CARDIAC PHYSIOLOGY 1. Coronary circulation. Draw a labelled diagram and describe in detail the coronary circulation. 2. Describe the arterial circulation of the heart with the aid of a diagram mentioning the unique features of coronary blood flow. 3. Explain the Goldman’s cardiac risk index and its importance to the anaesthetist 4. Factors affecting coronary circulation 5. Discuss factors affecting oxygen demand and supply to the myocardium 6. Describe the pressure and volume changes during different phases of cardiac cycle 7. What is preload and after load? 8. What are the determinants of left ventricular diastolic function? 9. How can ischemia be monitored during anaesthesia? 10. Discuss the factors that affect myocardial oxygen consumption and the clinical significance. ADRENERGIC DRUGS GENERAL 1. Adrenergic agonists 2. Adrenergic receptor antagonist and their uses 3. Name the adrenergic agonists and antagonists. Describe in detail their uses in anaesthesia practice BETA BLOCKERS 1. Beta receptor blockade-its relation in anaesthesia 2. Perioperative beta blocker therapy 3. Manifestation and treatment of beta-adrenergic toxicity 4. Effect of atenolol pre-treatment on CVS, NMJ and IOP 5. Classify β-blockers and mention their benefits in subjects of ischemic heart disease (IHD) scheduled for surgery. 6. Recommendations for perioperative Beta blockade. ALPHA 2 AGONISTS 1. What are alpha 2 agonists? Discuss the pharmacodynamics and anaesthetic uses of alpha 2 agonists 2. Clinical use of alpha 2 agonists in anaesthesia CLONIDINE 1. Clonidine in anaesthesia practice 2. Clonidine in ICU 3. Discuss PK and PD of clonidine and its role in clinical practice DEXMEDETOMIDINE 1. Dexmedetomidine: Clinical applications and complications 2. Dexmedetomidine 3. Discuss pharmacokinetics and pharmacodynamics of dexmedetomidine. What is its role in clinical practice 4. Role of Dexmedetomidine in anaesthesia practice 5. (a)Role of dexmedetomidine in critically ill patients (b) Compare dexmedetomidine with clonidine CALCIUM CHANNEL BLOCKERS 1. Calcium channel blockers and anaesthesia 2. CCB’s in surgical patients CVS PHARMACOLOGY 1. Compare and contrast dopamine and dobutamine (as an inotropic agent) 2. Classify inotropes on the basis of their mechanism of actions. 3. Classify antihypertensive drugs. Describe the management of hypertensive emergency Describe the management of a hypertensive episode during anaesthesia 4. Compare and contrast Sodium Nitroprusside and Nitro-glycerine and its clinical implications 5. Inodilators and its uses 6. . Angiotensin 2 agonist 7. Levosimendan I m dnb Anaesthesiology pg These are my questions for my upcoming internal assessment Consider each question as a 10mark and give me answers accordingly in detail in a document Take references from Stoelting’s Pharmacology & Physiology, Miller’s Anesthesia, Morgan & Mikhail’s Clinical Anesthesiology, barash clinical
You are a DNB Anaesthesiology exam answer writer. Research the following CARDIAC PHYSIOLOGY topics using the medical library database (query_library_db) and write detailed 10-mark exam answers for each. Use references from Stoelting's Pharmacology & Physiology, Miller's Anesthesia, Morgan & Mikhail's Clinical Anesthesiology, and Barash Clinical Anesthesia. INSTRUCTIONS: 1. First read the skill file: read_file('/skills/readonly/medical-library/SKILL.md', limit=1000) 2. Search the library using query_library_db for each topic 3. Write comprehensive answers suitable for a DNB Anaesthesiology internal assessment (10 marks each = approximately 400-600 words per answer) TOPICS TO COVER: **CARDIAC PHYSIOLOGY:** 1. Coronary circulation - Draw a labelled diagram and describe in detail the coronary circulation. (Include: anatomy of coronary arteries - RCA, LCA with LAD and LCx; coronary veins; territories supplied; autoregulation; factors affecting coronary blood flow) 2. Describe the arterial circulation of the heart with the aid of a diagram mentioning the unique features of coronary blood flow. (Include: anatomy, dominance, unique features like: diastolic perfusion, wall tension effects, O2 extraction, autoregulation, metabolic regulation) 3. Explain Goldman's cardiac risk index and its importance to the anaesthetist. (Include: original Goldman index, Lee's Revised Cardiac Risk Index, RCRI scoring, perioperative cardiac risk stratification, ACC/AHA guidelines, functional capacity assessment) 4. Factors affecting coronary circulation. (Include: physical factors - heart rate, diastolic time, perfusion pressure; metabolic autoregulation; neural control; humoral factors; pathological factors) 5. Discuss factors affecting oxygen demand and supply to the myocardium. (Include: determinants of MVO2 - heart rate, wall tension/preload/afterload, contractility, basal metabolism; O2 supply - coronary blood flow, O2 content, Hb, O2 extraction; supply-demand balance; ischemia threshold) 6. Describe the pressure and volume changes during different phases of cardiac cycle. (Include: all 7 phases - isovolumetric contraction, rapid ejection, reduced ejection, isovolumetric relaxation, rapid filling, slow filling, atrial systole; corresponding pressures in LV, aorta, LA; Wiggers diagram description; volumes - EDV, ESV, SV, EF) 7. What is preload and afterload? (Include: definitions, Frank-Starling law, clinical measurement, clinical significance in anaesthesia, manipulation) 8. What are the determinants of left ventricular diastolic function? (Include: active relaxation, passive compliance, pericardial constraint, filling pressures, grades of diastolic dysfunction, clinical relevance in anaesthesia) 9. How can ischemia be monitored during anaesthesia? (Include: ECG monitoring - lead selection, ST segment analysis, lead II vs V5; TEE; PA catheter; new biomarkers; clinical signs; limitations) 10. Discuss the factors that affect myocardial oxygen consumption and the clinical significance. (Include: major determinants - heart rate x wall tension, contractility; minor determinants; TTI/DPTI; RPP; clinical applications in anaesthetic management of IHD patients) For each answer, write: - A clear heading - Introduction (2-3 lines) - Main content with subheadings - Clinical significance/Anaesthetic implications - Brief conclusion - References cited inline Return the COMPLETE TEXT of all 10 answers, fully written out, ready to paste into a document. Do not truncate or summarize - write full exam-quality answers.
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