CVP Coagulation and Anticoagulation Management 3

Question 1

Post-CPB coagulopathy is most commonly caused by:

Accepted Answer

Dilutional coagulopathy combined with platelet dysfunction

Answer

Post-CPB coagulopathy is predominantly caused by hemodilution of coagulation factors and platelets combined with acquired platelet dysfunction from contact with CPB circuit surfaces and hypothermia.

Question 2

Desmopressin (DDAVP) is indicated in cardiac surgery primarily to treat bleeding associated with:

Accepted Answer

Acquired platelet dysfunction including uremic and aspirin-related defects

Answer

DDAVP stimulates endothelial release of stored von Willebrand factor, enhancing platelet adhesion and aggregation, making it effective for uremic platelet dysfunction and aspirin-induced platelet defects.

Question 3

"Heparin rebound" occurring hours after successful protamine reversal is caused by:

Accepted Answer

Release of tissue-sequestered heparin after protamine is metabolized

Answer

Heparin rebound occurs when heparin sequestered in tissues or bound to plasma proteins is released into circulation after protamine has been eliminated, causing renewed anticoagulation.

Question 4

Cell salvage (autotransfusion) during cardiac surgery is contraindicated in which of the following situations?

Accepted Answer

Active bacterial endocarditis with bacteremic surgical field

Answer

Cell salvage is contraindicated when the surgical field is contaminated with bacteria or malignant cells, as reinfusing this blood can cause bacteremia, sepsis, or tumor dissemination.

Question 5

The most common cause of platelet dysfunction during cardiopulmonary bypass is:

Accepted Answer

Contact activation of platelets by the CPB circuit surfaces

Answer

Contact between platelets and the foreign surfaces of the CPB circuit causes activation, degranulation, and receptor downregulation, resulting in acquired platelet dysfunction that persists after bypass.

(CVP) Cardiovascular Perfusionist Practice Test

(CVP) Cardiovascular Perfusionist Practice Test

CVP Coagulation and Anticoagulation Management 3