CCS Hemostasis and Coagulation Management 2

Question 1

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

Accepted Answer

Platelet transfusion

Answer

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

Question 2

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

Accepted Answer

Factor VIII and fibrinogen

Answer

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

Question 3

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

Accepted Answer

100,000/µL

Answer

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

Question 4

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

Accepted Answer

Tranexamic acid

Answer

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

Question 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?

Accepted Answer

Administer platelet transfusion

Answer

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

CCS - Certified Cardiac Surgeon Practice Test

CCS - Certified Cardiac Surgeon Practice Test

CCS Hemostasis and Coagulation Management 2