Quiz
CC - Cardiac
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Questions in this quiz (75)
1The normal resting potential of the ventricular cell is largely the result of the:
- AExtracellular movement of sodium
- BExtracellular movement of potassium
- CIntracellular movement of negatively charged proteins
- DIntracellular movement of calcium
2Match the loop with corresponding cardiac pathology.
Mitral Stenosis [blank_start]-[blank_end]
Mitral Regurgitation [blank_start]-[blank_end]
Aortic Stenosis [blank_start]-[blank_end]
Aortic Regurgitation [blank_start]-[blank_end]
- AA
- BB
- CC
- DD
- EE
- FA
- GB
- HC
- ID
- JE
- KA
- LB
- MC
- ND
- OE
- PA
- QB
- RC
- SD
- TE
3After perfusing the myocardium, most of the blood returns to the right atrium via the:
- Acardiac veins
- Bbronchial veins
- Cazygous vein
- Dcoronary sinus
4In the normal patient, the orifice of the mitral valve is approximately:
- A1 - 1.5 cm^2
- B2 - 3.5 cm^2
- C4 - 6 cm^2
- D7 - 9 cm^2
5A 65 year old male is undergoing a TURP under general anesthesia. During the procedure a CVP catheter is placed to facilitate fluid management and this tracing... is obtained. This tracing is consistent with:
- AFluid overload
- BMitral stenosis
- CVSD
- DTricuspid regurgitation
632 year old female with mitral regurgitation is scheduled for a myomectomy. management should include...
- Amaintenance of blood pressure with phenylephrine
- Bcareful avoidance of tachycardia with an esmolol infusion
- Cafterload reduction with a nitroprusside infusion
- Dthe avoidance of regional anesthesia
7The area of the myocardium most vulnerable to ischemia is the:
- Aright epicardium
- Bright subendocardium
- Cleft epicardium
- Dleft subendocardium
8The Bainbridge reflex: Select 2
- Ais elicited as a result of an increased volume of blood in the heart
- Bcauses a slowing of the heart
- Ccauses a decrease in ADH secretion
- Dcauses a decrease in ANP release
- Eincrease venous sequestration of blood
9An 84-year-old man with a history of severe aortic stenosis is scheduled for a cystoscopy to evaluate his hematuria. The most appropriate anesthetic technique in this patient would be:
- Aa spinal anesthetic to the T10 level
- Ban epidural anesthetic to the L2 level
- Can inhalational anesthetic with desflurane and oxygen
- Da local anesthetic with narcotic/benzodiazepine sedation
10During depolarization of the ventricular cell, activation of the slow calcium channels occurs during phase:
- A0
- B1
- C2
- D3
11During repair of a perforated colonic diverticula, the following hemodynamic parameters were obtained: mean arterial pressure = 92 mmHg, central venous pressure = 2 mmHg and cardiac output = 7.5 L/min. From this, the systemic vascular resistance can be calculated to be:
- A550 dyn sec / cm^5
- B960 dyn sec / cm^5
- C1240 dyn sec / cm^5
- D1670 dyn sec / cm^5
12This EKG rhythm strip is considered:
- AWPW syndrome
- B1st degree AVB
- Ccomplete heart block
- DWenkebach block
13Auscultatory findings associated with mitral valve prolapse include a: (Select 2)
- Aholosystolic murmur
- Bmid-systolic click
- Clate systolic murmur
- Ddiastolic murmur
14During cardiopulmonary bypass, roller pumps:
- Amaintain output regardless of the systemic resistance encountered
- Brequire complete occlusion of the tubing in order to pump blood
- Care usually placed between the venous cannula and the reservoir
- Dcause less trauma to the blood cells than centrifugal pumps
15Electrophysiologic effects of verapamil are the result of:
- Abinding to the slow L-type calcium channels
- Bbinding to the slow T-type calcium channels
- Cbinding to calcium channels in their resting active state
- Dinhibiting potassium efflux during myocardial repolarization
16The rhythm strip is consistent with:
- AAV pacing
- Bcomplete heart block
- CMobitz II block
- Dan intraventricular conduction delay
17The incidence of cardiac complications in surgical patients 50 years of age and older, having non-cardiac surgery is approximately [blank_start]-[blank_end]%
- A10
18A potent endothelial-derived vasodilator that has also been shown to inhibit platelet aggregation is:
- Athromboxane A2
- Bprotein C
- Cnitric oxide
- Dthrombomodulin
19In the figure, the orange mark corresponds to lead:
- ALead I
- BLead II
- CLead III
20Anatomically, the sinoatrial node is located:
- Ain the right atrium at the junction of the superior vena cava
- Bin the left atrium at the insertion of the superior pulmonary vein
- Cin the septal wall of the right atrium anterior to the opening of the coronary sinus
- Din the AV groove
21In the normal patient, the major determinant of left ventricular preload is:
- ALV contractility
- Bsystemic vascular resistance
- Cheart rate
- Dpulmonary venous return
22The hexaxial reference system is often used to show the vector of depolarization or axis of the electrocardiogram. Match the Vectors with the correct letter in the picture
C [blank_start]-[blank_end]
D [blank_start]-[blank_end]
E [blank_start]-[blank_end]
F [blank_start]-[blank_end]
- AI
- BII
- CIII
- DAVF
- EAVL
- FAVR
- GI
- HII
- IIII
- JAVF
- KAVL
- LAVR
- MI
- NII
- OIII
- PAVF
- QAVL
- RAVR
- SI
- TII
- UIII
- VAVF
- WAVL
- XAVR
23Most of the perfusion of the left ventricle occurs:
- Aupon the opening of the aortic valve
- Bupon the closing of the aortic valve
- Cat the point of peak aortic blood flow
- Dupon closing of the mitral valve
24The ECG findings in the figure have been associated with:
- Ahypermagnesemia
- Bhyperkalemia
- Ccongenital short QT syndrome
- Dprocainamide administration
25Contraction of the cardiac myocyte occurs when intracellular calcium levels rise and the calcium binds to:
- Atropomyosin
- Btroponin I
- Ctroponin C
- Dtroponin T
26The pulmonary artery tracing below is most consistent with:
- Anormal ventricular function
- Bmitral stenosis
- Cmitral regugitation
- Ddiastolic dysfunction
27Compensatory mechanisms generally present in patients with congestive heart failure include:
(Select 2)- Adecreased peripheral vascular resistance
- Bincreased catecholamine production
- Cincreased venous capacitance with a reduction in preload
- Dincreased ADH secretion
- Ereduced renin production
- Freduction in plasma aldosterone levels
2828 year old female is scheduled for a lap chole. PMI is significant for fainting episodes and her ECG shows prolongation of the QT interval. Anesthetic management should include: (Select 2)
- Ahyperventilation to achieve a PaCO2 < 35 mmHg
- Bpremedication to reduce pre-op anxiety
- Cthe administration of beta-blockers
- Dthe administration of droperidol to reduce the incidence of post-op nausea & vomiting
29The greatest degree of volume overload of the left ventricle is seen in patients with:
- Aaortic regurgitation
- Baortic stenosis
- Cmitral regurgitation
- Dmitral stenosis
30Anatomically, the atrioventricular node is located:
- Ain the right atrium at the junction of the superior vena cava
- Bin the left atrium at the insertion of the superior pulmonary vein
- Cin the septal wall of the right atrium anterior to the opening of the coronary sinus
- Din the AV groove
31According to LaPlace's law, ventricular wall tension can be decreased by:
- Aincreasing wall thickness
- Bincreasing intraventricular pressure
- Cincreasing the ventricular radius
- Dincreasing the afterload
32The ST segment changes in the rhythm strip are likely to be seen in a patient with:
- Ahypokalemia
- Bhypothermia
- Chypocalcemia
- Drenal failure
33Arterial pulse pressure is inversely proportional to the:
- Acompliance of the arterial tree
- Bpreload
- Cafterload
- Dstroke volume
34During cardiopulmonary bypass, reduction of the core temperature to 27 degrees Celcius, results in a reduction of oxygen consumption of approximately [blank_start]-[blank_end] %
- A50
35Volatile anesthetic agents:
- Adepress the entry of calcium into the myocardial cells
- Bstimulate the muscarinic receptors of the vagus
- Cincrease the sensitivity of the contractile proteins to calcium
- Dcause greater myocardial depression in patients with hypercalcemia
36The rhythm strip is consistent with:
- Afirst degree block
- BMobitz I block
- Cmobitz II block
- Dcomplete heart block
37Unstable angina is defined as:
(Select 3)- Achronic angina that become more frequent
- Bangina at rest
- Ca repeating sharp parasternal pain lasting several seconds
- Da repeating dull aching parasternal pain lasting several hours
- Enew onset angina
38Blood flow through the systemic capillaries is
- Anon-pulsatile
- Bturbulent
- Ccontrolled by sympathetic innervation to the capillary walls
- Dgreatest on the venous side of the capillary
39During initiation of cardiopulmonary bypass in the adult patient, pump flow is gradually increased to [blank_start]-[blank_end] L/min/m^2
- A2
40Heart rate is normally controlled by the:
- ASA node
- BAV node
- Cbundle of HIS
- DPerkinje fibers
41In the normal patient, loss of atrial contraction will reduce ventricular filling by approximately [blank_start]-[blank_end] %
- A20
42Causes of secondary hypertension include: (Select 2)
- Ahypoaldosteronism
- Bhypercortisolism
- Chepatic failure
- Drenal artery stenosis
- Ecritical aortic stenosis
43Most of the changes in coronary arterial blood flow are the result of:
- Aparasympathetic stimulation
- Balpha-adrenergic stimulation
- Cbeta-adrenergic stimulation
- Dlocal metabolic demand
44Normal aortic valve orifice area in the adult is approximately:
- A1 - 2 cm^2
- B2.5 - 3.5 cm^2
- C4 - 5 cm^2
- D5.5 - 6.5 cm^2
45Patients with a sinus arrhythmia experience an increase in heart rate:
- Aduring a forced exhalation
- Bduring a Valsalva maneuver
- Cduring inspiration
- Das a result of increased sympathetic tone
46The majority of myocardial oxygen demand occurs during:
- Aventricular filling
- Bisovolumetric contraction
- Cventricular ejection
- Disovolumetric relaxation
47In the figure, the orange mark represents -
- Afilling
- Bejection
- Cisovolumetric contraction
- Disovolumetric relaxation
- EMV opens
- FMV closes
48Pharmacological agents that reduce the conversion of plasminogen to plasmin and interfere
- Adesmopressin
- Baminocaproic acid
- Cheparin
- Drecombinant factor VIIa
49An 24-year-old man with a history of severe hypertrophic cardiomyopathy is scheduled for a staging laparoscopy to evaluate Hodgkin's lymphoma. Anesthetic considerations in this patient include the use of:
- Aafterload reduction with nitroprusside
- Binotropic support with dopamine to maintain cardiac output
- Cphenylephrine as a vasopressor as needed
- Dloop diuretics to minimize preload
50In the heart, the fastest conduction velocities are found in the:
- ASA node
- BAV node
- CHis-Purkinje system
- Dright ventricular myocytes
51From the pressure-volume loop provided, calculate the ejection fraction:
Approximately [blank_start]-[blank_end] %
- A60
52In the healthy adult at rest, the coronary blood flow is approximately:
- A250 mL/min
- B500 mL/min
- C750 mL/min
- D1000 mL/min
53During cardiopulmonary bypass, carbon dioxide elimination is dependent on:
- Athe thickness of the blood film in contact with the membrane
- Btotal gas flow to the oxygenator
- Cthickness of the oxygenator membrane
- Doxygen concentration in the gas flow to the oxygenator
54Initiation of cardiopulmonary bypass is associated with a decrease in:
- Avasopressin levels
- Bplasma cortisol levels
- Cplatelet glycoprotein receptors
- Dfibrinolysis
55Cardiac sympathetic fibers originate from:
- Acranial nerve X
- BC3 - C5
- CT1 - T4
- DT6 - T9
56The rhythm strip is consistent with:
- Abundle branch block
- BAV pacing
- Cventricular pacing
- Dcomplete heart block
57Slowly climbing a single flight of stairs corresponds to approximately:
- A2 metabolic equivalents (METs)
- B4 metabolic equivalents (METs)
- C8 metabolic equivalents (METs)
- D16 metabolic equivalents (METs)
58During cardiopulmonary bypass, hypertension is said to exist if the mean systemic pressure exceeds:
- A75 mmHg
- B100 mmHg
- C110 mmHg
- D120 mmHg
59During initiation of cardiopulmonary bypass in the adult patient, mean systemic pressures fall as a result of:
- Ainadequate pump output
- Ba decrease in blood viscosity
- Cvasoconstriction in response to hypothermia
- Dvasodilation from histamine release
60Local anesthetics depress cardiac conduction by:
- Abinding to the slow calcium channels
- Bbinding to potassium channels
- Cdirectly stimulating the SA node
- Dbinding to fast sodium channels
61The primary determinant of systemic vascular resistance in the normal patient is:
- Ablood viscosity
- Barteriolar tone
- Cthe elastic properties of the aorta and large vessels
- Dthe gradient across the aortic valve
62Pulmonary hypertension is defined as:
- Asustained pulmonary systolic pressure greater than 30
- Bsustained pulmonary mean pressure > 25
- Csustained pulmonary artery occlusion pressure > 25
- Dsustained pulmonary artery diastolic pressure > 18
63Under normal conditions, oxygen saturation in the coronary sinus is approximately [blank_start]-[blank_end] %
- A30
64Signs and symptoms consistent with cardiac tamponade include:
(Select 2)- Aincreased voltage seen in the precordial leads of the ECG
- BJVD
- Cmuffled heart sounds
- DCVP and pulmonary artery occlusion pressure < 100 mmHg
- Ebradycardia
65On the CVP tracing below, ventricular contraction corresponds best with:
- AA
- BB
- CC
- DD
665'10" 175 pound patient is undergoing coronary artery bypass grafting. During the procedure the CO is 4.5 L/min. From this information, the cardiac index is calculated to be:
[blank_start]-[blank_end] L/min/m^2- A2.27
67The two most important preoperative cardiac risk factors are unstable angina and:
- Aevidence of congestive heart failure
- Bprevious myocardial infarction with Q-wave presence
- Cinsulin dependent diabetes mellitus
- Drenal insufficiency
68A 73-year-old man is brought to the operating room for repair of multiple lacerations and reduction of bilateral femur fractures. His past medical history includes atrial fibrillation and he is receiving coumadin daily. The most rapid reversal of the anticoagulation effects of coumadin can be achieved with:
- Aaminocaproic acid
- Bprotamine
- Cvitamin K
- Dfresh frozen plasma
69The transplanted heart:
- Aresponds normally to atropine
- Bresponds normally to ephedrine
- Cusually has a low resting rate (50-60 beats/min)
- Dhas a normal starling relationship between preload & CO
70In the absence of anemia or hypoxia, the best determinant of the adequacy of cardiac output is:
- Athermodilution cardiac output
- Bmixed venous oxygen saturation
- Cdye dilution cardiac output
- Dthe cardiac index
71Normally, the largest fraction of the total blood volume is found in the:
- Avenous system
- Barterial tree
- Ccapillary system
- Dpulmonary circulation
72The rhythm strip below is consistent with:
- A1st degree block
- BMobitz I block
- CMobitz II block
- Dcomplete heart block
73During cardiopulmonary bypass, centrifugal pumps:
- Amaintain output regardless of the resistance encountered
- Bcan deliver pulsatile blood flow
- Care usually placed between the venous cannula and the reservoir
- Dcause less trauma to the blood cells than roller pumps
74Prior to initiation of cardiopulmonary bypass, activated clotting time (ACT) should exceed:
- A100 seconds
- B200 seconds
- C300 seconds
- D400 seconds
75in the CVP tracing, the increase in pressure resulting from venous return entering the atrium before the tricuspid valve opens is best represented by:
- AA
- BB
- CC
- DD
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- NCE Anesthesia (Core Concepts) Quiz on CC - Cardiac, created by Katie Scanlon on 05/12/2016.
- Author
- Katie Scanlon
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- English
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