Cardiovascular

A. Heart:

1. List the 3 leading causes of death in the US. (according to www.nih.gov)

a)
b)
c)

2. Discuss the anatomic borders of the heart with surgical precision.

3. Regarding the heart

a) The base is at the level of the 2nd rib
b) The apex (PMI) is in the 5th intercostal space, slightly medial to the mid clavicular line
c) Both
d) Neither

4. Regarding the heart

a) It is the size of a fist
b) It has a mass of 200-390 grams
c) It pumps @ 35 Liters of blood per minute
d) All
e) None

5. The heart is covered by a double layered membrane called the ______________.

6. The space between the visceral and parietal pericardium called the
_________ ___________ normally contains _______ml of fluid.

7. Common causes of pericarditis include

a) Infections b) Lupus and other “systemic” diseases
c) Both d) Neither
Discuss Pericardial friction rub:

8. Complications of pericarditis include

a) Effusion b) Tamponade c) Fibrous adhesions d) All

9. Which of the following is characterized by elevated intrapericardial pressure

(>15 mmHg), which restricts venous return and ventricular filling with a consequence of
decreased stroke volume and pulse pressure, and elevated heart rate and venous pressure.
a) Effusion b) Tamponade c) Fibrous adhesions d) All

10. (Complications of cardiac tamponade include: (according to Harrisson,s Principles

of internal medicine)
a) Shock b) Death c) Both d) Neither
11. Removal of fluid from the pericardial space is called ____________________

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12. The heart wall consists of
a) Endocardium b) Myocardium c) Epicardium d) All

13. Which layer of the heart wall contains Perkinje fibers

a) Endocardium
b) Myocardium
c) Epicardium
d) All
e) None

14. The myocardium is most developed in the

a) Right atrium b) Right ventricle c) Left atrium d) Left ventricle

15. The heart is divided into lateral compartments by Artial and ventricular _______

16. Blood returning to the heart from the pulmonary and systemic circuits enter the
a) Artia b) Ventricles c) Both d) Neither

17. Regarding the surface anatomy of the heart, the coronary sulcus is a groove that
marks the division between
a) Left and right atria b) Left and right ventricles
c) The atria and the ventricles d) None of the above

18. On each side of the heart, the atrium and ventricle communicate through atrio-
ventricular orifice which is protected by a ______________

19. Which valve guards the right atrio-ventricular orifice.

a) Mitral b) Tricuspid c) Aortic d) Pulmonic

20. Blood flow into the right atrium includes

a) Blood returning from the systemic circuit via the superior and inferior vena cavae
b) Blood returning from the heart via the coronary sinus
c) Both
d) Neither

21. Blood flow through heart valves is unidirectional due to the action of
a) Chordae tendinae b) Papillary muscles c) Both d) Neither

22. When the RA contracts, blood flows through the ______________valve into the RV

23. Most blood flow entering the RV is due to

a) Contraction of the RA b) Passive flow through the tricuspid valve
c) Back flow from the pulmonary circuit d) None of the above

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24. Discuss the sequence of activity which is intitated by contraction of the right
ventricle.
25.The only example in the adult in which venous blood is oxygenated is
___________________

26. Blood from the pulmonary circuit returns to the heart by entering the
a) Left ventricle b) Left atrium c) Right ventricle d) Right atrium

27. Blood flows into the LV through the

a) Aortic valve b) Mitral valve c) Tricuspid valve d) Pulmonic valve

28. When the left ventricle contracts, blood is pushed through the Aortic valve into the
a) Aorta and systemic circuit b) Pulmonary trunk and pulmonary circuit
c) Both d) Neither

29. Dysfunction of heart valves include

a) Prolapse b) Stenosis c) Regurgitation d) All

30. Which heart valve is most commonly involved in prolapse.

a) Tricuspid b) Pulmonic c) Mitral d) Aortic

31. Regarding mitral propapse

a) Affects 3% of the population
b) May progress to regurgitation
c) Females 14-30 affected most
d) Common in connective tissue disease
e) All

32. Narrowing of the lumen of a valve, with or without calcification, scarring or

degeneration is called:
a) Prolapse b) Stenosis c) Regurgitation d) None of the above

33. Aortic stenosis is associated with

a) Left ventricular hypertrophy
b) Angina
c) Syncope on exertion
d) Heart failure
e) All of the above

34. According to the formula BP=CO x TPR, it is understandable that persons with
aortic stenosis would experience syncope on exertion due to low blood pressure because
a) Exercise decreases TPR
b) A decrease in TPR is normally compensated for by raising CO to maintain BP
c) The stenosis prevents an increase in CO
d) All
e) None

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35. Regarding aortic stenosis
a) 50% of cases who experience angina will die within 5 years if untreated
b) 50% of cases who experience heart failure will die within 1 year if untreated
c) Both d) Neither

36. Aortic stenosis may be treated with

a) Diuretics
b) Nitrates and Beta blockers
c) Antioagulants
d) Valve repair or replacement
e) All of the above

37. Regarding Mitral stenosis

a) Most cases in adults are due to rheumatic heart disease
b) 60% of patients are female
c) It is often precipitated by pregnancy
d) Left ventricular filling is impaired
e) All of the above

38. Mitral stenosis may be associated with all except

a) Left ventricular hypertropathy
b) Hemoptysis
c) Systemic embolism
d) Heart failure
e) All

39. Right heart failure includes all of the following except

a) Orthopnea b) Edema c) Anorexia d) Ascites e) Fatigue

40. Left heart failure includes

a) Orthopnea
b) Dyspnea on exeretion
c) Paroxysmal nocturnal dyspnea
d) All
e) None

41. Aortic regurgitation may be associated with

a) Hill’s sign
b) Hypertension
c) Rheumatic heart disease
d) Infective endocarditis
e) All

42. Which of the following may be associated with spontaneous rupture

of cordae tendinae
a) Mitral prolapse b) Mitral regurgitation c) Mitral stenosis d) None

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43. Mitral regurgitation is characterized by heart murmur and symptoms of
a) Left heart failure B) Right heart failure c) Both d) Neither

44. In tricuspid regurgitation there is back flow of blood into the

a) Right atrium b) Right ventricle c) Left atrium d) Left ventricle

45. Tricuspid regurgitation is characterized by all except

a) Murmur b) Hepatic congestion with RUQ pain
c) Symptoms of left heart failure d) Pulsatile liver

46. Defective heart valves may be Rx with

a) Commissurotomy
b) Percutaneous Balloon valvuplasty
c) Valve replacement
d) All

47. Branches of the left coronary artery include

a) Circumflex artery
b) Posterior interventricular artery
c) Both
d) Neither

48. The marginal artery is a branch of the

a) Left coronary artery b) Right coronary artery c) Both d) Neither

49. An insult to any branch of the coronary arteries may result in

a) Valve disease b) Ischemic heart disease c) Both d) Neither

50. Common syndromes associated with ischemic heart disease include:

a) Atherosclerotic Coronary Artery Disease (ASCAD)
b) Myocardial infarction
c) Both
d) Neither

51. List the major risk factors for ASCAD

a)
b)
c)
d)
e)
f)
g)

52.The mortality rate associated with ASCAD is ___ per 1000 persons

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53. ASCAD may be associated with
a) Gouty arthritis
b) Arcus senilis
c) Diagonal ear lobe crease
d) All
e) None of the above

54: Define Angina, discuss the various types:

a) Angina pectoris
b) Unstable angina
c) Variant angina

True or False or fill in the blank

55. Myocardial infarction occurs when the heart’s demand for oxygen is less than its
supply.

56.Myocardial infarction may range in severity from asymptomatic to fatal.

57. Persons taking nitroglycerine should enhance their quality of life by using viagra

58. Electrocardiography (EKG) is 85% accurate in determining myocardial infarction

59. The worst complication of a MI is _________________

60. A person comes to the clinic with chest pain, he should be sent home without further
evaluation if his EKG is normal.

61. The MB isoenzyme of Creatine Kinase (CK) is elevated 6 hours before a heart attack.

62. Serum Glutamine Oxaloacetate (SGOT) now known as Aspartate Aminotransferase

(AST) is elevated 12 hours following a myocardial infarction.

63. Lactic Acid Dehydrogenase (LDH) is decreased 24 hours post infarction

64. A focal area of increased uptake on a radionucleotide heart scan can identify the
location of a myocardial infarction.

65. If you suspect that someone is having a heart attack you should
a) Start CPR if there is no pulse
b) Use an AED if available
c) Both
d) Neither

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66. Discuss a generic protocol for Rx of myocardial infarction
a) Oxygen status
b) Pain and anxiety
c) Arrhythmias
d) Conduction disturbance
e) Pump failure

67. What is the sequence of activity during the cardiac cycle

a) Ventricular systole, ventricular systole, atrial diastole, atrial systole
b) Atrial diastole, atrial systole, ventricular diastole, ventricular systole
c) Atrial systole, atrial diastole, ventricular systole, ventricular diastole
d) Ventricular systole, atrial systole, ventricular diastole, atrial diastole
e) None of the above

68. The term diasystole refers to

a) Contraction b) Relaxation c) Both d) Neither

69. The first heart sound (S1) relates to opening of

a) Mitral and tricuspid valves b) Aortic and Pulmonic valves
c) Both d) Neither

70. The first heart sound may be described as a

a) “Lub” b) “Dub” c) Click d) Snap

71. Normal heart sounds (S1 and S2) are related to

a) Atrial activity b) Ventricular activity c) Both d) Neither

72. S1 is heard during

a) Ventricular systole b) Ventricular diastole
c) Atrial systole c) Atrial diastole

73. A split S2 may reflect

a) Normal condition
b) Heart block
c) Atrial septal defect
d) Pulmonic stenosis
e) All of the above

74. A split S2 is usually best heard

a) On inspiration b) While holding the breath
c) On expiration d) None of the above

75. An accentuated S2A may indicate

a) Arterial hypertension b) Aortic valve syphilis
c) Both d) Neither

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76. An accentuated S1 may be due to
a) Strenuous exericise
b) Anemia
c) Hyperthyroidism
d) Mitral stenosis
e) All of the above

Matching

77. Mitral or tricuspid stenosis a) Diminished S1

78. Physiologic in new born but pathologic in older persons

(Infarction, Mitral/tricuspid incompetence) b) Varying S1

79. May relate to hypertension, CAD, aortic stenosis,

cardiomyopathy or may occur without heart disease c) Split S1

80.Complete heart block d) S3

81. First degree heart block e) S4

82. Mitral regurgitation f) Diastolic opening

snap

83. Dilation of the aorta, HTN, aortic valve dysfunction,

pulmonary HTN, Pulmonic stenosis g) Systolic ejection
click

84. Heart murmurs may result from

a) Heart valve disease
b) Dilated heart chamber
c) Intravascular irregularity
d) Increased blood flow or shunting
e) All

85. An A-V malformation could cause a murmur due to

a) Shunting b) Increased blood flow c) Both d) Neither

86. Murmurs may be classified as

a) Systolic b) Diastolic c) Continuous d) All

87. Murmurs may be classified by their

a) Pitch b) Quality c) Radiation d) All

88. The most common cause of cardiomyopathy is ______________

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89.Congestive cardiomyopathy is usually due to
a) Endocrine disorder b) Metabolic disorder
c) Heavy metal toxicity d) None of the above

90. Radiologic changes associated with cardiomyopathy include

a) Enlarged heart b) Pulmonary vascular congestion
c) Both d) Neither

91. Which of the following is caused by an autosomal dominant gene

a) Idiopathic hypertrophic subaortic stenosis (IHSS)
b) Hypertrophic obstructive cardiomyopathy
c) Both
d) Neither

92 IHSS involves all except

a) Hypertrophy of the interventricular septum
b) Decreased function of the mitral valve
c) Angina with syncope on exertion
d) CHF with dyspnea,orthopnea and PND
e) Increased vigor and vitality

93. Regarding atrial septal defect (ASD)

a) Blood is shunted Left to Right through the foramen ovale
b) Patients may be sympton free for years, but usually die between
30 and 50 years of age.
c) S/S include dyspnea on exertion and respiratory tract problems
d) Rx is surgery
e) All

94. All of the following are true regarding VSD except

a) Involves L to R shunting
b) Surgery should be done during the first year
c) Most common congenital heart defect
d) S/S include severe pulmonary hypertension, CHF, aortic regurgitation
and cardiomegaly

95. Regarding Patent Ductus Arteriosus

a) Represents 12% of congenital heart disease
b) Risk factors include maternal rubella and birth at high altitude
c) Females affected more
d) Prognosis is variable depending on size of shunt.
e) All

96. Right to Left shunts include

a) Pulmonary stenosis b) Tetrology of Fallot
c) Coartation of the aorta d) All

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97. The electrical conduction system of the heart begins in the ______________
at the __________________node which is also called the ____________________

98. If the ___________________fails to fire, a heartbeat will be initiated by another

group of cells called an ectopic pacemker.

99. When different groups of cells around the heart compete for initiation of the heart
beat the patient is diagnosed with __________________ __________________

100. When the SA node initiates a wave of depolarization the EKG will record a
a) P wave b) QRS complex c) T wave d) PR interval

101. Regarding the EKG tracing

a) The P wave represents atrial contraction (depolarization)
b) The QRS represents atrial diastole
c) Both
d) Neither

102. The electrical impulse from the SA node travels through the atria to trigger the
a) Bundle of His
b) Left and right bundle branches
c) Atrio-ventricular node
d) None of the above

103. The AV node contains small diameter fibers which _________ the rate of
conduction.

104. When the electrical impulse passes through the AV node

a) The atria continue to empty
b) The ventricles fill
c) The EKG begins to record a pause
d) All

105. Leaving the AV node, the electrical impulse travels along the atrio-ventricular
septum through large fibers (high speed) called the _________________ or the
____________________________ which also runs through the interventricular septum.

106. The fibers described in #102 sepearate to form left and right __________________
______________ which terminate in Perkinje fibers.

107. As an electrical impulse passes through the perkinje fibers

a) Left ventricle contracts b) Right ventricle contracts
c) A QRS complex is recorded d) All

108. Which of the following represents depolarization of the ventricles

a) T wave b) QRS complex c) ST segment d) T wave

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109. Regarding electrocardiography
a) Results are recorded on graph paper
b) System is calibrated so that 0.2 seconds elapse between the heavy black lines
c) There are 5 small squares between two heavy black lines
d) Each small square (time between 2 light lines) is 0.04 seconds
e) All of the above

110. The typical EKG reading is recorded on a ______second strip

111. The patient may be attached to ____ leads

112. Limb leads involve all except

a) Leads 1, 11 and 111 b) V1, V2 and V3
c) AVR, AVL,AVF d) Right arm, left arm, left foot

113. V4, V5 and V6 represent

a) Limb leads b) Chest leads c) Both d) Neither

114. Which lead are placed near the apex of the heart
a) V1 b) V2 c) V3 d) V6 e) None of the above

115 Lead AVR records electrical activity of the heart at

a) Left arm b) Left foot c) Right arm d) None of the above

116. A “demand pacemaker” is located at the

a) SA node b) AV node c) Both d) Neither

117. Ectopic pacemakers are located in the

a) Atria b) Ventricles c) Both d) Neither

118. In emergencies or pathology, ectopic pacemakers may stimulate to contract

as fast as _____ to ______ beats per minute.

Matching
119. SA node a) 30-40 beats per minute
120. AV node b) 75
121. Ectopic atrial pacemaker c) Rate on demand
122. Ventricular pacemaker d) 60

123. Important factors to consider in reading an EKG include

a)
b)
c)
d)
e)

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124. Heart rate is usually determined by the distance between
a) P waves b) R waves c) T waves d) None

125. Which set of numbers is most commonly used to determine heart rate
a) 300, 150, 100, 75, 60, 50
b) 300, 250, 214, 187, 167, 150
c) 150, 136, 125, 115, 107, 100
d) 100, 94, 88, 83, 79, 75
e) 75, 71, 68, 65 62, 60

126. In determining heart rate, you should check for

a) Abnormal waves, pauses or irregularity
b) Relationship between P waves and QRS complexes
c) P-R interval
d) QRS interval
e) All

127. Major disturbances of heart rate include

a) Bradycardia b) Tachycardia c) Both d) Neither

128. Normal sinus rhythm is characterized by

a) All waves are present b) Equal distance between similar waves
c) Both d) Neither

129. EKG tracing #1 represents

a) Bradycardia b) Tachycardia c) NSR d) None

130. EKG #2 represents__________ with a heart rate of _______

131. EKG # 3 represents _______ with a rate of _______________

132. EKG tracing #4 represents

a) Bradycardia b) Tachycardia c) NSR d) None

133. Regarding Sinus arrhythmia

a) P waves are identical b) Heart rhythm varies c) Both d) Neither

134. In wandering pacemaker, the EKG (#5) shows

a) P waves change shape b ) Varying rhythm c) Both d) Neither

135. Regarding atrial flutter (#23)

a) Heart rate 250-350
b) Identical P waves
c) May be normal
d) May reflect myocardial damage
e) All

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136. EKG # 6 shows a varying rhythm with multiple ectopic spikes but no real P waves.
This represents:
a) Normal sinus rhythm
b) Atrial fibrillation
c) Wandering pacemaker
d) Atrial flutter
e) None of the above

137. Premature ventricular contractions (PVC’s) ( seen on EKG #7-10)

a) A wide QRS is seen because electrical conduction does not follow the usual
bundle branch distribution
b) Originates from ectopic forces in the ventricle
c) followed by a long pause
d) All of the above

138. The tracing in EKG #7 represents _____________________

139. PVC’s may combine with normal beats to create

a) Bigeminy b) Trigeminy c) Both d) Neither

140. The tracing in EKG # 8 represents

a) Bigeminy b) Trigeminy c) Both d) Neither

141. A dual rhythm caused by 2 different pacemakers acting independently

as seen in EKG #11 is called ___________________________

142. Regarding EKG # 10

a) This is a normal EKG
b) The ventricle throws an uncomplicated PVC
c) A PVC falls on a T wave indicating an unstable heart
d) None of the above

143. If the SA node fails to fire

a) The heart stops b) An “escape beat” may restart the heart
c) Both d) Neither

B. Vascular

144. List five arteries where a pulse may be felt: (Must know or drop the course now!)
a)____________________
b)____________________
c)____________________
d)____________________
e)____________________

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145. The radial artery is the most common point for taking of
a) Pusle b) Arterial Blood Gases(ABG) c) Both d) Neither

142. The effectiveness of CPR is best measured at the ___________ or _________artery.

143. The adequacy of circulation in persons with diabetes or atherosclerotic disease best
determined by bilateral evaluation of :
a) Pedal pulse b) Foot temperature c) Both d) Neither

144. Systolic blood pressure refers to the force of blood against the inner wall of blood
vessels during
a) Atrial systole b) Ventricular systole c) Both d) Neither

145. What is the pulse pressure of a person who has a systolic pressure of 110 and a
diastolic pressure of 70____________

146. Blood pressure is determined by

a) Heart action
b) Blood volume
c) Peripheral resistance
d) Blood viscosity
e) All of the above

147. Regarding heart action, Cardiac output is affected by

a) Stroke volume b) Heart rate c) Both d) Neither

148. Mean arterial pressure (MAP) refers to

a) CO x TPR b) Diastolic pressure + 1/3 pulse pressure
c) Both d) Neither

149. Factors influencing peripheral resistance include

a) Vasoconstriction
b) Vasodilation
c) Psychogenic factors
d) All
e) None

150. Peripheral resistance through a blood vessel is influenced by the vessel’s

a) Length b) Radius c) Both d) Neither

151. Regarding viscosity of blood

a) Increased by hemorrhage and anemia thereby increasing BP
b) Decreased by polycythemia thereby decreasing BP
c) Both d) Neither

152. Discuss Starling’s Law of the heart in reference to blood pressure and cardiac

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output.

153. Blood flow through the venous system is largely facilitated by

a) Skeletal muscle contractions b) Respiratory movements
c) Vasoconstriction of veins d) All of the above

154. The most common cause of hypertention (persistently elevated arterial pressure) is
a) Kidney disease b) Increased blood volume c) Endocrinopathy d) Idiopathic

155. Blood returning to the right atrium constitutes

a) Pre-load b) After-load c) Both d) Neither

156. According to Starling’s Law, increased preload will increase

a) End-diastolic pressure b) Stroke volume c) Cardiac output d) All of the
above

157. Blood pressure may be elevated by

a) Nutritional factors
b) Diabetes
c) Oral contraceptives
d) Blood vessel disorder
e) All

158. Blood pressure may be influenced by abnormal function of

a) Pituitary b) Thyroid c) Adrenal d) Parathyroid e) All

159. Complications of HTN include

a) Stroke b) Atherosclerosis c) Heart failure d) All

160. Rx of Hypertension may include: (pick any and as many as you deem appropriate)
a) Stress reduction b) Low sodium diet
c) Diuretics d) Beta adrenergic blockers
e) Vasodilators f) Calcium channel blockers
g) Angiotensin converting enzyme inhibitors h) Peripherally acting Alpha
adrenergic blockers
i) Other - please indicate:

161. Central venous pressure measures blood pressure in the _____________________

162. Regarding CVP

a) Engorged neck veins may indicate an elevated CVP
b) Elevated CVP indicates a weak heart
c) Normal or decreased CVP suggest a strong heartbeat
d) All of the above

163. When two heart beats occur so close together that the second beat may be heard

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with a stethescope but no pulse is felt because it pumped little or no blood (ectopic
arrthythmia or A-Fib), the patient is said to have a _____________ ___________

164. Variations in pulse include

a) Pulsus alterans b) Pulsus parodoxus c) Both d) Neither

165. Pressorceptors are found in

a) Aorta b) Carotid arteries c) Both d) Neither

166. Which of the following arteries represent the first branches of the aorta:
a) Phrenic b) Coronary c) Celiac c) Carotid

167. Branches of the aortic arch include

a) Brachiocephalic
b) Left common carotid
c) Left subclavian
d) All of the above

168. The right subclavian and right common carotid arteries are branches of the
_______________________ artery

169. List 5 branches of the thoracic aorta

a)
b)
c)
d)
e)

170. Branches of the celiac artery include

a) Left gastric b) Splenic c) Hepatic d) All

171. The upper digestive tract is supplied by branches of the

a) Left gastric b) Splenic c) Hepatic d) All

172. The gallbladder recieves its blood supply from a branch of the
______________artery.

173. Regarding the phrenic artery

a) It is unpaired b) Supplies the diaphragm c) Both d) Neither

174. Blood supply to the gallbladder is via the cystic artery, a branch of
the:________________

175. Blood supply to the appendix is via a branch of which artery?

a) Celiac b) Superior mesenteric c) Inferior mesenteric d) Common iliac

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176.Cross section of the umbilicus would reveal the presence of:
a) One umbilical vein and two arteries
b) One umbilical vein and one artery
c) Two umbilical veins and one artery
d) Two umbilical veins and two arteries

177. Events which occur soon after birth include:

a) Closure of the foramen ovale
b) Closure of the ductus arteriosus
c) Closure of the ductus venosus
d) All of the above
e) None of the above

Fill in the blanks

178. The artery most associated with stroke is the______________________________

179. The walls of large arteries are nourished by small blood vessels called ___________

180. Blood is usually drawn from the forearm by inserting a hypodermic needle into
the __________________vein.

181. When the Inferior vena cava is blocked, blood can be shunted to the Superior vena
cava via the____________________________.

182. The largest blood vessel in the body is the________________________________.

183. The Phrenic artery supplies blood to the

a) Lungs
b) Diaphragm
c) Both
d) Neither

185. The blood supply to the vermiform appendix is derived from a branch of the
a) Superior mesenteric artery b) Inferior Mesenteric artery
c) Both d) Neither

184. Important branches of the superior mesenteric artery include

a) Renal
b) Supra Renal
c) Gonadal
d) All or the above
e) None of the above

186. Which branches of the abdominal aorta ate unpaired

a) Celiac

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 b) Superior mesenteric
c) Inferior Mesenteric
d) All

187. The inferior mesenteric artery supplies blood to the

a) Descending colon
b) Sigmoid colon
c) Rectum
d) All or the above

188. The brachiocephalic veins merge to form the

a) Superior Vena cava
b) Inferior Vena cava
c) Coronary sinus
d) None of the Above

189. All blood vessels from the stomach, intestines, spleen and pancreas drain into the
a) Hepatic vein b) Portal Vein
c) Azygous vein d) Inferior Vena cava

190. Which of the following branches of the internal carotid artery is called the
artery of stroke.
a) Opthalmic
b) Anterior chorid
c) Anterior Cerebral
d) Middle cerebral

191. Which areas on the lateral surface of the brain ate supplied by the middle cerebral
artery
a) Primary motor area b) Sensory areas for face and arms
b) Speech d) All of the above

192. Important branches of the internal carotid artery include

a) Ophthalmic b) Posterior communicating artery
c) Anterior chorid artery d) All of the above

193. Terminal Branches of the internal carotid artery include

a) Anterior cerebral b) Posterior cerebellar
d) Both d) Neither

194. Which of the following contribute the Circle of Willis

a) Internal carotid aterey b) Vertebral artery
b) Both d) Neither

195. In the fetus , blood is shunted away from the liver via the

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 a) Ductus Arteriosus b) Ductus Venosus
c) Both d) Neither

196. Blood passing through the fetal foramen ovale constitutes a

a) R to L Patologic shunt b) L to R Pathologic shunt
c) L to R physiologic shunt d) R to L physiologic shunt

197.Fetal Blood in the Pulmonary trunk is shunted to the aorta via the
a) Ductus Arteriosus b) Ductus Venosus
c) Both d) Neither

198. At birth plumonary vascular pressure

a) Increases
b) Decreases
c) No change
d) Increases then decreases
e) Decreases then increases

199. Cardiovascular changes which occur at birth include

a) Closure of Ductus Arteriosus
b) Closure of Ductus Venosus
c) Both
d) Neither

200. When does the Ductus Arteriosus normally close

a) 1st week Post partum
b) 1st Month
c) 1st Year
d) In the older child

201. Which of the following is not comparable with life after birth
a) Failure of foramen ovale to close
b) Failure of Ductus Arteiosus to close
c) Failure of Ductus Venosus to close
d) All
e) None

202. Describe the first pass effect

203. A woman experiences heavy bleeding following minor gynecologic surgery. Which
of the following arteries is not likely to be involved ?
a) Uterine
b) Internal Pudenal
c) External Pudenal
d) Lingual

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204. A person gets “blood poisoning” after picking his face. This situation is frequently
associated with thrombosis of the __________________________

205. Regarding the walls of blood vessels, the tunica adventicia is the
a) Inner layer b) Middle layer
c) Outer layer d) None of the above

206. Varicose veins involve

a) Distended blood vessels b) Incompetnt valves
c) Both d) Neither

207. Factors which promote varicosity include

a) Prolonged standing
b) Obesity
c) Pregnancy
d) Genetics
e) All of the above

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