CCS Hemostasis and Coagulation Management

Question 1

What is the target activated clotting time (ACT) required before initiating cardiopulmonary bypass (CPB)?

Accepted Answer

Greater than 480 seconds

Answer

Greater than 300 seconds

Answer

Greater than 200 seconds

Answer

Greater than 150 seconds

Question 2

Which anticoagulant is the standard of care for anticoagulation during cardiopulmonary bypass?

Accepted Answer

Heparin

Answer

Warfarin

Answer

Bivalirudin

Answer

Fondaparinux

Question 3

What is the standard initial heparin dose given before cardiopulmonary bypass in cardiac surgery?

Accepted Answer

300 units/kg

Answer

100 units/kg

Answer

500 units/kg

Answer

50 units/kg

Question 4

Which drug is used to reverse heparin anticoagulation at the conclusion of cardiopulmonary bypass?

Accepted Answer

Protamine sulfate

Answer

Vitamin K

Answer

Fresh frozen plasma

Answer

Tranexamic acid

Question 5

A patient on chronic warfarin therapy requires emergent cardiac surgery. What is the most appropriate immediate intervention to reverse anticoagulation?

Accepted Answer

Give 4-factor prothrombin complex concentrate (4F-PCC)

Answer

Administer protamine sulfate

Answer

Transfuse packed red blood cells

Answer

Administer vitamin K alone

Question 6

Which coagulation test best monitors heparin anticoagulation during cardiopulmonary bypass?

Accepted Answer

Activated clotting time (ACT)

Answer

Prothrombin time (PT)

Answer

Activated partial thromboplastin time (aPTT)

Answer

Thromboelastography (TEG)

Question 7

Heparin resistance during cardiac surgery is most commonly associated with which condition?

Accepted Answer

Antithrombin III deficiency

Answer

Factor V Leiden mutation

Answer

Protein C deficiency

Answer

Von Willebrand disease