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Core Knowledge and Fundamentals Flashcards

7 cards from real FANZCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. The Frank-Starling law of the heart states that within physiological limits, increased ventricular end-diastolic volume leads to:

    Answer: Increased stroke volume

    The Frank-Starling mechanism describes how increased preload (end-diastolic volume) stretches myocardial fibres, optimising actin-myosin overlap and increasing the force of contraction, thereby increasing stroke volume.

  2. A patient's arterial line waveform shows pulsus paradoxus. Which condition is most likely?

    Answer: Cardiac tamponade

    Cardiac tamponade causes exaggerated interventricular dependence; inspiration reduces left ventricular filling disproportionately, causing a >10 mmHg fall in systolic BP — classic pulsus paradoxus.

  3. Mean arterial pressure (MAP) is best calculated as:

    Answer: Diastolic BP + (Pulse pressure / 3)

    MAP = DBP + (PP/3) because diastole occupies approximately two-thirds of the cardiac cycle, giving diastolic pressure greater weight in the average; equivalently MAP = (SBP + 2×DBP) / 3.

  4. Pulmonary artery occlusion pressure (PAOP/PCWP) is used as a surrogate for:

    Answer: Left ventricular end-diastolic pressure

    PAOP reflects left atrial pressure and, in the absence of mitral valve disease, approximates left ventricular end-diastolic pressure, providing an index of left heart preload.

  5. Which type of shock is characterised by high cardiac output, low systemic vascular resistance, and low central venous oxygen saturation?

    Answer: Distributive shock

    Distributive shock (e.g., septic shock) causes massive vasodilation with high cardiac output, low SVR, and despite elevated mixed venous O2 saturation initially, impaired cellular oxygen utilisation leads to lactic acidosis.

  6. During cardiopulmonary bypass, which pH management strategy involves adjusting PaCO2 for the patient's hypothermic temperature?

    Answer: pH-stat

    pH-stat management corrects blood gas measurements to the patient's actual temperature and adds CO2 to maintain PaCO2 at 40 mmHg temperature-corrected, increasing cerebral blood flow and improving homogeneous cooling.

  7. Myocardial oxygen supply is primarily determined by which variables?

    Answer: Coronary perfusion pressure and diastolic filling time

    Coronary perfusion occurs predominantly during diastole, so coronary perfusion pressure (aortic diastolic BP minus LVEDP) and diastolic filling time are the primary determinants of myocardial oxygen delivery.