GMS 6474 Study Guide w study questions NEWEST
2026-2027 ACTUAL EXAM COMPLETE 200
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY
GRADED A+ BRAND NEW!!
A 30-year-old man had his EKG measured at his physician's office, but his records were lost. The
EKG technician remembered that the QRS deflection was large and positive in lead aVF and 0 in
lead I. What is the mean electrical axis? - CORRECT ANSWER: 90
A hiker is climbing a mountain, and his chemoreceptors have started firing. What has caused this
increase in chemoreceptor activity? - CORRECT ANSWER: decreased PaO2
A hiker is on a trail and a giant grizzly bear steps out of the forest. His heart immediately begins
beating faster. What is the mechanism causing this response? Describe the pathway. - CORRECT
ANSWER: epinephrine and norepinephrine bind beta 1 receptor to increase HR
A patient enters the clinic with a systolic pressure of 140 and a diastolic pressure of 80. What is
his Mean Arterial Pressure (MAP)? - CORRECT ANSWER: 100
A patient has come in to the ER with a gunshot wound. You suspect the bullet hit an artery
because the patient has lost a lot of blood (hemorrhage). Describe the atrial receptor reflex
response. Include autonomic and endocrine responses. - CORRECT ANSWER: The hemorrhage
results in a decreased "Type B" firing within the atrial receptor. This is because there is a lower
blood volume when the hemorrhage occurs The B Fiber increases the sympathetic nerve activity
within the kidneys. This results in an increase in renin secretion and vascular resistance, there is
also an increase in ACTH and AVP secretion. ACTH secretion also increases cortisol. Cortisol
has both active and permissive effects on the cardiovascular function.
A patient has come to the ER due to dizziness and fainting. The ECG trace shows 2 PQRST
waves, followed by 1 P-wave with no QRST complex. How would you diagnose this patient? -
,CORRECT ANSWER: I would diagnose the patient with a second degree heart block with
Morbitz type 2. There is usually two pqrst waves and one p wave alone.
A patient has come to the ER with severe dehydration. Her heart rate is 110bpm, her BP is 80/50,
and she is non-responsive (unconscious). Your first response is to give her a bolus of saline
intravenously. How is her cardiac output affected? Describe the Frank-Starling Law, and how it
relates to her care. - CORRECT ANSWER: The Frank Starling law states that the length of
cardiomyofibrils are proportional to the strength of contraction. There is an increase in EDV
when there is an increase in venous return. Essentially, whatever is pumped into the heart will
have the same amount pumped out. Because the patient has a low blood pressure, their overall
blood volume is low as well. When adding bolus the fluids circulating will increase and so will
the volume of blood being pumped in and out of the heart. This would increase the preload,
which will increase CO and blood pressure.
A patient was born with a congenital heart defect called "Coarctation of the Aorta," in which the
aorta narrows at specific point in the arch, followed by an immediate return to normal diameter
size. (Think of it as if a rubber band is restricting the middle of the aortic arch) What would this
restriction point in the aortic arch do to blood flow after the coarctation? - CORRECT
ANSWER: Turbulent Flow
A patient's CO is 5.5L/min and her heart rate is 75bpm. What is her stroke volume? - CORRECT
ANSWER: CO = HR x SV
5.5L = 75x
73.33 ml
Access to the actin active site is regulated by __________ in smooth muscle cells and
_____________ in cardiac and skeletal muscle. - CORRECT ANSWER: Myosin
phosphorylation, calcium binding troponin
According to Ohm's Law, deltaP = F*R. Flow to the pulmonary vasculature is equal to that of the
systemic vasculature. How does the pulmonary vasculature accommodate the same amount of
blood flow as the systemic vasculature? - CORRECT ANSWER: decreased resistance
,action potential of cardiac muscle cells - CORRECT ANSWER: ...
action potential of nodal cells (picture) from discussion - CORRECT ANSWER: ...
baroreflex questions will come from Dr. Scheuers lectures & integration lectures - CORRECT
ANSWER: ...
Because of the placement of the positive electrodes, and the predominant direction of the
depolarization wave of the heart, the QRS complex is ________ in lead I and II. - CORRECT
ANSWER: positive
Briefly describe the steps of the Cross-Bridge Cycle. - CORRECT ANSWER: Step 1: Binding of
activated myosin to Actin; ADP + Pi are still attached to myosin
Step 2: Myosin head swivels and causes actin filament displacement. ADP + Pi are released from
myosin
Step 3: ATP binds to myosin and there is a dissociation between actin and myosin; this is referred
to as cross-bridge detatch
Step 4: Myosin head is then activated by energy from the hydrolysis of ATP; ADP + Pi remain
bound to myosin; returns to initial myosin activated state
Calcium is released and sequestered differently in Skeletal and Cardiac muscles. What is one
physiological relevance of cardiac muscle calcium handling? - CORRECT ANSWER: Relies on
Calcium Induced Calcium Release for regulation of contractile strength
Calcium is released and sequestered differently in Skeletal and Cardiac muscles. What is the
physiological relevance of skeletal muscle calcium handling? - CORRECT ANSWER: large
calcium stores in the SR allows for full contraction once activated
calculate .04 boxes in ECG trace between R-R intervals - CORRECT ANSWER: ...
, calculate cardiac output from Hr and Sv. - CORRECT ANSWER: Cardiac Output = Heart Rate x
Stroke Volume
calculate flow (aka cardiac output) & resistance from Ohm's law - CORRECT ANSWER: P =
Flow * Resistance
calculate heart rate from an example of ECG tracing - CORRECT ANSWER: # of boxes x .04
seconds = X seconds per beat
60 seconds/min / X = ___ BPM
calculate intervals of ECG & know what is normal - CORRECT ANSWER: PR interval should
be .12-.20 seconds
QRS complex should be no less than .10 seconds
QT interval is less than half of one R-R interval
ECG = electrical activity
Cardiac Cycle = mechanical events
calculate MAP - CORRECT ANSWER: diastolic pressure + 1/3 pulse pressure (SP-DP)
MAP = 1/3 systolic + 2/3 diastolic pressure
Calculate the Systemic and Pulmonary Driving pressures.
Mean Aortic Pressure: 90mmHg
Mean Pulmonary Arterial Pressure: 10mmHg
Right Atrial Pressure: 2mmHg
Left Atrial Pressure: 4mmHg - CORRECT ANSWER: Systemic Driving Pressure : Aortic
Pressure - Right Arterial Pressure = 90 - 2 = 88.
Pulmonary Driving Pressure : Mean Pulmonary Arterial Pressure - Left Atrial Pressure = 10 - 4 =
6.
2026-2027 ACTUAL EXAM COMPLETE 200
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY
GRADED A+ BRAND NEW!!
A 30-year-old man had his EKG measured at his physician's office, but his records were lost. The
EKG technician remembered that the QRS deflection was large and positive in lead aVF and 0 in
lead I. What is the mean electrical axis? - CORRECT ANSWER: 90
A hiker is climbing a mountain, and his chemoreceptors have started firing. What has caused this
increase in chemoreceptor activity? - CORRECT ANSWER: decreased PaO2
A hiker is on a trail and a giant grizzly bear steps out of the forest. His heart immediately begins
beating faster. What is the mechanism causing this response? Describe the pathway. - CORRECT
ANSWER: epinephrine and norepinephrine bind beta 1 receptor to increase HR
A patient enters the clinic with a systolic pressure of 140 and a diastolic pressure of 80. What is
his Mean Arterial Pressure (MAP)? - CORRECT ANSWER: 100
A patient has come in to the ER with a gunshot wound. You suspect the bullet hit an artery
because the patient has lost a lot of blood (hemorrhage). Describe the atrial receptor reflex
response. Include autonomic and endocrine responses. - CORRECT ANSWER: The hemorrhage
results in a decreased "Type B" firing within the atrial receptor. This is because there is a lower
blood volume when the hemorrhage occurs The B Fiber increases the sympathetic nerve activity
within the kidneys. This results in an increase in renin secretion and vascular resistance, there is
also an increase in ACTH and AVP secretion. ACTH secretion also increases cortisol. Cortisol
has both active and permissive effects on the cardiovascular function.
A patient has come to the ER due to dizziness and fainting. The ECG trace shows 2 PQRST
waves, followed by 1 P-wave with no QRST complex. How would you diagnose this patient? -
,CORRECT ANSWER: I would diagnose the patient with a second degree heart block with
Morbitz type 2. There is usually two pqrst waves and one p wave alone.
A patient has come to the ER with severe dehydration. Her heart rate is 110bpm, her BP is 80/50,
and she is non-responsive (unconscious). Your first response is to give her a bolus of saline
intravenously. How is her cardiac output affected? Describe the Frank-Starling Law, and how it
relates to her care. - CORRECT ANSWER: The Frank Starling law states that the length of
cardiomyofibrils are proportional to the strength of contraction. There is an increase in EDV
when there is an increase in venous return. Essentially, whatever is pumped into the heart will
have the same amount pumped out. Because the patient has a low blood pressure, their overall
blood volume is low as well. When adding bolus the fluids circulating will increase and so will
the volume of blood being pumped in and out of the heart. This would increase the preload,
which will increase CO and blood pressure.
A patient was born with a congenital heart defect called "Coarctation of the Aorta," in which the
aorta narrows at specific point in the arch, followed by an immediate return to normal diameter
size. (Think of it as if a rubber band is restricting the middle of the aortic arch) What would this
restriction point in the aortic arch do to blood flow after the coarctation? - CORRECT
ANSWER: Turbulent Flow
A patient's CO is 5.5L/min and her heart rate is 75bpm. What is her stroke volume? - CORRECT
ANSWER: CO = HR x SV
5.5L = 75x
73.33 ml
Access to the actin active site is regulated by __________ in smooth muscle cells and
_____________ in cardiac and skeletal muscle. - CORRECT ANSWER: Myosin
phosphorylation, calcium binding troponin
According to Ohm's Law, deltaP = F*R. Flow to the pulmonary vasculature is equal to that of the
systemic vasculature. How does the pulmonary vasculature accommodate the same amount of
blood flow as the systemic vasculature? - CORRECT ANSWER: decreased resistance
,action potential of cardiac muscle cells - CORRECT ANSWER: ...
action potential of nodal cells (picture) from discussion - CORRECT ANSWER: ...
baroreflex questions will come from Dr. Scheuers lectures & integration lectures - CORRECT
ANSWER: ...
Because of the placement of the positive electrodes, and the predominant direction of the
depolarization wave of the heart, the QRS complex is ________ in lead I and II. - CORRECT
ANSWER: positive
Briefly describe the steps of the Cross-Bridge Cycle. - CORRECT ANSWER: Step 1: Binding of
activated myosin to Actin; ADP + Pi are still attached to myosin
Step 2: Myosin head swivels and causes actin filament displacement. ADP + Pi are released from
myosin
Step 3: ATP binds to myosin and there is a dissociation between actin and myosin; this is referred
to as cross-bridge detatch
Step 4: Myosin head is then activated by energy from the hydrolysis of ATP; ADP + Pi remain
bound to myosin; returns to initial myosin activated state
Calcium is released and sequestered differently in Skeletal and Cardiac muscles. What is one
physiological relevance of cardiac muscle calcium handling? - CORRECT ANSWER: Relies on
Calcium Induced Calcium Release for regulation of contractile strength
Calcium is released and sequestered differently in Skeletal and Cardiac muscles. What is the
physiological relevance of skeletal muscle calcium handling? - CORRECT ANSWER: large
calcium stores in the SR allows for full contraction once activated
calculate .04 boxes in ECG trace between R-R intervals - CORRECT ANSWER: ...
, calculate cardiac output from Hr and Sv. - CORRECT ANSWER: Cardiac Output = Heart Rate x
Stroke Volume
calculate flow (aka cardiac output) & resistance from Ohm's law - CORRECT ANSWER: P =
Flow * Resistance
calculate heart rate from an example of ECG tracing - CORRECT ANSWER: # of boxes x .04
seconds = X seconds per beat
60 seconds/min / X = ___ BPM
calculate intervals of ECG & know what is normal - CORRECT ANSWER: PR interval should
be .12-.20 seconds
QRS complex should be no less than .10 seconds
QT interval is less than half of one R-R interval
ECG = electrical activity
Cardiac Cycle = mechanical events
calculate MAP - CORRECT ANSWER: diastolic pressure + 1/3 pulse pressure (SP-DP)
MAP = 1/3 systolic + 2/3 diastolic pressure
Calculate the Systemic and Pulmonary Driving pressures.
Mean Aortic Pressure: 90mmHg
Mean Pulmonary Arterial Pressure: 10mmHg
Right Atrial Pressure: 2mmHg
Left Atrial Pressure: 4mmHg - CORRECT ANSWER: Systemic Driving Pressure : Aortic
Pressure - Right Arterial Pressure = 90 - 2 = 88.
Pulmonary Driving Pressure : Mean Pulmonary Arterial Pressure - Left Atrial Pressure = 10 - 4 =
6.
