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Adult Cardiac 7

By David Blitzer / February 4, 2023

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Question 1 of 20

1. Question
Hypotension upon initiation of bypass is due to:
- Sudden Hemodilution
- Hypothermia
- Catecholamine Release
- Protamine Administration
Correct

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Question 2 of 20

2. Question
18. On bypass, a high line pressure may be due to:
- The arterial cannula tip placed against the aortic wall
- The arterial cannula occluded by the Aortic crossclamp
- An Aortic dissection
- All choices
Correct

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Question 3 of 20

3. Question
Which of the following is NOT a benefit of moderate Hypothermia on CPB?
- Reduced metabolism and oxygen demand
- A margin of safety in the event of an equipment failure
- Maintains a better heart rhythm
- Less blood trauma
Correct

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Question 4 of 20

4. Question
When warming a patient from Deep Hypothermic Circulatory Arrest (DHCA), which answer describes the best rewarming strategy?
- Rewarm at a rate of 1 degree Celsius per 10 minutes
- Rewarm at a rate of 1 degree Celsius per 3 minutes
- Rewarm at a rate of 1 degree Celsius per minute
- Rewarm the patient as fast as possible
Correct

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Question 5 of 20

5. Question
19. Which answer best describes the response of CO2 to a patient’s temperature?
- As patient’s temperature decreases, CO2 becomes more soluble
- As patient’s temperature decreases, CO2 becomes less soluble
- As patient’s temperature increases, CO2 solubility remains the same
- s patient’s temperature increases, CO2 becomes more soluble
Correct

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Question 6 of 20

6. Question
Prior to weaning from CPB, which of the following statements should be true?
- There should be a stable heart rhythm
- There should be no bleeding from inaccessible areas
- There should be good myocardial contractility
- All choices
Correct

Incorrect
Question 7 of 20

7. Question
Which of the following describes the best sequence of events following introduction of a massive air embolism on CPB?
- Stop CPB, patient in steep trendelenberg, remove aortic cannula and purge ascending aorta of air, retrograde cerebral perfusion, re-institution of CPB with hypothermia and pharmacologic cerebral protection
- Stop CPB, remove aortic cannula and purge ascending aorta of air, re-institution of CPB in steep trendelenberg position, with hypothermia and pharmacologic cerebral protection
- Systemic hypothermia and pharmacologic cerebral protection, stop CPB, patient in steep trendelenberg, remove aortic cannula and purge ascending aorta of air, retrograde cerebral perfusion, re-institution of CPB
- Stop CPB, patient in steep trendelenberg, retrograde cerebral perfusion, re-institution of CPB with hypothermia and pharmacologic cerebral protection
Correct

Incorrect
Question 8 of 20

8. Question
10. Which of the following is NOT an indicator that a cannula-induced aortic dissection may have occurred?
- Sudden, unexplained decrease in venous return to the CPB pump
- Profound drop in systemic blood pressure
- Sudden increase in arterial line pressure
- Sudden increase in systemic blood pressure
Correct

Incorrect
Question 9 of 20

9. Question
When beginning to warm a patient from Deep Hypothermic Circulatory Arrest (DHCA), which best describes the acceptable temperature gradient between the arterial outlet and venous inflow?
- a. <5 degrees C
- b. < 10 C
- c. < 15 C
- d. Rewarm the patient as fast as possible
Correct

Incorrect
Question 10 of 20

10. Question
Which of the following is NOT a benefit of moderate Hypothermia on CPB?
- a. Reduced metabolism and oxygen demand
- b. A margin of safety in the event of an equipment failure
- c. Decreased inflammatory activation
- d. Avoidance of pH correction using pH-stat or alpha-stat techniques
Correct

Incorrect
Question 11 of 20

11. Question
On bypass, a high line pressure may be due to:
- a. The arterial cannula tip placed against the aortic wall
- b. The arterial cannula occluded by the Aortic crossclamp
- c. An Aortic dissection
- d. All choices
Correct

Incorrect
Question 12 of 20

12. Question
Hypotension upon initiation of bypass is due to:
- a. Sudden hemodilution
- b. Hypothermia
- c. Catecholamine Release
- d. Protamine Administration
Correct

Incorrect
Question 13 of 20

13. Question
A 100kg patient is cooled to a rectal temperature of 18 degrees Celsius. What is the maximum safe circulatory arrest time if antegrade cerebral perfusion is employed?
- a. 30-45 minutes
- b. 45-60 minutes
- c. 75-90 minutes
- d. 90-120 minutes
Correct

Incorrect
Question 14 of 20

14. Question
What is the maximum acceptable arterial cannula pressure gradient?
- a. 250 mmHg
- b. 100 mmHg
- c. 500 mmHg
- d. 50 mmHg
Correct

Incorrect
Question 15 of 20

15. Question
Which of the following does not increase the risk of having a positive Panel-Reactive Antibody (PRA) test during heart transplantation:
- a. Pregnancy
- b. Ischemic Cardiomyopathy as Heart Failure Etiology
- c. Blood Transfusions in the past
- d. LVAD support prior to transplant
Correct

Incorrect
Question 16 of 20

16. Question
In the International code for pacemakers, if the third letter is I:
- a. The device will pace regardless of what is sensed
- b. If the device senses intrinsic activity on the leads indicated by the first letter, it will not fire
- c. If the device senses intrinsic activity on the leads indicated by the second letter, it will not fire
- d. The device will inversely pace the ventricle and the atria
Correct

Incorrect
Question 17 of 20

17. Question
Which of the following is true regarding the placement of CRT leads?
- a. RA lead should be placed at the level of the tricuspid annulus
- b. RA lead should ideally be placed in the appendage
- c. A coronary sinus lead should be placed every time, if possible
- d. If needed for resynchronization therapy, an additional RV lead can be placed transvenously in the coronary sinus
Correct

Incorrect
Question 18 of 20

18. Question
The most common long term complication of permanent pacemakers is:
- a. Infection with a rate of 10-20%
- b. Infection with a rate of about 3%
- c. Lead fibrosis
- d. Venous thrombosis
Correct

Incorrect
Question 19 of 20

19. Question
Current class I recommendations for AICD implant are:
- a. EF < 35% (nonischemic or at least 40 days post-MI), with NYHA Class II or III CHF; EF < = 30% if Class I CHF)
- b. Non-sustained VT after an MI if EF > 50%
- c. Survivors of VF or hemodynamically unstable sustained VT in the presence of identifiable and treatable causes
- d. Routinely after cardiac transplantation
Correct

Incorrect
Question 20 of 20

20. Question
The proper placement of a RV transvenous lead:
- a. Is irrelevant as long as sensing and capture are adequate
- b. Is in the RV free wall if the lead has a passive fixation
- c. Should be in the RVOT to avoid interference with the conduction system
- d. Should aim for a septal insertion
Correct

Incorrect

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