Physio Viva 2009

Physio Viva 2009 How do you measure blood pressure? What is blood pressure? What is pressure? What is this? (shows a transducer) Describe (points to the diaphragm) What is the function of a transducer? (examiner then connects a tubing to the transducer) What does the tubing do to the measurement? What is damping? How much to damp? Why do you need to damp? How much is the natural frequency of the diaphragm? Would you use the same natural frequency for measurement of CVP? (answer I think is yes) Why do you want a quick response? Tell me about hepatic blood flow. What are the relative flow of portal vein and hepatic artery? Where does the portal vein drain from? What are the organs that drain into the portal vein? What are the substances carried in the portal vein? What is absorbed from the intestine and carried in the portal vein? How about fat? – don’t think so. Carried via lymphatics. Draw the structures of the liver. Tell me about the cells that line the cannaliculi What are Kupffer cells? Given ABG pH:7.30 (H+) 50nmol/l pO2: 55 pCO2:65 FiO2:0.28 (PiO2: 200mmHg) What are the abnormalities? Answered respiratory acidosis… How do you know? What is the relationship between pH, PCO2 and HCO3? – Henderson Hasserbach equation. If this patient was hyperventilating what is the cause of the ABG? What would you expect the HCO3 level in respiratory acidosis? How does the renal compensate for respiratory acidosis? What is the source of HCO3? What is the pKa of the Henderson Hasserbach equation? What does H+ bing to in tubular fluid? How diluted can urine be? Examiner then draws a nephron. Write the osmolarity at PCT, tip of Loop of Henle, and collecting duct. If a person drinks 2 litre of water ,how does the body excrete this water load? How much is the osmolarity of pure water? How does ADH work? What happens at the ascending LOH?

Tell me regarding control of respiration. What are the afferent, central modulator and efferent? Is the diaphragm more important or the intercostals muscles? When is the diaphragm less important? ( pregnancy, other causes of splinting of diaphragm) Tell me regarding the carotid and aortic bodies. What are the cells in the carotid body? (Type 1 glomus cells) Tell me regarding the central chemoreceptors. Are they sensitive to PaO2? Medullary respiratory centre – is the ventral control important in normal respiration? What are the other factors that are involve in control of respiration? What happens when you get a cut? – I told about pain, withdrawal reflex, stress response and bleeding. Tell me about bleeding. Tell me more about platelets. What are the granules in platelets? What do they secrete? What are their functions? What else do platelets do other than forming a plug? – co factor in coagulation cascade Where is the largest pressure drop in our vessels? – arterioles Why is the pressure drop greatest in the arterioles? What is the formula for resistance? Which vessel has the highest resistance? –capillary What is the summation of resistance in a parallel circuit and circuit in series? Give examples of circulation in the body in series. Given ABG pH;7.29 pCO2:65 pO2:80 HCO3:28 if we just look at the pO2, can this be a venous sample? Why? How does the renal compensate in respiratory acidosis? Can we eliminate CO2 via renal?