1.
Which of the following statements is CORRECT :
Correct Answer
A. In HF patients , SV is lesser compared to normal individuals.
Explanation
In patients with heart failure (HF), stroke volume (SV) is lower compared to normal individuals. SV refers to the amount of blood pumped out of the heart with each heartbeat. In HF, the heart is unable to pump efficiently, leading to a decrease in SV. This can result in symptoms such as fatigue, shortness of breath, and fluid retention. Therefore, the statement "In HF patients, SV is lesser compared to normal individuals" is correct.
2.
Beta blockers are used in :
Correct Answer
B. Chronic HF.
Explanation
Beta blockers are used in chronic heart failure (HF) because they help to improve the symptoms and outcomes of the condition. Beta blockers work by blocking the effects of adrenaline on the heart, which reduces the heart's workload and helps it to pump more efficiently. This can lead to a decrease in symptoms such as shortness of breath and fatigue, and can also improve survival rates in patients with chronic HF. In contrast, beta blockers are not typically used in acute HF, as they can initially worsen symptoms and may be contraindicated in certain cases.
3.
Which of the following is not the major intrinsic compensatory mechanism in HF patients?
Correct Answer
A. Myocardial hypotropHy.
Explanation
Myocardial hypertrophy is a major intrinsic compensatory mechanism in HF patients. In heart failure, the heart muscle becomes weakened and is unable to pump blood effectively. To compensate for this, the heart undergoes hypertrophy, which means the heart muscle cells increase in size. This allows the heart to generate more force and pump blood more efficiently. Myocardial hypertrophy is an adaptive response to maintain cardiac output in HF patients. On the other hand, myocardial hypotrophy, or a decrease in the size of heart muscle cells, is not a compensatory mechanism in HF patients.
4.
In treatment of HF we should:
Correct Answer
D. Decrease the preload & the afterload
Explanation
In the treatment of heart failure (HF), it is important to decrease the preload and the afterload. Preload refers to the amount of blood filling the heart before it contracts, and decreasing it can help reduce the workload on the heart. Afterload, on the other hand, refers to the resistance the heart has to overcome to pump blood out to the body, and decreasing it can also relieve the strain on the heart. By decreasing both the preload and the afterload, the heart's workload is reduced, allowing it to function more efficiently and improving symptoms of heart failure.
5.
Leakage of this substance can lead to Arrhythmia:
Correct Answer
A. Ca+2\due to excessive beta activation
Explanation
Excessive beta activation can lead to the leakage of Ca+2, which can result in arrhythmia. Beta activation increases the influx of calcium ions into the cells, causing an imbalance in the electrical conduction system of the heart. This disruption can lead to irregular heart rhythms, known as arrhythmias. Therefore, the leakage of Ca+2 due to excessive beta activation can be a potential cause of arrhythmia.
6.
Which of the following statements is CORRECT:
Correct Answer
B. Down regulation takes place after increased sympathetic stimulation
Explanation
Down regulation refers to a decrease in the number or sensitivity of receptors in response to increased stimulation. Sympathetic stimulation activates the sympathetic nervous system, which is responsible for the "fight or flight" response. Therefore, it is logical to assume that down regulation would take place after increased sympathetic stimulation, as the body tries to maintain homeostasis by decreasing the number or sensitivity of receptors.
7.
Which of the following statements is INCORRECT :
Correct Answer
A. Most of Digoxin is metabolized and excreted by the kidneys
Explanation
The statement "Most of Digoxin is metabolized and excreted by the kidneys" is incorrect. Digoxin is primarily eliminated from the body through non-renal routes, such as hepatic metabolism and biliary excretion. Only a small percentage of the drug is excreted unchanged by the kidneys.
8.
Which of the following graphs represents the early after depolarization (Ca+2 overload)?
Correct Answer
B. Option 2
9.
Toxicity regarding Digoxin includes :
Correct Answer
E. B+C
Explanation
The correct answer is B+C. Digoxin toxicity can cause both hypokalemia (low potassium levels) and hypercalcemia (high calcium levels). Hypokalemia occurs because digoxin inhibits the sodium-potassium ATPase pump, leading to increased intracellular sodium levels and subsequent exchange of potassium from the cells. Hypercalcemia can occur due to the inhibition of the sodium-calcium exchanger, leading to increased intracellular calcium levels. Both of these electrolyte imbalances can contribute to the toxic effects of digoxin on the heart and other organs.
10.
How do Beta blockers improve cardiac function in HF?
Correct Answer
A. By decreasing cardiac remodelling
Explanation
Beta blockers improve cardiac function in HF by decreasing cardiac remodeling. In heart failure, the heart undergoes structural changes such as enlargement and thickening of the muscle, which can further impair its function. Beta blockers work by blocking the effects of adrenaline on the heart, reducing the workload on the heart and preventing further remodeling. This helps to improve cardiac function, reduce symptoms, and improve overall outcomes in patients with heart failure.
11.
Which is important to monitor in patients taking Digoxin?
Correct Answer
B. Potassium
Explanation
Monitoring potassium levels is important in patients taking Digoxin because Digoxin can cause an imbalance in potassium levels. Low potassium levels can increase the risk of Digoxin toxicity, while high potassium levels can reduce the effectiveness of Digoxin. Therefore, regular monitoring of potassium levels is necessary to ensure the safe and effective use of Digoxin.
12.
Which describes the mechanism of action of milirinone in HF?
Correct Answer
B. Increases cardiac contractility
Explanation
Milrinone is a phosphodiesterase inhibitor that increases cardiac contractility by inhibiting the breakdown of cyclic adenosine monophosphate (cAMP). This leads to increased levels of cAMP in cardiac cells, which activates protein kinase A and ultimately enhances cardiac contractility. Therefore, the correct answer is "Increases cardiac contractility".
13.
Which of the following is correct regarding Digoxin when used for atrial fibrillation
Correct Answer
D. Digoxin levels of 1 to 2ng\ml are desirable in the treatment of atrial fibrillation
Explanation
Digoxin levels of 1 to 2ng/ml are desirable in the treatment of atrial fibrillation because this range ensures therapeutic efficacy while minimizing the risk of toxicity. Digoxin is a medication commonly used for rate control in atrial fibrillation, but not for rhythm control. It works by inhibiting the sodium-potassium ATPase pump, leading to increased intracellular calcium levels and enhanced contractility of the heart. Digoxin does not block voltage-sensitive calcium channels and it actually decreases conduction velocity through the AV node. Therefore, the correct answer is that maintaining digoxin levels of 1 to 2ng/ml is desirable in the treatment of atrial fibrillation.
14.
What is the source of Digoxin drug ?
Correct Answer
A. Digitalis
Explanation
Digitalis is the correct source of Digoxin drug. Digoxin is derived from the leaves of the Digitalis plant. The plant contains compounds called cardiac glycosides, which have a positive inotropic effect on the heart. These compounds, including Digoxin, are used to treat various heart conditions such as congestive heart failure and atrial fibrillation.
15.
We need to adjust Digoxin dosage in patients with :
Correct Answer
A. Renal failure
Explanation
The correct answer is renal failure. Digoxin is primarily eliminated through the kidneys, so patients with renal failure may have impaired clearance of the drug. This can lead to an accumulation of digoxin in the body, increasing the risk of toxicity. Therefore, adjusting the dosage is necessary to prevent adverse effects.