Cardiovascular physiology, fluids, and blood management: curriculum recognition: practice question

A Anaesthesia 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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Anaesthesia · Cardiovascular physiology, fluids, and blood management: curriculum recognition

Sample item

Which finding best predicts that a fluid bolus will raise the stroke volume of a mechanically ventilated patient in sinus rhythm?

AA raised pulmonary artery occlusion pressureBLarge respiratory variation in arterial pulse pressureCA low central venous pressureDA low urine output

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

The answer and the reasoning

B. Large respiratory variation in arterial pulse pressure

In a ventilated patient on the steep part of the Starling curve, the stroke volume varies widely with the respiratory cycle, which appears as pulse pressure variation. Static filling pressures such as CVP and wedge pressure predict responsiveness poorly. Variation is reliable only in sinus rhythm with adequate tidal volumes.

Option by option

A. A raised pulmonary artery occlusion pressure
A raised wedge pressure suggests adequate or high filling, not responsiveness.
B. Large respiratory variation in arterial pulse pressure (correct)
Correct. A large variation shows the heart is preload-responsive.
C. A low central venous pressure
A low central venous pressure does not reliably predict a response to fluid.
D. A low urine output
Low urine output has many causes and does not predict a haemodynamic response.

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 Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Large respiratory variation in arterial pulse pressure. In a ventilated patient on the steep part of the Starling curve, the stroke volume varies widely with the respiratory cycle, which appears as pulse pressure variation.

Why is "A raised pulmonary artery occlusion pressure" not the answer?

A raised wedge pressure suggests adequate or high filling, not responsiveness.

Why is "A low central venous pressure" not the answer?

A low central venous pressure does not reliably predict a response to fluid.

Why is "A low urine output" not the answer?

Low urine output has many causes and does not predict a haemodynamic response.

What concept does this question test?

It tests Cardiovascular physiology, fluids, and blood management: curriculum recognition in Anaesthesia. Static filling pressures such as CVP and wedge pressure predict responsiveness poorly. Variation is reliable only in sinus rhythm with adequate tidal volumes.

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 physiology, fluids, and blood management: curriculum recognition?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.