CVS MOCK EXAM QS

By Joshua BowerPeer Support 2013/2014J.Bower@warwick.ac.uk

An 81yo man with a history of heart failure has fallen at home. Pulse 25bpm. You perform an ECG.

The ECG shows complete (third degree) heart block.

Great website : http://www.emedu.org/ecg/givemall.php

(i) Define cardiac output, and state the normal value in a healthy adult

(ii) How is it related to stroke volume?(iii) What is likely to happen to SV and CO in a patient with

complete heart block?

(i) CO (5l/min) is the output of each ventricle in one minute(ii) CO = SV x HR(iii) CO will fall, though SV may initially increase, owing to

increased time for filling the heart

A 51 year old lorry driver divorced recently and lives alone. He is complaining of tiredness, intermittent indigestion, nausea and says he has vomited blood on several occasions over the past

three or four weeks.(i) What fraction of the total blood volume is contained in the

systemic veins?(ii) What is the significance of this volume of blood?

(i) 65-70%(ii) Acts as a reservoir, under nervous (sympathetic) control,

which can be used to alter CO

(iii) What immediate physiological responses will sustain CO in the face of blood loss through vomiting? [3]

(iii) Increased sympathetic tone to blood vessels increasing peripheral resistance venous return. Autonomic effects on the heart will have positive inotropic and chronotropic effects.

Suggest a drug type appropriate to treat:(i) Heart failure

(ii) MI

(i) Diuretics, ACEIs, nitrates, digoxin, beta-blockers(ii) Beta-blockers, streptokinase, tPA, aspirin, morphine,

metoclopramide

QUESTIONS?By Joshua BowerPeer Support 2013/2014J.Bower@warwick.ac.uk