Table 1 Examples of experimental conditions and questions for small group discussion

Experiment 1. Effects of the venous blood loss

1.1) Early effects of the venous blood loss

1.1.1) After draining blood from the venous system (femoral vein), what are the most probable changes in the parameters including BP, PP, HR, CVP, RR, Hct, and UF? Explain the mechanisms of these changes.

1.1.2) A 20-year-old man presented with severe haemorrhage. His BP was 95/65 mmHg and his HR was regular at 160 BPM. A physician chose to treat him with a negative inotropic drug in an attempt to lower his HR to the normal baseline. Is his management suitable? Explain with reasons.

1.2) Late effects of the venous blood loss (15 min later)

Fifteen minutes after the onset of bleeding, BP began to rise, and HR began to decrease but still did not reach the baseline. Hct declined and urine flow increased, but again did not reach the baseline. What are the probable mechanisms that could explain these changes?

Experiment 2. Effects of arterial blood loss and the treatments by normal saline infusion and blood transfusion

2.1) Effects of arterial blood loss

What are the differences in terms of cardiovascular responses between arterial bleeding from femoral artery (this experiment) and venous bleeding from femoral vein (the prior experiment)? Explain the mechanisms of these differences.

2.2) Effects of normal saline infusion after arterial bleeding

What are the most probable changes in the parameters including BP, HR, CVP, Hct, and UF after the administration of normal saline solution of the same quantity with the amount of blood loss?

2.3) Effects of blood transfusion as a compensation for arterial bleeding (This experiment was performed 10 min after normal saline infusion. The blood for transfusion was obtained from the femoral vein in experiment 1 and was transfused via the femoral vein.)

2.3.1) Ten minutes after normal saline infusion, BP decreased and HR increased. Explain the probable mechanisms of these changes.

2.3.2) What are the probable changes in terms of cardiovascular responses after blood transfusion compared with normal saline infusion?

Experiment 3. Effects of nitroglycerin administration

3.1) After an administration of nitroglycerin, what are the most probable changes in the parameters including BP, PP, HR, CVP, RR, and UF?

3.2) What should be the mechanisms of action of nitroglycerin on the cardiovascular system that can best explain all the parameter changes mentioned above?

Experiment 4. Effects of adrenaline administration

4.1) What are the most probable effects of adrenaline administration on the parameters including BP, HR, and RR at an indicated time according to the recorded tracing? Explain the mechanisms of these changes.

4.2) State the effects of adrenaline on UF and explain the mechanisms of this change.

Experiment 5. Effects of different doses of dopamine administration

5.1) State the effects of a gradual increase in dopamine intravenous infusion from 1 μg/kg/min to 20 μg/kg/min on BP, HR, RR, and UF. Compare the effects that occurred while receiving dopamine in different doses.

5.2) Explain the mechanisms of action of dopamine that can best explain the results of this experiment.

Experiment 6. Vagus nerve stimulation before and after atropine administration

6.1) Explain the effects of right vagus nerve stimulation on BP, HR, and RR before an intravenous administration of atropine.

6.2) During the intravenous atropine administration, what are the expected changes in BP and HR? Explain the probable mechanisms.

6.3) Explain the effects of right vagus nerve stimulation on BP, HR, and RR after an intravenous administration of atropine.

Experiment 7. Effects of nitroglycerin after atropine administration

What are cardiovascular responses to the intravenous injection of nitroglycerin after atropine administration? Are they similar to the responses before atropine administration (experiment 3)? Explain the probable mechanisms.

Experiment 8. Effects of adrenaline after atropine administration

What are cardiovascular responses to the intravenous injection of adrenaline after atropine administration? Are they similar to the responses before atropine administration (experiment 4)? Explain the probable mechanisms.