ABCP Board Exam Questions & Answers 100% Solved

Metabolic acidosis is characterized by: - Answer a fall in the plasma HCO3- concentration and a low pH The patient is a 71 year old male who presents to the OR with a history of congestive heart failure. His history is positive for increasing shortness of breath, 3 pillow orthopnea, lower extremity edema, and dyspnea with mild exertion. Preoperative lab values are as follows (Arterial values): pH: 7.41, pCO2: 60, pO2: 50, HCO3-: 38.1, BE + 12, SaO2: 72%, Hgb/Hct: 7.6/23 Based on the above information, you diagnose: - Answer chronic respiratory acidosis with fully compensated metabolic alkalosis and hypoxemia The patient is weaned from CPB and you get the results of the postoperative arterial blood gas. The results are: pH: 7.42, pCO2: 36, pO2: 95, HCO3-: 26, BE: -1, SaO2: 99%, Hgb/Hct: 8.6/26 Based on the above, your diagnosis is: - Answer normal ventilatory status and normal arterial blood gas values Laboratory findings in chronic respiratory acidosis includes: - Answer elevated PaCO2, elevated plasma HCO3, low or low-normal pH The ascending aortic segment: - Answer begins at the aortic valve annulus and ends just proximal to the innominate artery What is the middle layer of an arterial wall made up of? - Answer Composed primarily of squamous epithelium, it is the thickest layer and provides compliance of the artery The P wave: - Answer When peaked, as in chronic obstructive pulmonary disease, is known as P pulmonade The ST Segment - Answer begins with the J point The intrinsic mechanism of blood coagulation is thought to be initiated by - Answer foreign surfaces the aortic valve will close - Answer when aortic pressure is greater than left ventricular pressure The gas law that states that the pressure of a gas in a closed container is inversely related to the volume of the container is - Answer boyle's law Hypoxia is - Answer an inadequate, reduced tension of cellular oxygen Protamine is: - Answer a poly cation that binds ionically to heparin to produce a stable precipitate Which antihypertensive drug can cause cyanide toxicity? - Answer Nipride Cardiac index is: - Answer equal to cardiac output divided by body surface area During pregnancy, the mothers cardiac output increases by - Answer 30-50% Which of the following techniques should be avoided if a patient has a history of cold agglutination or if it is suspected? - Answer cold blood cardioplegia what issue is at the greatest risk for injury due to cold agglutination on CPB? - Answer Myocardium Which of the following lab results is the most important factor when creating a care plan on CPB for a patient with cold agglutin disease? - Answer The critical temperature What would not cause cold agglutinins to develop? - Answer allergic reaction to platelet inhibitor During bypass for a liver transplant, the patient temperature should be: - Answer maintained at normothermia Ideal pump flow during liver transplant surgery should be: - Answer ½-2/3 of pre bypass cardiac output The circuit that is most commonly used for liver transplant is - Answer Venous Venous Circuit Which of the following vessels are cannulated during liver transplant surgery? - Answer Portal vein, inferior vena cava (femoral vein), internal jugular vein Which of the following is least likely to occur during bypass for liver transplant? - Answer A decrease in systemic vascular resistance A 45 year old patient with a history of end stage liver disease is being evaluated for liver transplantation. The patient gives a history of 60 pack/year cigarette smoking and a history of consuming at least a 12 pack of Budweiser beer a day for 10 years. Based on the above history, which of the following is true? - Answer The patient must prove a history of abstinence from alcohol for at least 6 months Which of the following is not implicated as a cause of end stage renal disease? - Answer Acute Hepatitis A Which of the following is used to treat malignant hyperthermia? - Answer Dantrolene Besides high temperatures, which is a symptom of malignant hyperthermia? - Answer Hypoxia Which does not induce uterine contractions? - Answer Magnesium Uterine contractions do what to uterine blood flow? - Answer Decrease flow According to the literature, what is the best time in gestation to have cardiac surgery? - Answer Second trimester The pregnant woman should be positioned in which position? - Answer Left lateral tilt Which of the following matters need not be considered when conducting bypass on a patient with sickle cell trait? - Answer Plasma pheresis All of the following may act as triggers of Malignant Hyperthermia, EXCEPT: - Answer Anticoagulation drugs Perfusion flow rates for a pregnant patient are estimated to be ideal at: - Answer 2.5-3.2 cardiac index ß2 receptor activators increase heart rate. This response is called? - Answer Chronotropic effect ß1 adrenergic drugs have which of the following effects? - Answer Increase heart rate and increase contractility Which drug type is clearly shown to decrease both myocardial infarct size and risk of reinfarction after MI? - Answer Beta blockers A drug is listed as an alpha (a) agonist. An agonist: - Answer binds to receptors and mimics the body's own regulatory molecules What is the effect of Beta (ß) adrenergic blocker drugs on the heart? - Answer Reduces contractility Which of the following is a potent direct beta (ß) adrenergic receptor agonist with minimal effects on alpha (α) adrenergic receptors? - Answer Isoproterenol (Isuprel) Which of the following statements is true about ß2 stimulation by regulatory molecules? - Answer It promotes glycogenolysis in the liver and increases blood glucose levels You add 250 mL of 5% Human Albumin to your prime. How many grams of Albumin have you added? - Answer 12.5 grams Diuretics have an important role in management of congestive heart failure because the function mainly to: - Answer Decrease preload Lidocaine is most useful for which type of arrhythmia? - Answer Ventricular What is the general effect of hypothermia upon heparin elimination? - Answer It delays elimination During deep hypothermic circulatory arrest, all of the following should be given except: - Answer Glucose DDAVP (desmopressin) effect: - Answer Increases platelet aggregation A 36 year old female patient has been taking 50 mg of Atenolol (a beta 1 selective blocker) by mouth per day for the past ten years. This drug carries a label of Pregnancy Risk Category C. This signifies that: - Answer Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in human. The drug may be useful despite its risks "The volume of plasma from which all drug is removed in a given time" is the definition of which term? - Answer Clearance The Albumin comes as 25%. If you add 100 ml of this strength to the pump, you will be administering how many grams of Albumin? - Answer 25 grams Class I antiarrhythmic agents exert their effects by? - Answer Blocking sodium channels An advantage of continuous warm blood cardioplegia is: A. increased oxygen delivery. B. significantly decreased myocardial oxygen tension. C. a shift of the oxygen dissociation curve to the left. D. lower myocardial oxygen consumption. - Answer A. increased oxygen delivery. Intra-aortic balloon augmentation is contraindicated in patients with: A. prosthetic aortic valves. B. aortic insufficiency. C. ventricular septal defects. D. peripheral atherosclerosis. - Answer B. aortic insufficiency. When using a roller pump, aortic dissection caused by the aortic cannula may be detected by: A. elevated venous return. B. elevated arterial line pressure. C. elevated left radial artery pressure. D. increased venous saturation. - Answer B. elevated arterial line pressure. The most significant advantage of venovenous ECMO over venoarterial ECMO is: A. improved cardiac support. B. unaffected pulmonary hemodynamics. C. superior arterial oxygenation. D. reduced pulmonary blood flow - Answer B. unaffected pulmonary hemodynamics. When compared to true membranes, hydrophobic microporous membrane oxygenators may exhibit which of the following characteristics? A. increased oxygen transfer. B. fluid passage to the gas compartment. C. decreased carbon dioxide transfer. D. reduced surface boundary layer - Answer B. fluid passage to the gas compartment. Polyvinyl Chloride tubing in the roller pump usually deteriorates by: A. crumbling away from the outside in. B. crumbling away from the inside out. C. cracking and breaking from the outer edge in. D. cracking and breaking from the inner edge out. - Answer C. cracking and breaking from the outer edge in. Activated Factor X is the first step in which of the following coagulation stages? A. intrinsic pathway. B. common pathway. C. waterfall sequence. D. extrinsic pathway. - Answer B. common pathway. Under normal physiological conditions, which organ has the lowest oxygen consumption per unit weight? A. brain. B. kidney. C. lungs. D. liver. - Answer B. kidney. The release of norepinephrine by the nerve impulses causes interaction with: A. alpha receptors. B. beta receptors. C. baroreceptors. D. chemoreceptors. - Answer A. alpha receptors. In a patient with a chronic hypoxic condition, the oxyhemoglobin dissociation curve is shifted to the right by: A. the Haldane effect. B. increased 2,3 DPG levels. C. the Bohr effect. D. increased ADP. - Answer B. increased 2,3 DPG levels. The use of Citrate Phosphate Dextrose(CPD-A) blood in the perfusate affects which parameter? A. potassium. B. ionized calcium. C. total carbon dioxide. D. blood sugar. - Answer B. ionized calcium. Dexamethasone is a potent, synthetic: A. curarizing agent. B. anti-arrhythmic. C. adrenocortical steroid. D. beta blocker. - Answer C. adrenocortical steroid. Deferoxamine (desferrioxamine) administered in large doses is a(an): A. diuretic. B. calcium channel blocker. C. antiarrhythmic agent. D. hydroxyl radical scavenger. - Answer D. hydroxyl radical scavenger. Iloprost is an analog of: A. IgA. B. aprotinin. C. prostacyclin. D. thromboxane. - Answer C. prostacyclin. With normal renal function, the half-life of Cephalexin is: A. 1 hour. B. 3 hours. C. 6 hours. D. 12 hours - Answer A. 1 hour. Treatment for a blood transfusion reaction should include which modalities? A. administration of Benzodiazepines, nitroprusside, and hydroxyethyl starch solution. B. administration of platelets, fresh frozen plasma, and cryoprecipitate. C. administration of steroids, diuretics, and heparin. D. administration of vasopressors, antibiotics, and cryoprecipitate - Answer C. administration of steroids, diuretics, and heparin. The treatment for an antithrombin III deficiency is: A. fresh frozen plasma. B. packed red cells. C. cryoprecipitate. D. platelet concentrate. - Answer A. fresh frozen plasma. The major branches of the left coronary artery are: A. the anterior descending and posterior descending. B. the marginal branch and the circumflex branch. C. the circumflex branch and the anterior descending branch. D. the marginal branch and the anterior descending branch - Answer C. the circumflex branch and the anterior descending branch. During congenital intracardiac surgery, excessive venous blood draining into the right atrium may indicate the presence of a/an: A. patent ductus arteriosus. B. patent foramen ovale. C. persistent left superior vena cava. D. anomalous pulmonary venous return. - Answer C. persistent left superior vena cava. The patient is a 67 year-old male weighing 102 Kg who has been previously diagnosed with coronary artery disease, an apical left ventricular aneurysm, and chronic renal failure. Laboratory values from the referring hospital indicate a BUN of 62 mg/dL and a creatinine of 2.4 mg/dL. Thirty (30) minutes after initiating CPB, it is noted that urine output has decreased significantly. Given a pre-operative creatinine of 2.4 mg/dL, this patient has approximately what percentage of normal renal function? A. 20%. B. 40%. C. 60%. D. 80%. - Answer B. 40%. The patient is a 67 year-old male weighing 102 Kg who has been previously diagnosed with coronary artery disease, an apical left ventricular aneurysm, and chronic renal failure. Laboratory values from the referring hospital indicate a BUN of 62 mg/dL and a creatinine of 2.4 mg/dL. Thirty (30) minutes after initiating CPB, it is noted that urine output has decreased significantly. Which of the following modifications in perfusion technique could be used to enhance urine output? A. administration of a chlorpromazine to increase renal blood flow. B. priming the circuit with a hypertonic solution. C. use of a hemoconcentrator. D. utilizing a pulsatile flow pump - Answer D. utilizing a pulsatile flow pump The patient is a 67 year-old male weighing 102 Kg who has been previously diagnosed with coronary artery disease, an apical left ventricular aneurysm, and chronic renal failure. Laboratory values from the referring hospital indicate a BUN of 62 mg/dL and a creatinine of 2.4 mg/dL. Thirty (30) minutes after initiating CPB, it is noted that urine output has decreased significantly. The most effective intervention in treating acute hyperkalemia after removal of the aortic clamp would be: A. ultrafiltration. B. administering 1 mg/kg of butanenide. C. administering dextrose and insulin. D. beginning a 3 ug/kg dopamine drip - Answer C. administering dextrose and insulin. The patient is a 67 year-old male weighing 102 Kg who has been previously diagnosed with coronary artery disease, an apical left ventricular aneurysm, and chronic renal failure. Laboratory values from the referring hospital indicate a BUN of 62 mg/dL and a creatinine of 2.4 mg/dL. Thirty (30) minutes after initiating CPB, it is noted that urine output has decreased significantly. A hemodialyzer differs primarily from a hemoconcentrator in: A. size and number of pores. B. effective surface area. C. maximum allowed transmembrane pressure. D. ability to remove urea nitrogen. - Answer A. size and number of pores. The patient is a 67 year-old male weighing 102 Kg who has been previously diagnosed with coronary artery disease, an apical left ventricular aneurysm, and chronic renal failure. Laboratory values from the referring hospital indicate a BUN of 62 mg/dL and a creatinine of 2.4 mg/dL. Thirty (30) minutes after initiating CPB, it is noted that urine output has decreased significantly. Total clearance of urea and creatinine by an ultrafiltrator: A. is identical. B. is not affected by temperature. C. increases with increasing hematocrit. D. is proportional to their sieving coefficients. - Answer D. is proportional to their sieving coefficients. The patient is a 67 year-old male weighing 102 Kg who has been previously diagnosed with coronary artery disease, an apical left ventricular aneurysm, and chronic renal failure. Laboratory values from the referring hospital indicate a BUN of 62 mg/dL and a creatinine of 2.4 mg/dL. Thirty (30) minutes after initiating CPB, it is noted that urine output has decreased significantly. Upon wearing from CPB, the following are observed: Cardiac Index: 1.71min/m2 Arterial blood pressure: 80/45mmHg PA pressure: 60/35mmHg Pulmonary wedge pressure: 30mmHg Central venous pressure: 15mmHg The above data are suggestive of: A. inadequate preload. 'B. increased afterload. C. biventricular failure. D. left heart failure - Answer D. left heart failure The patient is a 67 year-old male weighing 102 Kg who has been previously diagnosed with coronary artery disease, an apical left ventricular aneurysm, and chronic renal failure. Laboratory values from the referring hospital indicate a BUN of 62 mg/dL and a creatinine of 2.4 mg/dL. Thirty (30) minutes after initiating CPB, it is noted that urine output has decreased significantly. Upon wearing from CPB, the following are observed: Cardiac Index: 1.71min/m2 Arterial blood pressure: 80/45mmHg PA pressure: 60/35mmHg Pulmonary wedge pressure: 30mmHg Central venous pressure: 15mmHg In treating the above parameters, one of the first interventions to be considered would be to: A. start a dobutamine infusion. B. start a nitroprusside infusion. C. insert an intra-aortic balloon pump. D. give a 500 cc fluid bolus. - Answer A. start a dobutamine infusion. The patient is a 67 year-old male weighing 102 Kg who has been previously diagnosed with coronary artery disease, an apical left ventricular aneurysm, and chronic renal failure. Laboratory values from the referring hospital indicate a BUN of 62 mg/dL and a creatinine of 2.4 mg/dL. Thirty (30) minutes after initiating CPB, it is noted that urine output has decreased significantly. Upon wearing from CPB, the following are observed: Cardiac Index: 1.71min/m2 Arterial blood pressure: 80/45mmHg PA pressure: 60/35mmHg Pulmonary wedge pressure: 30mmHg Central venous pressure: 15mmHg