CVP Pharmacology and Blood Management 2 — Questions and Answers
Question 1: What is cell salvage (cell saver) during cardiac surgery?
- A device that collects, washes, and concentrates shed red blood cells for reinfusion (Correct answer)
- A method to freeze blood for future use
- A technique to count blood cells
- A way to test blood compatibility
Correct answer: A device that collects, washes, and concentrates shed red blood cells for reinfusion
Cell salvage collects blood lost during surgery, washes it to remove debris and contaminants, concentrates the red blood cells, and returns them to the patient.
Question 2: What is the risk of protamine administration?
- Allergic reactions including anaphylaxis, hypotension, and pulmonary hypertension (Correct answer)
- No significant risks
- Only nausea
- Excessive clotting
Correct answer: Allergic reactions including anaphylaxis, hypotension, and pulmonary hypertension
Protamine can cause serious adverse reactions including anaphylaxis, hypotension, and pulmonary vasoconstriction, particularly in patients with certain risk factors.
Question 3: What is the significance of platelet dysfunction after cardiopulmonary bypass?
- Bypass causes platelet activation and damage leading to impaired function and increased bleeding risk (Correct answer)
- Platelets function better after bypass
- Platelet dysfunction only occurs in elderly patients
- It has no clinical significance
Correct answer: Bypass causes platelet activation and damage leading to impaired function and increased bleeding risk
Contact with the bypass circuit activates and damages platelets, leading to functional impairment even when platelet counts are adequate, contributing to post-bypass bleeding.
Question 4: What is the role of calcium chloride after bypass?
- To improve cardiac contractility and correct hypocalcemia from citrated blood products (Correct answer)
- To prevent infection
- To thin the blood
- To reduce pain
Correct answer: To improve cardiac contractility and correct hypocalcemia from citrated blood products
Calcium chloride is given after bypass to improve cardiac muscle contraction and correct low calcium levels that result from citrate in blood products binding calcium.
Question 5: What is heparin resistance and how is it managed?
- A reduced response to heparin requiring higher doses or antithrombin III supplementation (Correct answer)
- An allergy to heparin
- Heparin never fails to work
- A condition where heparin works too well
Correct answer: A reduced response to heparin requiring higher doses or antithrombin III supplementation
Heparin resistance occurs when standard doses fail to achieve adequate ACT levels, often due to low antithrombin III levels, and is managed with additional heparin or AT III concentrate.
Question 6: What blood products may be needed after cardiac surgery?
- Packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate depending on specific deficiencies (Correct answer)
- Only whole blood
- No blood products are ever needed
- Only saline solutions
Correct answer: Packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate depending on specific deficiencies
Different blood products address specific deficiencies: PRBCs for anemia, platelets for thrombocytopenia, FFP for clotting factor deficiency, and cryoprecipitate for fibrinogen deficiency.
CVP Pharmacology and Blood Management 2
What is cell salvage (cell saver) during cardiac surgery?