Cardiovascular system: jugular venous pulse: 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 system: jugular venous pulse

Sample item

A 70-year-old man with an irregularly irregular pulse has no visible 'a' wave in the jugular venous pulse. What is the physiological reason?

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

The answer and the reasoning

C. Loss of effective atrial contraction

The a wave is produced by right atrial contraction at end diastole. In atrial fibrillation there is no coordinated atrial systole, so the a wave disappears. The c wave and v wave arise from other events.

Option by option

  • A. Tricuspid valve bulging during ventricular systole

    Tricuspid bulging produces the c wave, which does not replace the a wave.

  • B. Raised right ventricular end-diastolic pressure

    High right ventricular pressure produces a prominent a wave, not an absent one.

  • C. Loss of effective atrial contraction (correct)

    Correct. Without organised atrial systole there is no a wave.

  • D. Passive filling of the atrium during systole

    Passive atrial filling produces the v wave.

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.

More Physiology questions

Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is C, Loss of effective atrial contraction. The a wave is produced by right atrial contraction at end diastole.

Why is "Tricuspid valve bulging during ventricular systole" not the answer?

Tricuspid bulging produces the c wave, which does not replace the a wave.

Why is "Raised right ventricular end-diastolic pressure" not the answer?

High right ventricular pressure produces a prominent a wave, not an absent one.

Why is "Passive filling of the atrium during systole" not the answer?

Passive atrial filling produces the v wave.

What concept does this question test?

It tests Cardiovascular system: jugular venous pulse in Physiology. In atrial fibrillation there is no coordinated atrial systole, so the a wave disappears. The c wave and v wave arise from other events.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 system: jugular venous pulse?

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.