D3.v · Myocardial Oxygen Supply & Demand

The initial information given to the candidates was - This station will explore your knowledge of the pharmacology and physiology of noradrenaline. Discuss the pharmacologic effects of noradrenaline on the human heart in-vivo. This viva explored the candidates’ knowledge in relation to the following points Pharmacology of noradrenaline Pressure-Volume Loop of the cardiac cycle Mark on the Pressure-Volume Loop the changes you would expect for an adult patient infused noradrenaline at 10 mcg/min. Explain the consequences of a noradrenaline infusion on myocardial oxygen consumption, work and efficiency. Dobutamine infusion of 5 mcg/kg/min and affect the Pressure-Volume Loop Examination feedback: This viva tested knowledge related to cardiac cycle, P-V loop, inotropes and most importantly a candidates ability to integrate those topics and then discuss them. Generally candidates knowledge in describing the basic P-V loop were sound, but were weaker in explaining how the P-V loop changed with changes in physiology and pharmacological intervention. Candidates were expected to generate discussions relating to the impact in changes to afterload, pre load and contractility as well as concept of potential energy as it elated to the P-V loop.