abcp clinical boards UPDATED ACTUAL
Questions and CORRECT Answers
A 35 year-old female on an extracorporeal left ventricular assist device (LVAD) continues to
deteriorate hemodynamically. A decision is made to initiate biventricular support.
LVAD cannulation sites? - CORRECT ANSWER Pulmonary vein to aorta
Which of the following represents the clearest indication to add right ventricular assist?
A. right atrial pressure > 20 mmHg with IABP and inotropic support.
B. left atrial pressure > 20 mmHg with IABP and inotropic support.
C. SVR of 1800 dyn-sec/cm5 with IABP support.
D. urine output < 20 mL/hr with optimal preload and IABP support. - CORRECT
ANSWER A
In right ventricular assist, pump inflow cannula entrapment is indicated by:
A. chattering of the line leading into the centrifugal pump head.
B. elevated right atrial pressures.
C. visible air clusters in the centrifugal cone outlet.
D. elevated pulmonary artery pressures. - CORRECT ANSWER A
If ventricular support is employed to wean a patient from CPB, heparin therapy to maintain
adequate anticoagulation is generally:
A. instituted at the time of insertion of assist cannulae.
B. continuously administered by drip immediately after bypass heparinization has been reversed.
C. not recommended with heparin-bonded circuits.
D. initiated within 24 hours after bleeding has been controlled. - CORRECT ANSWER
A 2 year-old child weighing 12 kg is scheduled for repair of an atrial septal defect. The parents
are Jehovah's Witnesses and request that no blood products be utilized.
,If this child's prebypass hematocrit is 40%, and the priming volume is 1200 ml, the anticipated
hematocrit on CPB is: A. 13%. B. 17%. C. 21%. D. 25%. - CORRECT ANSWER B
All of the following methods of blood conservation can be used for this case EXCEPT:
A. intraoperative cell salvage.
B. hemoconcentration.
C. platelet sequestration.
D. diuresis - CORRECT ANSWER C
A 67-year-old male is referred for an elective CABG which is scheduled in two days. Past
medical history is significant for hypertension and recent upper respiratory tract infection. The
blood bank has determined that the patient has cold hemagglutinin disease. The thermal
amplitude is 4-22oC.
What is the most clinically relevant characteristic of cold agglutinins?
A. hemoglobinuria.
B. thermal amplitude.
C. serum titer.
D. polyclonal antibodies - CORRECT ANSWER B
In this patient, clinically significant cold agglutinins are manifested by:
A. history of recent upper respiratory tract infection
B. low critical temperature.
C. narrow thermal amplitude.
D. an acute onset of ischemia. - CORRECT ANSWER B
What is the optimal management strategy for this patient? - CORRECT
ANSWER Preoperative plasmapheresis with fresh frozen plasma
which of the following is an indication for pre-operative IABP support?
, A. atrial fibrillation.
B. transient ischemic attack.
C. aortic dissection.
D. post infarction angina. - CORRECT ANSWER D
In this patient, myocardial protection should be initiated with:
A. warm crystalloid cardioplegia.
B. warm blood cardioplegia.
C. cold crystalloid cardioplegia.
D. cold blood cardioplegia. - CORRECT ANSWER B
In this patient, subsequent myocardial protection should be maintained with: A. warm crystalloid
cardioplegia.
B. warm blood cardioplegia.
C. cold crystalloid cardioplegia.
D. cold blood cardioplegia - CORRECT ANSWER C
In preparation for weaning the patient from CPB the IABP is turned on. Late IABP deflation
results in:
A. enhanced afterload reduction.
B. sub-optimal coronary perfusion.
C. a decrease in pulmonary wedge pressure.
D. an increase in myocardial oxygen demand. - CORRECT ANSWER D
A 23-year-old female (wt 60kg, ht 160cm) with sickle cell anemia presents for an atrial septal
defect repair. The peripheral blood smear demonstrates marked dysmorphic and sickled cells Lab
results were as follows: Hemoglobin 7.5gm/dL Hematocrit 25% Na+ 135mEq/L K+ 5.1mEq/L
Glucose 121mg/dL BUN 18mg% Creatinine 1.0mg/dL Blood type: B negative Antibody screen:
negative
Questions and CORRECT Answers
A 35 year-old female on an extracorporeal left ventricular assist device (LVAD) continues to
deteriorate hemodynamically. A decision is made to initiate biventricular support.
LVAD cannulation sites? - CORRECT ANSWER Pulmonary vein to aorta
Which of the following represents the clearest indication to add right ventricular assist?
A. right atrial pressure > 20 mmHg with IABP and inotropic support.
B. left atrial pressure > 20 mmHg with IABP and inotropic support.
C. SVR of 1800 dyn-sec/cm5 with IABP support.
D. urine output < 20 mL/hr with optimal preload and IABP support. - CORRECT
ANSWER A
In right ventricular assist, pump inflow cannula entrapment is indicated by:
A. chattering of the line leading into the centrifugal pump head.
B. elevated right atrial pressures.
C. visible air clusters in the centrifugal cone outlet.
D. elevated pulmonary artery pressures. - CORRECT ANSWER A
If ventricular support is employed to wean a patient from CPB, heparin therapy to maintain
adequate anticoagulation is generally:
A. instituted at the time of insertion of assist cannulae.
B. continuously administered by drip immediately after bypass heparinization has been reversed.
C. not recommended with heparin-bonded circuits.
D. initiated within 24 hours after bleeding has been controlled. - CORRECT ANSWER
A 2 year-old child weighing 12 kg is scheduled for repair of an atrial septal defect. The parents
are Jehovah's Witnesses and request that no blood products be utilized.
,If this child's prebypass hematocrit is 40%, and the priming volume is 1200 ml, the anticipated
hematocrit on CPB is: A. 13%. B. 17%. C. 21%. D. 25%. - CORRECT ANSWER B
All of the following methods of blood conservation can be used for this case EXCEPT:
A. intraoperative cell salvage.
B. hemoconcentration.
C. platelet sequestration.
D. diuresis - CORRECT ANSWER C
A 67-year-old male is referred for an elective CABG which is scheduled in two days. Past
medical history is significant for hypertension and recent upper respiratory tract infection. The
blood bank has determined that the patient has cold hemagglutinin disease. The thermal
amplitude is 4-22oC.
What is the most clinically relevant characteristic of cold agglutinins?
A. hemoglobinuria.
B. thermal amplitude.
C. serum titer.
D. polyclonal antibodies - CORRECT ANSWER B
In this patient, clinically significant cold agglutinins are manifested by:
A. history of recent upper respiratory tract infection
B. low critical temperature.
C. narrow thermal amplitude.
D. an acute onset of ischemia. - CORRECT ANSWER B
What is the optimal management strategy for this patient? - CORRECT
ANSWER Preoperative plasmapheresis with fresh frozen plasma
which of the following is an indication for pre-operative IABP support?
, A. atrial fibrillation.
B. transient ischemic attack.
C. aortic dissection.
D. post infarction angina. - CORRECT ANSWER D
In this patient, myocardial protection should be initiated with:
A. warm crystalloid cardioplegia.
B. warm blood cardioplegia.
C. cold crystalloid cardioplegia.
D. cold blood cardioplegia. - CORRECT ANSWER B
In this patient, subsequent myocardial protection should be maintained with: A. warm crystalloid
cardioplegia.
B. warm blood cardioplegia.
C. cold crystalloid cardioplegia.
D. cold blood cardioplegia - CORRECT ANSWER C
In preparation for weaning the patient from CPB the IABP is turned on. Late IABP deflation
results in:
A. enhanced afterload reduction.
B. sub-optimal coronary perfusion.
C. a decrease in pulmonary wedge pressure.
D. an increase in myocardial oxygen demand. - CORRECT ANSWER D
A 23-year-old female (wt 60kg, ht 160cm) with sickle cell anemia presents for an atrial septal
defect repair. The peripheral blood smear demonstrates marked dysmorphic and sickled cells Lab
results were as follows: Hemoglobin 7.5gm/dL Hematocrit 25% Na+ 135mEq/L K+ 5.1mEq/L
Glucose 121mg/dL BUN 18mg% Creatinine 1.0mg/dL Blood type: B negative Antibody screen:
negative
