CVP Coagulation and Anticoagulation Management 2

Question 1

Which antifibrinolytic agent acts as a broad serine protease inhibitor, directly inhibiting plasmin, kallikrein, and thrombin?

Accepted Answer

Aprotinin

Answer

Aprotinin is a naturally derived serine protease inhibitor that directly inhibits plasmin, kallikrein, and thrombin, providing broad antifibrinolytic and anti-inflammatory effects during CPB.

Question 2

On a TEG (thromboelastography) tracing, the Maximum Amplitude (MA) primarily reflects:

Accepted Answer

Platelet function and platelet-fibrin clot strength

Answer

MA represents the maximum clot strength on TEG and is primarily determined by platelet function (~80%) and fibrin cross-linking (~20%), reflecting overall clot integrity.

Question 3

A post-CPB patient has persistent microvascular bleeding with markedly reduced fibrinogen on ROTEM. The most appropriate blood product is:

Accepted Answer

Cryoprecipitate

Answer

Cryoprecipitate contains the highest concentration of fibrinogen, Factor VIII, vWF, and Factor XIII per unit volume, making it the preferred treatment for hypofibrinogenemia-related coagulopathy.

Question 4

Tranexamic acid reduces surgical blood loss primarily by:

Accepted Answer

Competitively blocking lysine-binding sites on plasminogen

Answer

Tranexamic acid is a synthetic lysine analogue that blocks the lysine-binding sites on plasminogen, preventing its binding to fibrin and subsequent activation to plasmin, thereby inhibiting fibrinolysis.

Question 5

Which coagulation factor is most significantly reduced by hemodilution and consumption during cardiopulmonary bypass?

Accepted Answer

Factor I (Fibrinogen)

Answer

Fibrinogen (Factor I) is the most significantly reduced coagulation protein during CPB due to hemodilution, consumption by the coagulation cascade, and fibrinolysis.

(CVP) Cardiovascular Perfusionist Practice Test

(CVP) Cardiovascular Perfusionist Practice Test

CVP Coagulation and Anticoagulation Management 2