CVS Part 2

Which of the following is not an action of macrophages within plaques with regards to atherosclerosis?

What is the transcription factor regulating inflammation?

How many mistakes can you find here?

The actions of noradrenaline result in a lower heart rate whilst adrenaline results in an increased heart rate. This is because baroreceptors detect the larger effect that noradrenaline has on increased blood pressure brining the heart rate down. Adrenaline on the other hand results in a lower diastolic blood pressure because of vasodilation.

Isoprenaline activates Beta 1 in the heart speeding up the heart rate. Noradrenaline can bind to all four of the adrenoreceptors whilst Adrenaline is unable to bind to B2 receptors. Alpha receptors result in an excitatory effect in smooth muscle cells whilst Beta cells only have stimulatory effects on the heart.

Alpha 1 is pre synaptic and causes inhibition of further transmitter release on activation. Alpha 2 actions activate the production of cAMP whilst Beta receptors inhibit it.

How many mistakes are there in this statement?

1) Baroreceptors are located in the X and Y innervated by P and Q respectively.

2) The afferent input to the heart stimulates the sympathetic system whilst inhibiting the parasympathetic system at the same time.

3) Mr J comes to you and you find out he has a haemorrhage :(. The haemorrhage results in a lower atrial pressure, thus lower baroreceptor firing. The direct effects of this via the nervous system are:

Which of the following is NOT a characteristic of abnormal bleeding? (select one)

To activate factor IIa, what is needed?

What factor is used to activate factor XIII?

What is the function of chemoattractants and growth factors for VSMC by macrophages?

Mr J comes to you and on doing some blood stuff, and you get some numbers from this.
C.O. = 6 L/min
H.R = 100/min
MAP = 120mmHg

Work out his stroke volume, and total peripheral resistance.

Atherosclerotic risk factors are

In the coagulation cascade, what is the correct order of activation in the intrinsic pathway? (Select one)

Match the following events and functions.

a) Vessel constriction
b) Formation of unstable platelet plug
c) Stabilisation of platelet plug with fibrin
d) Fibrinolysis

1) Stops blood loss
2) Restores vessel integrity
3) Limits blood flow to damaged area
4) Limits blood loss

Which of the following statements is correct?

Match the posh name of vessel layers to their meaning.

a) Tunica Intima
b) Tunica Media
c) Tunica Adventitia

1) Endothelium
2) SMC
3) Nerves

Which of the following is NOT used to reduce blood pressure?

Which of the following statements is FALSE?

Defects or deficiencies in which of the following affect primary haemostasis?

A drop in arterial blood pressure results in lower levels of NaCl detected by the Macula Densa cells, in lower pre-glomerular vessel pressure and activation of the Beta 1 receptors in the kidney which all lead to Renin release.

Renin acts on Angiotensinogen which gets converted to Angiotensin I which then gets converted to Angiotensin II via ACE. No further enzymes are involved. Angiotensin II then acts to inhibit renin production and increases arterial blood pressure. AT1 receptors are G coupled and also couple to PLA2. Activation of these receptors by Angiotensin II increases blood pressure.

How many mistakes can be found in the above?

What is angiogenesis?

How many mistakes can you find in this?

Plasminogen and tissue plasminogen activator normally don't interact. However, tissue plasminogen is activated when bound to fibrin and will convert plasminogen to plasmin which breaks down blood clots to degradation products.

Blood doesn't clot completely (because it is an amplification system) because of direct and indirect inhibitory mechanisms. Direct methods involve antithrombin which directly inhibits thrombin and an indirect inhibition is the inhibition of thrombin generation via the protein C pathway. Antithrombin only inhibits thrombin.

In indirect inhibition, thrombin binds to thrombomoudlin on the endothelium which deactivates it, whilst activating protein C which also binds to the complex forming a separate protein C and protein S complex that inhibits factors VIIIa and Va.

True or False.

Angioplasty is used to treat stable angina.

Myocardial ischaemia is a reduction in blood flow meaning demand can't be met and can be caused by stenosis of pre arterioles preventing them from changing diameter to match demand.

Angina Pectoris is a discomfort in the chest, jaw, shoulders, arms or back provoked by exertion or emotional stress. Causes can include MI, a thrombosis or a stenosis causing ischaemia.

Myocardial cell death arises from interrupted blood flow to the heart. This can be caused by coronary plaque rupture, plaque erosion or dissection.

A white thrombus is fibrin rich, common in venous vessels and can be treated via anticoagulant or anti-fibrinolytic therapy.

Thrombophilia is...

Which factor is dominant in venous thrombosis?

Which of the following is NOT linked to hypertension?

Which of the following is NOT an example of abnormal bleeding?

Which receptors are mostly located post-synaptically?

Tissue factor (VIIa) activates which two factors?

Which of the following are NOT common causes of coagulation factors deficiency?

Which of the following statements is correct?

Platelets can directly bind to exposed collagen via X or to von Willebrand factor via Y. On activation, they release ADP and prostaglandins further activating platelets by inducing the platelet aggregation response. At this point, the shape changes and additional receptors P and Q are exposed which bind to other platelets and are linked by R and S, sealing the injury. Coagulation can also be activated by the actions of thrombin.

What are X, Y, P, Q, R and S?

Mr Choudhary comes to you, a first year medical student to test you because he think he has defects in his primary haemostasis and wants to know what the patterns of bleeding are for it that could be applicable to him.

Ruptured plaques...

Tyrosine is the precursor for Dopamine, Noradrenaline and Adrenaline.

The vasomotor centre innervates almost all blood vessels and is composed of a number of areas, some of which are listed below.