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Hemostasis and Coagulation Management Flashcards

7 cards from real CCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Which blood product is most appropriate to correct dilutional thrombocytopenia causing microvascular bleeding after cardiopulmonary bypass?

    Answer: Platelet transfusion

    Platelet transfusion addresses thrombocytopenia and platelet dysfunction that commonly occur after CPB due to hemodilution and platelet activation by the bypass circuit.

  2. Cryoprecipitate is the preferred product for replacing which coagulation factor in a cardiac surgery patient with significant bleeding?

    Answer: Factor VIII and fibrinogen

    Cryoprecipitate is rich in fibrinogen (factor I), factor VIII, vWF, and factor XIII, making it the preferred product when fibrinogen replacement is specifically needed.

  3. What minimum platelet count is generally recommended before performing cardiac surgery to reduce perioperative bleeding risk?

    Answer: 100,000/µL

    A platelet count of at least 100,000/µL is generally recommended before cardiac surgery to minimize bleeding risk during and after the procedure.

  4. Which antifibrinolytic agent is most commonly used in cardiac surgery to reduce perioperative blood loss?

    Answer: Tranexamic acid

    Tranexamic acid is the most widely used antifibrinolytic in cardiac surgery; it inhibits plasminogen activation and reduces fibrinolysis, thereby decreasing perioperative blood loss.

  5. A patient develops excessive bleeding after protamine reversal of heparin following CPB, with a normal ACT. Thromboelastography shows decreased clot amplitude. Which intervention is most appropriate?

    Answer: Administer platelet transfusion

    Decreased clot amplitude on TEG indicates platelet dysfunction or thrombocytopenia; platelet transfusion addresses this defect in platelet-mediated clot strength.

  6. Which laboratory finding is most consistent with disseminated intravascular coagulation (DIC) in a post-cardiac surgery patient?

    Answer: Low fibrinogen, prolonged PT/aPTT, elevated D-dimer, thrombocytopenia

    DIC is characterized by simultaneous clotting and fibrinolysis, resulting in low fibrinogen (consumed), prolonged PT/aPTT, elevated D-dimer (fibrin degradation), and thrombocytopenia.

  7. Desmopressin (DDAVP) is used perioperatively in cardiac surgery primarily to treat bleeding associated with which condition?

    Answer: Platelet dysfunction due to aspirin or uremia

    DDAVP releases stored vWF and factor VIII from endothelial cells, improving platelet adhesion in patients with aspirin-induced or uremia-induced platelet dysfunction.