CCP Cardiopulmonary Physiology & Pathophysiology 3

Question 1

Which statement best describes the Frank-Starling mechanism as it applies to perfusion management?

Accepted Answer

Stroke volume increases with preload up to a point, then plateaus or declines in a failing heart

Answer

The Frank-Starling mechanism states that stroke volume increases with preload within physiologic limits, but a failing ventricle may not augment output with further volume loading.

Question 2

A patient on bypass develops a sudden decrease in mixed venous oxygen saturation (SvO2). Which is the LEAST likely cause?

Accepted Answer

Increased arterial oxygen content from higher FiO2

Answer

Increased arterial oxygen content (from higher FiO2) would improve SvO2, not decrease it; the other options all reduce oxygen delivery or increase consumption.

Question 3

What is the clinical importance of V/Q mismatch in patients with chronic obstructive pulmonary disease undergoing cardiac surgery?

Accepted Answer

Areas of low V/Q act as shunt, increasing PaCO2 and decreasing PaO2

Answer

Low V/Q regions in COPD act like shunt units, allowing deoxygenated blood to pass without gas exchange, raising PaCO2 and lowering PaO2.

Question 4

During hypothermic bypass at 28°C, a perfusionist checks blood gases using the alpha-stat strategy. What is the primary goal of this approach?

Accepted Answer

Maintain pH at 7.40 and PaCO2 at 40 mmHg when measured at 37°C regardless of patient temperature

Answer

Alpha-stat management maintains pH 7.40 and PaCO2 40 mmHg when measured at 37°C (in vitro), allowing physiologic changes to occur naturally with hypothermia.

Question 5

Which cardiac lesion creates the greatest risk of paradoxical embolism during cardiac surgery?

Accepted Answer

Patent foramen ovale allowing right-to-left shunting

Answer

A patent foramen ovale allows venous emboli (air or thrombus) to cross from the right to left atrium and enter the systemic circulation.

(CCP) Certified Clinical Perfusionist Practice Test

(CCP) Certified Clinical Perfusionist Practice Test

CCP Cardiopulmonary Physiology & Pathophysiology 3