CVP Coagulation and Anticoagulation Management

Question 1

What is the minimum Activated Clotting Time (ACT) required before initiating cardiopulmonary bypass?

Accepted Answer

400 seconds

Answer

200 seconds

Answer

300 seconds

Answer

480 seconds

Question 2

What is the standard initial heparin dose administered before cardiopulmonary bypass?

Accepted Answer

300 units/kg

Answer

100 units/kg

Answer

200 units/kg

Answer

400 units/kg

Question 3

Heparin exerts its anticoagulant effect primarily by potentiating which plasma protein?

Accepted Answer

Antithrombin III

Answer

Protein C

Answer

Alpha-2 macroglobulin

Answer

Thrombomodulin

Question 4

What is the standard protamine-to-heparin ratio used to reverse anticoagulation after CPB?

Accepted Answer

1 mg protamine per 100 units heparin

Answer

0.5 mg protamine per 100 units heparin

Answer

2 mg protamine per 100 units heparin

Answer

3 mg protamine per 100 units heparin

Question 5

A patient requires escalating heparin doses to achieve a target ACT before CPB. The most likely cause of heparin resistance is:

Accepted Answer

Antithrombin III deficiency

Answer

Protein C deficiency

Answer

Factor V Leiden mutation

Answer

Von Willebrand disease

Question 6

Which point-of-care test is the standard method for monitoring 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-induced thrombocytopenia type II (HIT II) is caused by:

Accepted Answer

IgG antibodies against heparin-platelet factor 4 (PF4) complexes

Answer

Direct heparin cytotoxicity to megakaryocytes

Answer

Complement activation causing platelet lysis

Answer

Direct inhibition of thrombopoietin by heparin