Cardiovascular: pulse pressure in aortic regurgitation: practice question

A Physiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Physiology · Cardiovascular: pulse pressure in aortic regurgitation

Sample item

A 28-year-old man with severe aortic regurgitation has a blood pressure of 160/45 mmHg. Which mechanism best explains the very wide pulse pressure?

AA reduced stroke volume due to impaired ventricular fillingBA large stroke volume enters the aorta and blood then runs back rapidly into the left ventricle in diastoleCIncreased total peripheral resistance from arteriolar constrictionDReduced compliance of the aorta from atherosclerosis

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. A large stroke volume enters the aorta and blood then runs back rapidly into the left ventricle in diastole

In aortic regurgitation the total stroke volume is increased, which raises systolic pressure. During diastole blood leaks back into the ventricle and runs off to the periphery, dropping diastolic pressure. Together these create a wide pulse pressure and bounding pulse.

Option by option

A. A reduced stroke volume due to impaired ventricular filling
A smaller stroke volume would narrow the pulse pressure.
B. A large stroke volume enters the aorta and blood then runs back rapidly into the left ventricle in diastole (correct)
Correct. Larger ejection and rapid diastolic runoff widen the pulse pressure.
C. Increased total peripheral resistance from arteriolar constriction
High peripheral resistance would raise diastolic pressure and narrow the pulse pressure.
D. Reduced compliance of the aorta from atherosclerosis
Rigid arteries cause a wide pulse pressure in the elderly, but this man is young without atherosclerosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is B, A large stroke volume enters the aorta and blood then runs back rapidly into the left ventricle in diastole. In aortic regurgitation the total stroke volume is increased, which raises systolic pressure.

Why is "A reduced stroke volume due to impaired ventricular filling" not the answer?

A smaller stroke volume would narrow the pulse pressure.

Why is "Increased total peripheral resistance from arteriolar constriction" not the answer?

High peripheral resistance would raise diastolic pressure and narrow the pulse pressure.

Why is "Reduced compliance of the aorta from atherosclerosis" not the answer?

Rigid arteries cause a wide pulse pressure in the elderly, but this man is young without atherosclerosis.

What concept does this question test?

It tests Cardiovascular: pulse pressure in aortic regurgitation in Physiology. During diastole blood leaks back into the ventricle and runs off to the periphery, dropping diastolic pressure. Together these create a wide pulse pressure and bounding pulse.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular: pulse pressure in aortic regurgitation?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.