D4.iii · Systemic Vascular Resistance

This viva will examine cardiovascular physiology and pharmacology. The systemic vascular resistance is suddenly increased. Describe the consequences of this on a healthy left ventricle. (Left ventricular pressure volume loop removed from report)

This viva will explore your knowledge of measurement of cardiac output and the determinants of systemic vascular resistance (SVR). How can the cardiac output be measured?

This Viva will discuss the pharmacology and the physiology of the peripheral circulation During the reading time, candidates were also shown a figure of SNP, and were asked if they recognised it. The viva then went on to discuss the pharmacology of SNP. This was generally well done. For the latter half of the viva, candidates were tested on their knowledge of the physiology of the peripheral circulation. Areas of weakness were, the understanding of the physiology of the endothelium, substances it secretes (eg prostacyclin, EDRF and endothelin), as well knowledge of the vasomotor centre.

Cardiogenic shock (BP 90/60, CI 1.8, SVR 1500). What drugs would you use to increase the blood pressure?