id
stringlengths
36
36
question
stringlengths
8
990
A
stringlengths
1
284
B
stringlengths
1
250
C
stringlengths
1
278
D
stringlengths
1
297
choice_num
int64
2
9
target
stringclasses
6 values
category
int64
1
3
E
stringlengths
1
604
F
stringclasses
14 values
G
stringclasses
3 values
H
stringclasses
3 values
I
stringclasses
1 value
500db74c-4447-56d3-b56b-7864d821de6a
A V/Q ratio of 1:0 is known as which one of the following?
Normal
Dead space
Shunt
Silent unit
4
B
1
null
null
null
null
null
7cd97bc9-a105-5b0d-93df-9cf68cd64bb1
A V/Q ratio of 0:0 is known as which one of the following?
Normal
Dead space
Shunt
Silent unit
4
D
1
null
null
null
null
null
6aa7cf81-3f82-5d80-9601-1f3f9001f888
A V/Q ratio of 0:1 is known as which one of the following?
Normal
Dead space
Shunt
Silent unit
4
C
1
null
null
null
null
null
dee78a7d-9068-5cca-838d-e32f851352f4
29. Which of the following statements regarding hypoxic pulmonary vasoconstriction (HPV) is false?
HPV leads to bronchiolar constriction.
HPV is stimulated by alveolar hypoxia.
HPV decreases blood flow.
HPV causes areas that were previously shunted to effectively become silent units.
4
A
1
null
null
null
null
null
5ea2755f-c289-5768-b72c-743de2849f50
Which of the following is/are direct inhibitor(s) of HPV?
Infection
Vasodilator drugs
Hypocarbia
A and C
5
E
1
All of the above
null
null
null
null
245e9c49-eb8e-5e6c-a364-e802a1ae3b83
Which of the following medical conditions shift(s) the oxyhemoglobin dissociation curve to the right?
Hypocapnia
Acidosis
Hyperthermia
B and C
5
D
1
A and B
null
null
null
null
a73f5302-16b8-5477-9de8-8891e00b6c18
In a normal patient, the Po2 drops from 100 to 40 mm Hg. What do you expect the pulse oximeter to read?
99%
95%
85%
<75%
4
D
1
null
null
null
null
null
c6a84037-19bf-583d-8570-e53a101dde94
Which of the following medical conditions cause(s) a leftward shift to the oxyhemoglobin dissociation curve?
Hypothermia
Alkalosis
Fetal hemoglobin
All of the above
4
D
1
null
null
null
null
null
3e4772c4-e063-56e0-9773-169ec8e284ce
Which of the following statements regarding respiratory acidosis is false?
It is improved with laparoscopic procedures.
It is always characterized by hypercarbia (PaCO2 > 45 mm Hg).
It occurs because of a decrease in minute alveolar ventilation.
It is usually characterized by a low pH (<7.35).
4
A
1
null
null
null
null
null
648a40ca-13c8-50e8-a1ec-5efd4aa0fc12
Which of the following statements is/are true regarding systemic effects of hypercapnia?
Arteriolar dilation
Increased sympathetic output
Pulmonary vasoconstriction
All of the above
4
D
1
null
null
null
null
null
53765e0a-d886-5522-8603-7d2f3f5196ce
Which of the following statements is false regarding hyperoxia?
It contributes to atelectasis.
Prolonged exposure may increase the risk of secondary infections.
It increases intracranial pressure.
It increases systemic vascular resistance.
4
C
1
null
null
null
null
null
f545b1ce-5532-5c13-af94-84c1b31a4036
37. Which of the following is/are the systemic effect(s) of hypoxia?
Peripheral vessels dilate
Increased ventilation
Increased cardiac output
All of the above
4
D
1
null
null
null
null
null
0c325aa4-5589-51be-a451-5772e543582f
Interpret this arterial blood gas (ABG): pH = 7.27, CO2 = 53, HCO2 = 24.
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
4
C
2
null
null
null
null
null
daa73226-a6e0-5a2a-8840-e2b543f5f456
Interpret this ABG: pH = 7.18, CO2 = 38, HCO3 = 16
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
4
A
2
null
null
null
null
null
33df2df2-e193-53a3-bc1d-a39a59c295f6
Interpret this ABG: pH = 7.60, CO2 = 37, HCO3 = 35
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
4
B
2
null
null
null
null
null
c9d529b4-7d4f-5cd7-960d-f159c92a7f40
The respiratory centers in the brain are located in which one of the following?
Cerebrum
Cerebellum
Brainstem
Spinal cord
4
C
1
null
null
null
null
null
2273a1a7-2dc9-5014-8071-86c87501b39d
Which of the following structures comprise(s) the peripheral chemoreceptors?
Carotid bodies
Carotid sinus
Aortic bodies
A and C
5
D
1
All of the above
null
null
null
null
02fec6f5-e07d-5db6-aca2-9a1cda5e7886
Central chemoreceptors are primarily sensitive to changes in which one of the following?
Carbon dioxide
Hydrogen ion concentration
Oxygen
Bicarbonate
4
B
1
null
null
null
null
null
45696ae6-6a1d-5d36-9f7a-6676f8884e85
The sources of ventilatory rhythmicity are located in which one of the following?
Dorsal respiratory group
Ventral respiratory group
Apneustic center
Pneumotaxic respiratory center
4
A
1
null
null
null
null
null
153a64aa-21e5-53fa-b68a-850407518850
45. Which of the following is/are known as cause(s) of true hyperventilation?
Arterial hypoxemia
Metabolic acidemia
A and B
None of the above
5
E
1
All of the above
null
null
null
null
446e1b82-6738-5687-ba3f-07d07471b3a9
At what level does PaO2 lack any influence on the carbon dioxide response curve?
<65 mm Hg
65 mm Hg
85 mm Hg
100 mm Hg
4
D
1
null
null
null
null
null
b291a79f-1aa7-5605-b080-9aea3599a1bf
Changes in physiology that can displace the carbon dioxide response curve to the right include which of the following?
Normal sleep
Opioids
Inhaled anesthetics
All of the above
4
D
1
null
null
null
null
null
5de0c7a5-077c-5075-acb8-242bf65c3c54
Which of the following statements is true regarding the oxyhemoglobin
Left shift leads to lower O2 affinity.
Left shift leads to higher O2 affinity.
Right shift leads to higher O2 affinity.
None of the above.
4
B
1
null
null
null
null
null
859b4e21-891a-57f0-8163-c75799c15cbd
50. How does fetal hemoglobin impact the hemoglobin dissociation curve?
Shifts it to the left.
Shifts it to the right.
Shifts it up.
Shifts it down.
4
A
1
null
null
null
null
null
e3256784-65f3-554e-8b3f-16ea7603baf6
With regards to smoking, which of the following statements is/are true?
Smoking leads to V/Q mismatch, bronchitis, and airway hyperreactivity.
Smoking leads to increased carboxyhemoglobin concentration.
Smoking is one of the main risk factors associated with postoperative morbidity.
All of the above.
4
D
1
null
null
null
null
null
9377e3b9-e1c5-5307-b0e9-8c801d22932a
Which of the following statements about smoking cessation is true?
Patients who quit smoking less than 8 weeks preoperatively have a significantly higher complication rate compared with those who quit more than 8 weeks preoperatively.
Smokers who decrease cigarette consumption in an attempt to quit without nicotine replacement therapy decrease their nicotine intake.
Smokers should be advised to stop smoking 3 months before elective operations to maximize the effect of smoking cessation.
If smokers stop for at least 2 weeks preoperatively, they benefit from improved mucociliary function.
4
A
1
null
null
null
null
null
1fa884b1-9eee-572a-88d7-99bf05267d17
Bronchodilators, such as albuterol, act on which type of receptor?
α1-Adrenergic
α2-Adrenergic
β1-Adrenergic
β2-Adrenergic
4
D
1
null
null
null
null
null
a88329ab-fe85-51f1-9c0c-b8c09551feb1
With regard to the action of anticholinergic bronchodilators, which of the following statements is/are true?
They act to block nicotinic receptors.
They block the formation of cyclic guanosine monophosphate.
They are muscarinic agonists.
B and C.
4
B
1
null
null
null
null
null
1ce44eb6-14db-52ec-9807-24cd1291b059
Which of the following statements describes the correct mechanism of action of β2-agonist bronchodilators?
Receptor activation leads to increased production of cyclic guanosine monophosphate.
Receptor activation leads to decreased production of cyclic guanosine monophosphate.
Receptor activation leads to increased production of cyclic adenosine monophosphate (cAMP).
Receptor activation leads to decreased production of cAMP.
4
C
1
null
null
null
null
null
a233f290-b124-5f11-b0b5-c550e9333744
Which of the following is the mechanism of action of leukotriene modifiers?
Decreasing the production of leukotrienes
Increasing the production of leukotrienes
Agonizing the leukotriene receptor agonist
Antagonizing the leukotriene receptor antagonist
4
D
1
null
null
null
null
null
5c92c38e-7c1e-5d9a-b9cc-0473f39f02cd
Which of the following statements is/are true regarding immunoglobulin E (IgE) blockers?
They inhibit binding of IgE to the receptor on the surface of mast cells and basophils.
One agent is a monoclonal antibody.
They can be used for the treatment of asthma.
All of the above.
4
D
1
null
null
null
null
null
ffd67eb3-656e-54d0-8fcb-056e8cddb44e
58. Which of the following is the mechanism of action of first-generation medications that target mast cells?
Enhancement of mast cell chemical mediator release
Stabilization of mast cells to inhibit release of chemical mediators
Antagonizing the H1 receptor
Agonizing the H1 receptor
4
B
1
null
null
null
null
null
92b1d6fe-cea4-509e-8613-6fee0e4fcddd
Which of the following statements is/are true about the mechanism of action of exogenous glucocorticoids?
They directly bind to glucocorticoid receptors to exert their action.
They inhibit molecules such as cytokines, chemokines, and arachidonic acid metabolites.
They upregulate anti-inflammatory mediators.
All of the above.
4
D
1
null
null
null
null
null
7b84091c-17cd-5f26-a0f0-4c31e8d3fef9
Select the correct order of greatest to least anti-inflammatory properties of the following glucocorticoids:
Hydrocortisone > prednisone > methylprednisolone > dexamethasone
Dexamethasone > methylprednisolone > prednisone > hydrocortisone
Dexamethasone > hydrocortisone > methylprednisolone > prednisone
Hydrocortisone > dexamethasone > prednisone > methylprednisolone
4
B
1
null
null
null
null
null
bbe09804-2f99-5a0f-a174-c30959336bb8
Which portion of the cardiac cycle has the highest myocardial oxygen consumption?
Isovolumic relaxation period
Ejection
Diastasis
Isovolumic contraction period
4
D
1
null
null
null
null
null
446af164-074a-5304-8e9d-e9f130cae665
Which of the following defines the Frank-Starling relationship?
The relationship between preload (resting myocardial length) and contractile performance
The relationship between the left ventricle (LV) pressure and wall stress
The relationship between pressure, flow, and resistance
The balance between hydrostatic pressure and oncotic pressure gradients across a membrane
4
A
1
null
null
null
null
null
fa1bf99a-6af4-59f4-85ef-76407f733016
Which of the following is the earliest indicator of myocardial ischemia?
Increased left ventricle end-diastolic volume (LVEDV) and decreased compliance
ECG abnormalities
Wall motion abnormalities
Congestive heart failure
4
A
1
null
null
null
null
null
e87858f7-7eb2-5d7c-8330-dfaa24380369
Which of the following contribute(s) to cardiac output?
Heart rate
Stroke volume
Preload
Afterload
5
E
1
All of the above
null
null
null
null
97e55170-49b9-5d00-b9dd-bb393dfe93cb
Which of the following factors will increase venous oxygen saturation measured in the pulmonary artery?
Decreases in cardiac output
Increases in oxygen consumption
Decreased temperature
Lower hemoglobin concentration
4
C
2
null
null
null
null
null
b97511d5-bc4e-52b9-a670-d087e67fc0c2
6. Which of the following indicate(s) impaired diastolic function of the LV?
Prolonged isovolumic relaxation time
"E" wave to "A" wave ratio less than 1 (E/A <1)
Prolonged time constant for LV relaxation measured at cardiac catheterization
All of the above
4
D
1
null
null
null
null
null
153b74c5-e0b5-5714-9d93-6152cdbad46c
Which of the following statements is false concerning baroreceptor function?
Pressure-sensitive stretch receptors are located in the carotid sinus and aortic arch.
The effects of such stretch are to reduce heart rate at the sinoatrial node, as well as the atrioventricular node.
The vagus nerve is the only nerve involved in the afferent limb of the baroreceptor response.
Massage of the carotid artery will increase parasympathetic stimuli and can slow narrow complex supraventricular tachycardia.
4
C
1
null
null
null
null
null
8e206f78-f505-524b-87c4-17d79b9e160f
Which of the following statements is true regarding blood pressure in the arterial vascular tree?
Pulse pressure is the difference between the systolic blood pressure (SBP) in the ventricle and the diastolic blood pressure (DBP) measured within the ventricle.
Mean arterial blood pressure (MAP) = DBP + (0.33 * pulse pressure).
The SBP measured in the femoral artery is lower than that measured in the aorta.
The DBP is higher in the femoral artery than in the aorta.
4
B
1
null
null
null
null
null
b7f73e08-2caa-53f1-9a7a-037bdfe47df6
Spontaneous respiration facilitates venous return primarily due to which of the following conditions?
Thoracic expansion creates a slightly positive pressure in the chest.
Mean intrathoracic pressure during spontaneous ventilation is slightly negative, facilitating venous return.
Downward movement of the diaphragm reduces intra-abdominal pressure.
Muscle contraction moves blood from the vasculature into muscles.
4
B
1
null
null
null
null
null
89aa5dc1-b5e8-5945-bfe0-e8c4f3fffae3
Distribution of blood throughout the circulatory system is not uniform. Which of the following components of the tree has the largest blood volume?
Venous system
Arterial system
Pulmonary vasculature
Heart
4
A
1
null
null
null
null
null
5d800ccd-f37e-5545-bfb2-e794d37fbb11
Which of the following statements is true?
The arterial system has higher compliance than the venous system.
The compliance of the venous system is 10-20 times greater than the arterial system.
Small changes of blood within the venous system result in large changes in pressure.
The cross-sectional area of the small and large arteries is larger than that of the corresponding veins.
4
B
1
null
null
null
null
null
5ae13f2d-2c5f-5762-aa77-c297b6d822e6
Which of the following does NOT contribute to reduced cardiac output and blood pressure in the setting of acute massive pulmonary embolism?
Tricuspid regurgitation
Occlusion of the pulmonary arterial vasculature by thrombotic material
Shift of the interventricular septum toward the left
Hypokinesis of the LV
4
D
3
null
null
null
null
null
18ce551c-277c-55db-b94b-078b09da9083
Which of the following is/are the primate determinant(s) of capillary blood flow?
Transmural pressure
Oncotic pressure
Contraction and relaxation of the precapillary and postcapillary sphincters
A and C
4
D
1
null
null
null
null
null
2544d08e-68cd-52fe-b846-2f7796feab47
14. Blood flow through a tube is determined by several factors and explained by
Blood flow is inversely proportional to the pressure gradient.
Blood flow is proportional to the radius of the tube to the second power.
Blood flow is proportional to the length of the tube.
Blood flow is inversely proportional to the viscosity of the fluid.
4
D
1
null
null
null
null
null
998fc416-51f3-5780-9a6f-5cb8f811459f
Which of the following tissues has the greatest capillary density?
Fat
Cartilage
Bone
Skeletal muscle
4
D
1
null
null
null
null
null
97e2be7f-20bf-54e9-a7a7-d799c0090ed5
Myocardial tissue has the highest oxygen extraction of any tissue. Which of the following statements is false concerning myocardial metabolism?
Normal coronary blood flow is approximately 250 mL/min or 5% of cardiac output.
Myocardial oxygen consumption is affected by heart rate, contractility, and wall stress.
Coronary blood flow to both the right and left ventricles occurs exclusively during diastole.
Venous oxygen saturation is higher in the right atrium than in the pulmonary artery.
4
C
1
null
null
null
null
null
048e1af8-5265-5278-acbc-30dfa98fb719
All of the following concerning cerebral perfusion are true EXCEPT which one?
Cerebral perfusion pressure is the difference between the MAP and the intracranial pressure or central venous pressure (CVP), whichever is higher.
Cerebral blood flow (CBF) always varies consistently depending on the blood pressure.
Blood carbon dioxide tension (PaCO2 ) plays a more important role in determining CBF than oxygen tension (PaO2 ).
CBF remains constant if the MAP is between 60 and 160 mm Hg.
4
B
1
null
null
null
null
null
f3dc9654-da12-5697-a994-088054719a5a
Which of the following statements is false?
There are 3 mechanisms whereby renal blood flow and glomerulofiltration rate are regulated: myogenic response, tubuloglomerular feedback, and sympathetic nervous system input.
The renal system does not exhibit autoregulation.
Sympathetic nervous system input results in constriction of all renal vessels.
The myogenic response is an intrinsic action of vascular smooth muscle inresponse to increased transmural pressure.
4
B
1
null
null
null
null
null
b4c9c684-3125-574f-907d-98a7ba6197c4
Approximately what percentage of cardiac output goes to the liver?
5%
10%
15%
25%
4
D
1
null
null
null
null
null
d309139e-297c-55d1-84ae-39cdf6b8d559
Which of the following statements describes coronary perfusion pressure?
The difference between the pressures in the aorta during systole and diastole
The difference between the pressure in the aorta and the mean arterial pressure
The difference between the aortic root pressure and the left or right ventricular pressure
The difference between the mean pulmonary pressure and the left atrial pressure (LAP)
4
C
1
null
null
null
null
null
94cac3af-5192-5e3f-bb63-5a9f6a90e163
21. A 73-year-old man complains of weakness and then falls to the ground. Cardiopulmonary resuscitation (CPR) including chest compressions is initiated. A monitor reveals that the patient is in ventricular fibrillation (VF). Defibrillation is performed, and the monitor reveals a wide complex rhythm at 90 beats per minute. Which of the following is appropriate?
Continue CPR for 2 minutes.
Cease CPR immediately.
Administer sodium bicarbonate.
Administer vasopressin.
4
A
2
null
null
null
null
null
8c01f535-537b-5d48-a8e4-6b1a00324ea1
Which of the following indicates adequacy of CPR during resuscitation?
PETCO2 more than 10 mm Hg during CPR
DBP less than 20 mm Hg
PETCO2 less than 10 mm Hg
Peripheral cyanosis
4
A
1
null
null
null
null
null
db7c5d8c-cb43-513a-b6a4-9aadd1db7b70
A patient is found to be in cardiac arrest, and asystole is noted on the ECG. CPR is initiated, and venous access is established. Which of the following is the first medication indicated?
Vasopressin 40 units
Epinephrine 1 mg
Amiodarone 300 mg
Sodium bicarbonate 50 mEq
4
B
2
null
null
null
null
null
a6c6bc28-9872-58bc-9039-6140ce3c0f6d
A young man is found lying down on the street unresponsive. He appears to be
Initiate CPR and continue for 2 minutes.
After 2 minutes of CPR if necessary, leave the patient and call 9-1-1.
Administer naloxone.
All of the above.
4
D
2
null
null
null
null
null
95891ae5-2289-52e2-ace0-823b1dfb435f
A patient is noted to have altered mental status and hypotension and complains of chest pain. The heart monitor shows a hear rate of 27 beats per minute. Blood pressure is 60/30 mm Hg. After administration of oxygen and lying the patient flat, atropine 0.5 mg is administered every 5 minutes for a total of 3 mg. No response is noted. Which of the following actions is next indicated?
Amiodarone 300 mg IV (intravenous) over 10 minutes
Additional atropine
Vasopressin 40 units
Dopamine infusion at 2-20 μg/kg/min
4
D
3
null
null
null
null
null
fc463bc8-f1a4-57b9-90b1-28d2a6cbef24
A patient is found to be in cardiac arrest. CPR is initiated, and IV access is established. After 2 minutes of CPR, VF is noted on the heart monitor. Epinephrine is administered, and CPR is resumed. VF is still noted. Which of the following is the next medication to be administered?
Amiodarone 150 mg IV
Amiodarone 300 mg IV
Atropine 0.5 mg
Vasopressin 40 units
4
B
1
null
null
null
null
null
1498476c-4b64-54e4-aef4-113844344be0
Which of the following is true concerning alternative routes of drug administration?
Interosseous (IO) access should not be attempted in children.
The same drug dose should be administered via the endotracheal tube as via IV/IO.
CPR does not need to be stopped when a medication is administered via the endotracheal route.
When administering lidocaine, epinephrine, or vasopressin via the endotracheal tube, the dose should be diluted in 10 mL or normal saline or sterile water.
4
D
1
null
null
null
null
null
ed45e887-c68e-5caa-ba2a-83672bee4c4f
28. A patient presents with complaints of slight light-headedness as well as palpitations. ECG is obtained, and it is noted that he has a narrow complex (QRS <0.12 s), monomorphic, regular rhythm. Which of the following is/are indicated?
Vagal maneuver
β-Blocker or calcium channel blocker
Adenosine
All of the above
4
D
2
null
null
null
null
null
59b5afe1-1627-50e8-833e-01d88eb45dbf
All of the following are considered goals for in the management of acute coronary syndrome in the setting of ST-segment elevation myocardial infarction (STEMI) EXCEPT?
Door-to-balloon time of 90 minutes for percutaneous coronary intervention (PCI)
Door-to-needle time of 30 minutes when fibrinolysis is utilized
Emergency room assessment of 10 minutes or less
Complete stabilization within the emergency department before catheterization
4
D
1
null
null
null
null
null
267908ff-fd3f-5062-8054-292434a39112
Which of the following statements is false regarding airway management during CPR?
Cricoid pressure should always be applied throughout chest compressions.
The oral pharyngeal size should be approximately the same as the distance from the tip of the patient's nose to the earlobe.
An excessively long oropharyngeal airway (OPA) may enter the esophagus and may result in gastric distention with air during bag-mask ventilation.
Ventilations during CPR should occur every 5-6 seconds.
4
A
1
null
null
null
null
null
0f46c517-62f6-5b91-821c-5878734603a2
Which of the following coronary arteries is located in the posterior interventricular groove?
Left anterior descending coronary artery
Right coronary artery
Posterior interventricular (descending) coronary artery (PDA)
Left circumflex coronary artery
4
C
1
null
null
null
null
null
082a7c62-0413-5486-b7e7-4613c45f39da
The aortic valve is composed of which of the following 3 leaflets?
Right, left, and anterior
Right, left, and noncoronary
Anterior, posterior, and septal
Anterolateral, posteromedial, and septal
4
B
1
null
null
null
null
null
5d294523-9bc4-5b07-b8da-067a911fffee
A patient presents with acute severe pulmonary edema and cardiogenic shock. Transesophageal echocardiography (TEE) demonstrates a ruptured papillary muscle. Which papillary muscle is most commonly affected?
Posteromedial
Septal
Noncoronary
Anterolateral
4
A
1
null
null
null
null
null
0206fffe-46dc-5330-90fc-532590eb7e02
A 55-year-old man is undergoing coronary artery bypass grafting. The TEE shows an enlarged coronary sinus. When saline is injected into an IV line in the left upper extremity, bubbles are noted, entering the left atrium (LA) near the inferior vena cava. Which of the following conditions most likely explains the findings?
An aberrant right coronary artery
Anomalous pulmonary venous return
A left-sided superior vena cava (SVC)
A patent foramen ovale
4
C
3
null
null
null
null
null
8329f640-2168-5f66-bfcc-db46c9b209ae
35. Which of the following structures is responsible for the conduction of impulses from the right atrium to the LA?
Purkinje fibers
Bundle of His
Left bundle branch
Bachmann bundle
4
D
1
null
null
null
null
null
1e0fc152-7550-5215-b072-00d46909a7ab
A 79-year-old man is scheduled to undergo lumbar laminectomy for spinal stenosis. His medical history is significant for aortic stenosis, with a valve area of 0.9 cm2 and a mean gradient of 45 mm Hg. Which of the following vasoactive agents would be most beneficial to this patient?
Dopamine
Phenylephrine
Hydralazine
Nitroglycerin
4
B
2
null
null
null
null
null
58f4a919-b2da-549f-80ab-5c2e5e8fe285
41. Which of the following is the MOST accurate description of perfusion of the left and right sides of the heart in a normal healthy adult?
Both the left and right sides of the heart are perfused during both systole and diastole.
Both the left and right sides of the heart are perfused during diastole only.
The left side of the heart is perfused during both systole and diastole; the right side of the heart is perfused during systole only.
The left side of the heart is perfused during diastole only; the right side of the heart is perfused during both systole and diastole.
4
D
1
null
null
null
null
null
95722958-fb3d-5b11-b699-9b54b61d5e25
In a patient with severe pulmonary hypertension (HTN), use of which of the following agents would best preserve perfusion to the right side of the heart
Milrinone
Vasopressin
Dobutamine
Phenylephrine
4
B
2
null
null
null
null
null
acbc7677-9285-520c-adae-d9caf08b079f
On a preoperative evaluation, the American College of Cardiology/American Heart Association (ACC/AHA) guidelines do NOT help direct your decisionmaking process with regard to which of the following ECG abnormalities?
Left bundle branch block
Atrial fibrillation with rapid ventricular response
Mobitz type II block
ST-elevation myocardial infarction
4
A
1
null
null
null
null
null
cbfa8a95-cf2a-5285-8eb4-92d5a4bde7f9
Which of the following components of the cardiac conduction system has the FASTEST conduction velocity?
SA node
AV node
His-Purkinje system
Ventricular myocardium
4
C
1
null
null
null
null
null
da551c17-2845-5cd6-8075-edb4aa0bc53f
A patient who received a heart transplant 2 years ago presents for laparoscopic appendectomy. Which of the following medications should be avoided during this planned general anesthetic?
Cisatracurium
Vecuronium
Neostigmine
Glycopyrrolate
4
C
2
null
null
null
null
null
360b5ce7-467d-54aa-a2ac-81d7b1fe0905
In a normal CVP tracing, where does the tricuspid valve close?
Between the a-wave and c-wave
At the peak of the c-wave
Between the c-wave and x-descent
Between the x-descent and v-wave
4
A
1
null
null
null
null
null
30e0cf97-bd9e-5d9d-a5bf-ee9caf0fed0d
The V5 ECG lead is MOST SENSITIVE for detecting which of the following?
Atrial fibrillation
Anteroseptal ischemia
Lateral wall ischemia
Conduction abnormalities
4
C
1
null
null
null
null
null
a25c919c-0522-5a8f-9173-fd86626dbaf9
Which of the following cardiac abnormalities would be MOST LIKELY to benefit from relative tachycardia?
Aortic stenosis
Mitral regurgitation
Hypertrophic obstructive cardiomyopathy (HOCM)
Unstable angina
4
B
2
null
null
null
null
null
934665f6-da70-53da-956a-12f0b0c526dd
Which of the following is the "agent of choice" for treatment of tachyarrhythmias associated with Wolff-Parkinson-White?
Metoprolol
Verapamil
Carvedilol
Procainamide
4
D
1
null
null
null
null
null
ad85c279-eff1-59c5-a20d-be846fe2421f
Which of the following is NOT considered a "cyanotic" heart lesion?
Truncus arteriosus
Pulmonic stenosis
Tricuspid atresia
Total anomalous pulmonary venous return
4
B
1
null
null
null
null
null
abb8d19a-e997-500a-9cc5-edc588d54d3d
52. Which of the following is LEAST LIKELY to be a complication of a transcatheter aortic valve replacement?
Complete heart block
Pneumothorax
Cardiac tamponade
Embolic stroke
4
B
1
null
null
null
null
null
f8c71180-5d94-51fc-97c7-fbfc021e4d0f
A patient with long-standing HTN and normally well-managed congestive heart failure is also found to have bilateral coarse rales on lung examination. He admits that he went to a wedding and had a dietary indiscretion, which is very rare for him. Which of the following is most likely true?
| Volume overload | Transient | Noncompliant ventricle | Permanent |
| Volume overload | Permanent | Noncompliant ventricle | Transient |
| Noncompliant ventricle | Transient | Volume overload | Transient |
| Noncompliant ventricle | Permanent | Volume overload | Permanent |
4
A
2
null
null
null
null
null
af6faa5c-f2ae-5320-85bc-30101b140df8
Which of the following is the MOST UNLIKELYcause of myocardial ischemia?
Severe tachycardia
Severe hypotension
Severe anemia
Severe hypokalemia
4
D
1
null
null
null
null
null
9acac981-dc89-5da4-8383-e6ee53eba163
Which of the following is false regarding heart failure with preserved ejection fraction (HFpEF)?
The most sensitive test of adequacy of tissue perfusion is mixed venous O2 saturation at rest.
The most common causes of HFpEF in the United Sates are chronic HTN and aortic stenosis.
Diagnosis of HFpEF requires echocardiography with Doppler.
Atrial systole contributes relatively more to the left ventricular end diastolic volume (LVEDV) in patients with HFpEF than it does to those with normal ventricular function.
4
A
1
null
null
null
null
null
f7fdedcc-f38d-5074-9115-5d5650e399c1
Which of the following is false regarding heart rate in normal healthy adults?
Cholinergic slowing of heart rate occurs via M2 muscarinic receptors.
Factors that decrease the rate of SA node depolarization increase the likelihood that the pacemaker of the heart will become located at the AV junction.
The normal intrinsic rate of the SA node increases over time.
β1-Adrenergic stimulation increases the rate of phase 4 depolarization.
4
C
1
null
null
null
null
null
8b9c3fe4-42fe-5a37-903e-6f77a50dc1ef
When the surgeon requests for the patient be placed in the "reverse Trendelenburg" position, which of the following is the PRIMARY parameter initially affected?
Systemic afterload
Venous return
Myocardial inotropy
Cerebral perfusion
4
B
1
null
null
null
null
null
4425c3c4-f0ee-51b5-87df-209e85684de7
58. You are about to induce anesthesia in a 38-year-old man with HOCM. Which of the following options should be your goals with regard to preload, afterload, rate, rhythm, and contractility?
| PRELOAD Increased | AFTERLOAD Increased | RATE Normal | RHYTHM Sinus | CONTRACTILITY Depressed |
| PRELOAD Increased | AFTERLOAD Decreased | RATE Decreased | RHYTHM Sinus | CONTRACTILITY Increased |
| PRELOAD Decreased | AFTERLOAD Increased | RATE Decreased | RHYTHM Sinus | CONTRACTILITY Depressed |
| PRELOAD Decreased | AFTERLOAD Decreased | RATE Increased | RHYTHM Sinus | CONTRACTILITY Increased |
4
A
2
null
null
null
null
null
4ba8ba4d-c9c0-5299-9aea-05298f5e3f62
Which of the following conditions is MOST sensitive to loss of the "atrial kick"?
Mitral regurgitation
Aortic insufficiency
Mitral stenosis
Diastolic dysfunction
4
D
3
null
null
null
null
null
dd94d180-a557-58fd-b2cc-6ad87901c31a
Which of the following is false regarding mitral stenosis?
Hyperdynamic states, such as sepsis, can lead to pulmonary edema.
Pulmonary capillary wedge pressure approximates left ventricular end-diastolic pressure (LVEDP).
The progression of disease includes right ventricular hypertrophy and dysfunction.
Medical management of mitral stenosis includes use of β-blockers and calcium channel blockers.
4
B
2
null
null
null
null
null
5802cac7-1dc7-5c41-aeb5-d876de59f9ab
What percentage of hepatic blood flow comes from the portal vein?
25%
50%
75%
90%
4
C
1
null
null
null
null
null
c54e1f2b-bbce-57da-bbad-a608629561a4
What percentage of oxygen delivery to the liver comes from the hepatic artery?
25%
50%
75%
90%
4
B
1
null
null
null
null
null
a62536f1-8517-53c9-b5bc-ad57fd301975
Hepatomegaly may be observed in all of the following conditions EXCEPT which one?
Congestive heart failure
Hypovolemic shock
Leukemia
Renal failure
4
B
1
null
null
null
null
null
05ac8484-e000-5207-9231-5aee7b7a38bf
The round ligament separates which 2 hepatic segments?
1 and 2
2 and 3
3 and 4
4 and 5
4
C
1
null
null
null
null
null
4a78dc65-d5d7-5755-b4a0-0fafb7020635
Which of the following signaling factors is decreased in a cirrhotic liver?
Nitric oxide
Endothelin
Norepinephrine
Thromboxane A2
4
A
1
null
null
null
null
null
d725bd35-f37d-57c9-925b-94cecc9758ad
6. Compared with the hepatic artery, which statement about portal vein is true?
Portal vein supplies 50% of the liver's overall blood flow.
Portal vein is a low-pressure/low-resistance system.
Portal vein blood is richly oxygenated.
Portal vein supplies 75% of the liver's overall oxygen delivery.
4
B
1
null
null
null
null
null
03287ed4-346a-5630-a319-ce084d8c4f12
Increase in the serum level of which of the following may be observed in liver failure?
IgG
Factor VII
Albumin
Ammonia
4
D
1
null
null
null
null
null
e893eec1-777c-5c26-8d6c-d61c220f0254
Glucose is synthesized in the liver as the result of all of the following processes EXCEPT which one?
Glycogenolysis
Gluconeogenesis
Tricarboxylic acid cycle
Oxidation of lactate
4
C
1
null
null
null
null
null
15cf3859-1f54-57fd-a79c-b5e99c04d636
In the assessment of patient with liver failure, which parameter is used in the MELD (model for end-stage liver disease) scoring system but NOT the Child-Pugh scoring system?
Creatinine
International normalized ratio (INR)
Bilirubin
Albumin
4
A
1
null
null
null
null
null
66e8a183-22ae-57b6-a950-2b68f3b45ff4
Elevation in the serum level of which factor is a specific marker of acute liver injury?
Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT)
Alkaline phosphatase
Lactate dehydrogenase (LDH)
4
B
1
null
null
null
null
null
d099fe56-4855-5fdc-95b8-0bb18b951461
Which laboratory test is a sensitive indicator for decreased synthetic function of the liver?
Aspartate aminotransferase
Albumin
International normalized ratio
γ-Glutamyl transpeptidase (GGT)
4
C
1
null
null
null
null
null