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IT Exam 3

Total questions: 150

Worksheet time: 2hrs 39mins

Name
Class
Date
1.

What is the myocardium?

a)

Muscular tissue of the heart

b)

Muscle cells of the heart

c)

A type of striated muscle which is different from the other type of striated muscle or smooth muscle

2.

What is cardiac myocytes?

a)

Muscular tissue of the heart

b)

A type of striated muscle

c)

Muscle cells of the heart tissue

3.

What do cardiac myocytes consist of?

a)

Autorhythmic cells

b)

Contractile cells

c)

Myocytes

d)

Myelin cells

4.

Which initiate/generate an action potential at a fixed rate?

a)

Autorhythmic cells

b)

Contractile cells

5.

Which propagate the action potential?

a)

Autorhythmic cells

b)

Contractile cells

6.

What allows T-tubules to contract more forcefully and in unison?

a)

Ca2+ release

b)

Mg release

c)

NaCl release

d)

K release

7.

Where is Ca2+ ions stored?

a)

Triad

b)

Sarcoplasmic reticulum

c)

Terminal cisternae

d)

T-tubule

8.

Which are the low-resistance pathways that permit cell-to-cell conduction of electrical (ionic) currents?

a)

Gap junctions

b)

Intercalated disks

c)

Sarcolemma reticulum

d)

Action potential

9.

What do gap junctions enable?

a)

Action potential

b)

Contractile force

c)

Ion communication

d)

Prolonged effects

10.

What is the primary function of the heart?

a)

Impart energy to the blood

b)

Generate and sustain arterial blood pressure

c)

Provide adequate perfusion of organs

d)

Communicate between ion gap junctions

11.

What are the elements of the heart?

a)

Sino-atrial node (SAN)

b)

Atrio-ventricular note (AVN)

c)

Bundle of His (left and right branches)

d)

Purkinje fibers (traverse across both ventricles)

e)

Synaptic Atrial node (SAN)

12.

What are the 3 stages of a heart beat?

a)

Atrial depolarization/contraction

b)

Ventricular depolarization/contraction

c)

Atrial and ventricular repolarization during the filling of the respective chambers (relaxed)

d)

Depolarization of the central chamber

13.

What is the primary pacemaker of the heart?

a)

SAN

b)

AVN

c)

Bundle of His

d)

Purkinje fibers

14.

What is the SAN responsible for?

a)

Generation and propagation of action potential at a regular rate

b)

Depolarization of action potential

c)

Repolarization of action potential

d)

Elimination of action potential at a regular rate

15.

True or false: A spontaneous AP from the SAN cause the atria to expand

a)

False

b)

True

16.

True or false: A spontaneous AP from the SAN cause the atria to contract

a)

True

b)

False

17.

A _______ membrane potential muse be reached during depolarization before an AP will be elicted?

a)

Threshold

b)

Trigger

c)

Depolarization

d)

Steady

18.

What two ions will flow inwards during electrical activity of cardiac myocytes?

a)

Ca

b)

Na

c)

K

d)

P

19.

What ion will flow inward to repolarize during electrical activity in cardiac myocytes?

a)

Na

b)

Ca

c)

K

d)

Cl

20.

Muscle contraction is associated with which ion?

a)

K

b)

Na

c)

Ca

d)

Cl

21.

What does fast response action potential of contractile cells reflect?

a)

Changes in ion conductances (g) when cells rapidly depol from -90 mV to a threshold of -70 mV

b)

Changes in ion repolarization when cells rapidly repol from -80 mV to a threshold of -70 mV

22.

What are the two alternating phases that make up the single cardiac activity?

a)

Diastole

b)

Systole

c)

Systolic

d)

Diastolic

23.

Which pertain to systole?

a)

contraction

b)

emptying

c)

relaxation

d)

filling

24.

Which pertain to diastole?

a)

relaxation

b)

filling

c)

contraction

d)

emptying

25.

Which pertain to diastole?

a)

AV valves open

b)

Semilunar valves closed

c)

Semilunar valves open

d)

AV valves closed

26.

Which pertain to systole?

a)

Semilunar valves are open

b)

AV valves are closed

c)

LUB

d)

Dub

27.

Which describe "End Diastolic Volume (EDV)"?

a)

Increases with preload

b)

Filled volume at ventricle

c)

Afterload

d)

Volume of blood remaining in the ventricle

28.

Which describes "End systolic volume (ESV)"?

a)

Against variable afterload

b)

Backpressure from arterial pressure

c)

Volume of blood remaining in the ventricle

d)

Increases with preload

29.

Which describes "Stroke volume (SV)"?

a)

Filled volume

b)

Remaining unejected volume

c)

Afterload

d)

Increases with preload

e)

Volume of blood ejected from each ventricle with each contraction

30.

True or false: the more the ventricular muscle is stretched the stronger it will contract and increase SV

a)

True

b)

False

31.

Which describes preload?

a)

Initial stretching of the ventricular myocyte

b)

Ability of the heart to change its force of contraction

c)

Stroke volume in response to changes in VR

32.

Which is VR?

a)

Venous return

b)

Total amount of blood that returns to the heart

c)

Total amount of blood that returns to circulation

d)

Increased stroke volume

33.

Which of these ACEi prodrugs can get activated by hepatic esterase?

a)

Benazepril

b)

Uridopril

c)

Enalapril

d)

Trandopril

e)

Quinapril

34.

Which of these ACEi can get activated by hepatic esterase?

a)

Ramipril

b)

Perindopril

c)

Moexipril

d)

Fosinopril

e)

Captopril

35.

What is the ending of a ARB?

a)

-pril

b)

-artan

c)

-xillin

d)

-ssium

36.

Which ARBs require metabolic activation hydrolysis during GI absorption?

a)

Azilsartan medoxomil

b)

Candesartan cilexetil

c)

Olmesartan medoxomil

d)

Losartan

37.

What is the generic name of the renin inhibitor?

a)

Aliskiren

b)

Tekurna

c)

Rasileze

38.

What is the generic name of the renin inhibitor?

a)

Aliskiren

b)

Tekturna

c)

Rasileze

39.

When are RAAS contraindicated?

a)

Pregnancy

b)

Kidney failure

c)

Children

d)

Use of tobacco

40.

What is the mechanism of action of renin inhibitor?

a)

Inhibits the action of renin to convert angiotensin to angiotensin I

b)

Activates the action of renin to convert angiotensin to angiotensin 1

c)

Inhibits the action of renin to begin the conversion of angiotensin 1 to angiotensin

41.

Which AT receptor subtype do ARBs antagonize and what is its effect?

a)

Antagonize AT1 receptors

b)

Activate AT1 receptors

c)

Increase bradykinin levels

d)

Do not increase bradykinin levels

42.

Which is more active losartan or exp-3174?

a)

Losartan

b)

EXP-3174

43.

What is the ending of an Alpha 1 antagonists?

a)

-pril

b)

-sartan

c)

-zosin

d)

-xillin

e)

-prolol

44.

What is the mechanism of action for alpha 1 antagonists?

a)

Block NE from binding

b)

Decreases MAP

c)

Decreases stroke volume

d)

Increases MAP

e)

Decreases TPR

45.

Why do Alpha 1 Antagonists cause reflex tachycardia and fluid retention?

a)

Alpha 1 decreases MAP

b)

SNS increases MAP

c)

Increases Renin release

d)

Increases heart rate

e)

Decreases heart rate

46.

What is a 1st generation beta adrenergic receptor antagonists?

a)

Non selective beta 1 and beta 2

b)

Beta-1 selective/cardio selective

c)

Beta block and additional activity (alpha block/vasodilation)

47.

What is a second generation beta adrenergic receptor antagonists?

a)

Non-selective beta 1 and beta 2

b)

beta 1-selective/cardio selective

c)

Beta block and additional activity

48.

What is the reason that you may see a difference in efficacy/adverse effects with Metoprolol?

a)

Extensive metabolism by CYP2D6

b)

Patients with poor CYP2D6

c)

Ultra CYP2D6 metabolizer

d)

Adverse reactions

e)

Efficacy increased

49.

If patients have poor CYP2D6 metabolizer what does that cause?

a)

Greater chance of drug interactions

b)

Lower drug efficacy

c)

Higher drug efficacy

d)

Lower chance of drug interactions

50.

Patients with ultra CYP2D6 metabolizer what can it cause?

a)

Accelerated metabolism

b)

Greater rate of drug elimination

c)

Higher chance of drug efficacy

d)

Potentially lower drug efficacy

51.

Which is a beta blocker/vasodilator?

a)

Nebivolol

b)

Labetalol

c)

Metoprolol

d)

Carvediolol

52.

Which are mixed alpha/beta blockers?

a)

Labetalol

b)

Carvedilol

c)

Nebivolol

d)

Metoprolol

53.

What is the mechanism of action of Labetalol and Carvedilol?

a)

Alpha 1 receptor antagonists

b)

Beta 1 and 2 receptor antagonists

c)

Reduces TPR

d)

Reduces HR

e)

Reduces CV

54.

What is the mechanism of action for Nebivolol?

a)

Blocks NE and E binding at Beta 1 receptor

b)

Stimulates eNOS

c)

Increased levels of NO in the vascular smooth muscle

d)

Activates sGC which converts GTP to cGMP

e)

Causes smooth muscle relaxation

55.

Select the non selective beta1 and b2

a)

Propranolol

b)

Nadolol

c)

Atenolol

d)

Bisoprolol

e)

Timolol

56.

Select the non selective b1 and b2

a)

Pindolol

b)

Carvedilol

c)

Labetalol

d)

Acebutalol

e)

Nebivolol

57.

Select the beta 1 blocker that is cardio selective

a)

Atenolol

b)

Betaxolol

c)

Bisoprolol

d)

Esmolol

e)

Metoprolol

58.

Select the beta 1 blockers that are cardio selective

a)

Metoprolol

b)

Acebutalol

c)

Nebivolol

d)

Carvedilol

e)

Timolol

59.

Why are beta blockers less likely to have adverse effects in patients with asthma and COPD than non-selective beta blockers?

a)

Beta 1 blockers work on the Heart and Kidney causing increased HR

b)

Increase force of contraction

c)

Stimulates renin secretion of working on bronchioles

d)

Works on the bronchioles

60.

Which are alpha 2 agonists?

a)

Clonidine

b)

Guanficine

c)

Methyldopa

d)

Metoprolol

61.

How does Alpha 2 agonists reduce MAP?

a)

Decrease TPR

b)

Decrease HR

c)

Decrease CO

d)

Decrease SV

62.

What is the site of action for CCB?

a)

Smooth muscle

b)

Cardiac muscle

c)

Skeletal muscle

d)

Endoplasmic reticulum

63.

Select the DHP’s

a)

Amlodipine

b)

Felodipine

c)

Isradipine

d)

Nicardipine

e)

Phenylalkamine

64.

Select the NON-DHPs

a)

Phenylalkamine

b)

Verapamil

c)

Diltiazem

d)

Benzothiazepine

e)

Amlodipine

65.

What is the target for CCBs?

a)

Inhibit L-type calcium channel

b)

Activate L-type calcium channel

c)

Increase HR

d)

Decrease SV

e)

Decrease TP

66.

What is the site of action for CCBs?

a)

Smooth muscle

b)

Cardiac muscle

c)

Skeletal muscle

d)

Rough muscle

67.

Which CCB exerts a stronger effect on arterial smooth muscle?

a)

DHP

b)

Diltiazem

c)

Verapamil

68.

Which CCB exerts a stronger effect on cardiac effects?

a)

DHP

b)

Diltiazem

c)

Verapamil

69.

Which CCBs are substrates of CYP3A4?

a)

ALL

b)

None

c)

Diltiazem

d)

Verapamil

70.

Why do CCBs cause constipation?

a)

Inhibit sigmoid colon myoelectric response

b)

Cause a increase in renin

c)

Increase blood pressure

d)

Decrease the serotonin uptake

71.

Which CCB is known to cause constipation?

a)

Verapamil

b)

Diltiazem

c)

DH

d)

Felodipine

72.

Select the direct vasodilators

a)

Hydralazine

b)

Minoxidil

c)

Monocycline

d)

Diphenhydramine

73.

What is the effect of minoxidil on MAP and TPR?

a)

Decrease

b)

Increase

74.

Which is the potassium channel opener that increases potassium permeability and hyperpolarizes?

a)

Minoxidil

b)

Hydralazine

c)

Memantine

d)

Alprazolam

75.

Which cause a decrease in TPR and MAP?

a)

Minoxidil

b)

Hydralazine

c)

Monoactamine

d)

Diphenhydramine

76.

Which medication causes patients to sometimes develop lupus like syndrome?

a)

Hydralazine

b)

Minoxidil

c)

Diclofenac

d)

Metoprolol

e)

Lisinopril

77.

After how many months can a patient develop lupus like syndrome in Hydralazine?

a)

1

b)

3

c)

6

d)

7

78.

What is hypertrichosis?

a)

Excessive hair growth

b)

Low hair growth

c)

Hair loss

d)

Loss of hair color

e)

Nail breakage

f)

Loss of nails

79.

What can cause hypertrichosis?

a)

Minoxidil

b)

Direct vasodilator

c)

Hydralazine

d)

Labetalol

80.

What is a third generation beta adrenergic receptor antagonists?

a)

Non selective beta 1 and beta 2

b)

Beta 1 selective/cardio selective

c)

Beta block and additional activity (alpha block/vasodilation)

81.

What region is the pacemaker of the heart?

a)

SA node

b)

AV node

c)

LV node

82.

Select which describes systole?

a)

contraction

b)

emptying

c)

relaxation

d)

filing

83.

select which apply to diastole:

a)

relaxation

b)

filling

c)

contraction

d)

emptying

84.

Which describes stroke volume?

a)

amount of blood pumped out of each ventricle with each contraction

b)

volume of blood pumped by each ventricle per minute

c)

Beats per minute

85.

Which two factors determine CO?

a)

Heart rate

b)

Stroke volume

c)

BP

d)

Ventricular contractility

86.

What is the effect of parasympathetic signaling on HR and rate of conduction?

a)

Muscarinic type 2 receptors

b)

Inhibitory

c)

Decreases heart rate and rate of conduction

d)

Increases heart rate and rate of condution

87.

What is the effect of parasympathetic signaling on HR and rate of conduction?

a)

Muscarinic type 2 receptors

b)

Inhibitory

c)

Decreases heart rate and rate of conduction

d)

Increases heart rate and rate of condution

88.

What is the effect of sympathetic signaling on HR and rate of conduction?

a)

Stimulatory

b)

Inhibitory

c)

Beta-1 adrenergic receptors

d)

Muscarinic type 2 receptors

e)

Increases HR and rate of conduction

89.

What 3 factors influence stroke volume?

a)

Ventricular contractility

b)

Preload/EDV

c)

Afterload

d)

Heart pressure

e)

Vasoconstriction

90.

Which increase stroke volume?

a)

Ventricular contractility

b)

Pre-load/edv

c)

Afterload

91.

Which decrease stroke volume?

a)

Ventricular contractility

b)

Pre-load/edv

c)

afterload

92.

What is the effect of sympathetic signaling on ventricular contractility?

a)

Increase stroke volume

b)

Decrease stroke volume

93.

What is the effect of sympathetic signaling on venous return and preload?

a)

Increase venous return

b)

Increase preload/edv

c)

Increase stroke volume

d)

Decrease stroke volume

e)

Decrease preload

94.

What effect would an increase in MAP have on afterload?

a)

Increase arteriole resistance

b)

Increase MAP

c)

Decrease stroke volume

d)

Increase afterload

e)

Decrease afterload

95.

How does vasoconstriction affect resistance, pressure and flow?

a)

Decrease flow

b)

Increase flow

c)

Increase resistance

d)

Increase pressure

e)

Decrease pressure

96.

How does vasodilation affect radius, resistance, pressure and flow?

a)

Increase radius

b)

Decrease radius

c)

Decrease resistance

d)

Decrease pressure

e)

Increase flow

97.

What is the major determinant of TPR in a healthy individual?

a)

Arteriole radius

b)

Arteriole volume

c)

Stroke Volume

d)

Cardiac output

98.

What is MAP?

a)

Mean arterial pressure

b)

Mean action potential

c)

Mean activity pressure

99.

What is the MAP?

a)

Average pressure driving blood forward into tissues throughout cardiac cycle

b)

Average pressure driving blood forward into muscle throughout cardiac cycle

100.

What two factors determine MAP?

a)

Cardiac output

b)

Total peripheral resistance

c)

Stroke Volume

d)

Heart rate

101.

How does sympathetic signaling increase MAP?

a)

Increase TPR

b)

Increase CO

c)

Increase MAP

d)

Decrease TPR

102.

Which of the following increases CO?

a)

Increase sympathetic signaling

b)

Increase parasympathetic signaling

c)

Increased afterload

d)

All of the above

103.

Increased venous return will:

a)

decrease CO

b)

increase CO

104.

In a healthy individual the major determinant of TPR is?

a)

Arteriole radius

b)

Blood viscosity

c)

All of the above

105.

Activation of which of the following systems can change TPR?

a)

Both RAAS

b)

RAAS

c)

ANS

106.

Activation of which of the following systems can change SV?

a)

RAAS

b)

ANS

c)

Both RAAS and ANS

107.

Activation of which of the following systems can change HR?

a)

RAAS

b)

ANS

c)

Booth RAAS and ANS

108.

Define hypertension

a)

Elevated BP

b)

Decrease BP

c)

High glycerides level

109.

What is a normal BP?

a)

120/80

b)

120-139/80-89

c)

140-159/90-99

d)

>160/>100

110.

What is considered prehtn?

a)

<120/<80

b)

120-139/80-89

c)

140-159/90-99

d)

>160/>100

111.

What is stage 1 htn?

a)

140-159/90-99

b)

<120/<80

c)

120-139/80-89

d)

>160/>100

112.

Which describes stage 2 HTN?

a)

>160/>100

b)

140-159/90-99

c)

120-139/80-89

d)

<120/<80

113.

What is the "silent killer"?

a)

HTN

b)

Hyperlipidemia

c)

Kidney damage

d)

Retinopathy

114.

What are the two factors that determine mean arterial pressure that could be elevated and lead to hypertension?

a)

CO

b)

TPR

c)

SV

d)

HR

115.

Which explains how increase RAAS could promote hypertension

a)

Increased sodium reabsorption

b)

Water conservation

c)

Increased blood volume

d)

Increased cardiac output

116.

How could increased angiotensin 2 cause hypertension?

a)

Increased arteriolar vasoconstriction

b)

Increased total peripheral resistance

c)

Increased blood volume

d)

Increased cardiac output

117.

What happens to natriuetic hormone function in hypertension?

a)

Can decrease sodium excretion

b)

Increase blood volume

c)

Increase blood pressure

d)

Promote HTN

e)

Increase sodium excretion

118.

What is the effect of endothelial damage on vasodilation/vasoconstriction?

a)

Decrease vasodilator

b)

Increase vasoconstrictor

c)

Increase vasodilator

d)

Decrease vasoconstrictor

119.

What is the effect of endothelial damage on TPR?

a)

Increase TPR

b)

Promotes hypertension

c)

Decreases TPR

d)

Inhibits hypertension

120.

What happens to plasma volume in HTN?

a)

Increase plasma volume

b)

Decreased plasma volume

121.

How does increased plasma volume affect CO?

a)

Increase

b)

Decrease

122.

What is TPR influenced by?

a)

Vessel diameter

b)

Blood volume

c)

Cardiac output

123.

Which are active drugs for ACEi?

a)

Captopril

b)

Lisinopril

c)

Fosinopril

d)

Ramipril

e)

Enalapril

124.

Select the ACEi prodrugs :

a)

Captopril

b)

Trandolapril

c)

Ramipril

d)

Enalapril

e)

Benazepril

125.

How is the mechanism of ACEi action linked to adverse effects of dry cough and angioedema?

a)

Bradykinin levels increased

b)

ACE is inhibited -> increase in prostaglandin production

c)

Prostaglandin production results in bronchoconstriction

126.

Which ARBs undergo metabolic activation?

a)

Azilsartan

b)

Candesartan

c)

Telmisartan

d)

Valsartan

e)

Losartan

127.

Which ARB drugs undergo hydrolysis during GI absorption?

a)

Azilsartan

b)

Candesartan

c)

Olmesartan

d)

Eprosartan

e)

Losartan

128.

Which AT receptor subtype do ARBs antagonize?

a)

AT1

b)

AT2

c)

AT3

d)

AT4

129.

What are the effects of ARBs antagonizing the AT1 receptor?

a)

Decrease BV

b)

Vasodilation

c)

Increase BV

d)

Vasoconstriction

130.

What are the sites/mechanism of metabolic activation for Losartan?

a)

CYP2C9

b)

CYP3A4

c)

CYP4A6

d)

CYP2A3

131.

What is the mechanism of action of a renin inhibitor?

a)

Blocks renin from converting angiotensin to angiotensin 1

b)

Blocks renin from converting angiotensin 1 to angiotensin 2

c)

Activates renin to convert angiotensin to angiotensin 1

132.

In what situation are drugs targeting the RAAS contraindication?

a)

Pregnancy

b)

Kidney failure

c)

Lupus

d)

HTN

133.

What are the drugs that act on the sympathetic nervous system?

a)

Doxazosin

b)

Prazosin

c)

Terazosin

d)

Flucozosin

e)

Hydrazosin

134.

Select all that apply: what is the mechanism of action of Alpha 1 antagonists?

a)

Blocks stimulation of smooth muscle contraction

b)

Reduced TPR (dilation of arterioles)

c)

Reduced SV and CO (dilation of veins)

d)

Reduced MAP

e)

Increased MAP

135.

List the non selective beta blockers

a)

Nadalol

b)

Propranolol

c)

Timolol

d)

Bisoprolol

136.

Which receptors are blocked by the non-selective beta blockers?

a)

Beta 1

b)

Beta 2

c)

Alpha 1

d)

Alpha 2

137.

Which beta blockers have intrinsic sympathetic activity?

a)

Acebutalol

b)

Penbutolol

c)

Pindolol

d)

Labetalol

e)

Nadolol

138.

What effects do beta blockers with intrinsic sympathetic activity have on beta receptors?

a)

Similar to other beta blockers

b)

Less reduction of HR

c)

Less reduction of CO

d)

Less reduction of TPR

139.

Select all the beta 1 blockers:

a)

Atenolol

b)

Betaxolol

c)

Bisoprolol

d)

Esmolol

e)

Metoprolol

140.

What is the reason (related to metabolism) that you may see differences in efficacy/adverse effects with Metoprolol?

a)

Extensively metabolized by CYP2D6

b)

High first pass metabolism

c)

Short half life 4-6 hours

d)

Long half life 10-12 hours

141.

Select the mixed alpha/beta blockers:

a)

Carvedilol

b)

Labetalol

c)

Nebivolol

142.

Select the beta blocker/vasodilator:

a)

Carvedilol

b)

Labetalol

c)

Nebivolol

143.

Which describe the mechanism of action for Nebivolol?

a)

Beta 1 blocker

b)

NO activation

c)

Smooth muscle relaxation

d)

Muscle constriction

e)

Decrease NO

144.

Why are beta 1 blockers less likely to have adverse effects in patients with asthma and COPD than non-selective beta blockers?

a)

Nonselective drugs bind to beta-1 and beta 2 receptors

b)

Block the effect of sympathetic signaling on the bronchioles

c)

Leads to bronchoconstriction

d)

Leads to bronchodilation

145.

Select the alpha 2 agonists:

a)

Clonidine

b)

Guanfacine

c)

Methyldopa

d)

Klonidine

e)

Verapamil

146.

What is the target for site of action of CCBs?

a)

L-type calcium channel

b)

R-type calcium channel blockers

147.

What is the site of action for CCBs?

a)

Smooth muscle

b)

Cardiac muscle

c)

Skeletal muscle

148.

Why do CCBs cause constipation?

a)

Block influx of Ca2+

b)

Reduce contraction of smooth muscle

c)

Slows down GI tract

d)

Speeds up GI tract

e)

Speeds up GI tract

149.

Select the direct vasodilators:

a)

Hydralazine

b)

Minoxidil

c)

Monoactamine

d)

Acetycholine

150.

What are the effects of direct vasodilators on TPR and MAP?

a)

Arteriole smooth muscle relaxation

b)

Reduces TPR

c)

Lowers MAP

d)

Increases TPR

e)

Arteriole smooth muscle constriction

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