A patient to be commenced on oral anticoagulant therapy for DVT would be treated with (a) Oral anticoagulant therapy with warfarin for a goal intenational normalized ration (INR) of 2–3 (b) Oral anticoagulant therapy with warfarin for a goal INR of 2.5–3.5 (c) Oral anticoagulant therapy with aspirin for a goal INR of 2–3

A patient to be commenced on oral anticoagulant therapy for DVT would be treated with (a) Oral anticoagulant therapy with warfarin for a goal intenational normalized ration (INR) of 2–3 (b) Oral anticoagulant therapy with warfarin for a goal INR of 2.5–3.5 (c) Oral anticoagulant therapy with aspirin for a goal INR of 2–3
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A patient on oral anticoagulant therapy is commenced on sulfamethoxazoletrimethoprim, double-strength twice daily. One may expect to see the international normalized ratio (a) Increase (b) Decrease (c) Remain unchanged

Description : A patient on oral anticoagulant therapy is commenced on sulfamethoxazoletrimethoprim, double-strength twice daily. One may expect to see the international normalized ratio (a) Increase (b) Decrease (c) Remain unchanged

Last Answer : Ans: A

You are treating a patient of deep vein thrombosis with warfarin. What value of International normalized ratio (INR) will you attempt by adjusting dose of the anticoagulant for an adequate therapeutic effect: A. 1.2 – 1.5 B. 1.3 – 1.7 C. 1.5 – 2.0 D. 2.0 – 3.0

Description : You are treating a patient of deep vein thrombosis with warfarin. What value of International normalized ratio (INR) will you attempt by adjusting dose of the anticoagulant for an adequate therapeutic effect: A. 1.2 – 1.5 B. 1.3 – 1.7 C. 1.5 – 2.0 D. 2.0 – 3.0

Last Answer : D. 2.0 – 3.0

A patient of acute myocardial infarction being treated in intensive care unit developed left ventricular failure with raised central venous pressure. It was decided to use glyceryl trinitrate. Which route/method of administration would be most suitable. (a) Sublingual (b) Oral (c) Intravenous bolus injection (d) Slow intravenous infusion

Description : A patient of acute myocardial infarction being treated in intensive care unit developed left ventricular failure with raised central venous pressure. It was decided to use glyceryl trinitrate. Which route/ ... (a) Sublingual (b) Oral (c) Intravenous bolus injection (d) Slow intravenous infusion

Last Answer : Ans: D

The standard management oral anticoagulant therapy for chronic treatment of venous thromboembolism is with the drug warfarin. Which of the following statement(s) is/are true concerning the administration of warfarin? a. An important complication of warfarin therapy is skin necrosis in patients with protein C deficiency b. Warfarin interferes with vitamin K dependent clotting factors II, VII, IX, X c. For effective anticoagulation the prothrombin time (PT) should be kept at 2 control d. It is recommended that warfarin be continued for at least one year after initial episode of deep venous thrombosis

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Last Answer : Answer: a, b Warfarin interferes with the vitamin K dependent clotting factors II, VII, IX and X, protein C, and protein S. An important complication of warfarin is skin ... the benefit from anticoagulant therapy and thus is the basis for discontinuing warfarin administration at this time

Mary has a family history of heart disease and wonders if garlic would be beneficial to her. Which of the following statements is correct about garlic? (a) Enteric-coated tablets release their contents in the stomach (b) Side effects include heartburn, flatulence, and sweating (c) The safety of garlic in pregnancy is unknown (d) Garlic does not interact with warfarin

Description : Mary has a family history of heart disease and wonders if garlic would be beneficial to her. Which of the following statements is correct about garlic? (a) Enteric-coated tablets release their contents in ... (c) The safety of garlic in pregnancy is unknown (d) Garlic does not interact with warfarin

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Which of the following cardiovascular agents is classified chemically as a glycoside? (a) Nifedipine (b) Digoxin (c) Flecainide (d) Cholestyramine (e) Warfarin

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A 54-year-old woman with severe hypercholesterolemia is to be treated with a combination of niacin and atorvastatin. With this drug combination, it is important that the patient be monitored closely for signs of (a) Agranulocytosis (b) Gallstones (c) Lactic acidosis (d) Myopathy (e) Thyrotoxicosis

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Last Answer : Ans: D

A 55-year-old patient currently receiving other drugs for another condition is to be started on diuretic therapy for mild heart failure. Thiazides are known to reduce the excretion of (a) Diazepam (b) Fluoxetine (c) Imipramine (d) Lithium (e) Potassium

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Last Answer : Ans: D

A patient who has had a previous stroke and is taking warfarin tells the nurse that he started taking garlic to help reduce his blood pressure. The nurse knows that garlic when taken together with warfarin a) can greatly increase the international normalization ratio (INR) and therefore increase the risk of bleeding. Garlic and warfarin taken together can greatly increase the INR, increasing the risk of bleeding.

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Last Answer : a) can greatly increase the international normalization ratio (INR) and therefore increase the risk of bleeding. Garlic and warfarin taken together can greatly increase the INR, increasing the risk of bleeding.

Aspirin in small doses (50 to 150 mg per day) (a) Is of benefit in patients of unstable angina (b) Has thrombolytic action (c) PREFerentially inhibits prostacyclin synthetase enzyme (d) MAY Alleviate need for Verapamil in variant angina

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Last Answer : Ans: A

Which of the following is a valid therapeutic use of interaction? A. Use of Probenecid with Penicillin B. Giving Aspirin with warfarin C. Instructing patient to take levofloxacin with milk or antacid D. Treatment of depression of MAO Inhibitor and Citalopram

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Last Answer : A. Use of Probenecid with Penicillin 

Which of the following is not an attribute of amlodipine ? (a) High and consistent oral bioavailability (b) Large volume of distribution (c) Generation of an active metabolite (d) Long elimination half-life

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Last Answer : Ans: C

Glyceryl trinitrate is administratered by all of the following routes except (a) Oral (b) Sublingual (c) Intramuscular (d) Intravenous

Description : Glyceryl trinitrate is administratered by all of the following routes except (a) Oral (b) Sublingual (c) Intramuscular (d) Intravenous

Last Answer : Ans: C

The oral absorption of following osmotic diuretic is negligible (a) Glycerin (b) Mannitol (c) Isosorbide (d) All of the above

Description : The oral absorption of following osmotic diuretic is negligible (a) Glycerin (b) Mannitol (c) Isosorbide (d) All of the above

Last Answer : Ans: B

A patient of megaloblastic anaemia was treated with oral folic acid 5 mg daily. After 2 weeks he reported back with cognitive deficit, sensory disturbance, depressed knee jerk, while blood picture and haemoglobin level were improved. What could be the most likely explanation: A. Folic acid was not adequately absorbed resulting in partial response B. Folate therapy has precipitated vitamin B12 deficiency in the neural tissue C. Folate therapy has unmasked pyridoxine deficiency D. Patient has folate reductase abnormality in the nervous system

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Last Answer : D. Patient has folate reductase abnormality in the nervous system

Hypothyroidism is a possible consequence of prolonged therapy with (a) Procainamide (b) Mexiletine (c) Sotalol (d) Amiodarone

Description : Hypothyroidism is a possible consequence of prolonged therapy with (a) Procainamide (b) Mexiletine (c) Sotalol (d) Amiodarone

Last Answer : Ans: D

Acute renal failure (ARF) may be caused by all of the following except (a) Acute tubular necrosis (ATN) due to drug therapy (e.g., aminoglycosides, contrast media) (b) Severe hypotension or circulatolry collapse (c) Decreased cardiac output, as from congestive heart failure (d) Hemolysis, myoglobinuria (e) Hyperkalemia

Description : Acute renal failure (ARF) may be caused by all of the following except (a) Acute tubular necrosis (ATN) due to drug therapy (e.g., aminoglycosides, contrast media) (b) Severe hypotension ... (c) Decreased cardiac output, as from congestive heart failure (d) Hemolysis, myoglobinuria (e) Hyperkalemia

Last Answer : Ans: E

Because of proven beneficial effects on “cardiac remodeling”, these agents are now indicated as first line therapy in CHF patients. Which of the following is representative of this group of drugs? (a) Hydrochlorothiazide (b) Enalapril (c) Furosemide (d) Carvedilol (e) Bumetanide

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Last Answer : Ans: B

Maximal medical therapy for treating angina pectoris is represented by which of the following choices? (a) Diltiazem, verapamil, nitroglycerin (b) Atenolol, isoproterenol, diltiazem (c) Verapamil, nifedipine, propranolol (d) Isosorbide, atenolol, diltiazem (e) Nitroglycerin, isosorbide, atenolol

Description : Maximal medical therapy for treating angina pectoris is represented by which of the following choices? (a) Diltiazem, verapamil, nitroglycerin (b) Atenolol, isoproterenol, diltiazem (c) Verapamil, nifedipine, propranolol (d) Isosorbide, atenolol, diltiazem (e) Nitroglycerin, isosorbide, atenolol

Last Answer : Ans: D

For treating the patient with congestive heart failure (CHF), which of the following dosages of dopamine is selected for its positive inotropic effects? (a) 2.0 mg/kg/min (b) 5–10 mg/kg/min (c) 10–20 mg/kg/min (d) 40 mg/kg/min (e) 40 mg/kg/min

Description : For treating the patient with congestive heart failure (CHF), which of the following dosages of dopamine is selected for its positive inotropic effects? (a) 2.0 mg/kg/min (b) 5–10 mg/kg/min (c) 10–20 mg/kg/min (d) 40 mg/kg/min (e) 40 mg/kg/min

Last Answer : Ans: B

Why should care be taken when prescribing warfarin and amiodarone in combination? A. Amiodarone and warfarin both have an anticoagulant effect. B. Amiodarone may reverse the anticoagulant effect of warfarin. C. Amiodarone may increase the anticoagulant effect of warfarin. D. Warfarin may reverse the antiarrhythmic effect of amiodarone.

Description : Why should care be taken when prescribing warfarin and amiodarone in combination? A. Amiodarone and warfarin both have an anticoagulant effect. B. Amiodarone may reverse the anticoagulant ... anticoagulant effect of warfarin. D. Warfarin may reverse the antiarrhythmic effect of amiodarone.

Last Answer : C. Amiodarone may increase the anticoagulant effect of warfarin. 

Propranolol should not be prescribed for a patient of angina pectoris who is already receiving (a) Nifedipine (b) Felodipine (c) Verapamil (d) Isosorbide mononitrate

Description : Propranolol should not be prescribed for a patient of angina pectoris who is already receiving (a) Nifedipine (b) Felodipine (c) Verapamil (d) Isosorbide mononitrate

Last Answer : Ans: C

A patient suffers from spisodic pain diffusely localized over the chest and upper abdomen, which is relieved by sublingual glyceryl trinitrate. He could be suffering from (a) Angina pectoris (b) Biliary colic (c) Esophageal spasm (d) All of the above

Description : A patient suffers from spisodic pain diffusely localized over the chest and upper abdomen, which is relieved by sublingual glyceryl trinitrate. He could be suffering from (a) Angina pectoris (b) Biliary colic (c) Esophageal spasm (d) All of the above

Last Answer : Ans: D

Quinidine can cause paradoxical tachycardia in a patient of (a) Stick sinus syndrome (b) Auricular extrasystoles (c) Auricular fibrillation (d) Ventricular extrasystoles

Description : Quinidine can cause paradoxical tachycardia in a patient of (a) Stick sinus syndrome (b) Auricular extrasystoles (c) Auricular fibrillation (d) Ventricular extrasystoles

Last Answer : Ans: C

Situations that predispose a digitalistreated patient to toxicity include (a) Hypercalcemia (b) Hyperkalemia (c) Hypermagnesemia

Description : Situations that predispose a digitalistreated patient to toxicity include (a) Hypercalcemia (b) Hyperkalemia (c) Hypermagnesemia

Last Answer : Ans: A

When digoxin is used in a patient with congestive heart failure (CHF), it works by exerting a positive effect on (a) Stroke volume (b) Total peripheral resistance (c) Heart rate (d) Blood pressure (e) Venous return

Description : When digoxin is used in a patient with congestive heart failure (CHF), it works by exerting a positive effect on (a) Stroke volume (b) Total peripheral resistance (c) Heart rate (d) Blood pressure (e) Venous return

Last Answer : Ans: A

A patient receiving a class I antiarrhythmic agent on a chronic basis complains of fatigue, low-grade fever, and joint pain suggestive of systemic lupus erythematosus (SLE). The patient is most likely receiving (a) Lidocaine (b) Procainamide (c) Quinidine (d) Flecainide (e) Propranolol

Description : A patient receiving a class I antiarrhythmic agent on a chronic basis complains of fatigue, low-grade fever, and joint pain suggestive of systemic lupus erythematosus (SLE). The patient is most likely receiving (a) Lidocaine (b) Procainamide (c) Quinidine (d) Flecainide (e) Propranolol

Last Answer : Ans: B

Regarding verapamil, which one of the following statements is false? (a) Angina pectoris is an important indication for the use of verapamil (b) Contraindicated in the asthmatic patient (c) Relaxes vascular smooth muscle (d) Slows the depolarization phase of the action potential in AV nodal cells (e) Used in management of supraventricular tachycardias

Description : Regarding verapamil, which one of the following statements is false? (a) Angina pectoris is an important indication for the use of verapamil (b) Contraindicated in the asthmatic patient (c) ... phase of the action potential in AV nodal cells (e) Used in management of supraventricular tachycardias

Last Answer : Ans: B

In a patient receiving digoxin for congestive heart failure, condition that may facilitate the appearance of toxicity include (a) Hyperkalemia (b) Hypernatremia (c) Hypocalcemia (d) Hypomagnesemia (e) All of the above

Description : In a patient receiving digoxin for congestive heart failure, condition that may facilitate the appearance of toxicity include (a) Hyperkalemia (b) Hypernatremia (c) Hypocalcemia (d) Hypomagnesemia (e) All of the above

Last Answer : Ans: D

A hypertensive patient has been using nifedipine for some time without untoward effects. If he experiences a rapidly developing enhancement of the antihypertensive effect of the drug, it is probably due to (a) Concomitant use of antacids (b) Fods containing tyramine (c) Grapefruit juice (d) Induction of drug metabolism (e) Over – the – counter decongestants

Description : A hypertensive patient has been using nifedipine for some time without untoward effects. If he experiences a rapidly developing enhancement of the antihypertensive effect of the drug, it is probably due to ... ) Grapefruit juice (d) Induction of drug metabolism (e) Over - the - counter decongestants

Last Answer : Ans: C

After being counseled about lifestyle and dietary changes, the patient was started on atorvastatin. During his treatment with atorvastatin, it is important to routinely monitor serum concentrations of (a) Blood urea nitrogen (BUN) (b) Alanine and aspartate aminotransferase (c) Platelets (d) Red blood cells (e) Uric acid

Description : After being counseled about lifestyle and dietary changes, the patient was started on atorvastatin. During his treatment with atorvastatin, it is important to routinely monitor serum concentrations of (a) ... Alanine and aspartate aminotransferase (c) Platelets (d) Red blood cells (e) Uric acid

Last Answer : Ans: D

If the patient has a history of gout, which of the following drugs is most likely to exacerbate this condition? (a) Colestipol (b) Gemfibrozil (c) Lovastatin (d) Niacin (e) Simvastatin

Description : If the patient has a history of gout, which of the following drugs is most likely to exacerbate this condition? (a) Colestipol (b) Gemfibrozil (c) Lovastatin (d) Niacin (e) Simvastatin

Last Answer : Ans: D

Which of the following is not true about warfarin, a. INR of 3 is enough to start any extraction. b. Affects extrinsic system and increases prothrombin time. c. Heparin can be given subcutaneously and acts rapidly. d. It takes at least 12 hours for Vitamin K to reverse the effects of coumarin.

Description : Which of the following is not true about warfarin, a. INR of 3 is enough to start any extraction. b. Affects extrinsic system and increases prothrombin time. c. Heparin can be given subcutaneously ... rapidly. d. It takes at least 12 hours for Vitamin K to reverse the effects of coumarin.

Last Answer : d. It takes at least 12 hours for Vitamin K to reverse the effects of coumarin.

Which of the following is not true about warfarin, ** A. INR of 3 is enough to start any extraction B. Affects extrinsic system and decreases prothrombin time C. Heparin can be given subcutaneously and acts rapidly D. It takes up to 12 hours for Vitamin K to reverse the effects of warfarin

Description : Which of the following is not true about warfarin, ** A. INR of 3 is enough to start any extraction B. Affects extrinsic system and decreases prothrombin time C. Heparin can be given subcutaneously and acts rapidly D. It takes up to 12 hours for Vitamin K to reverse the effects of warfarin

Last Answer : B. Affects extrinsic system and decreases prothrombin time

Patient on anti-coagulant therapy requires an extraction to be performed. Which of the following is NOT true: A. Minor post operative bleedings can be reduced somehow by using tranexamic acid B. Prothrombin value (INR) of 3 is enough to perform extraction C. It takes at least 8 hours for heparin to take effects D. Heparin should be administered sub-cutaneous

Description : Patient on anti-coagulant therapy requires an extraction to be performed. Which of the following is NOT true: A. Minor post operative bleedings can be reduced somehow by using tranexamic acid B. ... takes at least 8 hours for heparin to take effects D. Heparin should be administered sub-cutaneous

Last Answer : C. It takes at least 8 hours for heparin to take effects

Which of the following is associated with Hyperuricaemia? 1) is usually due to an excess purine consumption 2) occurs in association with acute lymphoblastic leukaemia 3) in primary gout is inherited in an autosomal dominant manner 4) can be reduced with low dose aspirin therapy 5) can be treated with uricosuric drugs even in renal failure

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Last Answer : Answers-2 Hyperuricaemia may be due to increased purine intake, urate production or reduced urate clearance, and is most commonly due to the latter. Therefore it can occur in association with enhanced ... . Many of the uricosuric drugs may be detrimental in renal failure and may not be effective.

All of the following medications should not be used routinely in pregnant patients during the third trimester except (a) Acetaminophen (b) Nonsteroidal anti-inflammatory drugs (c) Warfarin (d) Lithium (e) Aspirin

Description : All of the following medications should not be used routinely in pregnant patients during the third trimester except (a) Acetaminophen (b) Nonsteroidal anti-inflammatory drugs (c) Warfarin (d) Lithium (e) Aspirin

Last Answer : Ans: A

The most effective drug for prevention of stroke in atrial fibrillation patients is: A. Aspirin B. Warfarin C. Low dose subcutaneous heparin D. Digoxin

Description : The most effective drug for prevention of stroke in atrial fibrillation patients is: A. Aspirin B. Warfarin C. Low dose subcutaneous heparin D. Digoxin

Last Answer : B. Warfarin

Which of the following medication is safe to use in the third trimester of pregnancy? A. Acetaminophen B. Warfarin C. Aspirin D. Oxycodone

Description : Which of the following medication is safe to use in the third trimester of pregnancy? A. Acetaminophen B. Warfarin C. Aspirin D. Oxycodone

Last Answer : A. Acetaminophen 

Induction of vomiting is indicated for the accidental poisoning patient who has ingested a) aspirin. Overdose of aspirin should be treated with emesis or lavage, followed by ingestion of activated charcoal to absorb the aspirin.

Description : Induction of vomiting is indicated for the accidental poisoning patient who has ingested a) aspirin. Overdose of aspirin should be treated with emesis or lavage, followed by ingestion of ... d) toilet bowl cleaner. Toilet bowl cleaners are corrosive, and induced vomiting is contraindicated.

Last Answer : a) aspirin. Overdose of aspirin should be treated with emesis or lavage, followed by ingestion of activated charcoal to absorb the aspirin.

Choose the correct statement about aspirin: A. In an afebrile patient acute overdose of aspirin produces hypothermia B. Aspirin suppresses flushing attending large dose of nicotinic acid C. Aspirin therapy prevents granulomatous lesions and cardiac complications of acute rheumatic fever D. Long term aspirin therapy increases the risk of developing colon cancer

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Last Answer : B. Aspirin suppresses flushing attending large dose of nicotinic acid

The following statements are true of oral anticoagulants except: A. They interfere with an early step in the synthesis of clotting factors B. Irrespective of the dose administered, their anticoagulant effect has a latency of onset of 1-3 days C. Their dose is adjusted by repeated measurement of prothrombin time D. They are contraindicated during pregnancy

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Last Answer : A. They interfere with an early step in the synthesis of clotting factors

Tests of coagulation are used to monitor anticoagulation treatment and detect intrinsic abnormalities in coagulation. Which of the following statement(s) is/are true concerning coagulation tests? a. Prothrombin time (PT) measures both the intrinsic and extrinsic clotting pathways and fibrinogen b. Activated partial thromboplastin time (aPTT) can be used to monitor both oral anticoagulation with Warfarin and intravenous anticoagulation with heparin c. Thrombin clotting time (TCT) is a measurement of the time it takes for exogenously administered thrombin to turn plasma fibrinogen into fibrin clot d. Whole blood activated clotting time (ACT) is a measurement of the ability of whole blood to clot and is used to monitor heparin levels intraoperatively during cardiovascular and peripheral vascu

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Major lipid class present in chylomicrons is (a) Endogenous triglycerides (b) Cholesterol esters (c) Dietary triglycerides (d) All of the above

Description : Major lipid class present in chylomicrons is (a) Endogenous triglycerides (b) Cholesterol esters (c) Dietary triglycerides (d) All of the above

Last Answer : Ans: C

Major beneficial effect of nitrates in classical angina is due to (a) Dilation of veins more than arteries (b) Increase in total coronary blood flow (c) An increase in the end diastolic size of the heart (d) An increase in the heart rate

Description : Major beneficial effect of nitrates in classical angina is due to (a) Dilation of veins more than arteries (b) Increase in total coronary blood flow (c) An increase in the end diastolic size of the heart (d) An increase in the heart rate

Last Answer : Ans: A

Following statement is true about lidocaine (a) Reduce the slope of Phase 4 (b) Threshold excitability is not altered (c) Action potential is not affected (d) All of the above

Description : Following statement is true about lidocaine (a) Reduce the slope of Phase 4 (b) Threshold excitability is not altered (c) Action potential is not affected (d) All of the above

Last Answer : Ans: A

The agent given sublingually in an acute attack of angina pectoris is (a) Glyceryl trinitrate (b) Amyl nitrite (c) Erythrital tetranitrate (d) Pentaerythritol tetranitrate

Description : The agent given sublingually in an acute attack of angina pectoris is (a) Glyceryl trinitrate (b) Amyl nitrite (c) Erythrital tetranitrate (d) Pentaerythritol tetranitrate

Last Answer : Ans: A

Digoxin given for cardiac failure is extremely valuable in patients of (a) Thyrotoxicosis (b) Beriberi (c) Cor pulmonale (d) Atrial fibrillation

Description : Digoxin given for cardiac failure is extremely valuable in patients of (a) Thyrotoxicosis (b) Beriberi (c) Cor pulmonale (d) Atrial fibrillation

Last Answer : Ans: D

Therapeutic dose of digoxin in a normal individual has the following effects, except (a) Increase in the speed of myocardial contractility (b) No significant change in cardiac output (c) Relaxation of peripheral vascular bed (d) Increase in the force of myocardial contractility

Description : Therapeutic dose of digoxin in a normal individual has the following effects, except (a) Increase in the speed of myocardial contractility (b) No significant change in cardiac output (c) Relaxation of peripheral vascular bed (d) Increase in the force of myocardial contractility

Last Answer : Ans: C