GENESIS

(Post Graduation Medical orientation Centre)

Intensive Care Recovery Batch
Total Number- 30 Subject: CVS Physiology Time: 30 Min
Spot Exam Date: 00/00/20

1. Absolute refractory period in the ventricles 4. Total peripheral resistance is directly proportional
(MD/MSMarch 12) to (MD, MS March 14)
a) Corresponds to the period of ventricular a) Diameter of blood vessels
depolarization b) Length of blood vessels
b) Corresponds to the period of ventricular c) Elasticity of vessel wall
contraction d) Viscosity of blood
c) Is the period when the ventricles are completely e) Velocity of blood flow
unexcitable FTFTT
d) Is shorter than the corresponding atrial muscle Explanation:
e) Decrease during stimulation of the vagus nerve to a. Inversely Proportional
the heart c. Inversely proportional
TTTFF
Explanation: 5. In resting condition, as blood passes through the
a. Depolarized cells cannot be excited. systemic capillaries there is an increase in (Diploma
b. This prevents tetanic contraction of heart. Basic, Medicine, Surgery, Pedi July 2020)
d. It is longer as is the duration of its depolarization. a) pH of blood
e. Shortening of the refractory period permits higher b) Cl- concentration in RBC
heart rates. (Vagus is parasympathetic, it is true in c) Mean corpucular volume of RBC
case of sympathetic nerve) [Ref: Roddie/6th/Q-79/P- d) Plasma protein concentration of blood
37] e) P50
FTTFT [ Ref: Ganong 25th / P-643]
2. The factors causing dilatation of blood vessels are
(Jan-11) 6. The net effects of stimulation of baroreceptors are
a) Nitric oxide (Diploma Basic, Medicine, Surgery, Pedi July 2020)
b) Endothelin-I a) Venodilation of peripheral circulatory system
c) Angiotensin-II b) Venodilation of pulmonary vessels
d) Neuropeptide Y c) To decrease heart rate
e) Prostacyclin d) To increase force of contraction of cardiac muscle
TFFFT [Ref: Ganong/25th/P-586) e) To decrease arterial blood pressure
TFTFT [Ref: Guyton 13th / P-220]
3. Tendency to turbulence flow is directly
proportional to (MD, MS, Paediatrics, Basic March- 7. The pulse pressure in the large arteries is directly
2020) proportional to (Jan-11)
a) Diameter of the blood vessel a) Stroke volume
b) Density of blood b) Heart rate
c) Velocity of blood flow c) Total peripheral resistance
d) Viscosity of blood d) Compliance of arterial wall
e) Elasticity of vessel wall e) Elasticity of vessel wall
TTTFF [Ref: Ganong/Ed-25th/P-572,573] TFFFF [Ref: BRS/6th/P-70 + Guyton/13th/P-181]
8. The valsalva manaeuver is followed by an 10. The split of 2nd heart sound in healthy individual
decrease in (MS March 13) (March 12)
a) Intrapleural pressure a) Is more prominent during inspiration
b) Intra abdominal pressure b) Tends to disappear during expiration
c) Cardiac out put c) Is best heard in pulmonary area
d) Arterial blood volume d) Is due to pulmonary valve closure just preceding
e) Heart rate aortic valve closure
TTFFT e) Is more prominent in aortic stenosis
Explanation: TTTFF
c. It rises as blood surges back to the central Explanation:
circulation d. The interval between aortic and pulmonary valve
d. It rises due to the great increase in cardiac output closure during inspiration is frequently long enough for
e. A reflex response to the surge in arterial pressure the second sound to be reduplicated called
[Ref: Ganong/25th/P-591 + Rodde/6th/Q-593/P-249] physiological, splitting of 2nd heart sound. [Preceding
means previous]
9. During the cardiac cycle in a normal human adult e. Soft 2nd heart sound
at rest, with a blood pressure of 120/70 mmHg [Ref: Ganong/25th/P-452 + Davidson/P-582, 620, 633
(March 12) + Macleods /14th/P-56]
a) The lowest pressure in the left ventricle is 70 mmHg
b) The maximum pressure difference across the mitral 11. In hypokalemia, ECG shows (Basic, MD, MS
valve is close to 120 mmHg March-13)
c) The maximum pressure different across the aortic a) Prolonged PR interval
valve is 120 mmHg b) ST depression
d) The lowest pressure in the aorta is 70 mmHg c) Prolonged QT interval
e) The lowest pressure in the left ventricle is o mmHg d) Prominent U
FTTTF (Explanation: e) Tall and slender
TTTTF Explanation: Previous discussion

12. Local metabolic activity is the main factor to

determine the rate of blood flow to [Basic, MD, MS
March 18]
a) Heart
b) Skin
c) Skeletal muscle
d) Lungs
e) Kidney
TFTFF [Ref: Roddie/6th/Q-69]

13. Vagal stimulation causes (Diploma July 2018)

a) Fall in blood pressure
b) Relaxation of bronchial smooth muscles
a. Lowest pressure in the left ventricle is the End c) Decreased cardiac output
diastolic volume (4-12) mm/Hg d) Decreased intestinal secretion
b. Lowest pressure in left atrium is 4mmHg & High e) Constriction of pupil
pressure in left ventricle is the systolic pressure. In this TF(constiction) TF(↑) T [Ref: Ganong/25th/P-260]
case 120 mmHg, so the maximum pressure difference
across the mitral valve is 116mm/Hg, which is close to 14. Elevated jugular venous pressure occurs in: (MS
120. March 13)
c. Lowest pressure in left ventricle is 4mmHg, highest a) Right heart failure
pressure in aorta is the systolic pressure (in this case b) Cirrhosis of liver
120mmHg). So pressure difference across the aortic c) Cardiac temponade
valve is 116mm/Hg. d) Left heart failure
d. Lowest pressure in aorta is diastolic pressure e) Constrictive pericarditis
e. Lowest pressure in left ventricle is the end diastolic TFTTT [Ref: Short Case of Abdullah/6th/P-134]
pressure (4-12) mm(Hg)
[Ref: Davidson 23rd/P-444/fig: 16.1]
15. ECG finding/s of atrial fibrillation is/are [Basic, 21. Major criteria of acute rheumatic fever are:
MD March 18] (Diploma July-19, Paediatrics Faculty)
a) Absence of T wave a) Arthralgia
b) Presence of U wave b) Chorea
c) Absence of P wave c) Elevated CRP
d) Presence of RsR pattern in V1 d) Subcutaneous nodule
e) Irregularly irregular Rwave e) Carditis
FFTFT [Ref: Davidson's/23rd/P-470 + Harrison/P- FTFTT [Ref: Davidson's/23rd/Box-16.75/P-516]
1813]
22. Examples of left to right shunt(MD, MS March 15)
16. Features of left heart failure are (Diploma a) Artrial septal defect
Medicine, paediatrics July 2020) b) Coarctation of the aorta
a) Dependent oedema c) Tetralogy of Fallot
b) Raised JVP d) Ventricular septal defect rarely
c) Basal crepitations e) Patent ductus arteriosus
d) Cough with frothy sputum TFFTT
e) Tender hepatomegaly Explanation: Lt to rt shunt:
FTTTF [Ref: Davidson 23rd / P-463] c) rt to left ASD, VSD, PDA, atrioventricular
shunt. septal detect.
17. The features of cardiac temponade includes (MS [Ref: Davidson's/23rd/P-534, 535]
March 13)
a) Decreasing arterial pressure
b) Increased venous Pressure 23. Tetralogy of fallot consists of [Basic, MS March
c) Distant heart sound 18 ]
d) Water hammer Pulse a) ASD
e) Collapse of the right atrium and right ventricle b) VSD
during diastole c) Dextroposition of the aorta
TTFFT [Ref: Davidson's/23rd/P-544] d) Pulmonary stenosis
e) Right ventricular hypertrophy
18. Syncope occurs in (Diploma July-19, Medicine FTFTT [Ref: Langmans/P-198-199 +
Faculty) Davidson's/23rd/P-536]
a) Sinus node disease
b) Vestibular neuronitis 24. Chronic constrictive pericarditis includes (MD
c) Supraventricular tachycardia March 16)
d) Benign positional paroxysmal vertigo a) Raised jugular venous pressure during inspiration
e) Mobitz type I second degree heart block b) Pulsus bisferiens
TFTFF [Ref: Davidson’s/23rd/P-182] c) High systolic blood pressure during inspiration
d) Ascites
19. Ejection systolic murmur is present in (Md, Basic e) High pulse pressure
March-2019) TFFTF
a) Aortic stenosis Explanation:
b) Tricuspid regurgitation b) Pulsus paradoxus
c) Aortic regurgitation [Aortic flow murmur] c) Large fall of BP during inspiration
d) Pulmonary stenosis [Ref: Davidson's/23rd/Box-16.109/P-543]
e) Atrial septal defect [Pulmonary flow murmur]
TFTTT [Ref: Davidson's/23rd/Fig-16.23/P-460 + 25. The antihypertensive drugs that lower diastolic
Macleod's/14th/P-59] blood pressure by inhibiting reni angiotensin system
are: (MPhil/Diploma July 13)
20. Functional murmur (March-12) a) Losartin
a) Occurs in anaemia b) Amlodipine
b) Is mid-diastolic c) Hydralazine
c) Radiates toward left axilla d) Ramipril
d) Is best heard in the pulmonary area e) Atenolol
e) Is present in left atrial myxoma TFFTF [Ref: Davidson's/23rd/P-466]
TFFTF Explanation: b) Always systolic
[Ref: Davidson's/23rd/P-459]
26. Conduits used in coronary artery bypass grafting 29. Volume overload indirectly act as pressure
are- (MS July 17, March-17) controller by (MD, MS March 14)
a) Radial artery a) Increasing secretion of ADH
b) Great saphenous vein b) Increasing secretion of atrial natriuretic peptide
c) Cephalic vein c) Increasing glomerular filtration rate
d) Internal thoracic artery d) Inhibiting release of renin
e) Tibial artery e) Decreasing tubular reabsorption of glucose
TTTTF FTTTF
Explanation: Explanation:
Arterial grafts Venous grafts a. ↑Volume →↓ ADH
1.Internal thoracic 1. Great/Long b. ↑ANP →↓Volume
artery/internal mammary saphenous vein c. ↑GFR →↓ Volume
artery 2. Short d. ↓ Renin →↓ Volume
2. Radial artery saphenous vein e. Always completely reabsorbed
3. Gastroepiploic artery 3. Cephalic vein [Ref: Guyton/13th/P-222]
4. Inferior epigastric artery
[Ref: Bailey & Love’s/27th/P-890] 30. Stretching of the atrial stretch receptors (MD, MS
March 14)
27. Immediately after closure of semilunar valves a) Increase ADH secretion
there is (Basic, MD, MS March 2015) b) Increase heart rate
a) Isometric contraction phase c) Increase diameter of afferent arteriole of kidney
b) Protodiastolic phase d) Increased aldosterone secretion
c) Isometric relaxation phase e) Increase atrial natriuretic peptide secretion
d) A decrease in velocity of blood flow in the aorta FTTFT [Ref: Guyton/13th/P-222]
close to zero
e) A decrease in intraventricular pressure upto 10 mm
Hg
FFTTT
Explanation:
c. After the valves are closed, pressure continues to
drop rapidly during the period of isometric ventricular
relaxation.
d. Aortic valve is closed, so velocity of blood flow in the
aorta will be closed to zero.
e. During this period, the intraventricolar pressures
rapidly decrease back to their low diastolic level.[Ref:
Guyton/P-114/Fig: 9.7]

28. Dicrotic notch in aortic pressure pulse curve

[Basic, MD, MS March 18]
a) Occurs at the end of protodiastole
b) Occurs at the end of ventricular systole
c) Occurs during rapid ventricular ejection phase
d) Coincides with closure of AV valves
e) Coincides with second heart sound
TFFFT [Ref: Ganong/25th/540-541 + Harrison/P-1825]