Clinical Questions for Boards – ABCP
UPDATED ACTUAL Questions and
CORRECT Answers
What is the defect associated with Malignant Hyperthermia - CORRECT ANSWER it's an
autosomal defect of Ryanodine subtype 1 receptor, RY1 on chromosome 19
What is RY1 responsible for? - CORRECT ANSWER contraction and coupling in skeletal
muscle
What are triggers for Malignant Hyperthermia? - CORRECT ANSWER depolarizing
muscle relaxants: succinylcholine and hologenated inhalation gases
What is the most common need for surgery during pregnancy? - CORRECT
ANSWER MS (mitral stenosis)
What is optimal timing for pregnant pt? - CORRECT ANSWER 2nd trimester (14-26 wks)
because fetus organs are formed and fetus maybe viable.
What pump flows and MAP should be maintained for pregnant pt on CPB? - CORRECT
ANSWER maintain fetal oxygenation , MAP>50mmHg, 2.5 L/min desirable (70 and up to
3.4 L/min can be good)
What type of flow is preferable for pregnant pts? - CORRECT ANSWER Pulsitile flow
prevents drop in UBF and limits rise in uterine vascular resistance (UVR)
What temp should a pregnant patient be kept? - CORRECT ANSWER maintain 35+
degrees because hypothermia decreases O2 exchange through placenta, provokes uterine
contractions and decreases placental BF
, What are CPB considerations for Sickle cell disease - CORRECT ANSWER 1) don't
induce sickle cell crisis via HYPOXIA, VASCULAR STASIS, HYPEROSMOLARITY,
ACIDOSIS
2) avoid hyperthermia: causes vasoconstriction, venous stasis
3) Only crystalloid CPG to flush HbS from coronaries
What are some CPB considerations for Methemoglobinemia? - CORRECT
ANSWER draw arterial and venous blood gases to rule out oxygenator
How do you treat methemoglobinemia? - CORRECT ANSWER 1-2mg/kg methylene blue
1% soln: converts MetHB to OxyHB
which allows for 10X increase in O2 carrying capacity
What should you monitor on CPB w/ Thalassemia pt - CORRECT ANSWER for signs of
hemolysis
How does CPB affect Spherocytosis and Elliptocytosis? - CORRECT ANSWER increases
hemolysis, platelet destruction, and protein denaturation
What's treatment for vWF? - CORRECT ANSWER DDAVP 0.2-3 mcg/kg over 30 mins
What if vWF pt doesn't respond to DDAVP? - CORRECT ANSWER give factor VIII
concentrates or cryp 1 unit/kg may be needed
What is treatment of choice for Hemophila A (classic hemophilia) - CORRECT
ANSWER DDAVP for mild to moderate hemophila A. otherwise VIII conc
What is treatment of choice for Hemophilia B? - CORRECT ANSWER factor IX
concentrates(Christmas)
UPDATED ACTUAL Questions and
CORRECT Answers
What is the defect associated with Malignant Hyperthermia - CORRECT ANSWER it's an
autosomal defect of Ryanodine subtype 1 receptor, RY1 on chromosome 19
What is RY1 responsible for? - CORRECT ANSWER contraction and coupling in skeletal
muscle
What are triggers for Malignant Hyperthermia? - CORRECT ANSWER depolarizing
muscle relaxants: succinylcholine and hologenated inhalation gases
What is the most common need for surgery during pregnancy? - CORRECT
ANSWER MS (mitral stenosis)
What is optimal timing for pregnant pt? - CORRECT ANSWER 2nd trimester (14-26 wks)
because fetus organs are formed and fetus maybe viable.
What pump flows and MAP should be maintained for pregnant pt on CPB? - CORRECT
ANSWER maintain fetal oxygenation , MAP>50mmHg, 2.5 L/min desirable (70 and up to
3.4 L/min can be good)
What type of flow is preferable for pregnant pts? - CORRECT ANSWER Pulsitile flow
prevents drop in UBF and limits rise in uterine vascular resistance (UVR)
What temp should a pregnant patient be kept? - CORRECT ANSWER maintain 35+
degrees because hypothermia decreases O2 exchange through placenta, provokes uterine
contractions and decreases placental BF
, What are CPB considerations for Sickle cell disease - CORRECT ANSWER 1) don't
induce sickle cell crisis via HYPOXIA, VASCULAR STASIS, HYPEROSMOLARITY,
ACIDOSIS
2) avoid hyperthermia: causes vasoconstriction, venous stasis
3) Only crystalloid CPG to flush HbS from coronaries
What are some CPB considerations for Methemoglobinemia? - CORRECT
ANSWER draw arterial and venous blood gases to rule out oxygenator
How do you treat methemoglobinemia? - CORRECT ANSWER 1-2mg/kg methylene blue
1% soln: converts MetHB to OxyHB
which allows for 10X increase in O2 carrying capacity
What should you monitor on CPB w/ Thalassemia pt - CORRECT ANSWER for signs of
hemolysis
How does CPB affect Spherocytosis and Elliptocytosis? - CORRECT ANSWER increases
hemolysis, platelet destruction, and protein denaturation
What's treatment for vWF? - CORRECT ANSWER DDAVP 0.2-3 mcg/kg over 30 mins
What if vWF pt doesn't respond to DDAVP? - CORRECT ANSWER give factor VIII
concentrates or cryp 1 unit/kg may be needed
What is treatment of choice for Hemophila A (classic hemophilia) - CORRECT
ANSWER DDAVP for mild to moderate hemophila A. otherwise VIII conc
What is treatment of choice for Hemophilia B? - CORRECT ANSWER factor IX
concentrates(Christmas)
