EDAIC - European Diploma in Anesthesiology and Intensive Care Cardiovascular Physiology and Pharmacology Questions and Answers

Question 1

A 65-year-old male with severe biventricular heart failure is receiving an intravenous infusion of milrinone.
What is the primary mechanism of action responsible for its inotropic and vasodilatory effects?

Accepted Answer

Inhibition of phosphodiesterase-3 (PDE3), leading to increased intracellular cAMP.

Answer

Stimulation of beta-1 adrenergic receptors, increasing intracellular cAMP.

Answer

Blockade of voltage-gated calcium channels, causing smooth muscle relaxation.

Answer

Sensitization of the contractile apparatus to calcium, without increasing intracellular calcium levels.

Question 2

During a rapid intravenous fluid bolus in a healthy, euvolemic patient, an increase in heart rate is observed despite a minimal change in arterial blood pressure. Which physiological reflex is predominantly responsible for this tachycardia?

Accepted Answer

Bainbridge reflex (atrial reflex)

Answer

Carotid sinus baroreceptor reflex

Answer

Bezold-Jarisch reflex

Answer

Chemoreceptor reflex

Question 3

A patient undergoing cardiac surgery has an aortic diastolic pressure of 70 mmHg and a left ventricular end-diastolic pressure (LVEDP) of 20 mmHg. What is the calculated coronary perfusion pressure (CPP) for the left ventricle?

Accepted Answer

50 mmHg

Answer

90 mmHg

Answer

70 mmHg

Answer

20 mmHg

Question 4

Which of the following best describes the effect of vasopressin (at therapeutic doses for vasoplegic shock) on systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR)?

Accepted Answer

Increases SVR with minimal or no effect on PVR

Answer

Decreases SVR and increases PVR

Answer

Increases SVR and increases PVR

Answer

Decreases both SVR and PVR

Question 5

The administration of a pure positive inotropic agent, such as dobutamine, would cause which of the following changes on a left ventricular pressure-volume (PV) loop, assuming constant preload and afterload?

Accepted Answer

An upward and leftward shift of the end-systolic pressure-volume relationship (ESPVR) line.

Answer

A rightward shift of the entire loop with a decreased end-systolic pressure.

Answer

An increase in end-systolic volume and a decrease in stroke volume.

Answer

A downward shift of the end-diastolic pressure-volume relationship (EDPVR) line.

Question 6

A patient on mechanical ventilation develops acute hypercapnia (PaCO2 increases from 40 mmHg to 65 mmHg) with associated acidosis. What are the expected direct effects on the systemic and pulmonary vasculatures?

Accepted Answer

Systemic vasodilation and pulmonary vasoconstriction

Answer

Systemic vasoconstriction and pulmonary vasoconstriction

Answer

Systemic vasodilation and pulmonary vasodilation

Answer

Systemic vasoconstriction and pulmonary vasodilation