CVS PHYSIOLOGY MULTIPLE CHOICE QUESTIONS

Origin of the Heartbeat & the Electrical Activity of the Heart

1. Which part of the ECG corresponds to ventricular repolarization?
A. The P wave
B. The QRS duration
C. The T wave
D. The U wave
E. The PR interval
2. Which of the following normally has a slowly depolarizing “prepotential”?
A. Sinoatrial node
B. Atrial muscle cells
C. Bundle of His
D. Purkinje fibers
E. Ventricular muscle cells
3. In second-degree heart block
A. the ventricular rate is lower than the atrial rate.
B. the ventricular ECG complexes are distorted.
C. there is a high incidence of ventricular tachycardia.
D. stroke volume is decreased.
E. cardiac output is increased.
4. Currents caused by opening of which of the following channels contribute to the
repolarization phase of the action potential of ventricular muscle fibers?
A. Na + channels
B. Cl − channels
C. Ca 2+ channels
D. K + channels
E. HCO 3− channels
5. In complete heart block
A. fainting may occur because the atria are unable to pump blood into the ventricles.
B. ventricular fibrillation is common.
C. the atrial rate is lower than the ventricular rate.
D. fainting may occur because of prolonged periods during which the ventricles fail
to contract.
The Heart as a Pump
1. The second heart sound is caused by
A. closure of the aortic and pulmonary valves.
B. vibrations in the ventricular wall during systole.
C. ventricular fi lling.
D. closure of the mitral and tricuspid valves.
E. retrograde fl ow in the vena cava.
2. The fourth heart sound is caused by
A. closure of the aortic and pulmonary valves.
B. vibrations in the ventricular wall during systole.
C. ventricular fi lling.
D. closure of the mitral and tricuspid valves.
E. retrograde fl ow in the vena cava.
3. The dicrotic notch on the aortic pressure curve is caused by
A. closure of the mitral valve.
B. closure of the tricuspid valve.
C. closure of the aortic valve.
D. closure of the pulmonary valve.
E. rapid fi lling of the left ventricle.
4. During exercise, a man consumes 1.8 L of oxygen per minute. His arterial O 2 content
is 190 mL/L, and the O 2 content ofhis mixed venous blood is 134 mL/L. His cardiac
output is approximately
A. 3.2 L/min.
B. 16 L/min.
C. 32 L/min.
D. 54 L/min.
E. 160 mL/min.
5. The work performed by the left ventricle is substantially greater than that performed
by the right ventricle, because in the left ventricle
A. the contraction is slower.
B. the wall is thicker.
C. the stroke volume is greater.
 D. the preload is greater.
E. the aft erload is greater.
6. Starling’s law of the heart
A. does not operate in the failing heart.
B. does not operate during exercise.
C. explains the increase in heart rate produced by exercise.
D. explains the increase in cardiac output that occurs when venous return is
increased.
E. explains the increase in cardiac output when the sympathetic nerves supplying the
heart are stimulated.
Blood as a Circulatory Fluid & the Dynamics of Blood & Lymph Flow
1. Which of the following has the highest total cross-sectional area in the body?
A. Arteries
B. Arterioles
C. Capillaries
D. Venules
E. Veins
2. Lymph fl ow from the foot is
A. increased when an individual rises from the supine to the standing position.
B. increased by massaging the foot.
C. increased when capillary permeability is decreased.
D. decreased when the valves of the leg veins are incompetent.
E. decreased by exercise.
3. The pressure in a capillary in skeletal muscle is 35 mm Hg at the arteriolar end and 14
mmHg at the venular end. The interstitial pressure is 0 mmHg. Th e colloid osmotic
pressure is 25 mmHg in the capillary and 1 mmHg in the interstitium. The net force
producing fl uid movement across the capillary wall at its arteriolar end is
A. 3 mm Hg out of the capillary.
B. 3 mm Hg into the capillary.
C. 10 mm Hg out of the capillary.
D. 11 mm Hg out of the capillary.
E. 11 mm Hg into the capillary.
4. The velocity of blood fl ow
A. is higher in the capillaries than the arterioles.
B. is higher in the veins than in the venules.
C. is higher in the veins than the arteries.
D. falls to zero in the descending aorta during diastole.
E. is reduced in a constricted area of a blood vessel.
5. When the radius of the resistance vessels is increased, which of the following is
increased?
A. Systolic blood pressure
B. Diastolic blood pressure
 C. Viscosity of the blood
D. Hematocrit
E. Capillary blood fl ow
6. A 30-year-old patient comes to her primary care physician complaining of headaches
and vertigo. A blood test reveals a hematocrit of 55%, and a diagnosis of polycythemia is
made. Which of the following would also be increased?
A. Mean blood pressure
B. Radius of the resistance vessels
C. Radius of the capacitance vessels
D. Central venous pressure
E. Capillary blood flow
7. A pharmacologist discovers a drug that stimulates the production of VEGF receptors.
He is excited because his drug might be of value in the treatment of
A. coronary artery disease.
B. cancer.
C. emphysema.
D. diabetes insipidus.
E. dysmenorrhea.
8. Why is the dilator response to injected acetylcholine changed to a constrictor response
when the endothelium is damaged?
A. More Na + is generated.
B. More bradykinin is generated.
C. The damage lowers the pH of the remaining layers of the artery.
D. The damage augments the production of endothelin by the endothelium.
E. The damage interferes with the production of NO by the endothelium.
Cardiovascular Regulatory Mechanisms
1. When a pheochromocytoma (tumor of the adrenal medulla) suddenly discharges a large
amount of epinephrine into the circulation, the patient’s heart rate would be expected to
A. increase, because the increase in blood pressure stimulates the carotid and aortic
baroreceptors.
B. increase, because epinephrine has a direct chronotropic effect on the heart.
C. increase, because of increased tonic parasympathetic discharge to the heart.
D. decrease, because the increase in blood pressure stimulates the carotid and aortic
chemoreceptors.
E. decrease, because of increased tonic parasympathetic discharge to the heart.
2. A 65-year-old male had been experiencing frequent episodes of syncope as he got out
of bed in the mornings. He was diagnosed with orthostatic hypotension due to a
malfunction in his baroreceptor reflex. Activation of the baroreceptor reflex
A. is primarily involved in short-term regulation of systemic blood pressure.
B. leads to an increase in heart rate because of inhibition of the vagal cardiac motor
neurons.
C. inhibits neurons in the CVLM.
D. excites neurons in the RVLM.
E. occurs only under situations in which blood pressure is markedly elevated.
3. A 45-year-old female had a blood pressure of 155/95 when she was at her physician’s
office for a physical. It was her first time to see this physician and her first physical in over
10 years. The doctor suggested that she begin monitoring her pressure at home.
Sympathetic nerve activity would be expected to increase
A. if glutamate receptors were activated in the NTS.
B. if GABA receptors were activated in the RVLM.
C. if glutamate receptors were activated in the CVLM.
D. during stress.
E. when one transitions from an erect to a supine posture.
4. Which of the following neurotransmitters are correctly matched with an autonomic
pathway?
A. GABA is released by NTS neurons projecting to the RVLM.
B. Glutamate is released by CVLM neurons projecting to the IML.
 C. GABA is released by NTS neurons projecting to the nucleus ambiguus.
D. GABA is released by CVLM neurons projecting to the RVLM.
E. Glutamate is released by CVLM neurons projecting to the NTS.
5. A 53-year-old woman with chronic lung disease was experiencing diffi culty breathing.
Her arterial Po2 and Pco2 were 50 and 60 mm Hg, respectively. Which one of the
following statements about chemoreceptors is correct?
A. Peripheral chemoreceptors are very sensitive to small increases in arterial Pco2
B. Activation of arterial chemoreceptors leads to a fall in arterial pressure.
C. Peripheral chemoreceptors are located in the NTS.
D. Central chemoreceptors can be activated by an increase in intracranial pressure
that compromises blood fl ow in the medulla.
E. Central chemoreceptors are activated by increases in tissue pH.
6. A 55-year-old man comes to his primary care physician complaining of erectile
dysfunction. He is given a prescription for Viagra, and on follow-up, reports that his
ability to sustain an erection has been improved markedly by this treatment. The action
of which of the following vasoactive mediators would primarily be increased in this
patient?
A. Histamine
B. Endothelin-1
C. Prostacyclin
D. Nitric oxide
E. Atrial natriuretic peptide
Circulation through Special Regions
1. Blood in which of the following vessels normally has the lowest PO2?
A. Maternal artery
B. Maternal uterine vein
C. Maternal femoral vein
D. Umbilical artery
E. Umbilical vein
2. The pressure differential between the heart and the aorta is least in the
A. left ventricle during systole.
B. left ventricle during diastole.
C. right ventricle during systole.
D. right ventricle during diastole.
E. left atrium during systole.
3. Injection of tissue plasminogen activator (t-PA) would probably be most beneficial
A. after at least 1 year of uncomplicated recovery following occlusion of a coronary
artery.
B. after at least 2 months of rest and recuperation following occlusion of a coronary
artery.
C. During the second week after occlusion of a coronary artery.
D. During the second day after occlusion of a coronary artery.
E. During the second hour after occlusion of a coronary artery.
4. Which of the following organs has the greatest blood flow per 100 g of tissue?
A. Brain
B. Heart muscle
C. Skin
D. Liver
E. Kidneys
5. Which of the following does not dilate arterioles in the skin?
A. Increased body temperature
B. Epinephrine
C. Bradykinin
D. Substance P
 E. Vasopressin
6. A baby boy is brought to the hospital because of convulsions. In the course of a workup,
his body temperature and plasma glucose are found to be normal, but his cerebrospinal
fluid glucose is 12 mg/dL (normal, 65 mg/dL). A possible explanation of his condition is
A. constitutive activation of GLUT 3 in neurons.
B. SGLT 1 deficiency in astrocytes.
C. GLUT 5 deficiency in cerebral capillaries.
D. GLUT 1 55K deficiency in cerebral capillaries.
E. GLUT 1 45K deficiency in microglia.
ANSWERS

Origin of the Heartbeat & the Circulation Through Special

Electrical Activity of the Heart Regions
1. C 1. D
2. A 2. A
3. A 3. E
4. D 4. E
5. D 5. E
The Heart as a Pump 6. D
1. A
2. C
3. C
4. C
5. E
6. D
Blood as a Circulatory Fluid & the
Dynamics of Blood & Lymph Flow
1. C
2. B
3. D
4. B
5. E
6. A
7. A
8. E
Cardiovascular Regulatory
Mechanisms
1. B
2. A
3. D
4. D
5. D