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Anaesthesia · Cardiovascular physiology, fluids, and blood management: curriculum recognition
Sample itemWhich finding best predicts that a fluid bolus will raise the stroke volume of a mechanically ventilated patient in sinus rhythm?
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.
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