Syllabus · Historical · V4 (2023) · Cardiovascular System
G3 · Determinants and Control of Cardiac Output
G3.vi · Determinants and Control of Cardiac Output
Describe the pressure-volume relationships of the ventricles and their clinical applications.
Written examination
SAQ history
LV Pressure–Volume Loop
2 exam appearances
Draw and label a left ventricular pressure volume loop in a normal adult (40% of marks). List the information that can be obtained from this loop (60% of marks).
65%
Draw and label a left ventricular pressure volume loop in a normal adult. List the information that can be obtained from this loop.
66%
Oral examination
VIVA history
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2025B · VIVA 5
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)
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2024B · Day 2 · VIVA 5
This VIVA will examine cardiovascular physiology and pharmacology. This is a diagram of the pressure-volume loop of a healthy left ventricle before and after the administration of drug “X”. Explain the phases of the normal loop (including derived information) and describe the changes following the administration of drug “X” with an example. (image removed from report)
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2023B · Day 1 · VIVA 4
This viva will examine cardiovascular physiology. Describe the features of this left ventricular pressure volume loop.
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2023B · Day 2 · VIVA 2
This viva will examine cardiovascular physiology. Describe the important features on this left ventricular pressure volume loop, including the shape of the loop, and the values on both axes? (Image removed from report.)
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2022B · Day 1 · VIVA 4
This viva will explore your understanding of the left ventricle. This is an idealised pressure vs volume loop of the left ventricle in a healthy adult. Please describe the loop. (Image removed from report.)
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2022B · Day 2 · VIVA 2
This viva will explore your knowledge and understanding of cardiovascular physiology and pharmacology. Explain the mechanical events shown in the left ventricular pressure-volume loop. (Image removed from report.)
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2019B · Day 2 · VIVA 8
This viva will test your knowledge of cardiovascular physiology and oxygen. Explain the mechanical events shown in the left ventricular pressure-volume loop below: (Image removed from report.)
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2018B · Day 2 · VIVA 3
This viva will test your knowledge of cardiovascular physiology. Explain the mechanical events shown in the left ventricular pressure-volume loop below: (Image removed from report.)
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2018A · Day 2 · VIVA 7
This viva is about cardiovascular physiology and blood. Describe the important features of a left ventricular pressure-volume loop.
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2017B · Day 1 · VIVA 1
This viva will explore your understanding of the left ventricular pressure volume relationship. Describe the cardiac cycle (ABCD). (Image removed from report.)
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2013A · VIVA 8
This focused upon knowledge of respiratory physiology. The first question asked candidates to use a pre-supplied graph below to draw a dynamic pulmonary compliance (pressure volume loop) graph of a normal healthy adult, as you would see with a maximal inspiratory effort followed by total exhalation. Explain the characteristics of the curves. The other major area of respiratory physiology to be tested was that of the expiratory flow curve.
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2012A · VIVA 2
This Viva will test your knowledge of common β-blockers, and their pharmacology. How would you classify β Blockers? .../12 12. Subsequent questions explored knowledge of haemodynamic properties, receptor mediated effects, esmolol pharmacokinetics and sotalol as an antiarythmic drug. Following which, candidates were asked about the Pressure-Volume loop of the cardiac cycle and changes in that loop following administration of esmolol and labetalol.
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2010B · VIVA 2
This viva will test your knowledge of cardiac physiology and blood pressure measurement. Outline the factors that affect cardiac output. This viva tested the candidates’ knowledge of cardiovascular physiology, specifically determinants of cardiac output, ventricular stroke work, volume loops, etc. It also tested knowledge of invasive arterial pressure measurement, including that relating to ideal design features of measuring systems and sources and types of errors of measurement. Candidates seemed to only have a superficial understanding of cardiac output and it’s determinants, they lacked depth in their explanations and were less familiar with right sided heart pressures and function. Measurement principles were much better covered.
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2008B · VIVA 7
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.
Sources: objective text from the relevant CICM syllabus; historical SAQ and VIVA wording from CICM examiner reports.