Cardiovascular system: constrictive pericarditis: 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: constrictive pericarditis

Sample item

A 45-year-old with previous tuberculous pericarditis has ascites, a raised jugular pressure, clear lungs and a pericardial knock. Right atrial pressure tracing shows a deep, rapid y descent. What is the haemodynamic reason?

AEarly rapid ventricular filling that stops abruptly against a rigid pericardiumBSlow ventricular relaxation from hypertrophyCAbsent atrial contractionDReduced venous return from respiratory collapse

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

The answer and the reasoning

A. Early rapid ventricular filling that stops abruptly against a rigid pericardium

A rigid pericardium allows the ventricles to fill rapidly in early diastole, giving a steep y descent, and then abruptly limits filling, giving the dip-and-plateau pattern. In tamponade the y descent is blunted instead.

Option by option

A. Early rapid ventricular filling that stops abruptly against a rigid pericardium (correct)
Correct. Brisk early filling that is abruptly arrested produces the steep y descent.
B. Slow ventricular relaxation from hypertrophy
Slow relaxation from hypertrophy blunts early filling, the opposite pattern.
C. Absent atrial contraction
Atrial contraction is preserved in sinus rhythm; its loss would remove the a wave.
D. Reduced venous return from respiratory collapse
Reduced venous return would lower rather than raise venous pressure.

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 A, Early rapid ventricular filling that stops abruptly against a rigid pericardium. A rigid pericardium allows the ventricles to fill rapidly in early diastole, giving a steep y descent, and then abruptly limits filling, giving the dip-and-plateau pattern.

Why is "Slow ventricular relaxation from hypertrophy" not the answer?

Slow relaxation from hypertrophy blunts early filling, the opposite pattern.

Why is "Absent atrial contraction" not the answer?

Atrial contraction is preserved in sinus rhythm; its loss would remove the a wave.

Why is "Reduced venous return from respiratory collapse" not the answer?

Reduced venous return would lower rather than raise venous pressure.

What concept does this question test?

It tests Cardiovascular system: constrictive pericarditis in Physiology. In tamponade the y descent is blunted instead.

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: constrictive pericarditis?

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.