Clinical Application Of Perfusion
Set Exam Questions With
Reviewed Correct Detailed
Answers& Rationales
New Update!!
1. What is the most clinically relevant characteristic of cold agglutinins? -
ANSWER Thermal Amplitude
2. A clinically insignificant cold agglutinin characteristic would be?
a) irreversible agglutination
b) complement binding
c) hemolysis
d) peak activity at 0-4 degrees celsius - ANSWER D. peak activity at 0-4
degrees celsius.
>>It is usually considered clinically insignificant if the thermal amplitude test is
less than 30 C.
3. What causes cold agglutinin manifestation - ANSWER low critical
temperatures.
4. What of the following is a pre operative indication for IABP support?
,a) a fib b)transient ischemic attack c)Ao dissection d) post infraction angina -
ANSWER d) post infarction angina
5. Which is a contraindication of a balloon pump?
a) RV dysfunction b) vent arryth. c)Ao regurg d)bivent. fail - ANSWER C--> Ao
regard
IABP would cause blood to be pushed back into the left ventricle.
6. Where should the IABP balloon be position in aorta before pumping begins? -
ANSWER In the descending aorta just distal to the left subclavian artery base.
7. In a patient recommended for a CABG what type of venous cannulation should
be used. - ANSWER Single two stage cannula. Cavoatrial cannula. (IVC/RA)
8. In a patient with cold agglutinins what type of cardioplegia should be given? -
ANSWER warm crystalloid cardioplegia.
9. Effluent from integrate cardioplegia is typically collected from where? -
ANSWER The right atrium.
10. What is the max temperature gradient between the heat exchanged water
bath and patient blood? - ANSWER 10 C? Practice test answer is 12 C.
11. What temperature does destruction to formed elements and protein
denaturation occur? - ANSWER 42 C. Osu Board review states that temps
should not exceed 38 C.
, 12. In which way would an increase in blood shift the oxyhemoglobin curve. -
ANSWER Shifts to the right.
>> Increase in O2 metabolism causes decreased O2 levels and shifts the curve to
the right.
13. Late IABP deflation results in what.
a. Enhanced after load reduction
b. sub optimal coronary perfusion
c. decrease pulm wedge pressure
d. increase in myocardial O2 demand. - ANSWER D. increase in myocardial O2
demand.
>>Late deflation would cause the heart to have to pump harder against the
balloon costing it more O2 and energy.
14. What IABP trigger mode is appropriate for a patient in Ventricular
Fibrillation? - ANSWER Internal triggering, which will cause the balloon to
deflate anytime it detects an r wave.
15. Management of a patient with clinically significant cold agglutinins would
include all of the following EXCEPT ?
a) bicaval venous cannulation
b)hemodilution
c)hypothermic CPB above critical temperature
d) high systemic flows(2.6-2.8 L/min/M^2) - ANSWER A. bicaval venous
cannulation.
Set Exam Questions With
Reviewed Correct Detailed
Answers& Rationales
New Update!!
1. What is the most clinically relevant characteristic of cold agglutinins? -
ANSWER Thermal Amplitude
2. A clinically insignificant cold agglutinin characteristic would be?
a) irreversible agglutination
b) complement binding
c) hemolysis
d) peak activity at 0-4 degrees celsius - ANSWER D. peak activity at 0-4
degrees celsius.
>>It is usually considered clinically insignificant if the thermal amplitude test is
less than 30 C.
3. What causes cold agglutinin manifestation - ANSWER low critical
temperatures.
4. What of the following is a pre operative indication for IABP support?
,a) a fib b)transient ischemic attack c)Ao dissection d) post infraction angina -
ANSWER d) post infarction angina
5. Which is a contraindication of a balloon pump?
a) RV dysfunction b) vent arryth. c)Ao regurg d)bivent. fail - ANSWER C--> Ao
regard
IABP would cause blood to be pushed back into the left ventricle.
6. Where should the IABP balloon be position in aorta before pumping begins? -
ANSWER In the descending aorta just distal to the left subclavian artery base.
7. In a patient recommended for a CABG what type of venous cannulation should
be used. - ANSWER Single two stage cannula. Cavoatrial cannula. (IVC/RA)
8. In a patient with cold agglutinins what type of cardioplegia should be given? -
ANSWER warm crystalloid cardioplegia.
9. Effluent from integrate cardioplegia is typically collected from where? -
ANSWER The right atrium.
10. What is the max temperature gradient between the heat exchanged water
bath and patient blood? - ANSWER 10 C? Practice test answer is 12 C.
11. What temperature does destruction to formed elements and protein
denaturation occur? - ANSWER 42 C. Osu Board review states that temps
should not exceed 38 C.
, 12. In which way would an increase in blood shift the oxyhemoglobin curve. -
ANSWER Shifts to the right.
>> Increase in O2 metabolism causes decreased O2 levels and shifts the curve to
the right.
13. Late IABP deflation results in what.
a. Enhanced after load reduction
b. sub optimal coronary perfusion
c. decrease pulm wedge pressure
d. increase in myocardial O2 demand. - ANSWER D. increase in myocardial O2
demand.
>>Late deflation would cause the heart to have to pump harder against the
balloon costing it more O2 and energy.
14. What IABP trigger mode is appropriate for a patient in Ventricular
Fibrillation? - ANSWER Internal triggering, which will cause the balloon to
deflate anytime it detects an r wave.
15. Management of a patient with clinically significant cold agglutinins would
include all of the following EXCEPT ?
a) bicaval venous cannulation
b)hemodilution
c)hypothermic CPB above critical temperature
d) high systemic flows(2.6-2.8 L/min/M^2) - ANSWER A. bicaval venous
cannulation.
