PBSE Perfusion Practice Exam

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• What is the effect of hypothermia during CPB on coagulation and platelet function, and how is it mitigated?
• Myocardial infarction is defined as:
• What is the role of humidification in CPB circuits and what risks are associated with mist or condensation?
• The dilution hematocrit for a 70 kg male with a pre-bypass hematocrit of 45% undergoing cpb with a prime of 2.0 liters would be:
• Which statement about NIRS monitoring is true?
• The normal arterio-venous oxygen difference is approximately:
• Which class of agents is commonly used to reduce bleeding during cardiopulmonary bypass, and what is their mechanism?
• Reduced coronary blood flow can result in:
• On CPB, what hematocrit range is typically targeted to maintain adequate oxygen delivery?
• What are key considerations in immediate postoperative management after weaning from CPB?
• What is the purpose of retrograde autologous priming (RAP) in CPB priming?
• An essential design feature of a single pass blood cardioplegia system is a:
• The classical pathway of complement activation is initiated by antibody-antigen reactions.
• If an oxygenator issue is suspected during CPB, what is the typical response?
• Which device is primarily used to detect air bubbles in the arterial line of CPB?
• What are the main myocardial protection strategies during CPB, and how do crystalloid and blood cardioplegia differ?
• Monitoring the effect of heparin rather than its concentration would be more beneficial in which clinical scenario?
• Counterpulsation assists the failing heart by:
• The effect of a calcium channel-blocking drug is which?
• If the diffusion coefficient for oxygen is 1, the diffusion coefficient for carbon dioxide is?
• Morphine sulfate effects include which of the following?
• The tissue in a true ventricular aneurysm is composed of:
• Which infection control practices are essential in CPB circuit management?
• What condition is characterized by cardiac enlargement and impaired systolic function of one or both ventricles?
• The sinoatrial node is supplied by the right coronary artery in about what percent?
• In Hypoplastic Left Heart Syndrome, arterial cannulation via the main PA delivers systemic perfusion through which vessel?
• During cerebral protection in aortic dissection surgery, which combination is most protective during circulatory arrest?
• How does prime volume relate to CPB management?
• What are the common components of prime solutions used for CPB?
• Which factors influence arterial and venous cannula placement during CPB?
• Cephalosporins have little antimicrobial activity against which organism?
• Obstruction of blood flow through the mitral valve would most likely be caused by a:
• The main function of an enzyme is to increase the rate of a biochemical reaction.
• Which of the following statements about cerebral ischemia due to air embolus is true?
• Counterpulsation improves coronary perfusion by raising which pressure?
• Which approach is used to access the mitral valve during minimally invasive surgery?
• In CPB, how are pH, PaCO2, and PaO2 interpreted and CPB settings adjusted?
• If the diffusion coefficient for oxygen is 1, the diffusion coefficient for carbon dioxide is approximately:
• Which of the following best describes the effect of adding CPB prime on hematocrit?
• The main function of the air bubble detector is to:
• The most frequent cause of cariogenic shock is:
• Compared with adults, neonatal/pediatric CPB typically features which of the following?
• Which agent reverses heparin at the end of CPB?
• Which organism is least susceptible to cephalosporins?
• What ethical considerations govern perfusion practice in the operating room?
• Which signs indicate potential oxygenator failure on CPB?
• The diagonal arteries supply the anterior wall of the left ventricle. Which one best describes this fact?
• What cerebral perfusion strategies are used during DHCA and what are antegrade vs retrograde approaches?
• During ECMO support, heparin requirements will increase when:
• Which practice most directly reduces air entrainment and microemboli in CPB circuits?
• Which items are essential to document during CPB?
• How does acid-base management differ in pediatric CPB?
• From the femoral site, an incorrect timing of balloon inflation is indicated by which waveform finding?
• Which clotting factor is activated by contact with foreign surfaces, roughened vascular walls, and platelet aggregates?
• Which factors influence pulmonary vascular resistance during CPB?
• A decrease in platelet function is indicated by which TEG parameter?
• The circumflex artery supplies the lateral aspect of the left ventricle in what percentage of patients?
• Which statement is true regarding MIS access to the mitral valve?
• Which drug increases the brain's tolerance to global ischemia when administered prior to the ischemic episode?
• What factors contribute to postoperative cognitive dysfunction after CPB, and what strategies mitigate risk?
• How does cannula size selection in pediatric CPB differ from adults?
• The effect of plasmin is to?
• Why is maintaining adequate mean arterial pressure important during CPB?
• Thromboelastography evaluates the viscoelastic properties of which sample?
• Which region is supplied by the diagonal arteries?
• Myocardial stunning can be defined as:
• Thromboelastography measures the viscoelastic properties of:
• Atrial myxomas are primarily located:
• What cerebral protection strategies are used during aortic arch repair?
• Extracorporeal microfiber filtration is most frequently employed in the following location during adult CPB:
• During resuscitation for CPB-induced air embolus, which action is likely performed?
• The most common site of traumatic aortic disruption due to deceleration injury is:
• Which of the following conditions is listed as a potential cause of inadequate heparin anticoagulation during cardiac surgery, besides antithrombin III deficiency and thrombocytopenia?
• During resuscitation for CPB-induced air embolus, which action is recommended?
• What is the approximate blood volume of a normal newborn weighing 9 pounds?
• Which condition is verapamil (Calan) indicated for?
• When is regional perfusion most beneficial?
• Why are blood gas values monitored during CPB?
• The primary structural units of proteins are?
• Which finding characterizes air embolus-induced cerebral ischemia?
• Which component of a typical cardiopulmonary bypass circuit collects venous return?
• What is the function of an arterial line during cardiopulmonary bypass?
• What are the perfusionist's responsibilities during an aortic arch repair?
• Myocardial infarction is defined as:
• Which statement about cerebral saturation monitoring with NIRS is true?
• The difference between total cardiopulmonary bypass and partial cardiopulmonary bypass is that:
• What is the role of the vacuum/venous reservoir in CPB and how is suction controlled?
• To achieve a concentration of 30meq/l KCl in a cardioplegia solution using a 1:1 blood:crystalloid cdpg set, how much KCl must be added to 0.9% NaCl to make 1 liter of the crystalloid solution?
• In a patient with acute type A aortic dissection and a history of CAD, which strategy best reduces the risk of postoperative organ and neurologic deficits?
• At a given pO2, increasing the pCO2 results in?
• Which approach provides brain protection during circulatory arrest in aortic surgery?
• Which condition is directly addressed by using FFP during CPB?
• During isolated limb perfusion, the reason for maintaining systemic pressure higher than limb pressure is to prevent:
• The conformational change of the platelet when stimulated by exposure to foreign surfaces is best described as a globular form with pseudopodia.
• The left anterior descending coronary artery originates from which structure?
• When is protamine typically administered to reverse heparin after CPB, and how is it given to minimize risks?
• In 85-95% of patients, the circumflex artery supplies which region of the heart?
• A characteristic of leukocytes is that they are larger than platelets.
• What practice helps prevent air entrainment in the CPB circuit?
• What is the purpose and method of intraoperative cell salvage in perfusion practice?
• What is the function of the venous suction line in CPB?
• Which cardiovascular effect is associated with amrinone (Inocor)?
• What is the recommended approach when pH becomes acidotic during CPB?
• If 5 liters of blood with a hematocrit of 45% are mixed with 3 liters of blood with a hematocrit of 25%, the resulting hematocrit would be:
• In Hypoplastic Left Heart Syndrome, arterial cannulation is performed via the:
• Which statement best describes MIS access to the mitral valve?
• What is cardiotomy suction and what effect does it have on hematocrit?
• A patient on bypass has a BSA of 1.5 m2, a CVP of 2mmHg and a MAP of 80mmHg. The blood flow is at 2.0 L/min/m2 index. The SVR is:
• The Bohr effect describes how increased carbon dioxide affects Hb's oxygen affinity. Which statement is true?
• What is the role of a cell saver during CPB?
• Which enzyme is primarily responsible for dissolving fibrin clots?
• What flow meter uses acoustics to measure blood flow?
• What does ACT stand for in coagulation monitoring?
• What circuit issue is most likely to prompt immediate corrective actions such as clamping or component exchange?
• A sample of blood cooled from 37 degrees will undergo what change?
• Dilated cardiomyopathy is characterized by enlargement of the heart and impairment of which function?
• Which factors influence the selection of the prime solution for CPB?
• What factors contribute to hemolysis on CPB and how can it be minimized?
• Which organs are targeted by regional perfusion?
• What do SVR and PVR indicate in CPB, and how are they monitored?
• Which sites are used for temperature monitoring during CPB and why?
• What QA/QC measures are used for CPB circuits?
• Oxygen delivery will be decreased when a low venous oxygen tension and high venous oxyhemoglobin saturation are present due to?
• What considerations govern the choice of prime solutions in neonates versus adults?
• Digitalis preparations are most commonly used to:
• Cannulation near the origin of the first great vessel is associated with which perfusion outcome?
• What are the critical monitor parameters during CPB and their typical targets?
• Why is reservoir level monitored during CPB?
• How is CO2 removal controlled during CPB?
• What is a reported disadvantage of cerebral saturation monitoring using NIRS technology?
• Intrathoracic chemotherapeutic perfusion temperatures should be maintained between:
• The diagonal coronary arteries supply which region?
• Acute cerebral ischemia induced by air embolus is characterized by:
• Which anesthetic agent has the shortest duration of action?
• During isolated limb perfusion, systemic pressure is maintained higher than limb perfusion pressure to prevent:
• Which intraoperative monitoring best assesses renal perfusion during CPB?
• What are common CPB circuit alarms and how should a perfusionist respond?
• Which is essential for anticoagulation management during CPB?
• What is not done during resuscitation for CPB induced air embolus?
• Activated clotting time measures coagulation initiated by which pathway?
• The normal arterio-venous oxygen difference is approximately?
• The oxygen-hemoglobin dissociation curve for fetal hemoglobin compared with maternal hemoglobin shows?
• Which strategies are commonly employed for renal protection during CPB?
• What is retrograde autologous priming and what are its risks?
• Cephalosporins have little antimicrobial activity against which organism?
• The left anterior descending coronary artery arises from which structure?
• Inocor (amrinone) effects on the pulmonary vasculature include which of the following?
• The most common site of traumatic aortic disruption due to deceleration injury is:
• How is oxygen delivery (DO2) calculated in perfusion, and what factors most influence it during CPB?
• Which statement best describes the difference between ECMO and conventional CPB?
• What distinguishes blood cardioplegia from crystalloid cardioplegia?
• What is the most accurate enzymatic measurement for the diagnosis of myocardial infarction?
• What sites are recommended for monitoring arterial pressures during left heart bypass for repairs of the descending aorta?
• Access to the mitral valve during minimally invasive cardiac surgery is achieved through which approach?
• Cannulation of the aortic arch near the origin of the first great vessel is associated with:
• Which of the following is an OSHA engineering control for limiting exposure to bloodborne pathogens?
• Which of the following lists the structures that return blood directly to the interior of the heart?
• Administration of FFP may be indicated during routine CPB for:
• A characteristic of the oxygen-dissociation curve for fetal hemoglobin is that?
• Why is accurate MAP important during CPB?
• Which blood products may be transfused during CPB and in which situations?
• Dipyridamole interferes with the function of which cells?
• The tissue in a true ventricular aneurysm is composed of which tissue feature?
• What is a common risk associated with protamine administration after CPB?
• Which factors most influence oxygen delivery during CPB?
• Which drug increases the brain's tolerance of global ischemia when administered prior to the ischemic episode?
• What is the typical target ACT during CPB, and why is heparin management critical?
• Which item is a contraindication to retrograde autologous blood salvage during cardiac surgery?
• What is regional perfusion and when is it used in CPB?
• Which option is a typical MIS access to the mitral valve?
• Ventricular septal rupture in adults is most often the result of a:
• What is the purpose and risk of warming blood during CPB?
• Which coagulation tests guide perioperative management on CPB and when are they used?
• Which vasoactive medications may be used to manage systemic perfusion during CPB?
• In about 55% of patients, which coronary artery gives rise to the blood supply for the SA node?
• Kaolin is used in coagulation monitoring to initiate measurement in which test?
• Which ion is the major cation in extracellular fluid?
• As defined by OSHA standards of blood borne pathogens, what is an example of an engineering control?
• An instrument that measures coagulation from the fluid state until clot lysis occurs is a:
• Inability to adequately anticoagulate with heparin during cardiac surgery may be due to which condition?
• Which pharmacologic strategy is commonly used to reduce bleeding during CPB?
• What are the main temperature strategies during CPB and when is deep hypothermic circulatory arrest indicated?
• Atrial myxomas are primarily located in which part of the heart?
• Which component connects the patient to the CPB circuit?
• What is the role of checklists and root cause analysis in perfusion safety?
• A contraindication for RBC salvage is:
• Which approach is used to access the mitral valve during minimally invasive surgery?
• How do arterial line samples and mixed venous samples guide intraoperative blood gas management?
• The blood volume of a normal 9-pound newborn is:
• What will minimize air emboli from a craniotomy reservoir?
• Which parameter is subtracted from mean arterial pressure when calculating SVR?
• Which parameter in thromboelastography is most directly impacted by platelet function?
• How does an oxygenator function in CPB and what parameters indicate performance?
• What are the core competencies of a perfusionist during CPB?
• Which strategy most effectively reduces exposure to donor blood during CPB?