Hemostasis & Suture Techniques Flashcards
7 cards from real CFA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Hemostasis & Suture Techniques flashcards as text
A patient on therapeutic anticoagulation with warfarin has an elevated INR of 3.8 preoperatively. The surgeon orders fresh frozen plasma (FFP). FFP corrects coagulopathy by:
Answer: Supplying all clotting factors consumed by warfarin inhibition
FFP contains all coagulation factors (II, VII, IX, X, and others) that warfarin inhibits, temporarily restoring hemostatic capability before surgery.
Which knot configuration is considered the MOST secure for tying polypropylene (Prolene) suture?
Answer: Surgeon's knot followed by two square throws (2-1-1)
Polypropylene is slippery and requires a surgeon's knot (double first throw) plus at least two additional square throws to prevent knot slippage.
Oxidized regenerated cellulose (Surgicel) should NOT be used in close proximity to neural tissue because:
Answer: Its low pH upon absorbing blood can cause tissue necrosis and nerve damage
Oxidized cellulose creates an acidic environment (pH ~2-3) as it breaks down, which can be neurotoxic and damage adjacent neural structures.
During subcuticular skin closure, the first assistant's primary task is to:
Answer: Keep the skin edges everted and approximated as the surgeon advances the suture
The first assistant uses skin hooks or fingers to maintain eversion and apposition of wound edges so the surgeon can place each intradermal bite precisely.
What advantage does a running locking suture have over a simple running suture for fascial closure?
Answer: Each loop locks individually, preventing tissue bunching and distributing tension more evenly
The locking loop of a running locking suture prevents the suture from sliding and allows each throw to bear tension independently, reducing tissue puckering.
When using a vessel loop for temporary vascular control, the first assistant should:
Answer: Apply gentle, sustained tension sufficient to occlude flow without traumatizing the vessel wall
The vessel loop is held with gentle, controlled tension that collapses the lumen to stop flow while avoiding intimal injury from excessive stretch or crushing.
Which hemostatic technique is most appropriate for controlling a small arterial bleeder identified deep in a narrow operative field where direct clamping is not feasible?
Answer: Using a long-tipped monopolar cautery probe for precise point coagulation
A long-tipped monopolar cautery probe allows the surgeon to reach deep, narrow operative fields and coagulate a small arterial bleeder with precision when clamps cannot access the site.