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Multiple Choice Questions (MCQ) Block Cardiovascular 2025

Total questions: 80

Worksheet time: 40mins

Name
Class
Date
1.

Mrs. Humaeroah has atrial septum defect (ASD) in his heart. Dr. Ingrid detected (from echocardiography) there was a large defect of 2 cm with blood flow shunting left-to-right at the atrial septum. What will be the oxygen saturation of Mrs. Humaeroah (measured at the aorta)?

a)

70 - 80%

b)

>100%

c)

80 - 90%

d)

90 - 100%

e)

60 - 80%

2.

Phase 3 of myocyte action potential is the final phase of repolarization that returns the transmembrane voltage back to the resting potential. What is the ion current that responsible for this phase?

a)

inward Na currents

b)

outward Ca currents

c)

outward K currents

d)

outward Na currents

e)

Inward K currents

3.

Phase 1 of the action potential of myocytes is a brief episode of transient repolarization. The current/activity responsible for phase 1 is:

a)

transient activation of potassium channels

b)

transient activation of calcium channels

c)

transient influx of potassium ions

d)

transient outflow of sodium ions

e)

transient influx of magnesium ions

4.

You are recording your friend's EKG. The EKG result is as shown in the image below. You conclude that this is a sinus rhythm because:

a)

a. The QRS segment is mostly positive in lead II

b)

b. There is no Q wave at the ECG

c)

c. The P wave is upright at lead II and negative at lead aVR

d)

d. The QRS is regylar

e)

e. The T wave is upright at most leads

5.

Mr. Sederhana, 70 years old, experienced severe chest pain 1 hour before being admitted to the hospital. The EKG is shown below. What sign on the EKG supports the early onset of a myocardial infarction?

a)

ST depression in lead III and aVF

b)

Rhythm is still sinus

c)

Inverted T waves in lead aVR

d)

Heart rate is not too fast (<100 bpm)

e)

T waves are tall and pointed in V2 to V6

6.

During light microscopic examination of a tissue, you notice a vessel with endothelial cells

and a few layers of smooth muscle. Which of the following vessels are you examining?

a)

a. Venule

b)

b. Elastic artery

c)

c. Large vein

d)

d. Capillary

e)

e. Arteriole

7.

The correct order of the atherosclerosis process is:

a)

Migration of LDL to the intima layer – endothelial dysfunction – oxidation of LDL – expression of scavenger receptors – adhesion of monocytes – migration of smooth muscle cells – formation of foam cells

b)

Endothelial dysfunction – migration of LDL to the intima layer – oxidation of LDL – adhesion of monocytes – expression of scavenger receptors – migration of smooth muscle cells – formation of foam cells

c)

Endothelial dysfunction – oxidation of LDL – migration of LDL to the intima layer – migration of smooth muscle cells – adhesion of monocytes – expression of scavenger receptors – formation of foam cells

8.

Regarding the risk factors for ischemic heart disease:

a)

The risk from smoking declines to almost normal soon after cessation

b)

It is more common in obese people

c)

Moderate consumption of alcohol reduces the risk of ischemic heart disease

d)

Meditation has been proven to reduce the development of ischemic heart disease

e)

Premenopausal women have almost the same risk as men in developing ischemic heart disease

9.

Regarding the first heart sound all the followings are correct, Except:

a)

a. The tricuspid component is heard at the lower end of the sternum.

b)

b. It is caused by the sudden closure of the mitral and tricuspid valves at the start of

ventricular diastole.

c)

c. The mitral component is heard better at the apex of the heart.

d)

d. Is loud (accentuated) in tachycardia.

10.

Tuan Nichols, 60 years old, enters the emergency department due to acute decompensated heart failure. From the physical examination of heart sounds, you hear a gallop after the second heart sound. What is the mechanism of this gallop?

a)

Opening of the pulmonary valve

b)

Opening of the mitral valve

c)

Contraction of the atrium to the "stiff" left ventricle

d)

Rapid filling of the ventricle into a non-compliant ventricle

e)

Closure of the aortic valve

11.

Coronary artery disease is caused by atherosclerotic plaque in the coronary artery. What is

the initial event of atherosclerosis formation?

a)

a. Phagocytosis of LDL cholesterol by the macrophages

b)

b. Migration of smooth muscle onto subintimal layer

c)

c. Activation of the monocytes become macrophages

d)

d. Activation of scavenger receptor in the macrophages

e)

e. Disruption of the single layer endothelium

12.

A 60-year old man with mitral valve regurgitation is undergoing echocardiography

examination. The flow Doppler from the echocardiogram can reveal the blood flow in the

heart. Which of the heart chambers will the regurgitating blood re-enter?

a)

a. Right atrium during systole

b)

b. Left ventricle during diastole

c)

c. Left atrium during diastole

d)

d. Left atrium during systole

e)

e. Right atrium during diastole

13.

Mr. Bowo, 50-year-old, suffered from anterior myocardial infarction 2 months ago. Previously healthy, now he is having shortness of breath due to heart failure. Chest X Ray revealed his enlarged heart. What can cause enlargement of the heart after myocardial infarction?

a)

Increased afterload

b)

Increased contractility

c)

Chronic myocardial ischemia

d)

Left ventricle remodeling

e)

Increased preload

14.

What is the normal electrical conduction pathway in the heart?

a)

SA node, AV node, Purkinje, bundle branches, bundle of His

b)

SA node, AV node, bundle of His, bundle branches, Purkinje

c)

SA node, bundle of His, AV node, bundle branches, Purkinje

d)

AV node, SA node, bundle of His, bundle branches, Purkinje

e)

SA node, AV node, bundle branches, bundle of His, Purkinje

15.

The main difference between the action potential of cardiac muscle cells and skeletal muscle cells is the presence of a plateau phase (phase 2). What actually happens during phase 2?

a)

Inflow of potassium ions

b)

Inflow of chloride ions

c)

Rapid inflow of sodium ions

d)

Inflow of calcium ions

e)

Inflow of magnesium ions

16.

What cell in the circulating blood is the precursor to macrophage and most

antigen-presenting cells?

a)

a. Monocyte

b)

b. Mast cell

c)

c. Basophil

d)

d. Lymphocyte

e)

e. Eosinofil

17.

Congenital heart lesions can be categorized as cyanotic or acyanotic. What is cyanosis

refers to?

a)

a. a blue-purple discoloration of the skin and mucous membranes caused by decrease

level of hemoglobin

b)

b. a blue-purple discoloration of the skin and mucous membranes caused by

left-toright shunt intracardiac

c)

c. a blue-purple discoloration of the skin and mucous membranes caused by stenosis

of pulmonary artery

d)

d. a blue-purple discoloration of the skin and mucous membranes caused by an

elevated level of oxygenated hemoglobin

e)

e. a blue-purple discoloration of the skin and mucous membranes caused by an

elevated level of deoxygenated hemoglobin

18.

One of the medications prescribed to Mr. Vistom is shown here.

How do you interpret this?

a)

a. This prescribed will be enough for 60 days

b)

b. Ramipril should be taken after meal

c)

c. Ramipril 5 mg to be taken two tablets each time

d)

d. Ramipril 5 mg to be taken twice daily

e)

e. Ramipril 5 mg was prescribed 10 tablets

19.

A 50-year old woman thought that her heart was beating too slow. Her ECG showed a

complete record of P, Q, R, S, T waves in every cycle with an RR interval of 1200 msec. Her

heart rate was:

a)

50

b)

80

c)

100

d)

120

e)

10

20.

All are the functions of the intercalated disks EXCEPT:

a)

a. Contain gap junctions that allow electrical continuity between cardiac cells

b)

b. Provide strong union between fibers.

c)

c. Connect two adjacent cardiac cells.

d)

d. Connect actin filaments of adjacent cells at M lines.

21.

Mr. Joko, 50-year-old, is known to have coronary artery disease. His doctor gave him

bisoprolol, a beta-blocker agent, as one of his regular medications. What is the mechanism

of this medication for his situation?

a)

a. Decrease his anxiety about the disease

b)

b. Reduce heart rate to decrease myocardial oxygen demand

c)

c. Prevent thrombus formation at the atherosclerotic plaque

d)

d. Prevent development of atherosclerotic plaque

e)

e. Vasodilate the coronary artery to increase myocardial oxygen supply

22.

While sitting in the plenary class of cardiovascular block, your name was mentioned to come forward. Your heart rate increased significantly from 60 beats per minute to 100 beats per minute. What is the mechanism of this increased heart rate?

a)

Increased renin angiotensin system

b)

Increased parasympathetic system

c)

Reentry electrical signal in the heart

d)

Enhanced automaticity of action potentials

e)

Increased sympathetic system

23.

Pacemaker cells are endowed with the property of automaticity. This property occurred due to certain characteristics of action potential which are different from those of myocyte action potential. Which property is not unique for action potential of pacemaker cell?

a)

a. The ion channel through which the pacemaker current passes is different from the

fast sodium channel responsible for phase 0 of the myocyte

b)

b. phase 4 of pacemaker cell action potential has an upward slope

c)

c. the maximum negative voltage of pacemaker cell is less negative

d)

d. All of those statements are correct

e)

e. the phase 0 upstroke of the pacemaker cell action potential relies mainly on Na

influx

24.

A patient with severe chest pain and bradycardia brought to Emergency room. The cardio X-ray CT revealed that the left anterior descending (LAD) coronary artery was blocked 70%. What sulci is LAD artery located?

a)

Posterior Interventricular

b)

Coronary sinus

c)

Anterior Intraventricular

d)

Right Marginal

e)

Left Marginal

25.

The Frank-Starling mechanism is a special feature in the contractility of cardiac muscle. Which statement is true regarding the Frank-Starling mechanism?

a)

In situations with increased contractility, the stroke volume will be the same as in a normal heart

b)

Within physiological limits, the more the ventricle is distended during diastole, the lower the cardiac output

c)

Cardiac output in heart failure can significantly increase with increased preload

d)

In heart failure, increased end-diastolic pressure in the left ventricle can lead to dangerous conditions (pulmonary congestion) without a significant increase in stroke volume

e)

The Frank-Starling mechanism works more efficiently in heart failure

26.

When examining your friend's heart sounds, you hear physiological splitting of the second heart sound during deep inspiration. What is the mechanism of this physiological splitting?

a)

Deep breathing causes delayed closure of the pulmonary valve

b)

Deep breathing causes delayed closure of the aortic valve

c)

Deep breathing causes earlier closure of the mitral valve

d)

Deep breathing causes earlier closure of the tricuspid valve

e)

Deep breathing causes delayed closure of the mitral valve

27.

Which basic tissue type predominates in the tunica media?

a)

Connective tissue

b)

Muscle

c)

Neuron

d)

Epithelium

e)

Nerve

28.

Ventricular pressure is higher than the atrial pressure in all phases of the cardiac cycle except in:

a)

isometric contraction phase

b)

maximum ejection phase

c)

reduced ejection phase

d)

atrial systole phase

29.

What is the normal pressure (cmH2O) of the heart chambers?

a)

RA = 2-8 ; LA = 2-10; RV = 15-30/2-8; LV 100-140/2-10

b)

RA = 2-8; LA = 2-10; RV = 100-140/2-8; LV 100-140/2-10

c)

RA = 15-30 ; LA = 15-30; RV = 100-140/2-8; LV 100-140/2-10

d)

d. RA = 15-30 ; LA = 15-30; RV = 15-30/2-8; LV 15-30/2-10

e)

e. RA = 15-30 ; LA = 15-30; RV = 15-30/2-8; LV 100-140/2-10

30.

Mr. Joko, 50 years old, is known to have ischemic heart disease. He experiences stable angina pectoris. How would you describe the typical characteristics of stable angina pectoris?

a)

Chest pain can be localized with two fingers

b)

Pain like being pinched in the left chest lasting one second

c)

Retrosternal pain provoked by physical activity, improves with rest

d)

Chest pain worsens with deep inspiration

e)

Sharp pain like tearing in the back radiating to the abdomen

31.

In the histology of myocytes, the sarcomere is the smallest contractile unit in the myofibril. Which labeling in this microscopic histology of myocytes indicates one sarcomere?

a)

Segment A

b)

Segment I

c)

Segment M

d)

Segment H

e)

Segment Z-to-Z

32.

Mr. Damar, 28 years old, is suffered from mitral stenosis. Lying down with head up 30 degree, the jugular vein was measured at 5 + 4 cmH2O. Blood pressure was 110/70 mmHg. Heart catheterisation revealed: pulmonary pressure (PA) pressure was 40/20 mmHg, pulmonary capillary wedge (PCW) pressure 26. Mean gradient trans-mitral was 19. Using the data above, describe the cardiac pressure of each chamber.

a)

Right atrial = 9; right ventricle = 40/20; left atrium = 26; left ventricle = 110/70

b)

Right atrial = 4; right ventricle = 40/9; left atrium = 26; left ventricle = 110/7

c)

Right atrial = 9; right ventricle = 40/9; left atrium = 26; left ventricle = 110/70

d)

Right atrial = 9; right ventricle = 40/9; left atrium = 19; left ventricle = 110/7

e)

Right atrial = 9; right ventricle = 40/9; left atrium = 26; left ventricle = 110/7

33.

ECG record gives valuable information about all of the following except:

a)

Disturbance of rhythm and conduction

b)

The influence of some drugs

c)

Ischemic changes of the myocardium

d)

Relative size of heart chamber

e)

Cardiac output

34.

During an action potential, there is a certain period in which muscle is refractory to restimulation. What is correct about the refractory periods?

a)

The ventricular muscle cells has a shorter refractory period that the atrial cells.

b)

The plateau phase of action potential in cardiac cells contribute to the absolute refractory period

c)

This phenomenon is inherited in nerves, skeletal and cardiac muscle cells.

d)

It is abnormal situation that may present in diseased cardiac cells

e)

Any strong stimulation can induce activation at the absolute refractory period.

35.

In which lead are you most likely to observe ST segment elevation during an acute and extensive infarction of the anterior and lateral walls of the heart?

a)

Lead I, II, III

b)

Lead I, aVL, and V1-V6

c)

Lead II, III, and aVF

d)

Lead aVR, aVL, and aVF

36.

What is the afterload factor in the regulation of stroke volume?

a)

contractile strength at a given muscle length, dependent of EDV

b)

Varying degree of stretching of myocardium by EDV.

c)

pressure that must be overcome for ventricles to eject blood

d)

degree of stretch of cardiac muscle cells before they contract

e)

pressure that must be overcome for Atrial to eject blood

37.

You are measuring the jugular vein pressure (JVP) of Mr. Bambang, 50-year-old. He has suffered from the congestive heart failure. The result of the JVP measurement was 5 + 4 cmH2O. What information contained in this measurement?

a)

The vertical height of the external jugular vein was 4 cm above the sternal angle

b)

The estimate right atrial pressure was 9 cmH2O

c)

The sternal angle is located approximately 5 cm above the center of the left ventricle

d)

The estimate left atrial pressure was 9 cmH2O

e)

The estimate left ventricle pressure was 5 cmH2

38.

Acute coronary syndrome occurs due to sudden occlusion of the coronary artery. What is the mechanism of the sudden occlusion?

a)

Thrombosis process due to infection at the atherosclerotic plaque

b)

Thrombosis process that was triggered by the ruptured plaque

c)

Progressive thickening of the atherosclerosis plaque

d)

Vessel wall rupture

e)

Thrombosis process due to increased blood viscosity

39.

An action potential was recorded in a myocyte, as revealed in the picture. What is the best

explanation of the occurrence of phase 0?

a)

a. influx of calcium ion into the cell through fast channels

b)

b. influx of potassium ion into the cell through fast channels

c)

c. efflux of chloride ion out of the cell through fast channels

d)

d. influx of natrium ion into the cell through fast channels

e)

e. influx of magnesium ion into the cell through fast channel

40.

EKG findings in bundle branch block (BBB):

a)

Prolonged & deformed QRS complex

b)

Slow HR rate

c)

Double hump QRS complex occurs in V5 & V6 in right BBB

d)

Related to the absence of P wave

41.

When examining your friend's heart sounds, you hear the first and second heart sounds that are normal. You learn further that the first heart sound is associated with:

a)

Closure of the aortic and pulmonary valves

b)

Filling of the ventricles during early diastole

c)

Opening of the aortic and pulmonary valves

d)

Closure of the mitral and tricuspid valves

e)

Opening of the mitral and tricuspid valves

42.

The following is NOT an instance of unstable angina

a)

Anginal pain occurring for the first time

b)

A sudden reduction in the distance the patient can walk without chest pain

c)

Anginal pain occurring after meals

d)

Chest pain on walking to the toilet 4 days after an episode of myocardial infarction

e)

Prolonged angina at rest

43.

A 56-year-old man with congestive heart failure comes to the Emergency Department due to pink frothy sputum. Which of the following blood vessels is most likely responsible for the patient's sputum?

a)

Pulmonary artery

b)

Pulmonary lymphatics

c)

Pulmonary veins

d)

Pulmonary capillaries

e)

Pulmonary trunk

44.

Echocardiography was done to assess the cardiac valves problem for Mr. Hariono, 14-year-old. It shown that he suffered from mitral valve regurgitation. While performing 

cardiac auscultation, you heard a systolic murmur of grade 5/6. What can be found while you do cardiac palpation examination? 

a)

a. Heaving 

b)

b. Thrill 

c)

c. Ictus cordis 

d)

d. Nothing 

e)

e. irregular heart rate

45.

A 30-year-old man fell down from a tree. He felt pain on his upper left chest. He went to the 

hospital, and an X ray photograph showed a fracture of his 5th left ribs near the cartilage joint. What nerve is most probably injured? 

a)

a. Intercostal nerve

b)

b. Thoracic suprema nerve 

c)

c. Subcostal nerve 

d)

d. Phrenic nerve 

e)

e. Vagar nerve

46.

A 50-year-old man is having a decompensated heart failure. During the examination at the 

Emergency Department, you heard a gallop of fourth heart sound at heart auscultation. What is the mechanism of this sound? 

a)

a. Closing of aortic valve 


b)

b. Closing of mitral valve 

c)

c. Turbulence of aortic regurgitation 

d)

d. Turbulence of mitral regurgitation

e)

e. Impaired compliance of left ventricle 

47.

Fast sodium channel is crucial in electrical depolarisation of cardiac cells. Which characteristic is true regarding the fast sodium channel? 

a)

a. in resting state, fast sodium channels are in open stated - allowing to sodium flow 

through the cell 


b)

b. fast sodium channels are easier to be activated in less negative resting potential 

membrane 

c)

c. fast sodium channels in pacemaker cells do not play a role in the generation of the 

action potential 

d)

d. Fast sodium channel is activated by chemical trigger 

e)

e. all of those statements are correct 

48.

A 20-year-old lady was diagnosed with severe mitral stenosis. Her ECG was shown below. 

She was told that her left atrium was enlarged. Which part of the ECG show that abnormality? 

a)

The ST segmen

b)

The P wave

c)

The T wave

d)

The QRS wave

e)

The PE interval

49.

The resting membrane potential of myocardial cells is about -90 mV. Below are the reason why the inside of the cell is negative relative to the outside, except? 

a)

a. Gradient concentration of Na+ 


b)

b. Gradient concentration

of Ca++ 

c)

c. Gradient concentration of Mg++ 

d)

d. Gradient concentration of K+ 

e)

e. Gradient concentration of Cl- 

50.

Echocardiography is an ultrasonography-based diagnostic tools in evaluating cardiac 

problem. It can NOT be used to evaluate: 

a)

a. Congenital heart disease 

b)

b. Heart valves anatomy 

c)

c. left ventricle ejection fraction 

d)

d. Pericardial effusion 

e)

e. Stenosis of coronary artery

51.

Fitri, a 39-year old pregnant woman presents with acute dyspnea. What is the NOT a likely 

cause of her symptoms 

a)

Asthma

b)

Mitral stenosis

c)

Acute Myocardial Infraction

d)

Pulmonary Embolism

e)

Pneumonia

52.

You are studying anatomy of an ECG. It was shown here. What happened in the marker 3 of the ECG? 

a)

Ventricular Repolarisation

b)

Atrial Depolarisation

c)

Atrial Repolarisation

d)

Ventricular repolarisation

e)

Atrioventricular delay

53.

The heart muscle is supplied by a system artery named coronary artery. This is a figure illustrating anatomical course of main branch of coronary artery. Mention the name of 

a)

a. A = left circumflex artery; B = left anterior descending artery; C = right coronary 

artery 


b)

b. A = left anterior descending artery; B = right coronary artery; C = left circumflex 

artery 

c)

c. A = right coronary artery; B 

artery 

= left circumflex artery; C 

=  left anterior descending 

d)

d. A = left anterior descending artery; B = left circumflex artery; C = right coronary 

artery 

e)

e. A = right coronary artery; B = left anterior descending artery; C = left circumflex 

artery 

54.

Mr T, a 59 year old gentleman, came to an outpatient clinic near his house because in the past few days he felt that he was easily tired. He had been diagnosed with dilated cardiomyopathy with low ejection fraction of 34%. He admitted to the physician on duty that he failed to fulfil his prescription since his last visit 3 weeks prior. He is struggling with menial day-to-day tasks; even taking a bath or sweeping the floor, which he used to be able to do effortlessly, now leave him breathless that he had to ask his children to help him. According to the New York Heart Association, what is Mr. T current heart failure functional class? 

a)

NYHA II

b)

NYHA I

c)

NYHA IV

d)

none

e)

NYHA III

55.

The cardiac cycle consists of precisely timed mechanical events. This figure displays the pressure of left-sided cardiac chambers during a normal cardiac cycle. Describe the events which occur at point A, B, C and D! 

a)

a. A = Mitral valve opens; B = aortic valve opens; C = aortic valve closes; D = mitral valve 

closes 


b)

b. A = Mitral valve opens; B = aortic valve opens; C = aortic valve closes; D = mitral valve 

opens 

c)

c. A = Mitral valve closes; B = aortic valve opens; C = aortic valve closes; D = mitral valve 

opens 

d)

d. A = aortic valve close; B = aortic valve opens; C = mitral valve closes; D = mitral valve 

opens 

e)

e. A = aortic valve opens; B = mitral valve opens; C = aortic valve closes; D = mitral valve 

opens 

56.

This is ECG of Mr. Visek, 35 years old. 

Statements below are correct about this ECG, except: 

a)

a. the rhythm is sinus 

b)

b. QRS duration is < 100 ms 

c)

c. there is no ST elevation 

d)

d. PR interval is 300 ms 

e)

e. there is no abnormal Q wave 

57.

Mr R, 53 yo, presented with dyspnea, swelling of both legs, and nausea. He has been diagnosed as kidney failure 3 years ago, and declined for dialysis recommendation Which electrolyte problem showed in his ECG? 

a)
Hyperkalemia
b)
Hyponatremia
c)
Hypercalcemia
d)
Hypokalemia
e)

none

58.

What is the determinant of increased stroke volume? 

a)

decrease contractility

b)

increase heart rate

c)

increase cardiac output

d)

increase afterload

e)

increase preload

59.

Histology of myocyte is different compared to smooth muscle cell and skeletal muscle cell. 

Which property that characterizes the uniqueness of myocardial cells? 

a)

a. Cardiac muscle cells contract consciously 

b)

b. Myocyte contains only one or two centrally located nuclei 

c)

c. Myocyte does not connect at the intercalated disk 

d)

d. Myocytes are not arranged in sarcomeres and so are not striated 

e)

e. Myocyte does not have cross-striated banding pattern

60.

A 63-year-old man, with a past history of myocardial infarction. He has been experiencing shortness of breath on exertion. His legs were edematous. At the Emergency Department, he was diagnosed with acute lung edema. What is the mechanism of his situation? 

a)

a. Increased permeability of the arteriole 

b)

b. Increased hydrostatic pressure 

c)

c. Increased oncotic pressure 

d)

d. Vasoconstriction of pulmonary arteriole 

e)

e. Impaired lymphatic drainage

61.

Cardiac contraction is an excitation-contraction coupling phenomenon. Action potential conducted to the myocyte induce contraction of the myocyte. What is the mechanism of excitation-contraction coupling? 

a)

a. Influx of Na ion into the cytoplasm trigger release of Ca ion 

b)

b. Influx of Ca at phase 2 trigger a process of inhibition of Troponin-Tropomyosin 

c)

c. Influx of Na+ induces ATP hydrolysis at myosin head 

d)

d. Depolarization phase 0 of action potential induces cross-bridging of actin and 

myosin 

e)

e. Influx of K+ induces ATP hydrolysis at myosin head

62.

Phase 2 of myocyte action potential is a relatively long plateau phase. What cause this long plateau phase? 

a)

the slow opening of L-type Na channels

b)

the near equality of current from inward Na influx and outward K efflux

c)

c. the near equality of current from inward Ca influx and outward K efflux

d)

d. the resting state of all channels resulting in zero net current

e)

e. long period of potassium channels

63.

The contractile process of cardiac muscle cell initiated when myosin head is activated. What trigger activation of myosin head?

a)

Activation of myosin head by actin

b)

ATP hydrolysis

c)

ADP hydrolysis

d)

Activation of troponin I

64.

The propagation of repolarization from the ventricular epicardium to the endocardium is 

represented by the: 

a)

T wave

b)

QT interval

c)

TP period

d)

QRS complex

65.

Which is determined by ECG: 

a)

Effects due to changes in fluid electrolytes

b)

Cardiac output

c)

Mechanical performance of the heart

d)

Systolic and diastolic information

66.

Persistence of a patent ductus arteriosus following birth causes 

a)

Diastolic murmur

b)

Systolic murmur

c)

Gallop rhythm

d)

Continuous murmur

67.

During the formation of atherosclerotic plaque, you learned about the formation of foam

cell. What is the mechanism involved in the formation of foam cells?

a)

a. b.

Migration of smooth muscle cell into the intimal layer

b)

Macrophage engorgement of cholesterol particles, promoted by scavenger

receptors

c)

Rupture of the intimal layer

d)

Thrombus formation at the intimal layer

e)

atelet activation at the intimal layer

68.

Several distinct proteins are responsible for cardiac muscle cells contraction. The major

proteins contributing in cardiac muscle cells contraction are?

a)

Actin & myosin

b)

Troponin & myosin

c)

Actin & tintin

d)

Troponin & tintin

69.

During fetal life, oxygenated blood leaves the placenta through the umbilical vein to the

fetus. There are shunts that allow most of the blood to bypass the liver and lungs. Which

shunt allows bypassing the liver to the inferior venous cava?

a)

Ductus venosus

b)

Truncus arteriosus

c)

Foramen ovale

d)

Septum secundum

70.

Electrical signal in the heart is generated in the sinoatrial node; and then conducted

throughout the heart via anatomical conduction system. In which part of the conduction

system was the electrical signal delayed?

a)

Atrioventrikular node

b)

Left bundle branch

c)

Right bundle branch

d)

Atrium

71.

Causes of diastolic murmur:

a)

Stenosis of pulmonary valve

b)

Stenosis of mitral valve

c)

Stenosis of aortic valve

d)

Intraventricular septal defect

e)

Aortic of pulmonary valve

72.

Left axis deviation of the ECG is described as:

a)

Tidak ada yang benar

b)

Right ventricle is enlarged.

c)

The axis of the heart is from -30 o

to +90 o

d)

The QRS is prominent positive in lead I and prominent negative in lead III

73.

In the pathophysiology of heart failure, increasing the preload volume of left ventricular will

a)

increase stroke volume slightly; much less than in normal heart

b)

increase stroke volume significantly as seen in normal heart

c)

increase heart rate significantly; as seen in normal heart

d)

increase afterload significantly as seen in normal heart

74.

A 20-year-old man was in a car accident. X-ray examination showed a fracture of sternum.

The heart surgeon opened the thorax to stop the bleeding. What vessel is most likely torn in

the anterior mediastinum?

a)

Pulmonary artery

b)

Internal thoracic artery

c)

Subclavian artery

d)

Intercostal artery

75.

During a normal cardiac cycle, an amount of blood is ejected from the heart. Refer to this

figure, at which period is the ejection phase?

a)

C to D

b)

B to C

c)

D to A

d)

a to B

76.

Immediately following birth, the neonate rapidly adjust to life outside the womb. As the

umbilical cord is clamped and the newly functional lungs replace placenta as the organ of

gas exchange, the transitional circulation occurs. Which of the following events is NOT

related the transitional circulation?

a)

fall of pulmonary vascular resistance

b)

increase in systemic vascular resistance

c)

increase blood flow through the umbilical vein

d)

rise in pulmonary blood flow

77.

You are learning the basic hemodynamic of the heart. This figure illustrated left ventricular

pressure and volume relationship in a cardiac cycle. How do you explain the event that

happen during point A to point D?

a)

Point A is the the end-systolic pressure of left ventricle

b)

Both mitral valve and aortic valve are open.

c)

The pressure at point A and point D is equal

d)

This is a phase called isovolumetric contraction

78.

You and your friend are doing hemodynamic measurement in clinical skill session. She has a

blood pressure of 120/80 mmHg, heart rate of 60 beats/min and respiratory rate of 20

x/min. While assuming that the normal stroke volume was 50 mL, what was her cardiac

output?

a)

7.2L/min

b)

7200ml/min

c)

3 L/min

d)

1000l/min

e)

3000L/min

79.

Mr. Vistom, 65 yo, had suffered from heart failure. He was admitted the hospital. He had to

take a sitting position to breath. He went back the emergency department. Blood pressure

was 180/100 mmHg, heart rate of 120 bpm, oxygen saturation was 88%. Physical

examination revealed wet rales at both lung. What is his current hemodynamic profile?

a)

Warm wet

b)

Dry wet

c)

Cool wet

d)

Cool dry

80.

Slowing of heart beat can be due to abnormal impulse formation or impaired impulse

conduction. Which of the arrhythmias below is due to abnormal impulse formation?

a)

Total AV block

b)

Second degree AV block

c)

Sick sinus symdrome

d)

Supraventricular takikardi