FIRST PROFESSIONAL MBBS ANNUAL EXAMINATION 2019
PAPER C
BLOCK 3
(CVS + RESPIRATION)
Time Allowed: 120 min
1) The Incisura or notch in the aortic pressure curve is;
a) Due to to 1st heart sound
b) Indicative of cardiovascular disease
c) Coincident with the 2nd heart sound
d) Absent in hypertension
e) Felt easily in normal radial pulse
2) Which one of the following organ has got tight junctions of capillary endothelial linings;
a) Heart
b) Kidney
c) liver
d) Brain
e) lung
3) The most significant effect of the parasympathetic stimulation on the general circulation is;
a) Increased cardiac contractility
b) Increased Vascular compliance
c) Increased Vascular resistance
d) Increased Heart rate
e) Increased vasodilatation
4) At a heart rate of about 75 beats per minute, the longest electrocardiogram Interval would generally be the:
a) Duration of the P wave
b) Duration of the ORS complex
c) P.R interval
d) Q T utter.)
e) R-R interval
5) A 62-Year-old man with congestive heart failure (CHF), brought to the pulmonology ward. The doctor said she has pulmonary edema secondary to heart failure. What will be the cause of pulmonary edema In this Patient;
a) Decreased pulmonary Interstitial oncotic pressure
b) Increased pulmonary capillary hydrostatic pressure
c) Increased pulmonary capillary oncotic pressure
d) Increased pulmonary interstitial hydrostatic pressure
e) Decreased pulmonary capillary permeability
6) A patient had an ECG at the local emergency department. The physician on duty stated that the patient had an A-V nodal rhythm. What Is the likely heart rate?
a).30/min
b) 50/mm
c) 65/min
d) 75/min
e) 85/min
7) Which phase of the cardiac cycle follows immediately after the beginning of the QRS wave?
a) Isovolumic relaxation
b) Ventricular ejection
c) Atrial systole
d) Diastasis
e) Isovolumic contraction
8) Sudden change in the resting membrane potential which is propagated Is called action potential. Which one of the following is important for the initiation of depolarization in the ventricular muscle fibers?
a) Ca+2 ions in the T-Tubules
b) Formation of plateau due to Ca+2 ions influx
c) K+ ions coming out of the cell rapidly
d) Rapid entry of Na+ ions into the cell
e) Sufficient K+ ions inside the cell
9) A male patient aged 50 years visited OPD for routine checkup. He was on beta blocker for the treatment of his hypertension. An ECG was recorded which showed First degree AV block. First degree AV block is characterized by which of the following
criteria In ECG?
a) 2 P waves followed by 1 QRS complex
b) 3 P waves followed by 1 QRS complex
c) Complete AV dissociation
d) PR interval of more than 0 20 sec
e) Wenckebach's Phenomenon
10) SA node is the normal pacemaker of the heart because it has the highest rate of discharge. If the pacemaker of the heart sets In the Purkinje Fibers, what would be the most likely heart rate?
a) 10-14 bpm
b) 15-30 bpm
c) 40-60 bpm
d) 70-80 bpm
e) 100-150 bpm
11) A patient brought to emergency after an accident had suffered severe blood loss. His BP was 70/40 mmHg and pulse was 120/min. Which of the following compensatory responses to hemorrhage occurs within the shortest time frame?
a) Baroreceptor-mediated sympathetic response
b) increase in angiotensin II
c) increase in Antidiuretic Hormone
d) increase in aldosterone secretion
e) Interstitial fluid shifts into plasma
12) 1st year medical student recorded his resting BP, as 110/70 mmHg and then began to exercise strenuously. After 10 minutes of exercise he again checked his BP which was 140/65. His pulse pressure was increased from 40 to 75 mmHg.
Which of the following decreases during strenuous exercise?
a) Cardiac output
b) Heart
c) Stroke volume
d) Total peripheral resistance
e) Venous return
13) A diabetic patient with autonomic neuropathy complained of frequent episodes of dizziness while standing up from supine position. This is called postural hypotension. Fall in cardiac output when a person changes his posture from lying down to standing position can. explained by which of the following?
a) Fick's principle
b) Frank Starling's Law
c) Ohm's law
d) Poiseuille's law
e) Reynold's principle
14) Sana is a 26 years old girl. She is used to taking salts regularly. She is advised by her physician to reduce the salt intake. How does reducing salt intake, help prevent high blood pressure;
a) allows vessels to relax
b) helps in digestion
c) helps in keeping the heart rate steady
d) raises level of HDL (good) Cholesterol
e) reduces fluid buildup in the body
15) Cardiac output usually varies with age, gender, weight and height. Which of the following is the correct statement regarding Cardiac Index?
a) it is the volume of blood per contraction of the ventricle
b) it is the tarmac output /m2 of body surface area
c) It usually high in people having huge body
d) It is inversely Proportional to Cardiac output
e) It increases with the advancing age
16) A 70 years old male patient was brought to CCU with cardiac arrest. Doctors started to resuscitate him and finally succeeded. What is the first step during the excitation-contraction coupling of the heart muscles?
a) Calcium attaches to the ryanodine receptors
b) Calcium moves out of the cytosol of myocytes
c) contraction of the sarcomeres occur
d) opening of voltage gated calcium channels on the membrane of T tubules
e) Opening of calcium pumps on the sarcoplasmic reticulum
17) A patient diagnosed as a case of heart failure has raised Jugular Venous Pulse. JVP indicates pressure in which of the following;
a) Aorta
b) Left ventricle
c) Right atrium
d) Superior vena cava.
e) Pulmonary artery
18) In myocardial ischemia, what abnormal change would you expect to see in the ECG of this patient;
a) Prolongation of PR interval
b) Small Q wave
c) Tall and tented T wave
d) Inversion of the T wave
e) Flattening of T wave
19) An Increase in arteriolar resistance, without a change in any other component of CVS, will produce:
a) A decrease in total peripheral resistance
b) An increase in capillary filtration
c) An Increase in arterial pressure
d) A decrease in afterload
e) A decrease in preload
20) During anaphylactic shock vasodilation is produced by the release of;
a) Bradykinin
b) Histamine
c) nitric Oxide
d) ANP (Atrial natriuretic peptide)
e) Adenosine
21} A patient Is Presented with a tall T wave on ECG finding. Which of the following is the most probably cause of abnormal ECG finding in this case?
a) Hyperkalemia
b) Hypokalemia
c) Hypercalcemia
d) hypocalcemia
e) hypernatremia
22) Which of the following is the most frequent cause of decreased coronary blood flow in patients with ischemic heart disease?
a) Increased adenosine re/ease
b) Atherosclerosis
c) Coronary artery spasm
d) Increased sympathetic tone of the coronary arteries
e) Occlusion of the coronary sinus
23) A 20 year old man has bled in a road accident. In casualty, the doctor on duty noted his BP 100/6S mmHg, pulse 108/min with low volume and he was sweating. His sweeting is due to;
a) Cushing’s syndrome
b) Bain Bridge reflex
c) Sympathetic stimulation
d) vagal stimulation
e) Hepatojugular reflex
24) A person may feel vertigo when he suddenly stands up from a lying position. Baroreceptors are working for regulation of arterial blood pressure in this situation. If the mean arterial pressure in the carotid arteries begins to fall:
a) The aortic baroreceptor firing rates increases
b) The carotid baroreceptor firing rates decrease
c) The sympathetic activity to the heart decreases
O) The Parasympathetic activity to the SA node increases
e) Systolic blood pressure will be decreasing
25) Work performed by the left ventricle Is substantially greater than that performed by the right ventricle largely as a result of differences in;
a) Stroke volume
b) Blood volume flow
c) Systemic Arterial pressures
d} Efficiency of myocardial contraction
e) Ventricular filling
26) The following is the data obtained from a Patient:
End diastolic volume = 120 ml
End systolic volume = 20 ml
Heart rate = 80 beats/min.
What will be the stroke volume of this patient ?
a) 50 ml
b) 100 ml
c) 150 ml
d) 200 ml
e) 250 ml
27) A patient was brought to casualty after a road traffic accident. Due to excessive bleeding, he had hypotension and a very weak pulse. He was determined to be in hypovolemic shock. What will you do first, if this patient Is in non-progressive stage of shock
a) Arrange an ECG
b) Advise an X-Ray first
c) Wait for his all reports.
d) infusion of plasma expanders
e) Shift the patient to another hospital
28) An increase In blood volume will cause
a) an increase in ADH secretion
b) a decrease in Na+ excretion in the urine
c) A decrease in renin secretion
d) An increased secretion of angiotensin II
e) An increased secretion of Aldosterone
29) Which event occurs after the first heart sound and before the second heart sound
a) Atrial contraction
b) Closure of the Atrioventricular (AV) valves
c) P-wave of the ECG
d) Rapid filling of the ventricles
e) Ventricular systolic ejection
30) Which of the following substances crosses capillary walls primarily through water-filled clefts between the endothelial cells?
a) 02
b) CO2
c) CO
d) Glucose
e) H202
31) Listed below are the hydrostatic and oncotic pressures within a microcirculatory bed:
Plasma colloid osmotic pressure = 25 mm Hg
Capillary hydrostatic pressure = 25 mm Hg
Venous hydrostatic pressure = 5 mm Hg
Arterial pressure = 80 mm Hg
Interstitial fluid hydrostatic pressure = - 5 mm Hg
Interstitial colloid osmotic pressure = 5 mm Hg
Capillary filtration coefficient = 15 ml / min / mm Hg
What Is the rate of net fluid movement across the capillary wall?
a) 125 ml / min
b) 150 ml / min
c) 100 ml / min
d) 250 ml / min
e) 200 ml / min
32) Which of the following conditions causes the pulse pressure to increase?
a) tachycardia
b) hypertension
c) hemorrhage
d) aortic stenosis
e) Myocardial Infarction
33) calculate heart rate If cardiac output is 5200 ml and stroke volume is 65 ml / beat
a) 65 beats / min.
b) 75 beats / min
c) 80beats / min
d) 72 beats / min
e) 84 beats / min
34) Both ADH and aldosterone act to;
a) increase urine volume
b) increase blood volume and blood Pressure
c) Decrease total peripheral resistance
d) Decrease venous return
e) Decrease thirst sensation
35) A baby boy born at 30 weeks of period of gestation started nasal flaring, tachypnea and intercostals recession just after birth.
On examination he had cyanosis and was grunting. Which of the following will be decreased in his blood?
a) Lecithin : sphingomyelin ratio
b) Arterial partial pressure of CO2
c) Arterial partial pressure or nitrogen
d) Random blood sugar
e) Serum bilirubin
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