Starling's Law of the Heart?

a) Ensures sufficient calcium is available for each contraction

b) Ensures that Cardiac Outputs (CO) for the right and left ventricles are equal

c) Has its basis in optimization of thick and thin filament overlap

d) Has its basis in the rate and quantity of calcium delivered to the myofilaments

e) B & C

f) A & D

46) When presented with an increased afterload in the aortic circulatory system, which of

the following would decrease according to the Starling Law?

a) SV of the initial contraction

b) ESV and EDV

c) Contractile force of consequent contraction

d) Preload and ventricular stretch

e) The number of structurally appropriate crossbridges

47) In cardiac and smooth muscle, there is an inverse relationship between shortening

velocity and afterload. Which of the following is true when comparing skeletal muscle to

cardiac muscle?

a) Cardiac muscle has a higher Vmax and higher velocity of shortening

b) Cardiac muscle has a higher Vmax and lower velocity of shortening

c) Cardiac muscle has a lower Vmax and higher velocity of shortening

d) Cardiac muscle has a lower Vmax and lower velocity of shortening

48) Intrinsic mechanisms for altering force of cardiac contraction are primarily dependent

upon the length-tension relationship (sarcomere length). The “Garden Hose Effect”

increases contractile force as a result of:

a) EDV

b) ESV

c) Pulmonary circulation filling

d) Systemic circulation filling

e) Coronary circulation filling

49) An increase in troponin sensitivity to calcium that would increase cardiac force at a

given calcium concentration due to increased stretch of the myocardium is an:

a) Intrinsic factor

b) Extrinsic factor



50) The positive inotropy seen in treppe is most dependent on:

a) ESV

b) EDV

c) SV

d) HR

e) CO

51) Which of the following is NOT true of the beta-receptor mediated events that cause

increased contractility when the sympathetic nervous system (SNS) is maximally active?

a) Adenylyl cyclase activity is increased

b) cAMP levels are increased

c) Protein kinases are activated

d) Various intracellular proteins are phosphorylated

e) Various sarcolemmal proteins are dephosphorylated

52) Which of the following is NOT true regarding increased SNS activity?

a) Phosphorylation of calcium channel proteins results in an increase in calcium

influx with each beat

b) Increased HR increases time for “trigger” calcium to be extruded from the cell

c) Phosphorylation of SR Ca++ ATPase protein Plb increases the rate of

resequestration of calcium

d) Lusitropy is increased resulting in quicker filling

e) Contractile force during consequent systole is increased

53) During increased SNS activity, what is the result of phosphorylation of troponin-I?

a) Decreases troponin affinity for calcium and slows relaxation of the

myocardium

b) Decreases troponin affinity for calcium and speeds relaxation of the

myocardium

c) Increases troponin affinity for calcium and slows relaxation of the myocardium

d) Increases troponin affinity for calcium and speeds relaxation of the

myocardium

54) In the presence of SNS stimulation, how can the parasympathetic nervous system

(PNS) decrease inotropy?

a) It acts as a negative inotropic agent, decreasing contractility by 30%

b) It inhibits contractility by antagonizing the SNS, decreasing cAMP and cGMP

c) It inhibits contractility by antagonizing the SNS, increasing cAMP and cGMP

d) A & B

e) A & C

55) A decrease in extracellular calcium would lead to:

a) Positive inotropy

b) Negative inotropy

c) Reverse treppe

d) Positive chronotropy

e) Negative chronotropy

56) Which of the following is least likely to lead to an extrasystole (PVC)?

a) Hypoxia

b) Caffeine

c) Low HR



d) Drugs

e) Alcohol

57) Which of the following is true regarding a premature ventricular contraction (PVC)?

a) The time after the PVC to the next heartbeat is shortened and the next heartbeat

is weaker

b) The time after the PVC to the next heartbeat is shortened and the next heartbeat

is stronger

c) The time after the PVC to the next heartbeat is lengthened and the next

heartbeat is weaker

d) The time after the PVC to the next heartbeat is lengthened and the next

heartbeat is stronger

58) In a 2nd degree AV heart block Mobitz type I (Wenckebach), the contraction interval

between the atria and ventricles lengthens until a beat is skipped. Which of the following

is true of the heartbeat immediately after the skipped beat?

a) It arises from the ventricles

b) It conducts in a backwards fashion

c) It is faster than the previous beat

d) It is weaker than the previous beat

e) It is stronger than the previous beat

59) Which of the following is NOT true regarding long-term contractility changes seen in

hypothyroidism?

a) Thyroid hormone levels decrease

b) Slow-type V3 myosin is increased

c) Fast-type V1 myosin is decreased

d) dP/dt is increased

e) Inotropy is decreased

Cardiology #2 – Physiology: Ionic Bases Of Myocardial Action Potentials

1) Which of the following would best describe cardiac cells of the sinoatrial (SA) or

atrioventricular (AV) node?

a) High resting gK, low resting gNa, Vr of about -90

b) High resting gK, low resting gNa, Vr of about -60

c) Low resting gK, high resting gNa, Vr of about -90

d) Low resting gK, high resting gNa, Vr of about -60

e) Low resting gK, low resting gNa, Vr of about -90

2) Which of the following is most responsible for the rapid depolarization seen in phase 0

of the cardiac action potential, with threshold around -70mV?

a) Rapidly decreasing gK

b) Rapidly increasing gK

c) Rapidly decreasing gNa

d) Rapidly increasing gNa

e) Rapidly decreasing gCa

3) On a vacation to Hawaii, a medical student is stung by a pufferfish. Which of the

following describes the effect of the tetrodotoxin (TTX) venom on the student?

a) It affects slow sodium channels, making the heart beat extremely fast

b) It affects slow sodium channels, stopping electrical activity



c) It affects the fast sodium channels, causing chaotic conduction

d) It affects the fast sodium channels, causing them to act like slow sodium

channels and paralyzing the heart muscle

e) If affects the slow and fast sodium channels, completely stopping all electrical

activity and conduction in the heart

4) Approximately how much time does a fast response cardiac action potential span?

a) 20ms

b) 25ms

c) 125ms

d) 250ms

e) 350ms

5) During which phase are baseline plasma Na+ levels most important?

a) Between 4 and 0, depolarization upstroke

b) Between 0 and 1, overshoot

c) Between 1 and 2, plateau

d) Between 2 and 3, systole

e) Between 3 and 4, repolarization

6) Which of the following types of gates is voltage-sensitive and thus closes during the

termination of rapid depolarization and initiation of a brief period of partial

repolarization: phase 1 (and staying closed until phase 3)?

a) h-gates

b) m-gates

c) n-gates

7) Which of the following ions flows during phase 1 due to the change in Vm within the

cell, being enhanced by beta-adrenergic stimulation and suppressed by acetylcholine?

a) Na+

b) Ca++

c) Cl-

d) K+

8) Which of the following is most responsible for the 0.1 – 0.2 second plateau near 0mV

during phase 2 (systole) of the cardiac action potential?

a) Increased gCa and decreased gNa

b) Increased gCa and increased gK

c) Decreased gCa and decreased gNa

d) Decreased gCa and increased gNa

e) Increased gCa and decreased gK

9) Which of the following is NOT true regarding the inward calcium current during the

plateau phase (phase 2) of the cardiac action potential?

a) “Slow acting” voltage-dependent Ca++ channels open

b) The Ca++ channels are sensitive at -30 to -50mV

c) The Ca++ channels require less depolarization than Na+ channels to open

d) The Ca++ channels tend to remain open longer than Na+ channels

e) The Ca++ channels do not have inactivation gates

10) Which of the following would result from a G-protein activated cAMP-dependent

protein kinase phosphorylating the Ca++ channels during the plateau phase of the cardiac

action potential, increasing the probability and duration of opening?



a) ICa decreases

b) Acetylcholine gets released

c) Inotropy increases

d) Chronotropy decreases

e) Lusitropy increases drastically

11) Which of the following would occur in a patient who is given a calcium channel

blocker, such as verapamil, nifedipine, or diltiazem?

a) Decreased length of phase 2 and decreased inotropy

b) Increased length of phase 2 and decreased inotropy

c) Decreased length of phase 2 and increased inotropy

d) Increased length of phase 2 and increased inotropy

12) During which phase of the cardiac action potential do the h-gates of the Na++

channels begin to reset, subjecting the cell to premature activation by a strong stimulus

(relative refractory period, RRP)?

a) Phase 0

b) Phase 1

c) Phase 2

d) Phase 3

e) Phase 4

13) Which of the following is most responsible for the rapid repolarization in phase 3 of

the cardiac action potential, during both the fast and slow response potentials?

a) Gradually decreasing gCa

b) Gradually decreasing gNa

c) Gradually decreasing gK

d) Gradually increasing gNa

e) Gradually increasing gK

14) During phase 4 (diastole) of the cardiac action potential, the membrane is

predominantly permeable to which ion?

a) Ca++

b) K+

c) Na+

d) Cl-

e) PO4-

15) Which of the following is primarily responsible for setting Vm (Ik1)?

a) Anomolous rectifier K+ channels

b) Transient outward K+ channels

c) Delayed rectifiers

d) Receptor operated muscarinic K+ channels

e) ATP-inhibited K+ channels

16) Which of the following hyperpolarize cardiac cells, shorten the plateau phase, and are

responsible for the bradycardic effect of the PNS?

a) Anomolous rectifier K+ channels

b) Transient outward K+ channels

c) Delayed rectifiers

d) Receptor operated muscarinic K+ channels

e) ATP-inhibited K+ channels



f) Na+ sensitive and fatty acid sensitive K+ channels

17) Which of the following is NOT true regarding phase 4 of the slow response cardiac

action potential (diastolic depolarization)?

a) A sodium “leakage” current causes gradual depolarization

b) Voltage-sensitive calcium channels open

c) Delayed rectifier channels shut down

d) Delayed rectifier current increases

e) Catecholamines would increase the rate of sodium entry

18) Which of the following is most responsible for depolarization during phase 0 and 2 of

the slow response cardiac action potential?

a) Ca++

b) K+

c) Na+

d) Cl-

e) PO4-

19) Which of the following mechanisms would increase the heart rate?

a) Threshold alterations of known mechanisms

b) Vagal stimulation (Gi activation)

c) Beta-adrenergic agonists (Gs activation)

d) Diastolic hyperpolarization

e) Opening of KACh channels

20) The absence of an action potential during the absolute refractory period (ARP) is due

to the closure of the voltage-dependent inactivation h-gates of the fast-type sodium

channel.

a) True

b) False

21) Which of the following is true regarding a stimulus and action potential during the

relative refractory period of cardiac cells?

a) A stronger than normal stimulus is required and the action potential will be of

greater magnitude

b) A stronger than normal stimulus is required and the action potential will be of

less magnitude

c) A weaker than normal stimulus is required and the action potential will be of

greater magnitude

d) A weaker than normal stimulus is required and the action potential will be of

less magnitude

Cardiology #3 – Physiology: The Cardiac Cycle

1) During which of the following phases of the cardiac cycle would the S4 heart sound be

heard due to atrial kick?

a) Atrial systole (Phase 1)

b) Isovolumic contraction (Phase 2)

c) Rapid ejection (Phase 3)

d) Reduced ejection (Phase 4)

e) Isovolumic relaxation (Phase 5)

2) Atrial contraction is always essential for ventricular filling.



a) True

b) False, it is most essential at low heart rates

c) False, it is most essential at high heart rates

d) False, it is only essential with AV stenosis

e) False, it is never essential

3) At the onset of isovolumic contraction (cardiac cycle phase 2) the Frank-Starling

mechanism exerts its maximal influence as preload is set. The ventricles contract with the

AV valves being forced shut and the ____ sound is heard.

a) S4

b) S3

c) S2

d) S1

4) On an atrial pressure curve, which of the following corresponds to the slight eversion

of the AV values under high ventricular pressure?

a) a-wave

b) c-wave

c) v-wave

d) x-descent

e) y-descent

5) 70-80% of the stroke volume is emptied from the ventricles during the rapid ejection

period, seen as which of the following on an atrial pressure curve?

a) a-wave

b) c-wave

c) v-wave

d) x-descent

e) y-descent

6) On an atrial pressure curve, which of the following is due to the continuous venous

return and increasing atrial volume after the rapid ejection phase?

a) a-wave

b) c-wave

c) v-wave

d) x-descent

e) y-descent

7) Which of the following results in 20-30% of stroke volume to be ejected and is

associated with the windkessel effect, especially during an intermittently pumping heart?

a) Reduced ventricular filling (Phase 7)

b) Atrial systole (Phase 1)

c) Isovolumic contraction (Phase 2)

d) Rapid ejection (Phase 3)

e) Reduced ejection (Phase 4)

8) During ventricular diastole (isovolumic relaxation), pressure in the ventricles drops

precipitously and approaches that of the atria, causing closure of certain heart valves and

leading to the ____ heart sound.

a) S4

b) S3

c) S2



d) S1

9) During the rapid ventricular filling phase of the cardiac cycle, the AV valves open and

blood rapidly pours into the ventricles, leading to the ____ heart sound and causing the y-

descent on the atrial pressure waveform.

a) S4

b) S3

c) S2

d) S1

10) Which of the following phases is most shortened at high heart rates?

a) Isovolumic contraction (Phase 2)

b) Rapid ejection (Phase 3)

c) Reduced ejection (Phase 4)

d) Isovolumic relaxation (Phase 5)

e) Rapid ventricular filling (Phase 6)

11) Which of the following is NOT true?

a) Right heart pressures are lower than left heart pressures

b) Right atria contract slightly before left atria

c) Right ventricular systole starts before left ventricular systole

d) Right ventricular systole ends after left ventricular systole

e) Right ventricular ejection begins before and ends after left ventricular ejection

12) Which of the following is NOT true regarding the first heart sound (S1)?

a) Heard at the initiation of ventricular systole

b) Occurs following the shutting of the AV valves

c) The sound is mostly due to the closing of the valves

d) The sound is due to the vibrations of the ventricular wall

e) The sound amplitude is dependent upon the force of contraction

13) Which of the following would lead to splitting of the S1 sound?

a) The aortic valve closing much sooner than the pulmonic

b) The pulmonic valve closing much sooner than the aortic

c) The right AV valve closing much sooner than the left

d) The left AV valve closing much sooner than the right

e) The AV valves closing at exactly the same time

14) When compared to S1, which of the following is NOT true of S2?

a) Is of higher frequency

b) Is of slower duration

c) Is of higher amplitude

15) Splitting of S2 is most commonly heard as:

a) The aortic valve closing sooner than the pulmonic

b) The pulmonic valve closing sooner than the aortic

c) The right AV valve closing sooner than the left

d) The left AV valve closing sooner than the right

e) The AV valves closing at exactly the same time

16) Which of the following heart sounds represents tensing of the ventricles at the end of

rapid filling and is typically heard in children and adolescents?

a) S4

b) S3



c) S2

d) S1

17) The S4 heart sound is associated with:

a) Atrial contraction

b) Atrial relaxation

c) Ventricular contraction

d) Ventricular relaxation

18) Which of the following is left ventricular stroke work (LVSW) in a normal heart?

MAP = mean arterial pressure (100mmHg), MPP = mean pulmonary pressure (18mmHg)

a) LVSW = EDV + ESV + MAP

b) LVSW = (ESV – EDV) / MAP

c) LVSW = (ESV – EDV) * MAP

d) LVSW = (EDV – ESV) / MAP

e) LVSW = (EDV – ESV) * MAP

19) Which of the following is a typical value for right ventricular stroke work (RVSW)?

a) 126 ergs

b) 700 ergs

c) 1260 ergs

d) 7000 ergs

e) 17,000 ergs

Match the following using the image here:

20) Opening of the aortic valve

21) Opening of the mitral valve

22) Closure of the mitral valve

23) Closure of the aortic valve

24) The area under the ventricular work curve can approximate:

a) Myocardial blood flow

b) Myocardial dysfunction

c) Myocardial oxygen utilization

d) Myocardial heat loss

e) Myocardial contraction force

25) Which of the following changes in the pressure-volume loop would be seen in a

patient with hypertension?

a) No change in volume, increase in pressure

b) No change in volume, decrease in pressure

c) No change in pressure, increase in volume

d) No change in pressure, decrease in volume

e) No changes to the pressure-volume loop

Cardiology #4 – Rheology: Blood Flow & Blood Pressure

1) Which of the following locations has the largest sum cross-sectional area and thus the

lowest mean linear velocity (Velocity = Flow / Area or Flow = Velocity * Area)?

a) Arteries

b) Arterioles

c) Capillaries

d) Venules



e) Veins

2) In which of the following locations does pressure decrease the most (dP/dt) due to a

high elastic modulus (dP/ddiameter)?

a) Arteries

b) Arterioles

c) Capillaries

d) Venules

e) Veins

3) Which of the following does NOT change in each segment of the circulatory system?

a) Velocity

b) Flow

c) Area

d) Amount of oxygen

e) Compliance (dV/dP)

4) Which group of blood vessels contains the greatest percentage of the total blood

volume?

a) Arteries because they have the largest diameter

b) Capillaries because they have the greatest total cross-sectional area

c) Arterioles because they have the highest resistance

d) Veins because they are the most distensible

5) Arteriosclerosis (“hardening” of the arteries) would most likely cause:

a) Decreased compliance and increased palpable pulse pressure

b) Decreased compliance and decreased palpable pulse pressure

c) Increased compliance and increased palpable pulse pressure

d) Increased compliance and decreased palpable pulse pressure

6) What component of arterioles is most responsible for regulating capillary hydrostatic

pressure and delivery of nutrients to the tissue?

a) Location in body

b) Compliance

c) Number of branches

d) Length

e) Diameter

7) Regulatory factors of arterioles include sympathetic stimulation, which causes

vasoconstriction, and pre-capillary sphincters, which occlude flow. These factors and

others are important as dilation and filling of all vessels would require:

a) 1 liter of blood

b) 3 liters of blood

c) 5 liters of blood

d) 15 liters of blood

e) 30 liters of blood

8) Exchange of nutrients and waste products can occur at:

a) Arterioles

b) Venules

c) Capillaries

d) A & C

e) B & C



9) A patient presents with burns that breaks down fenestrae within the capillaries. Which

of the following would most likely occur?

a) Tissue ischemia

b) Tissue hypoxia

c) Tissue edema

d) Arteriole backflow

e) Venous insufficiency

10) Which of the following is NOT correct regarding percent of total blood volume?

a) Veins contain about 55%

b) Venules contain about 5%

c) Pulmonary circulation contains about 10%

d) Arteries contain about 25%

e) Capillaries and arterioles contain <10%

11) Which of the following would most likely occur if a patient lost basal sympathetic

tone in the venous circulation?

a) Venous inflammation

b) Syncope

c) Varicosities

d) Venous thrombi

e) Myocardial infarction

12) Which of the following is true of flow if resistance is doubled?

a) Flow will quadruple

b) Flow will double

c) Flow will not change

d) Flow will be cut in half

e) Flow will be cut in quarter

13) In a vessel exhibiting laminar blood flow, at what location in the vessel cross-section

is velocity the highest (Vmax)?

a) At the center of the vessel

b) Halfway between the center and the walls

c) At the vessel walls

d) At all points along the cross-section

e) At no point along the cross-section due to turbulence

14) Which of the following describes laminar velocity of blood flow, with Q = P / R?

a) Velocity = (Resistance / Area) / Pressure

b) Velocity = (Resistance / Pressure) / Area

c) Velocity = (Area / Pressure) / Resistance

d) Velocity = (Area / Resistance) / Pressure

e) Velocity = (Pressure / Resistance) / Area

15) Which of the following describes the Bernoulli Equation for pressure?

a) Pressure = 4 * Density * Velocity

b) Pressure = 2 * Density * Velocity

c) Pressure = Density * Velocity

d) Pressure = 1/2 * Density * Velocity

e) Pressure = 1/4 * Density * Velocity



16) Even though blood is a non-Netwonian colloidal suspension, its viscosity does not

change with flow.

a) True

b) False, it increases with slowed flow

c) False, it decreases with slowed flow

17) According to the Fahraeus-Lindqvist effect, which cross-sectional location would one

find large blood components such as erythrocytes?

a) At the center of the vessel

b) Halfway between the center and the walls

c) At the vessel walls

d) At all points along the cross-section

e) At no point along the cross-section due to turbulence

18) Which of the following conditions would be the most susceptible to low oxygen

availability in tissues with “plasma skimming?”

a) Diabetes

b) Hypertension

c) Epileptic

d) Anemia

e) Wilson disease

19) Decreasing which of the following will increase Reynold’s number (NR) for the

initiation of turbulent blood flow?

a) Blood velocity

b) Blood vessel diameter

c) Blood viscosity

d) Density of whole blood

20) At which of the following locations is turbulent flow most likely due to an increased

Reynold’s number?

a) Low pressure, small diameter, bifurcating vessels

b) High pressure, small diameter, straight vessels

c) High pressure, small diameter, bifurcating vessels

d) High pressure, large diameter, straight vessels

e) High pressure, large diameter, bifurcating vessels

21) According to the Poiseuille-Hagen relationship, doubling the radius of a vessel would

have what effect on blood flow?

a) Flow would increase by 2 times

b) Flow would increase by 4 times

c) Flow would increase by 8 times

d) Flow would increase by 16 times

e) Flow would increase by 32 times

22) Which of the following is true of viscosity when hematocrit rises above normal levels

(40-45%) during dehydration or polycythemia?

a) Viscosity decreases proportionally

b) Viscosity decreases more than proportionally

c) Viscosity increases proportionally

d) Viscosity increases more than proportionally



23) Regarding a flow versus perfusion pressure curve, which of the following is true of

the critical closing pressure (CCP) and flow during sympathetic stimulation?

a) CCP will equal 20mmHg and flow will be constant

b) CCP will decreases and for a given pressure flow will decreases

c) CCP will decreases and for a given pressure flow will increase

d) CCP will increase and for a given pressure flow will decreases

e) CCP will increase and for a given pressure flow will increase

24) Which of the following is true of the pulmonary circulatory system?

a) High pressure and high resistance

b) High pressure and high compliance

c) Low pressure and high resistance

d) Low pressure and high compliance

25) Which of the following corresponds to the first audible Korotkoff sound when

auscultating the brachial artery?

a) S1 heart sound

b) S2 heart sound

c) Systolic pressure

d) Diastolic pressure

e) Atrial kick

26) Which of the following locations best coincides with brachial artery pressures?

a) Right atrium

b) Right ventricle

c) Pulmonary artery

d) Left atrium

e) Left ventricle

f) Aorta

27) If the pressure generated by the heart distended the aorta so that it contained the

entire end diastolic volume (EDV), which of the following would be true?

a) EDV = 0

b) ESV = 0

c) EDV – ESV = 0

d) ESV – EDV = 0

e) EDV + ESV = 0

28) Which of the following is NOT a determinant of central arterial blood pressure?

a) Cardiac output

b) Venous return

c) Peripheral resistance

d) Compliance

e) End diastolic volume

29) Which of the following product components of blood pressure is NOT regulated?

a) Compliance

b) Heart rate

c) Stroke volume

d) Peripheral resistance

30) A marathon runner would likely have a pulse pressure less than 40mmHg.

a) True



b) False

31) What is the mean arterial pressure (MAP) for an individual with measured blood

pressure of 120/60?

a) 60

b) 80

c) 96

d) 100

e) 120

32) Which of the following changes very little when comparing the ascending aorta to the

saphenous artery?

a) Compliance

b) Diastolic pressure

c) Systolic pressure

d) Pulse pressure

e) MAP

33) Venous pressures are greatest at what location when lying supine or prone?

a) Neck

b) Chest

c) Abdomen

d) Pelvis

e) Extremities

34) Which of the following occurs during expiration?

a) Intrapleural pressure decreases, compressing the vena cava

b) Intrapleural pressure decreases, compressing the aorta

c) Intrapleural pressure increases, compressing the vena cava

d) Intrapleural pressure increases, compressing the aorta

35) Which of the following is the most important mechanism in returning venous blood?

a) Expiration

b) Inhalation

c) Parasympathetic tone

d) Skeletal muscle pump

e) Catecholamine release

36) If blood flow is increased, which of the following is most likely true, given that HR

and SV are the major central factors affecting MAP?

a) Peripheral resistance decreases

b) Peripheral resistance increases

c) Blood pressure decreases

d) Blood pressure increases

37) Which of the following is NOT true?

a) Decreased stroke volume decreases MAP and decreases capillary flow

b) Increased heart rate increases capillary flow

c) Increased peripheral resistance increases MAP

d) Decreased heart rate decreases MAP

e) Decreased peripheral resistance lowers capillary flow

38) Which of the following is responsible for long term control of blood flow?

a) Sympathetic nervous system



b) Parasympathetic nervous system

c) Endocrine system

d) Renal system

e) Local tissue factors

39) Which of the following occurs first when certain tissues require increased oxygen and

blood flow (hyperemia) during stress?

a) Sympatholysis

b) Increased SNS drive

c) Precapillary sphincter contraction

d) Decreased vagal stimulation

e) Production of local tissue factors

40) Which of the following areas is innervated by nerves in the C1-C7 range?

a) Arteries

b) Heart

c) Arterioles

d) Veins

41) In a patient with acute hypertension (< 160mmHg), baroreceptors at the carotid sinus

and aortic arch will measure ____ and cause a reflexive ____.

a) Pressure; Inhibition of sympathetics

b) Pressure; Excitation of parasympathetics

c) Pressure; Transfer of blood from the venous to arterial side

d) Flow; Inhibition of sympathetics

e) Flow; Excitation of parasympathetics

42) Which of the following is NOT true regarding the Bainbridge Reflex?

a) Increased venous return in the atria will cause a reflex tachycardia

b) Atrial baroreceptors inhibit the vagal center

c) The vasculature is affected due to its parasympathetic innervations

d) Neural inhibition of antidiuretic hormone causes an increase in BP

e) Atrial natriuretic peptide (ANP) is released due to increased atrial volume

f) Unlike the normal baroreceptor reflex, the Bainbridge reflex is capable of

detecting and coping with changes in venous circulation

43) How does the Bainbridge Reflex decrease parasympathetic drive?

a) By increasing HR

b) By decreasing HR

c) By increasing flow

d) By decreasing flow

e) By increasing compliance

44) Which of the following best describes the action of local tissue factors (LTFs)?

a) Cause vessel dilation by relaxing precapillary sphincters

b) Cause vessel constriction by tightening precapillary sphincters

c) Cause hypertension by increasing flow

d) Cause hypotension by increasing vascular resistance

e) Cause short-term dilation via the co-release of nitric oxide and prostaglandins

45) Which of the following is a vasocontrictor (contracts smooth muscle)?

a) Hypoxia

b) Nitric oxide (NO)



c) Hypercapnia

d) Acidosis

e) Vasopressin (ADH)

46) Which of the following is a vasodilator (relaxes smooth muscle)?

a) Endothelin

b) Adenosine

c) Histamine

d) Hypokalemia

47) Which of the following describes the action of atrial natriuretic peptide (ANP)?

a) Vasoconstricting and decreases kidney excretion of electrolytes and water

b) Vasoconstricting and increases kidney excretion of electrolytes and water

c) Vasodilatory and decreases kidney excretion of electrolytes and water

d) Vasodilatory and increases kidney excretion of electrolytes and water

48) Reactive hyperemia would be most common in which situation?

a) During a myocardial infarction

b) During continual exercise

c) During long periods of rest

d) During increased sodium intake

e) During decreased myogenic tone

Cardiology #5 – Physiology: Cardiovascular Stress, Shock, & Cerebral Flow

1) Which of the following is true regarding the initiation of exercise?

a) There is a reflex tachycardia

b) Anticipatory response inhibits vagal tone

c) Anticipatory response increases sympathetic drive

d) Circulatory resistance is increased in some areas

e) Blood pressure and heart rate are decreased momentarily

2) What percentage of cardiac output goes to skeletal muscle during exercise?

a) 5%

b) 15%

c) 50%

d) 85%

e) 100%

3) Which of the following is NOT true regarding exercise?

a) Stroke volume is maximized early in exercise

b) Cutaneous blood flow rises during intense levels of exercise

c) Sympathetic induced vasoconstriction causes increased cutaneous blood flow

during exercise

d) Heart rate and stroke volume increase during exercise

e) Pulse pressure and MAP increase during exercise due to increased atrial

vasoconstriction and decreased venous capacitance through venoconstriction

4) Which of the following results from increased hydrostatic pressure during exercise?

a) Capillaries retain fluid, increasing hematocrit slightly

b) Capillaries retain fluid, decreasing hematocrit slightly

c) Capillaries lose fluid, increasing hematocrit slightly

d) Capillaries lose fluid, decreasing hematocrit slightly



5) At some point, there is a circulatory limit to maximal exercise. Which of the following

does NOT occur with exercise to exhaustion?

a) Hypothermia

b) HR maximizes

c) Stroke volume maximizes

d) Dehydration and fluid loss increase

e) Sympathetic drive overcomes capillary vasodilation

6) Which of the following orthostatic changes results in the most rapid decrease in

thoracic blood volume (30% change)?

a) Standing to supine

b) Standing to sitting

c) Supine to sitting

d) Sitting to standing

e) Supine to standing

7) Which of the following does NOT occur during a major orthostatic change resulting in

decreased central blood volume?

a) Blood flow and arterial pressure decrease initially

b) Baroreceptor reflex decreases parasympathetic drive

c) The cardio-inhibitory center of the medulla is inhibited

d) Total peripheral resistance decreases

e) Diastolic pressure remains nearly constant

8) Which of the following situations would NOT affect sympathetic capacities, thus not

cause syncope for a patient who undergoes an orthostatic change?

a) Syphilis

b) Congestive heart failure

c) Diabetes

d) Hypotension

e) Alpha-adrenergic receptor blockage

9) An infant presents with superventricular tachycardia (SVT). The attending physician

asks you to perform a Valsalva maneuver to increase vagal tone and hopefully terminate

the SVT without the use of drug therapy. Which of the following would be the best

option for this patient?

a) Have the patient attempt to forcefully exhale air

b) Have the patient breathe out through a straw

c) Have the patient bear down as if trying to defecate

d) Insert an IV line and administer a large bolus of normal saline

e) Place a bag of ice and cold water on the patient’s face

10) Which of the following is seen as a sign of progressive (severe) hemorrhagic shock,

but not a sign of compensated hemorrhagic shock?

a) Baroreceptor reflex

b) Angiotensin release increased

c) Anomolous viscosity (“sludge”)

d) CNS ischemic response at low pressures

e) Vasopressin release increased

11) Which of the following leads to increased capacitance and decreasing venous return?

a) Plasma hypovolemic shock



b) Neurogenic shock

c) Anaphalactic shock

d) Septic shock

e) Hemorrhagic shock

12) Which of the following maneuvers could help improve a patient who lost

autoregulation of cerebral blood flow due to a particular potent vasodilator?

a) Increasing blood pressure

b) Decreasing blood pressure

c) Increasing breathing rate

d) Decreasing plasma volume

e) Increasing cerebral paCO2 levels

13) Cerebral circulation has excellent autoregulation between what MAP ranges?

a) 20mmHg to 100mmHg

b) 70mmHg to 120mmHg

c) 30mmHg to 130mmHg

d) 60mmHg to 160mmHg

e) 40mmHg to 220mmHg

14) Which of the following vascular locations is least regulated by sympathetic nervous

system control?

a) Brain

b) Extremities

c) Neck

d) Heart

e) Spleen

15) The Cushing phenomenon would most likely be activated in which of the following

patient presentations?

a) Adrenal deterioration

b) Myocardial infarction

c) Cerebral tumor

d) Congestive heart failure

e) Epileptic seizure

16) Which of the following explains the principle behind cerebral functional magnetic

resonance imaging (fMRI)?

a) Cortical release of 14C-2-deoxyglucose is associated with cerebral stroke

b) Neuronal uptake of Ca++ is associated with regional neural activity

c) Neuronal release of 14C-2-deoxyglucose is associated with retinal stimulation

d) Cortical blood pressure is associated with regional glucose tolerance

e) Cortical blood flow is associated with regional neural activity

17) Which of the following (local tissue factors) has the largest impact on cerebral blood

flow (can double flow)?

a) Hyperosmolarity

b) Hypoxia

c) Hyperkalemia

d) Hypercapnia

e) Inorganic phosphate

18) Which of the following would lead to the greatest amount of cerebral vessel dilation?



a) Decreased hydrogen ion in the arterial blood

b) Decreased hydrogen ion in the cerebrospinal fluid

c) Increased hydrogen ion in the arterial blood

d) Increased hydrogen ion in the cerebrospinal fluid

19) Which of the following is a potent dilator of the pial arterioles and is released in

response to cerebral hypoxia?

a) K+

b) CO2

c) Brain naturetic peptide

d) Adenosine

e) Prostacyclin

Cardiology #6 – Physiology: Capillary Exchange & Coronary Circulation

1) Which of the following locations would withstand the highest relative pressure

according to the Laplace equation? (Tangential hoop tension ranges from 16-200,000

dynes/cm^2)

a) Aorta

b) Vena cava

c) Arterioles

d) Venules

e) Capillaries

Match the type of capillary with the location:

2) Renal glomeruli a) Continuous type

3) Muscle, nervous system, fat b) Fenestrated “open” type

4) Liver, bone marrow, spleen c) Fenestrated “closed” type

5) Endocrine glands d) Discontinuous/sinusoidal type

6) Capillary endothelial cells are able to detect ischemia and alert portions of the

upstream circulation with a mechanism involving:

a) Adenosine

b) Nitric oxide

c) CO2

d) K+ & H+

e) Vasopressin

7) Which of the following describes the Starling equation for flow? kf = filtration flux

constant, Pc = hydrostatic capillary pressure, Pi = hydrostatic interstitial pressure, !c =

oncotic capillary pressure, !i = oncotic interstitial pressure

a) Flow = kf * ((Pc + !i) – (Pi + !c))

b) Flow = kf * ((Pc + !c) – (Pi + !i))

c) Flow = kf * ((Pi + !i) – (Pc + !c))

d) Flow = kf + ((Pc + !c) – (Pi + !i))

e) Flow = kf + ((Pi + !c) – (Pc + !i))

8) Which of the following scenarios would increase hydrostatic capillary pressure (Pc)?

a) Ateriolar or venous constriction

b) Ateriolar or venous dilation

c) Ateriolar constriction or venous dilation

d) Ateriolar dilation or venous constriction



9) Which of the following would NOT affect hydostatic interstitial pressure (Pi)?

a) Tissue edema

b) Capillary filtration and absorption

c) Hematocrit value

d) Tissue compliance

e) Lymph drainage

10) Which of the following locations has the lowest Reflection Coefficient, thus the

highest permeability relating to oncotic pressure?

a) Brain

b) CNS

c) Skeletal muscle

d) Kidney

e) Bone

11) During surgery, a patient’s MAP drops and the anesthesiologist hangs albumin for IV

administration. Which of the following factors is being most affected by this colloid?

a) Pc = hydrostatic capillary pressure

b) Pi = hydrostatic interstitial pressure

c) !c = oncotic capillary pressure

d) !i = oncotic interstitial pressure

12) Which of the following situations would lead to decreased arteriolar filtration and

increased venular reabsorption?

a) Arteriolar dilation

b) Dehydration

c) Increased venous pressure

d) Hypoproteinemia

e) Venous constriction

13) A patient undergoes a Swan-Ganz catheterization to measure pulmonary capillary

wedge pressure. After testing, left ventricular failure is suspected. Which of the following

would be the most likely clinical sign?

a) Venous obstruction

b) Peripheral edema

c) Exercise-induced dysrhythmia

d) Lymphatic obstruction

e) Pulmonary edema

14) Even with highly permeable capillaries, the lympatics tend to keep which of the

following values low?

a) Pc = hydrostatic capillary pressure

b) Pi = hydrostatic interstitial pressure

c) !c = oncotic capillary pressure

d) !i = oncotic interstitial pressure

15) Which of the following locations does NOT normally receive venous return from the

coronary circulation?

a) Coronary sinus

b) Right atrium

c) Left atrium

d) Right ventricle



e) Left ventricle

16) Typically, which of the following is true when comparing the left and right coronary

artery flow to aortic pressure (flow)?

a) The left coronary artery follows aortic pressure

b) The right coronary artery follows aortic pressure

c) Both coronary arteries follow aortic pressure

d) Neither coronary artery follows aortic pressure

Cardiology #7 – Physiology: Physical Performance & Cardiovascular Exercise

1) Which of the following describes energy charge (") within cells?

a) " = ([ATP] + [ADP] / 2) / ([ATP] + [ADP] + [AMP])

b) " = ([ATP] / 2 + [ADP]) / ([ATP] + [ADP] + [AMP])

c) " = ([ATP] + [ADP] / 2) / ([ATP] - [ADP] - [AMP])

d) " = ([ATP] / 2 + [ADP]) / ([ATP] - [ADP] - [AMP])

e) " = ([ATP] / 2 + [ADP] / 2) / ([ATP] * [ADP] * [AMP])

2) Health-related physical fitness is most profoundly influenced by genetics.

a) True

b) False, it is most influenced by exercise habits

c) False, it is most influenced by the environment

3) Aerobic fitness is inversely related to the incidence of coronary heart disease and

hypertension.

a) True

b) False

4) Which of the following describes volume of oxygen used (VO2)?

a) The oxygen consumed by an organism to maintain skeletal muscle function and

replenish Ca++

b) The oxygen consumed by an organism to support vital cardio-respiratory

processes

c) The oxygen consumed by an organism to sustain organism life for 24 hours

d) The maximal volume of oxygen which can be consumed by an organism for

aerobic energy production during exercise

e) The oxygen consumed by an organism to combust energy sources in order to

maintain and replenish ATP

5) Which of the following describes VO2, which is about 0.25L/min for a 70kg person?

a) VO2 = (HR + SV) * (aO2 – vO2)

b) VO2 = (HR + SV) * (aO2 + vO2)

c) VO2 = (HR – SV) * (aO2 – vO2)

d) VO2 = (HR – SV) * (aO2 + vO2)

e) VO2 = CO * (aO2 – vO2)

6) For an average man with hematocrit (Hct) of 42%, or 14mg Hb/dL, how much oxygen

is carried in one deciliter (100mL) of blood?

a) 1.34mL

b) 14mL

c) 16mL

d) 21mL

e) 42mL



7) Which of the following would be used for categorizing a person who has a VO2max of

34-42mL O2/kg/min?

a) Unfit (unfit)

b) Sedentary (average)

c) Minimally trained (good)

d) Well trained (optimal)

e) Superior (elite athlete)

8) Which of the following is NOT a component of musculoskeletal fitness?

a) Muscular strength

b) Muscular endurance

c) Muscle size

d) Flexibility

9) Postural control is a component of which of the following?

a) Cardio-respiratory fitness

b) Musculoskeletal fitness

c) Motor fitness

d) Metabolic fitness

10) Which of the following components relates to the maintenance of ATP concentrations

of about 5mM even during intense exercise?



c) Motor fitness


e) Morphological fitness

11) Which of the following mechanisms is NOT correct with regard to metabolic fitness?

a) Creatine phosphate + ADP <=>ATP + Cr

b) 2 ADP <=> ATP + AMP

c) Glucose => 2 ATP + 4 pyruvate + 2 NADH

d) Kreb cycle production of NADH, FADH2, and ATP from GTP

e) Beta-oxidation of fatty acids and use of glycerol

f) Amino acid degradation, gluconeogenesis

g) Electron transport chain use of NADH and FADH2

12) During steady-state exercise at a level less than 70-80% of VO2max, what energy

source is relied on most heavily, especially in aerobically fit individuals?

a) Beta-oxidation of fatty acids

b) Rephosphorylation of ATP via creatine phosphate

c) Kreb cycle

d) Glucose and glycogen

e) Gluconeogenesis

13) What muscle fibers are mainly responsible for locomotion and may become fatigued

as glycogen levels decrease during low to moderate exercise?

a) Type I

b) Type I and IIa

c) Type I and IIb

d) Type IIa and IIb

e) Type IIa, IIb, and IIx



14) Which of the following techniques would be most beneficial to maintain glycogen

levels for an individual planning on running a marathon?

a) Sodium loading the day before the marathon

b) Hydration with water only, avoiding sports drinks

c) Imbibition of dilute glucose the day prior to the marathon

d) Heavy caffeine use through “energy drinks”

e) Carbohydrate depletion and loading cycles

15) Bone tensile strength is a component of:



c) Motor fitness


e) Morphological fitness

16) Which of the following principles of aerobic training and conditioning relates to the

degree of stress put on the system in question, such as increasing weight or running

longer distances?

a) Specificity

b) Overload

c) Progression

d) Warm-up/Cool-down

e) Individual differences

17) Which of the following describes training heart rate, which is approximated at 50-

60% of VO2max? (HRmax = 220 – age)

a) HRtraining = HRrest + ((HRmax – HRrest) * 70%)

b) HRtraining = HRrest + ((HRmax – HRrest) * 60%)

c) HRtraining = HRrest + ((HRmax – HRrest) * 50%)

d) HRtraining = HRmax + ((HRmax – HRrest) * 70%)

e) HRtraining = HRmax + ((HRmax – HRrest) * 60%)

18) Which of the following is the most important when considering aerobic exercise?

a) Duration of 20-40 minutes

b) Duration of >60 minutes

c) Intensity

d) Frequency of 3-4 times per week

e) Frequency of 5-7 times per week

19) Which of the following would NOT be a result of chronic aerobic training?

a) Increased left ventricular muscle mass and efficiency

b) Increased number of red blood cells and blood volume

c) Increased glycogen use and lipid sparing

d) Increased capillary and mitochondrial densities in skeletal muscle

e) Increased lactate tolerance (H+ buffering capacity)

20) During exercise, venous oxygenation (right atrium) decreases from 75% to:

a) 70%

b) 50%

c) 25% James Lamberg

d) 10%



AnswerKey

Card #1

1) C

2) E

3) A

4) D

5) B

6) A

7) B

8) C

9) C

10) C

11) E

12) B

13) D

14) E

15) B

16) B

17) C

18) A

19) A

20) C

21) B

22) E

23) D

24) C

25) C

26) A

27) A

28) D

29) C

30) E

31) D

32) C

33) D

34) E

35) C

36) D

37) B

38) A

39) A

40) C

41) A

42) D

43) E

44) C

45) E

46) A

47) D

48) E

49) A

50) D

51) E

52) B

53) A

54) C

55) B

56) C

57) D

58) E

59) D

Card #2

1) B

2) D

3) D

4) D

5) B

6) A

7) C

8) E

9) C

10) C

11) A

12) D

13) E

14) B

15) A

16) D

17) D

18) A

19) C

20) A

21) B

Card #3

1) A

2) C

3) D

4) B

5) D

6) C

7) E

8) C

9) B

10) E

11) C

12) C

13) D

14) C

15) A

16) B

17) A

18) E

19) C

20) D

21) A

22) C

23) F

24) C

25) A

Card #4

1) C

2) B

3) B

4) D

5) A

6) E

7) E

8) C

9) C

10) D

11) B

12) D

13) A

14) E

15) D

16) B

17) A

18) D

19) C

20) E

21) D

22) D

23) D

24) D

25) C

26) F

27) B

28) B

29) A

30) A

31) B

32) E

33) E

34) C

35) D

36) D

37) E

38) C

39) D

40) B

41) A

42) C

43) C

44) A

45) E

46) B

47) D

48) B

Card #5

1) E

2) D

3) C

4) C

5) A

6) E

7) D

8) B

9) E

10) C

11) B

12) C

13) D

14) A

15) C

16) E

17) D

18) D

19) D

Card #6

1) E

2) B

3) A

4) D

5) C

6) B

7) A

8) D

9) C

10) D

11) C

12) B

13) E

14) D

15) C

16) B

Card #7

1) A

2) B

3) A

4) E

5) E

6) D

7) B

8) C

9) C

10) D

11) C

12) A

13) B

14) E

15) E

16) B

17) A

18) C

19) C

20) C

quiz cardiovascular part 1 of 3

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