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Cardiovascular Physiology

মোট প্রশ্ন৬৮এই পাতা৬৭প্রতি পাতা১০০
প্রশ্ন দেখুনঅনুশীলন
ঘনত্ব
উত্তর
উত্তরিতবর্তমানপুনরায় দেখুনঅসম্পূর্ণ

Cardiovascular Physiology

PrepBank · পাতা ১ / ১ · ১–৬৭ / ৬৮

১.
Which limb is spared from lead placement in ECG?
  1. ক
    ক) RA
  2. খ
    খ) RL
  3. গ
    গ) LA
  4. ঘ
    ঘ) LL
সঠিক উত্তর: খ
খ) RL
উত্তর
সঠিক উত্তর: খ
খ) RL
খ
ব্যাখ্যা
Explanation:
২.
At a normal heart rate the duration(second) of atrial systole is
  1. ক
    0.1
  2. খ
    0.3
  3. গ
    0.5
  4. ঘ
    0.7
সঠিক উত্তর: ক
0.1
উত্তর
সঠিক উত্তর: ক
0.1
ক
ব্যাখ্যা
Explanation:
At a normal heart rate the duration of systole and diastole are:
Atrial systole: 0.1 second
Atrial diastole: 0.7 second
Ventricular systole: 0.3 second
Ventricular diastole: 0.5 second
৩.
Rapidly acting BP regulating mechanisms excludes
  1. ক
    Baroreceptor mechanism
  2. খ
    Chemoreceptor mechanism
  3. গ
    Renin angiotensin mechanism
  4. ঘ
    CNS ischemic mechanism
সঠিক উত্তর: গ
Renin angiotensin mechanism
উত্তর
সঠিক উত্তর: গ
Renin angiotensin mechanism
গ
ব্যাখ্যা

Explanation:
Rapidly acting regulating mechanisms (acute nervous reflexes) (acts within seconds to minutes)
• Baroreceptor mechanism
• Chemoreceptor mechanism
• CNS ischemic mechanism

৪.
ECG localization of Lateral (LCX) STEMI
  1. ক
    V1–V2
  2. খ
    I, aVL
  3. গ
    II, III, aVF
  4. ঘ
    V7–V9, ST depression in V1–V3
সঠিক উত্তর: খ
I, aVL
উত্তর
সঠিক উত্তর: খ
I, aVL
খ
৫.
Myocardial contractility is best correlated with the intracellular concentration of?
  1. ক
    ক) Na+
  2. খ
    খ) K+
  3. গ
    গ) Ca2+
  4. ঘ
    ঘ) Cl−
সঠিক উত্তর: গ
গ) Ca2+
উত্তর
সঠিক উত্তর: গ
গ) Ca2+
গ
ব্যাখ্যা
Contractility of myocardial cells depends on the intracellular [Ca2+], which is regulated by Ca2+ entry across the cell membrane during the plateau of the action potential and by Ca2+ uptake into and release from the sarcoplasmic reticulum (SR). Ca2+ binds to troponin C and removes the inhibition of actin–myosin interaction, allowing contraction (shortening) to occur.
৬.
Pacemaker of heart
  1. ক
    SA node
  2. খ
    AV node
  3. গ
    RBB
  4. ঘ
    Purkinjie fibre
সঠিক উত্তর: ক
SA node
উত্তর
সঠিক উত্তর: ক
SA node
ক
ব্যাখ্যা
কোন ব্যাখ্যা যোগ হয় নি।
৭.
Vasoconstrictor agent:
  1. ক
    Serotonin
  2. খ
    Epinephrine in liver
  3. গ
    Prostaglandin
  4. ঘ
    NO
সঠিক উত্তর: ক
Serotonin
উত্তর
সঠিক উত্তর: ক
Serotonin
ক
৮.
Factors That Cause a Hypereffective Heart
  1. ক
    Increased arterial pressure against which the heart must pump
  2. খ
    Nervous excitation of the heart
  3. গ
    Valvular heart disease
  4. ঘ
    An inflammation of the heart muscle
সঠিক উত্তর: খ
Nervous excitation of the heart
উত্তর
সঠিক উত্তর: খ
Nervous excitation of the heart
খ
ব্যাখ্যা
Factors That Cause a Hypoeffective Heart
► (1) Increased arterial pressure against which the heart must pump, such as in hypertension.
► (2) Inhibition of nervous excitation of the heart.
► (3) Pathological factors that cause abnormal heart rhythm or rate of heartbeat.
► (4) Coronary artery blockage, causing a "heart attack”.
► (5) Valvular heart disease.
► (6) Congenital heart disease.
► (7) Myocarditis, an inflammation of the heart muscle.
৯.
A 65-year-old man presents with central crushing chest pain for the first time. He is transferred immediately to the closest cardiac unit to undergo a primary percutaneous coronary intervention. There is thrombosis of the left circumflex artery only. Angioplasty is carried out and a drug-eluding stent is inserted. What are the most likely changes to have occurred on ECG during admission?
  1. ক
    ST depression in leads V1-4
  2. খ
    ST elevation in leads V1-6
  3. গ
    ST depression in leads II, III and AVF
  4. ঘ
    ST elevation in leads V5-6
সঠিক উত্তর: ঘ
ST elevation in leads V5-6
উত্তর
সঠিক উত্তর: ঘ
ST elevation in leads V5-6
ঘ
১০.
Romano-Ward syndrome is
  1. ক
    AD
  2. খ
    AR
  3. গ
    XLR
  4. ঘ
    XLD
সঠিক উত্তর: ক
AD
উত্তর
সঠিক উত্তর: ক
AD
ক
১১.
Total peripheral resistance is inversely proportional to
  1. ক
    ক) Velocity of blood flow
  2. খ
    খ) Viscosity of blood
  3. গ
    গ) Cross sectional area of blood vessels
  4. ঘ
    ঘ) Length of blood vessels
সঠিক উত্তর: গ
গ) Cross sectional area of blood vessels
উত্তর
সঠিক উত্তর: গ
গ) Cross sectional area of blood vessels
গ
ব্যাখ্যা

★Total peripheral resistance
Directly proportional to
-Velocity
-Viscosity
-Length of blood vessels
Inversely proportional to
-Lumen of blood vessels
-4th power of radius
-Elasticity of arterial wall

১২.
TDP is associated with
  1. ক
    QRS complex
  2. খ
    PR interval
  3. গ
    ST elevation
  4. ঘ
    RR interval
সঠিক উত্তর: ক
QRS complex
উত্তর
সঠিক উত্তর: ক
QRS complex
ক
ব্যাখ্যা
QRS complexes with variable peaks that appear to twist around the isoelectric line characterize torsades de pointes (TDP).

• Predisposing risk factors for TDP include congenital channelopathies, severe bradycardia, drugs, and hypokalemia.

• Drug-induced TDP is of major concern because it can be life threatening; class IA/III antiarrhythmic agents, antipsychotics, antibiotics, and antihistamines are among the list of drugs that are noted to destabilize repolarization.
১৩.
Which initiates cardiac cycle
  1. ক
    ক) Atrial systole
  2. খ
    খ) Atrial diastole
  3. গ
    গ) Ventricular systole
  4. ঘ
    ঘ) Ventricular diastole
সঠিক উত্তর: ক
ক) Atrial systole
উত্তর
সঠিক উত্তর: ক
ক) Atrial systole
ক
ব্যাখ্যা
Explanation:
Atrial systole initiates cardiac cycle because the sinus node (pacemaker) of the heart is located in the right atrium.
১৪.
Which part of the ECG corresponds to ventricular repolarization?
  1. ক
    ক) The P waves
  2. খ
    খ) The QRS duration
  3. গ
    গ) The T wave
  4. ঘ
    ঘ) The PR interval
সঠিক উত্তর: গ
গ) The T wave
উত্তর
সঠিক উত্তর: গ
গ) The T wave
গ
ব্যাখ্যা
The P wave is primarily produced by atrial depolarization, the QRS complex is dominated by ventricular depolarization, and the T wave by ventricular repolarization.
১৫.
Cardiac reserve in Severe Heart Failure
  1. ক
    100-200% of Normal CO
  2. খ
    300-400% of Normal CO
  3. গ
    Infinity
  4. ঘ
    Zero
সঠিক উত্তর: ঘ
Zero
উত্তর
সঠিক উত্তর: ঘ
Zero
ঘ
১৬.
Maximum % of total blood that can be removed with almost no effect on cardiac output?
  1. ক
    ক) 5
  2. খ
    খ) 10
  3. গ
    গ) 15
  4. ঘ
    ঘ) 20
সঠিক উত্তর: খ
খ) 10
উত্তর
সঠিক উত্তর: খ
খ) 10
খ
ব্যাখ্যা
Explanation:
About 10% of the total blood volume can be removed with almost no effect on arterial pressure or cardiac output, but greater blood loss usually diminishes the cardiac output first and falls to zero when about 40% to 45% of the total blood volume has been removed.
১৭.
Most important factor for CO
  1. ক
    VR
  2. খ
    EDV
  3. গ
    ESV
  4. ঘ
    TPR
সঠিক উত্তর: ক
VR
উত্তর
সঠিক উত্তর: ক
VR
ক
ব্যাখ্যা
Although heart function is obviously crucial in

determining cardiac output, the various factors of the  peripheral circulation that affect flow of blood into the heart  from the veins, called venous return, are normally the  primary controllers of cardiac output.

(Ref. Guyton & Hall-14th, P-245
১৮.
Tissue oxygenation is not dependent on
  1. ক
    Cardiac output
  2. খ
    Hb
  3. গ
    Oxygen saturation
  4. ঘ
    Pulse rate
সঠিক উত্তর: ঘ
Pulse rate
উত্তর
সঠিক উত্তর: ঘ
Pulse rate
ঘ
ব্যাখ্যা
কোন ব্যাখ্যা যোগ হয় নি।
১৯.
The low-resistance pathways between myocardial cells that allow for the spread of action potentials are the
  1. ক
    ক) Gap junctions
  2. খ
    খ) T tubules
  3. গ
    গ) Sarcoplasmic reticulum
  4. ঘ
    ঘ) Intercalated disks
সঠিক উত্তর: ক
ক) Gap junctions
উত্তর
সঠিক উত্তর: ক
ক) Gap junctions
ক
ব্যাখ্যা
The gap junctions occur at the intercalated disks between cells and are low-resistance sites of current spread.
২০.
The pulse pressure in the large arteries is directly proportional to
  1. ক
    ক) Stroke volume
  2. খ
    খ) Heart rate
  3. গ
    গ) Total peripheral resistance
  4. ঘ
    ঘ) Compliance of arterial wall
সঠিক উত্তর: ক
ক) Stroke volume
উত্তর
সঠিক উত্তর: ক
ক) Stroke volume
ক
ব্যাখ্যা

Pulse pressure (PP)
-PP Directly proportional to SV
-PP inversely proportional to compliance/Arterial elasticity

২১.
ECG changes in Hyperkalemia
  1. ক
    prominent U wave
  2. খ
    ST depression
  3. গ
    wide QRS complex
  4. ঘ
    T wave inversion
সঠিক উত্তর: গ
wide QRS complex
উত্তর
সঠিক উত্তর: গ
wide QRS complex
গ
২২.
Following cardiovascular changes occurs after birth –
  1. ক
    ক) Decrease in the system vascular resistance
  2. খ
    খ) Pulmonary arterial constriction
  3. গ
    গ) Increased in right ventricular pressure
  4. ঘ
    ঘ) Closure of ductus venosus
সঠিক উত্তর: ঘ
ঘ) Closure of ductus venosus
উত্তর
সঠিক উত্তর: ঘ
ঘ) Closure of ductus venosus
ঘ
ব্যাখ্যা

Cardiovascular changes following birth are-
-Increase arterial oxygen tension
-Decreased Pulmonary vascular resistance
-Increased Pulmonary blood flow
-Increased systemic vascular resistance
-Closure of Ductus arteriosus and ductus venosus
-closure Foramen ovale

২৩.
Which goes against 4th Heart Sound?
  1. ক
    High pitched sound.
  2. খ
    Duration of the sound is 0.02 -0.04 seconds
  3. গ
    It occurs due to vibrations which set up in atrial musculature during atrial systole
  4. ঘ
    It coincides with interval between end of 'P' wave and onset of 'Q' wave in ECG
সঠিক উত্তর: ক
High pitched sound.
উত্তর
সঠিক উত্তর: ক
High pitched sound.
ক
ব্যাখ্যা
• It is produced during atrial systole and considered as physiologic heart sound.
Characteristics:
• It is short and low pitched sound.
• Duration of the sound is 0.02 -0.04 seconds.
Causes:
• It occurs due to vibrations which set up in atrial musculature during atrial systole.
Fourth heart sound and ECG:
• It coincides with interval between end of 'P' wave and onset of 'Q' wave in ECG.
২৪.
Ejection systolic murmur is present in
  1. ক
    PDA
  2. খ
    Tricuspid stenosis
  3. গ
    MR
  4. ঘ
    Pulmonary stenosis
সঠিক উত্তর: ঘ
Pulmonary stenosis
উত্তর
সঠিক উত্তর: ঘ
Pulmonary stenosis
ঘ
২৫.
Most potent vasodilator
  1. ক
    CO2
  2. খ
    H+
  3. গ
    K+
  4. ঘ
    O2
সঠিক উত্তর: ক
CO2
উত্তর
সঠিক উত্তর: ক
CO2
ক
ব্যাখ্যা
কোন ব্যাখ্যা যোগ হয় নি।
২৬.
Closure of semilunar valve which heart sound produce
  1. ক
    S3
  2. খ
    opening snap
  3. গ
    S1
  4. ঘ
    S2
সঠিক উত্তর: ঘ
S2
উত্তর
সঠিক উত্তর: ঘ
S2
ঘ
২৭.
Heart rate is accelerated by
  1. ক
    ক) Exercise
  2. খ
    খ) Fear
  3. গ
    গ) increased baroreceptor activity
  4. ঘ
    ঘ) increased intracranial pressure
সঠিক উত্তর: ক
ক) Exercise
উত্তর
সঠিক উত্তর: ক
ক) Exercise
ক
ব্যাখ্যা
Reference-Ganong physiology/26th/P-580/T-32-3
২৮.
Which are the major sites of resistance of circulation?
  1. ক
    ক) Arteries
  2. খ
    খ) Arterioles
  3. গ
    গ) Capillaries
  4. ঘ
    ঘ) Veins
সঠিক উত্তর: খ
খ) Arterioles
উত্তর
সঠিক উত্তর: খ
খ) Arterioles
খ
ব্যাখ্যা
Explanation:
Arterioles are the major site of the resistance to blood flow. So, arterioles are the stop clocks of the circulation.
২৯.
Pulse pressure does not depend on
  1. ক
    ক) Age
  2. খ
    খ) Sex
  3. গ
    গ) Stroke volume
  4. ঘ
    ঘ) Arterial elastic constant
সঠিক উত্তর: খ
খ) Sex
উত্তর
সঠিক উত্তর: খ
খ) Sex
খ
ব্যাখ্যা

Explanation:
Pulse pressure
Is the difference between systolic and diastolic pressure. Normal pulse pressure is 30 - 60 mm Hg (average 50 mm Hg).
Pulse pressure depends on three factors:
• Age
• Stroke volume
• Arterial elastic constant

৩০.
Cardiac cycle is the term used to describe the sequence of events that occur as the heart works to pump blood through the body. The opening of the atrioventricular(AV) valves occurs at about the same time in the cardiac cycle as-
  1. ক
    ক) Beginning of diastole
  2. খ
    খ) Beginning of systole
  3. গ
    গ) End of isovolumic contraction
  4. ঘ
    ঘ) First heart sound
সঠিক উত্তর: ক
ক) Beginning of diastole
উত্তর
সঠিক উত্তর: ক
ক) Beginning of diastole
ক
ব্যাখ্যা
The second is a shorter, high-pitched “dub” (second sound), caused by vibrations associated with closure of the aortic and pulmonary valves just after the end of ventricular systole and beginning of diastole.
৩১.
Cardiac output is increased to highest limit in
  1. ক
    ক) Beriberi
  2. খ
    খ) Anaemia
  3. গ
    গ) MI
  4. ঘ
    ঘ) Cardiac shock
সঠিক উত্তর: ক
ক) Beriberi
উত্তর
সঠিক উত্তর: ক
ক) Beriberi
ক
ব্যাখ্যা
Explanation:
৩২.
BP on lower limb is measured over
  1. ক
    Anterior tibial artery
  2. খ
    Posterior tibial artery
  3. গ
    Popliteal artery
  4. ঘ
    Femoral artery
সঠিক উত্তর: গ
Popliteal artery
উত্তর
সঠিক উত্তর: গ
Popliteal artery
গ
ব্যাখ্যা

Explanation:
Site of blood pressure measurement
• Arms (over brachial artery)
• Thighs (over popliteal artery)

৩৩.
Ventricular depolarisation in ECG is represented by
  1. ক
    ক) P wave
  2. খ
    খ) QRS complex
  3. গ
    গ) T wave
  4. ঘ
    ঘ) ST segment
সঠিক উত্তর: খ
খ) QRS complex
উত্তর
সঠিক উত্তর: খ
খ) QRS complex
খ
ব্যাখ্যা

Explanation:
Atrial depolarization: represented by the 'P' wave
• Atrial repolarization: none
• Ventricular depolarization: represented by the QRS' complex
• Ventricular repolarization: represented by the T' wave

৩৪.
Which of the following ECG interval corresponds to Ventricular action potential
  1. ক
    PR
  2. খ
    QRS
  3. গ
    ST
  4. ঘ
    QT
সঠিক উত্তর: ঘ
QT
উত্তর
সঠিক উত্তর: ঘ
QT
ঘ
৩৫.
Calculate EF % when SV 70 ml ,ESV 120 ml,EDV 50 ml , HR 76 bpm
  1. ক
    50
  2. খ
    55
  3. গ
    58
  4. ঘ
    60
সঠিক উত্তর: গ
58
উত্তর
সঠিক উত্তর: গ
58
গ
৩৬.
Direct method of measurement of cardiac output
  1. ক
    ক) Fick method
  2. খ
    খ) Indicator method
  3. গ
    গ) Dye dilution method
  4. ঘ
    ঘ) Doppler echocardiography
সঠিক উত্তর: ক
ক) Fick method
উত্তর
সঠিক উত্তর: ক
ক) Fick method
ক
ব্যাখ্যা

Explanation:
Measurement of cardiac output
Cardiac output can be measured using either of the following techniques:
• Direct method: Fick method
• Indirect method: Indicator / dye dilution method
• Doppler echocardiography

৩৭.
Highest cardiac output occurs in
  1. ক
    Liver
  2. খ
    Heart
  3. গ
    Brain
  4. ঘ
    Kidney
সঠিক উত্তর: ক
Liver
উত্তর
সঠিক উত্তর: ক
Liver
ক
৩৮.
The “no-reflow” phenomenon refers to
  1. ক
    Heart
  2. খ
    Kidney
  3. গ
    Blood vessels
  4. ঘ
    Git
সঠিক উত্তর: ক
Heart
উত্তর
সঠিক উত্তর: ক
Heart
ক
ব্যাখ্যা
The “no-reflow” phenomenon refers to the inability to reperfuse myocardial tissue despite the reopening of the infarct-related artery. No-reflow often happens in acute myocardial infarction patients during primary percutaneous coronary intervention (PCI), which has a strong negative impact on clinical outcome, negating the potential benefit of primary PCI. No-reflow is associated with a higher rate of mortality and early postinfarction complications.
৩৯.
Increased pressure within the carotid sinus results in -
  1. ক
    ক) Reflex bradycardia
  2. খ
    খ) Reflex hyperpnea
  3. গ
    গ) Increase in sympathetic tone
  4. ঘ
    ঘ) Decrease in diameter of blood vessels
সঠিক উত্তর: ক
ক) Reflex bradycardia
উত্তর
সঠিক উত্তর: ক
ক) Reflex bradycardia
ক
ব্যাখ্যা

Increased pressure within carotid sinus causes-
-Decreased Heart rate
-Decreased sympathetic tone/Vasomotor tone
-Increased parasympathetic discharge
-Decreased myocardial contractility
-Causes vasodilation and venodilation
-Decreased TPR

৪০.
Bifid broad P wave indicates hypertrophy of
  1. ক
    Left atrium
  2. খ
    Right atrium
  3. গ
    Left ventricle
  4. ঘ
    Right ventricle
সঠিক উত্তর: ক
Left atrium
উত্তর
সঠিক উত্তর: ক
Left atrium
ক
ব্যাখ্যা

Explanation:
'P' wave may become tall peaked or broad and bifid (notched)
Tall, peaked: right atrial hypertrophy
Bifid broad: left atrial hypertrophy

৪১.
At a normal heart rate, the duration(second) of ventricular systole is
  1. ক
    ক) 0.1
  2. খ
    খ) 0.3
  3. গ
    গ) 0.5
  4. ঘ
    ঘ) 0.7
সঠিক উত্তর: খ
খ) 0.3
উত্তর
সঠিক উত্তর: খ
খ) 0.3
খ
ব্যাখ্যা

Explanation:
At a normal heart rate the duration of systole and diastole are:
Atrial systole: 0.1 second
Atrial diastole: 0.7 second
Ventricular systole: 0.3 second
Ventricular diastole: 0.5 second

৪২.
Effect of exercise on cardiac output excludes
  1. ক
    ক) Positive chronotropism
  2. খ
    খ) Positive inotropism
  3. গ
    গ) Decrease venous return and thus stroke volume
  4. ঘ
    ঘ) Decrease in total peripheral resistance
সঠিক উত্তর: গ
গ) Decrease venous return and thus stroke volume
উত্তর
সঠিক উত্তর: গ
গ) Decrease venous return and thus stroke volume
গ
ব্যাখ্যা

Explanation:
Effect of exercise on cardiac output
Exercise increase cardiac output and it is proportionate exercise intensity. The responses to exercise are:
• Positive chronotropism (i.e. increase heart rate)
• Positive inotropism (i.e. increase myocardial contractility)
• Increase venous return and thus stroke volume
• Decrease in total peripheral resistance

৪৩.
The second heart sound is caused by
  1. ক
    closure of the aortic and pulmonary valves.
  2. খ
    vibrations in the ventricular wall during systole.
  3. গ
    ventricular filling
  4. ঘ
    closure of the mitral and tricuspid valves.
সঠিক উত্তর: ক
closure of the aortic and pulmonary valves.
উত্তর
সঠিক উত্তর: ক
closure of the aortic and pulmonary valves.
ক
৪৪.
Highest oxygen consumption per 100 gm tissue
  1. ক
    Liver
  2. খ
    Kidney
  3. গ
    Brain
  4. ঘ
    Heart
সঠিক উত্তর: ঘ
Heart
উত্তর
সঠিক উত্তর: ঘ
Heart
ঘ
৪৫.
Pathological causes of sinus bradycardia exclude
  1. ক
    ক) Pregnancy
  2. খ
    খ) Hypothyroidism
  3. গ
    গ) Myocardial infraction
  4. ঘ
    ঘ) Raised intracranial pressure
সঠিক উত্তর: ক
ক) Pregnancy
উত্তর
সঠিক উত্তর: ক
ক) Pregnancy
ক
ব্যাখ্যা

Explanation:
Pathological causes of sinus bradycardia
• Hypothermia
• Hypothyroidism
• Myocardial infraction
• Raised intracranial pressure
• Cholestatic jaundice
• Drugs (beta-blockers, digoxin, antiarrhythmic drugs)

৪৬.
Following which is most important control system under negative feedback mechanism-?
  1. ক
    ক) Blood clotting
  2. খ
    খ) LH surge.
  3. গ
    গ) Regulation of water balance
  4. ঘ
    ঘ) Blood pressure control system
সঠিক উত্তর: ঘ
ঘ) Blood pressure control system
উত্তর
সঠিক উত্তর: ঘ
ঘ) Blood pressure control system
ঘ
ব্যাখ্যা
Blood pressure regulation is the most important Which is regulated by negative feedback mechanism.
৪৭.
A 58-year-old man has made an excellent functional recovery after an anterior MI. He is entirely asymptomatic and there is no abnormality on physical examination. His blood pressure is 134/78 mmHg and he is undertaking a cardiac rehabilitation programme. Which of the following would you not recommend as part of his secondary prevention planning?
  1. ক
    Aspirin
  2. খ
    Simvastatin
  3. গ
    Omega-3 fatty acids
  4. ঘ
    Bisoprolol
সঠিক উত্তর: গ
Omega-3 fatty acids
উত্তর
সঠিক উত্তর: গ
Omega-3 fatty acids
গ
ব্যাখ্যা
There is strong clinical trial evidence for the other four classes of drugs (A-D), although it is not clear how long the duration of therapy should be in each case. This benefit is applicable to normotensive patients with 'normal' LDL levels, although what constitutes normal in this case is controversial. Targets are likely to be reduced in the near future. One clinical trial did appear to shown additional benefit for the omega-3 fatty acids  this was in a population where few were receiving statins. Subsequent data have not supported their routine use.
৪৮.
Cardiac output is decreased to lowest limit in
  1. ক
    Beriberi
  2. খ
    Anaemia
  3. গ
    MI
  4. ঘ
    Cardiac shock
সঠিক উত্তর: ঘ
Cardiac shock
উত্তর
সঠিক উত্তর: ঘ
Cardiac shock
ঘ
ব্যাখ্যা
Explanation:
৪৯.
Tall peaked P wave indicates hypertrophy of
  1. ক
    ক) Left atrium
  2. খ
    খ) Right atrium
  3. গ
    গ) Left ventricle
  4. ঘ
    ঘ) Right ventricle
সঠিক উত্তর: খ
খ) Right atrium
উত্তর
সঠিক উত্তর: খ
খ) Right atrium
খ
ব্যাখ্যা

Explanation:
'P' wave may become tall peaked or broad and bifid (notched)
Tall, peaked: right atrial hypertrophy
Bifid broad: left atrial hypertrophy

৫০.
Which organ receives most percentage of cardiac output from all of the following?
  1. ক
    ক) Kidney
  2. খ
    খ) Adrenal gland
  3. গ
    গ) Thyroid gland
  4. ঘ
    ঘ) Brain
সঠিক উত্তর: ক
ক) Kidney
উত্তর
সঠিক উত্তর: ক
ক) Kidney
ক
ব্যাখ্যা
Explanation:
৫১.
Pulmonary circulation
  1. ক
    ক) 7%
  2. খ
    খ) 9%
  3. গ
    গ) 13%
  4. ঘ
    ঘ) 16%
সঠিক উত্তর: খ
খ) 9%
উত্তর
সঠিক উত্তর: খ
খ) 9%
খ
৫২.
Which of the following is effective tool for diagnosis of Sick Sinus Syndrome?
  1. ক
    ECG
  2. খ
    Echo
  3. গ
    ETT
  4. ঘ
    Haulter monitoring
সঠিক উত্তর: ঘ
Haulter monitoring
উত্তর
সঠিক উত্তর: ঘ
Haulter monitoring
ঘ
৫৩.
A 55-year-old man comes to his primary care clinician 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?
  1. ক
    Histamine
  2. খ
    Endothelin-1
  3. গ
    Prostacyclin
  4. ঘ
    NO
সঠিক উত্তর: ঘ
NO
উত্তর
সঠিক উত্তর: ঘ
NO
ঘ
ব্যাখ্যা
কোন ব্যাখ্যা যোগ হয় নি।
৫৪.
In the first 6 hours, the gold standard for Diagonosis of MI
  1. ক
    Trop I
  2. খ
    Echo
  3. গ
    Ck MB
  4. ঘ
    ECG
সঠিক উত্তর: ঘ
ECG
উত্তর
সঠিক উত্তর: ঘ
ECG
ঘ
৫৫.
Which of the following contribute to the platue phase of the action potential of ventricular muscle fibers-?
  1. ক
    ক) Na+ influx
  2. খ
    খ) K+ influx
  3. গ
    গ) Ca+ influx
  4. ঘ
    ঘ) K+ efflux
সঠিক উত্তর: গ
গ) Ca+ influx
উত্তর
সঠিক উত্তর: গ
গ) Ca+ influx
গ
ব্যাখ্যা

Plateau phase in action potential of Cardiac muscle due to-
-Slow voltage gated Ca+ channel
-Increase Ca++ influx
-Decrease K+ efflux
-coincides of ventricular systole
-results in prolonged refractory period

৫৬.
Stimulation of baroreceptor
  1. ক
    Increase in heart rate
  2. খ
    Decrease in force of contraction
  3. গ
    Increase in arterial blood pressure
  4. ঘ
    Venodilation of pulmonary vessels
সঠিক উত্তর: খ
Decrease in force of contraction
উত্তর
সঠিক উত্তর: খ
Decrease in force of contraction
খ
৫৭.
Which is usually used to measure cardiac cycle length?
  1. ক
    ক) PR interval
  2. খ
    খ) QRS complex
  3. গ
    গ) ST segment
  4. ঘ
    ঘ) RR interval
সঠিক উত্তর: ঘ
ঘ) RR interval
উত্তর
সঠিক উত্তর: ঘ
ঘ) RR interval
ঘ
ব্যাখ্যা
Explanation:
The RR interval is the time between successive QRS complexes and is usually used to measure the cardiac cycle length (i.e. duration of ventricular cardiac cycle). RR interval is an indicator of ventricular rate.
৫৮.
Inhibitor of Endothelin 1
  1. ক
    Angiotensin 2
  2. খ
    GF
  3. গ
    NO
  4. ঘ
    Hyooxia
সঠিক উত্তর: গ
NO
উত্তর
সঠিক উত্তর: গ
NO
গ
৫৯.
Plateau phase of action potential
  1. ক
    Is due to K efflux
  2. খ
    Oprning of transient calcium channel.
  3. গ
    Causes prolongation of refractory period
  4. ঘ
    Coincides with ventricular diastole
সঠিক উত্তর: গ
Causes prolongation of refractory period
উত্তর
সঠিক উত্তর: গ
Causes prolongation of refractory period
গ
ব্যাখ্যা
Mainly due to calcium influx

▶  due to slow long lasting ca²+- Na+

▶  coincides with ventricular systole

▶  Results in prolonged refractory period
৬০.
In Pulsus bigeminy there is abnormality in
  1. ক
    Rate
  2. খ
    Rythm
  3. গ
    Volume
  4. ঘ
    Condition of vessel wall
সঠিক উত্তর: খ
Rythm
উত্তর
সঠিক উত্তর: খ
Rythm
খ
ব্যাখ্যা
Explanation:
Pulses bigeminy: This is due to premature ectopic beats following every sinus beat. The pulse rhythm is not regular because every weak pulse is premature.
৬১.
Cardiac output decreases in
  1. ক
    ক) Anxiety
  2. খ
    খ) Eating
  3. গ
    গ) High environmental temperature
  4. ঘ
    ঘ) Standing from lying position
সঠিক উত্তর: ঘ
ঘ) Standing from lying position
উত্তর
সঠিক উত্তর: ঘ
ঘ) Standing from lying position
ঘ
ব্যাখ্যা
[Ganong 24th p-524]
৬২.
Plateau phase in action potential of cardiac muscle due to-
  1. ক
    ক) Is due to efflux of K+
  2. খ
    খ) Is due to fast sodium channel
  3. গ
    গ) Is due to slow Ca+ Na channel
  4. ঘ
    ঘ) Coincides with ventricular diastole
সঠিক উত্তর: গ
গ) Is due to slow Ca+ Na channel
উত্তর
সঠিক উত্তর: গ
গ) Is due to slow Ca+ Na channel
গ
ব্যাখ্যা

Plateau phase in action potential of Cardiac muscle due to-
-Slow voltage gated Ca+ channel
-Increase Ca++ influx
-Decrease K+ efflux
-coincides of ventricular systole
-results in prolonged refractory period

৬৩.
Which of the following agents or changes has a negative inotropic effect on the heart?
  1. ক
    ক) Increased heart rate
  2. খ
    খ) Sympathetic stimulation
  3. গ
    গ) Norepinephrine
  4. ঘ
    ঘ) Acetylcholine (ACh)
সঠিক উত্তর: ঘ
ঘ) Acetylcholine (ACh)
উত্তর
সঠিক উত্তর: ঘ
ঘ) Acetylcholine (ACh)
ঘ
ব্যাখ্যা
A negative inotropic effect is one that decreases myocardial contractility. Contractility is the ability to develop tension at a fixed muscle length. Factors that decrease contractility are those that decrease the intracellular [Ca2+]. Increasing heart rate increases intracellular [Ca2+] because more Ca2+ ions enter the cell during the plateau of each action potential. Sympathetic stimulation and norepinephrine increase intracellular [Ca2+] by increasing entry during the plateau and increasing the storage of Ca2+ by the sarcoplasmic reticulum (SR) [for later release]. Cardiac glycosides increase intracellular [Ca2+] by inhibiting the Na+–K+ pump, thereby inhibiting Na+–Ca2+ exchange (a mechanism that pumps Ca2+ out of the cell). Acetylcholine (ACh) has a negative inotropic effect on the atria.
৬৪.
Which one is called pacemaker of heart?
  1. ক
    SA node
  2. খ
    AV node
  3. গ
    Bundle of His
  4. ঘ
    Purkinje fibre
সঠিক উত্তর: ক
SA node
উত্তর
সঠিক উত্তর: ক
SA node
ক
ব্যাখ্যা

Explanation:
The normal pacemaker tissue of the heart is the SA node because:
• SA node has the highest automaticity (discharge rate 70 -100 bpm.)
• Each natural heart beat begins in the SA node
• The SA node maintains normal cardiac rhythm

৬৫.
Which of the following part of heart has no parasymphatetic activity?
  1. ক
    Atria
  2. খ
    Ventricle
  3. গ
    SA node
  4. ঘ
    AV node
সঠিক উত্তর: খ
Ventricle
উত্তর
সঠিক উত্তর: খ
Ventricle
খ
৬৬.
Amplitude of pulse pressure in the aorta is directly proportional to
  1. ক
    Total peripheral resistance
  2. খ
    Aortic compliance
  3. গ
    Stroke volume
  4. ঘ
    Velocity of blood flow
সঠিক উত্তর: গ
Stroke volume
উত্তর
সঠিক উত্তর: গ
Stroke volume
গ
ব্যাখ্যা
Amplitude of pulse pressure in the corta is directly to-

  Stroke volume
  velocity of blood flow
  Elasticity of vessel
  Raised in old age
৬৭.
Ejection click occurs following which heart sound?
  1. ক
    1st
  2. খ
    2nd
  3. গ
    3rd
  4. ঘ
    4th
সঠিক উত্তর: ক
1st
উত্তর
সঠিক উত্তর: ক
1st
ক
ব্যাখ্যা
Explanation:
Ejection click: an ejection click sound occurs immediately following the first heart sound. The sudden opening of a deformed but mobile aortic or pulmonary valve produces the ejection click.