Question 1

1.	Which of the following is not part of the oxygen delivery equation?

Accepted Answer

FiO2

Answer

SaO2

Answer

Hemoglobin

Answer

Cardiac output

Question 2

2.	Which of the following statements concerning the arterial blood pressure is correct?

Accepted Answer

Is 120/80 mmHg

Answer

Depends solely on the cardiac output

Answer

Is the arithmetic average of the systolic and diastolic pressures.

Answer

Is due to the vascular resistance of the capillaries.

Question 3

3.	Which of the following statements concerning the control of the vasculature is correct?

Accepted Answer

Parasympathetic vasodilator fibres innervate the blood vessels of the exocrine glands of the gastro-intestinal tract.

Answer

Autoregulation refers to the nervous control of the blood vessels

Answer

Myogenic response of the blood vessel refers to a contraction initated by the nerve innervation instead of the myocyte cell itself

Answer

The diameter of the arterioles is entirely regulated by the sympathetic nervous system.

Question 4

4.	Which of the following statements concerning the nervous regulation of the circulation is correct?

Accepted Answer

If the arterial pressure suddenly falls the baroreceptor reflex increases the heart rate.

Answer

The baroreceptors are mainly responsible for the long-term regulation of systemic blood pressure.

Answer

The baroreceptors are found in the aortic and carotid bodies

Answer

The baroreceptors have no effect on the cardiac contractility

Question 5

5.	Which of the following is not important in cardiac output?

Accepted Answer

Pulmonary artery systolic pressure

Answer

Cardiac contractility

Answer

Right atrial pressure

Answer

Left ventricle end diastolic pressure

Question 6

6.	These are the phases of diastole except:

Accepted Answer

Isovolumetric contraction

Answer

Diastasis

Answer

Atrial kick

Answer

Rapid filling

Question 7

7.	Which of the following statements is not true about the Frank-Starling curve?

Accepted Answer

The stretch of the myocardial fibres always lead to the greater force of ventricular contraction.

Answer

There is an optimal length between sarcomeres at which the tension in the muscle fibre is greatest, resulting in the greatest force of contraction.

Answer

Heart failure caused by the impaired contractile function of the left ventricle causes a downward shift of the left ventricular performance curve.

Answer

Stroke volume is at the Y-axis, left ventricle end diastolic volume on the X-axis.

Question 8

8.	Which of the following describes the relationship between cardiac output, mean arterial pressure and systemic vascular resistance?

Accepted Answer

Ohm’s law

Answer

Bernoulli's principle

Answer

Henry’s law

Answer

Fick’s principle

Question 9

9. Which of the following is the least invasive way to monitor cardiac output?

Accepted Answer

Transaortic/transpulmonary Doppler cardiac output monitor

Answer

Calibrated pulse contour analysis

Answer

Mixed venous saturation

Answer

Pulmonary artery catheter

Question 10

10. The following parameters are either measured or derived by pulmonary artery catheter except:

Accepted Answer

Left ventricle end diastolic volume

Answer

Pulmonary vascular resistance

Answer

Core body temperature

Answer

Cardiac index

Question 11

11. The following statements are true about uncalibrated pulse contour analysis cardiac output monitors except:

Accepted Answer

Able to provide extra lung water index parameter

Answer

One of the minimally invasive cardiac output monitor

Answer

Require arterial line for analysis

Answer

Come with or without preloaded data

Question 12

12. Which of the following statements is true about Doppler cardiac output monitoring?

Accepted Answer

Doppler shift in frequency occurs when the ultrasound wave is reflected back from moving RBCs, with the shift in frequency proportional to the velocity of the blood flow.

Answer

Corrected (systolic) flow time (FTc) is the indicator for contractility

Answer

Stroke volume is the product of the velocity of RBC and cross-sectional area of the IVC.

Answer

Able to give continuous beat to beat cardiac output monitoring.

Question 13

13. The following statements are true about transoesophageal echocardiography except:

Accepted Answer

Contraindicated in patients with ulcerative colitis.

Answer

In addition to the estimation of cardiac output, it allows visualization of the cardiac chambers, valves, and pericardium .

Answer

"Kissing" of the papillary muscle may indicate the need for fluids if the right heart is functioning normally.

Answer

The finding of an RV D-shape may suggest the presence of RV dysfunction/failure

Question 14

14. 	The following are the methods of assessing fluid responsiveness except:

Accepted Answer

Systemic vascular resistance variations

Answer

Pulse pressure/stroke volume variations

Answer

Passive leg raising

Answer

End-expiratory occlusion test

Question 15

15. Which of the following is the dynamic fluid responsiveness test?

Accepted Answer

Stroke volume variations

Answer

Pulmonary artery occlusion pressure

Answer

Global end diastolic index

Answer

Central venous pressure

Question 16

16. The following are limitations of heart and lung interaction parameters except :

Accepted Answer

High tidal volume

Answer

Cardiac arrhythmias

Answer

Spontaneous breathing

Answer

Open chest

Question 17

17. The following statements are true about the VTI variation except :

Accepted Answer

VTI variation uses parasternal long axis view

Answer

VTI variation has a very high sensitivity and specificity

Answer

VTI variation of more than 12% predicts fluid responsiveness

Answer

VTI variation is calculated as the difference between the maximum and the minimum VTI divided by the mean of the two values

Question 18

18. While patient is under general anaesthesia, which one of the following parameters is the most likely to be excluded by the clinician with regards to microcirculation :

Accepted Answer

Ketone

Answer

Base excess

Answer

Lactate

Answer

CO2 gap

Question 19

19. Which of the following statements is the best to describe the endothelial glycocalyx (EG)?

Accepted Answer

EG is a membrane bound covering of the endothelial cells that is found on the intraluminal surfaces of all blood vessels and organs

Answer

EG is important in determining the autoregulation function of the brain

Answer

EG is a fat-rich layer lining the vascular endothelium

Answer

EG is important in myocardial performance

Question 20

20. Which of the following is not the function of the endothelial glycocalyx?

Accepted Answer

ATP production

Answer

Mechanotransduction

Answer

Control of coagulation

Answer

Vascular permeability

Question 21

21. Which of the following situations is less likely to damage endothelial glycocalyx layer?

Accepted Answer

Hypovolaemia

Answer

Hyperoxia

Answer

Hyperglycaemia

Answer

Inflammation

Question 22

22. Which of the following best describes perioperative assessment ?

Accepted Answer

Revised cardiac risk index (RCRI) is able to discriminate well (high concordance index) between high versus low risk patient undergoing non-cardiac surgery

Answer

Prognostic index of Lee's criteria is accurate in elderly vascular surgery patient

Answer

PoSSuM scoring incorporates only physiological parameters in risk assessment

Answer

Hardman Index is used to  score perioperative mortality in elective abdominal aneurysm cases

Question 23

23. Choose the best statement regarding functional capacity assessment :

Accepted Answer

4 METs is equivalent to climbing 2 flights of stairs

Answer

1 metabolic equivalent (MET) represents VO2 of 3.5ml/kg/min of an adult during strenous exercise

Answer

Duke Activity Status Index allows precise calculation of predicted VO2

Answer

The ability to achieve 4 METs is advisable when contemplating undergoing major surgery

Question 24

24. Regarding cardiopulmonary exercise testing :

Accepted Answer

It involves unloaded cycling

Answer

Monitoring is not required in recovery period

Answer

An anaerobic threshold of >11 ml/kg/min is associated with low postoperative mortality after major surgery

Answer

It does not allow differentiation of the cause between cardiac and respiratory cause of dyspnoea

Question 25

25. Stress response to major surgery

Accepted Answer

Increases in blood lactate reflects stress response to surgery

Answer

Patient will be in an anticoagulant state

Answer

Systemic inflammatory response generated during major surgery is associated with increase in oxygen consumption (VO2) of >50%

Answer

Acute phase reactant interleukin 6 decreases in response to surgery

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