EDAIC MCQs with simplified explanations. FREE UPLOADS BY WWW.TARGETEDAIC.COM (24)

The section ‘EDAIC MCQs with simplified explanations’ covers a different topic each day with the intent that candidates can prepare one small topic each day, making steady progress in their exam preparation.

Question: All are true with respect to findings of Valsalva manoeuvre in a patient with autonomic neuropathy except

1. No HR increase during forced expiration
2. During the fourth phase, there is a marked blood pressure “overshoot”
3. There is an uncompensated fall in BP during the second phase
4. The reflex bradycardia of phase four is markedly attenuated or absent
5. Blood pressure steadily increases as long as the patient maintains forced expiration.

Answers:

1. false
2. true
3. false
4. false
5. true

Explanation:

Heart rate and BP changes are recorded as the patient maintains a forced expiration against closed glottis or fixed resistance for 15 seconds (at least 7 seconds).

Normal response (4 phases are recorded)

• Phase 1: thoracoabdominal pressure is high→ ↑venous return→↑BP and a reflex ↓HR.
• Phase 2: sustained ↑ intrathoracic pressure→ ↓venous return→ ↓BP and a reflex ↑HR.
• Phase 3: starts with the release of pressure as the patient inhales out after 10 seconds. Intrathoracic vessels expand and act as a sink for the blood →↓BP. HR remains elevated.
• Phase 4: ↑HR along with an increased venous return→↑BP above the previous normal. This leads to reflex ↓HR, initially falling below the patient’s average HR. Then, HR and BP return to normal.

 Response in autonomic neuropathy:

• Blood pressure declines progressively and heart rate does not increase for as long as forced expiration can be maintained.
• During the fourth phase, there is no blood pressure “overshoot” but only a gradual recovery of pre-Valsalva blood pressure, and no reflex bradycardia occurs.

Need some more practice. Click here for more free MCQs uploaded on the site.

The candidates sitting in the current examination or preparing for next year should try and read about the asked topic in daily ‘EDAIC MCQs with answers’ and indulge in active discussion with fellow students. In addition, you can join our Facebook group to stay updated with targetedaic content and MCQ discussion.

The ‘EDAIC MCQs with simplified explanations’ section covers a different topic each day with the intent that candidates can prepare one small topic each day, making steady progress in their exam preparation.