This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Miscellaneous, Subject name: Anaesthesia
[{'content': 'A 62-year-old woman with a history of coronary aery disease presents with a pancreatic head tumor and undergoes a pancreaticoduodenectomy. Postoperatively, she develops a leak from the pancreaticojejunostomy anastomosis and becomes septic. A Swan-Ganz catheter is placed, which demonstrates an increased cardiac output and decreased systemic vascular resistance. She also develops acute renal failure and oliguria. Which of the following is an indication to sta dopamine? \nSelect and explain. \nA. To increase splanchnic flow, B. To increase coronary flow, C. To decrease hea rate, D. To lower peripheral vascular resistance', 'role': 'user'}, {'content': 'Answer: B \nExplanation: Dopamine has a variety of pharmacologic characteristics that make it useful in critically ill patients. At all doses, the diastolic blood pressure can be expected to rise; since coronary perfusion is largely a result of the head of pressure at the coronary ostia, coronary blood flow should be increased. In low doses (1-5 mg/), dopamine affects primarily the dopaminergic receptors. Activation of these receptors causes vasodilation of the renal and mesenteric vasculature and mild vasoconstriction of the peripheral bed, which thereby redirects blood flow to kidneys and bowel. At these low doses, the net effect on the overall vascular resistance may be slight. As the dose rises (2-10 mg/), b1 -receptor activity predominates and the inotropic effect on the myocardium leads to increased cardiac output and blood pressure. Above 10 mg/(kg*min), a-receptor stimulation causes peripheral vasoconstriction, shifting of blood from extremities to organs, decreased kidney function, and hypeension.', 'role': 'assistant'}]