How it is examined
The CICM First Part written section is two papers, each with 10 short answer questions and 50 multiple choice questions, over 2.5 hours. Candidates who reach the Angoff standard in both the SAQs and the MCQs progress to cross-table vivas: 2 minutes of reading, then 10 minutes with the examiners on basic sciences applied to intensive care, including monitoring equipment. Up to five attempts are allowed. Check the CICM website and syllabus for current details.
Expect SAQs on the cardiac cycle, pressure-volume loops, venous return curves and the effects of interventions such as PEEP or vasopressors. Vivas often use arterial and CVP waveforms.
Core concepts
| Concept | What to explain |
|---|---|
| Cardiac cycle | Pressure, volume and ECG timing; Wiggers diagram |
| Pressure-volume loop | Effects of preload, afterload and contractility changes |
| Cardiac output | Heart rate and stroke volume; measurement methods |
| Venous return | Mean systemic filling pressure minus right atrial pressure over resistance to venous return |
| Coronary circulation | Left ventricular perfusion mainly in diastole; autoregulation |
| Regional circulations | Cerebral, renal and splanchnic autoregulation |
| Arterial waveform | Dicrotic notch, damping and resonance |
| Shock physiology | Compensation and decompensation by type |
Venous return and the Guyton model
Venous return depends on the gradient between mean systemic filling pressure and right atrial pressure, divided by the resistance to venous return. Where the venous return curve crosses the cardiac function curve is the operating point. Fluids raise mean systemic filling pressure; venoconstriction does too by shifting unstressed to stressed volume; positive pressure ventilation raises right atrial pressure and can reduce venous return.
Practice questions
SAQ-style practice
Draw and explain a left ventricular pressure-volume loop, and show the effect of increased afterload.
Show a model answer outline
- Four phases: filling, isovolumetric contraction, ejection, isovolumetric relaxation.
- End-systolic pressure-volume relationship reflects contractility.
- Raised afterload: higher ejection pressure, smaller stroke volume, higher end-systolic volume.
- Label axes (volume in mL, pressure in mmHg).
Worked MCQ · Coronary flow
During which phase is left ventricular coronary blood flow greatest?
- A Isovolumetric contraction
- B Rapid ejection
- C Early diastole
- D Reduced ejection
- E Atrial systole
Show the reasoning
Answer C. Left ventricular intramyocardial pressure compresses the coronary vessels in systole, so most left coronary flow occurs in diastole, particularly early diastole. Tachycardia shortens diastole and reduces perfusion time.
Common mistakes
- Unlabelled loops and curves.
- Mixing up preload and afterload effects.
- Ignoring the venous side of the circulation.
- Forgetting measurement limitations.
- Not linking to vasopressor choice.
Free sample cardiovascular physiology questions
Questions from our Intensive care (CICM) bank. Choose your answer, then open the explanation.
A fall in blood pressure causes which baroreceptor response?
- AVenodilation
- BReduced firing, more sympathetic tone
- CReduced heart rate
- DIncreased firing, more vagal tone
- ENo change until the MAP falls below 40 mmHg
Show answer and explanation
Answer B. Carotid sinus and aortic arch baroreceptors fire less when pressure falls, reducing vagal and increasing sympathetic outflow: tachycardia, vasoconstriction and venoconstriction.
Learning point: Hypotension: baroreceptors fire less; sympathetic outflow rises.
According to Laplace law, ventricular wall stress rises with:
- ALarger chamber radius
- BSmaller chamber radius
- CThicker ventricular wall
- DLower intraventricular pressure
- ELower heart rate
Show answer and explanation
Answer A. Wall stress = P x r / 2h. Dilation (larger radius) and higher pressure increase stress; wall thickening (hypertrophy) reduces it.
Learning point: Wall stress = Pr/2h.
What does a low mixed venous oxygen saturation (SvO2) indicate?
- AReduced oxygen consumption under sedation
- BLeft-to-right intracardiac shunt
- CDelivery not meeting demand
- DHigh oxygen delivery relative to need
- ECytotoxic hypoxia from cyanide
Show answer and explanation
Answer C. Normal SvO2 is about 70 to 75%. A low SvO2 means oxygen extraction is high because delivery (CO, Hb, SaO2) is inadequate for consumption. Cyanide, sepsis with impaired extraction and left-to-right shunts can raise it.
Learning point: Low SvO2: DO2 not meeting VO2.
Practise more cardiovascular physiology questions free
Every cardiovascular physiology subtopic in our bank
The bank holds 21 cardiovascular physiology questions across 21 subtopics. You can filter by any of them, build a custom block and track your accuracy subtopic by subtopic.
- Arterial line damping1
- Baroreceptor reflex1
- Cardiac action potential1
- Cardiac action potential phases1
- Cardiac output1
- Cerebral autoregulation1
- Coronary blood flow1
- Ejection fraction1
- Frank-Starling1
- Laplace and wall stress1
- Laplace law1
- Mean arterial pressure1
- Microcirculation1
- Mixed venous oxygen saturation1
- Mixed venous saturation1
- Oxygen delivery1
- Pressure-volume loop1
- Pulse pressure variation1
- SA node1
- Valsalva manoeuvre1
- Venous return1
Common questions
Do I need to know pressure-volume loops?
Yes. They are a common way to test preload, afterload and contractility.
Is the Guyton model examined?
Venous return physiology is a recurring theme in intensive care physiology teaching and exams.
How are waveforms tested?
Vivas often include arterial and CVP waveforms and questions about damping and artefact.
How many cardiovascular physiology questions are in the Intensive care (CICM) bank?
There are 21 cardiovascular physiology questions across 21 subtopics, and the bank grows as new questions pass review.
Can I practise only cardiovascular physiology questions?
Yes. Filter by area or by any subtopic to build a custom block, in tutor mode with explanations after each question or in timed mode.
How are cardiovascular physiology questions explained?
Every question explains why the answer is right and why each other option is wrong, with a learning point and the Australian source behind it.
How much of the Intensive care (CICM) mock is cardiovascular physiology?
About 16 questions in each 100-question mock come from cardiovascular physiology, following our mock blueprint.
Which sources is this cardiovascular physiology page based on?
It summarises current Australian guidance, including CICM First Part Examination; CICM First Part Syllabus. Guidelines change, so always check the latest edition.
When was this cardiovascular physiology guide last updated?
It was last reviewed on 9 November 2026. We update topic pages when the exam or Australian guidance changes.
How do I unlock all Intensive care (CICM) questions?
Choose a Intensive care (CICM) plan: 3 or 6 months of access, from A$469.99, one payment with no auto-renew. It opens every area, not just cardiovascular physiology.
Sources
Clinical content is summarised from current Australian guidance at the date above. Guidelines change, so always check the latest edition.