Welcome to your THEME 2 — 🌬️ Breathlessness and Ankle Swelling
1.
Which hemodynamic change occurs immediately after loss of placental circulation?
2.
Which condition results from narrowing of a cardiac valve opening?
3.
In mitral stenosis, breathlessness primarily develops due to increased pressure in the:
4.
The major immediate effect of severe hemorrhage on cardiac output is:
5.
Which condition is most likely to produce low cardiac output by reducing venous return rather than reducing myocardial contractility?
6.
Which structure prevents prolapse of atrioventricular valves during ventricular contraction?
7.
A patient with cardiac tamponade develops low cardiac output despite normal myocardial contractile proteins. Which primary factor is reduced?
8.
Which integrated sequence best represents progression of severe valvular dysfunction?
9.
A patient develops ankle swelling after prolonged standing. Which mechanism is most directly involved?
10.
Which event occurs during isovolumetric contraction of the left ventricle?
11.
Which event is represented by the P wave on ECG?
12.
Which pressure relationship maintains blood flow across the foramen ovale during fetal life?
13.
Closure of which valves produces the first heart sound?
14.
Which phase of the cardiac cycle is characterized by ventricular contraction?
15.
An increase in end-diastolic volume normally causes:
16.
A patient with ischemic heart disease develops reduced myocardial ATP production. Which function is impaired first?
17.
A healthy student starts running. Which sequence best explains the rise in cardiac output?
18.
A patient develops rupture of chordae tendineae after infective endocarditis. Which immediate functional abnormality is expected?
19.
Which parameter represents the percentage of blood ejected from the ventricle during systole?
20.
A patient with weak left ventricular contraction has a low ejection fraction. Which pressure-volume loop change best supports this finding?
21.
In a patient with nephrotic syndrome, generalized edema develops despite normal capillary pressure. Which change best explains this edema?
22.
Which embryological process is most important in separating pulmonary and systemic outflow tracts?
23.
Which pressure relationship causes opening of the mitral valve?
24.
A lymphatic capillary is seen with overlapping endothelial cells and an incomplete basement membrane. What is the main functional advantage?
25.
A patient has raised right atrial pressure. Which effect on peripheral tissues is most likely?
26.
A patient with elephantiasis develops chronic swelling of the lower limb. Which fluid abnormality is most characteristic?
27.
The second heart sound is mainly produced by closure of:
28.
A pressure-volume loop becomes wider after moderate exercise. Which change most likely explains this widening?
29.
A patient with aortic stenosis has difficulty ejecting blood from the left ventricle. Which hemodynamic factor is primarily increased?
30.
A murmur is most commonly produced by:
31.
A decrease in arteriolar diameter most directly affects cardiac output by increasing:
32.
Which structure directs oxygenated blood toward the fetal heart immediately after entering the fetus?
33.
A patient with chronic hypertension develops left ventricular hypertrophy. Which cardiac sound abnormality is most likely associated with reduced ventricular compliance?
34.
During inspiration, venous return increases mainly because blood is drawn toward the thorax. Which pressure change produces this effect?
35.
A patient with long-standing ventricular septal defect later develops pulmonary hypertension and cyanosis. Which pathophysiological sequence best explains this progression?
36.
A patient with myocardial infarction develops fatigue and cold extremities. Which immediate physiological problem best explains these features?
37.
Which combination correctly correlates ECG activity with mechanical cardiac events?
38.
A patient with right ventricular failure has ankle swelling and raised jugular venous pressure. Which mechanism best explains these findings?
39.
Which ECG component is associated with ventricular depolarization?
40.
Which ion is essential for initiation of cardiac muscle contraction?
41.
A patient has edema due to low plasma protein concentration. Which treatment effect would most directly oppose the edema mechanism?
42.
A student compares two arterioles with the same pressure gradient. One arteriole shows slight relaxation of smooth muscle. Which change best explains the marked rise in flow?
43.
Which condition is most likely associated with high cardiac output?
44.
Which phase of ventricular diastole contributes the greatest amount of ventricular filling?
45.
Which fetal vessel later forms the ligamentum venosum after birth?
46.
Which chamber acts as the major pumping chamber for systemic circulation?
47.
Which factor increases myocardial contractility under normal physiological conditions?
48.
A decrease in interstitial pressure after removal of excess tissue fluid will most directly reduce:
49.
A fall in SERCA pump activity in cardiac muscle will most directly prolong which phase of myocardial function?
50.
A neonate with persistent pulmonary hypertension retains fetal-type circulation mainly because:
51.
A neonate develops cyanosis due to right-to-left shunting. Which physiological event most directly permits deoxygenated blood to enter systemic circulation?
52.
An increase in sympathetic activity would produce which combination of effects?
53.
A drug causes relaxation of vascular smooth muscle by increasing nitric oxide activity. What is the expected effect on local perfusion?
54.
During which phase are all four cardiac valves closed?
55.
A tissue receives stable flow despite a moderate fall in perfusion pressure. Which mechanism supports this response?
56.
A patient with severe anemia develops increased cardiac output. Which mechanism best explains this compensation?
57.
The first effective breath after birth primarily alters neonatal circulation by producing:
58.
A rise in arterial pressure stretches an arteriole, followed by smooth muscle contraction. Which response is being demonstrated?
59.
A patient with severe aortic regurgitation develops left ventricular dilatation mainly because of:
60.
Which event immediately follows closure of the mitral valve during the cardiac cycle?
61.
During isovolumetric relaxation, which event occurs first?
62.
The primary function of SERCA pumps in cardiac muscle is to:
63.
Which structure is primarily responsible for regulating peripheral resistance?
64.
A vascular abnormality presents as persistent dilation of superficial dermal vessels without significant endothelial proliferation. Which diagnosis is most likely?
65.
A pressure-volume loop shows a marked increase in end-systolic volume with reduced loop width. Which functional abnormality is most likely present?
66.
Which metabolic pathway is the major source of energy in normal cardiac muscle?
67.
Which phase of the cardiac cycle contributes most directly to coronary artery filling?
68.
A failing left ventricle activates sympathetic compensation. Which short-term benefit is expected?
69.
During heavy exercise, increased venous return mainly occurs due to:
70.
A patient has severe tricuspid regurgitation. Which chamber is directly exposed to backward blood flow during ventricular systole?
71.
Which event best links increased tissue metabolism to improved oxygen delivery?
72.
The high mitochondrial content of cardiac muscle is most closely related to its requirement for:
73.
Regurgitation of the mitral valve primarily causes:
74.
Which method for measurement of cardiac output is based on oxygen consumption?
75.
During ventricular systole, papillary muscles contract primarily to:
76.
A patient with severe tachycardia develops reduced cardiac output despite increased heart rate. The most likely physiological explanation is:
77.
Which fetal vascular channel allows oxygen-rich blood to bypass hepatic sinusoids before reaching the inferior vena cava?
78.
The primary reason coronary perfusion occurs mainly during ventricular diastole is:
79.
Which heart valve prevents backflow of blood from the left ventricle into the left atrium?
80.
The Frank-Starling mechanism mainly explains the relationship between:
81.
A burn injury causes fluid loss into tissues. Which Starling-related change is most responsible?
82.
Which vascular lesion is formed by proliferation of capillary-sized blood vessels during infancy?
83.
A capillary bed has thin endothelial cells, pores and high filtration capacity. Which functional outcome is most expected?
84.
Which event occurs immediately after ventricular pressure exceeds aortic pressure?
85.
Which event occurs when ventricular pressure exceeds aortic pressure?
86.
A newborn with transposition of great vessels survives because blood mixing occurs through a patent fetal communication. Which structure most immediately improves systemic oxygenation?
87.
Which histological feature of sinusoidal capillaries explains their role in liver and bone marrow?
88.
A congenital defect causes increased pulmonary blood flow and left ventricular volume overload without early cyanosis. Which condition best fits this pattern?
89.
A patient with heart failure develops pulmonary edema and reduced urine output. Which integrated mechanism best links both findings?
90.
A patient with acute inflammation develops redness and swelling at the affected site. Which sequence best explains the swelling?
91.
A capillary has a very thin wall and large surface area. Which function is best supported by this structure?
92.
During exercise, blood flow to skin increases after body temperature rises. What is the main functional purpose?
93.
A rise in right atrial pressure above normal tends to reduce venous return because it:
94.
Which physiological adaptation converts fetal circulation from a parallel system into a series circulation?
95.
Stroke volume is calculated by subtracting:
96.
A tissue with increased metabolic activity shows local accumulation of CO₂, H⁺ and adenosine. What is the immediate vascular response?
97.
Which change would most likely decrease cardiac output?
98.
Which mechanism best explains production of the first heart sound?
99.
A drug that reduces excessive preload in congestive heart failure will most directly reduce:
100.
A child with congenital heart disease develops clubbing and cyanosis due to chronic hypoxemia. Which mechanism best explains these findings?
101.
Which valve lies between the right atrium and right ventricle?
102.
In fetal circulation, the blood with highest oxygen content is normally found in the:
103.
During moderate exercise, coronary blood flow increases. Which factor is most responsible at tissue level?
104.
Increased afterload most directly results in:
105.
Which factor directly determines cardiac output?
106.
A patient with left-sided heart failure is most likely to develop:
107.
Which finding is more characteristic of right-sided heart failure?
108.
Which measurement method estimates cardiac output from oxygen consumption and arteriovenous oxygen difference?
109.
Aortic stenosis produces a systolic murmur because turbulent flow occurs during:
110.
Which event occurs during ventricular systole?
111.
A patient with reduced left ventricular contractility has an end-diastolic volume of 140 mL and an end-systolic volume of 90 mL. Which parameter is most directly reduced?
112.
In heart failure, sodium and water retention initially increases preload. Why can this worsen symptoms later?
113.
Which heart sound may normally be heard in children during rapid ventricular filling?
114.
Which phase begins immediately after closure of semilunar valves?
115.
Failure of neural crest cell migration is most strongly associated with which congenital cardiac defect?
116.
A child has cyanosis, right ventricular hypertrophy, and decreased pulmonary blood flow. Which additional abnormality is most characteristic?
117.
In a neonate with duct-dependent congenital heart disease, prostaglandin E1 administration is beneficial because it:
118.
Which autonomic influence decreases heart rate?
119.
A patient develops pulmonary edema secondary to left-sided valvular disease. Which sequence best explains this complication?
120.
Breathlessness in left-sided heart failure mainly results from:
