Free Cardiac Surgery Trivia Questions and Answers

Question 1

Which of the following ailments increases the likelihood that patients will experience a postoperative embolic stroke?

Accepted Answer

Ascending aortic manipulation

Answer

A primary risk factor for developing intraoperative or postoperative (most common) embolic strokes is manipulation of the ascending aorta. Atrial fibrillation (Afib) is another condition that frequently precedes strokes, especially if it lasts for a long time (48 hours). Heparin usage requires caution because 30% of infarcts have a chance of turning hemorrhagic. Several infarcts of various sizes could develop after cardiac surgery. The initial computed tomography (CT) scan may not be diagnostic, thus subsequent scans may be required. The most sensitive diagnostic is diffusion-weighted magnetic resonance imaging, but it may not be available and could reveal infarcts that weren't known to exist before surgery.

Question 2

The most common causes of acute renal failure and the need for renal replacement therapy include

Accepted Answer

Fluid overload, metabolic acidosis, and hyperkalemia

Answer

Indications for renal replacement therapy (RRT) include metabolic acidosis, fluid overload, and hyperkalemia. Increased disorientation, pericarditis, or gastrointestinal bleeding are some further warning signs. Increased oliguria and serum creatinine necessitate further analysis and could initiate RRT to stop further kidney damage. For patients needing RRT following heart surgery, intermittent hemodialysis (given over 3–4 hours three times a week) and continuous venovenous hemofiltration are frequently employed. Slow continuous ultrafiltration, continuous venovenous hemofiltration, and continuous venovenous hemodiafiltration are all examples of continuous venovenous systems.

Question 3

Chest tubes are inserted into the mediastinum and right pleural cavity of a patient recovering after mitral valve replacement and cardiopulmonary bypass, with suction adjusted at -20 cm H2O. 120 mL of bloody discharge was produced in the first four hours; however, when the patient is shifted to the side, 70 mL of dark red blood instantly drains out the chest tube, followed by a slowing of the flow. Currently, hemodynamic condition is stable. The most probable reason for the elevated discharge is

Accepted Answer

Pooling of blood

Answer

The pooling of blood may produce higher outflow from the chest tube when the patient is moved. Bright crimson blood and a steady stream of discharge are signs of acute onset bleeding. In particular, if discharge slows down after first speeding up, dark red blood signifies older blood rather than recent bleeding. No more than 200 mL in 2–6 hours of chest tube drainage should be used. A transesophageal echocardiography may be necessary if there is a suspicion of cardiac tamponade in addition to coagulation testing, repeat chest x-rays to measure the width of the mediastinum, and excessive bleeding.

Question 4

Systolic blood pressure that is higher than average is a sign of abnormal pulsus paradoxus.

Accepted Answer

More than 10 mm Hg lower during inhalation than exhalation

Answer

Systolic blood pressure that is noticeably lower during intake than expiration is known as pulsus paradoxus. A pulsus paradoxus with a difference of more than 10 mm Hg is regarded as abnormal and is frequently a symptom of cardiac tamponade. It is normal to experience a drop in blood pressure of 10 mm Hg or less during inspiration, but a larger pressure difference could be a sign of various cardiopulmonary complications, such as pericardial effusion, pericarditis, pulmonary embolism, cardiogenic shock, chronic obstructive pulmonary disease, asthma, and obstruction of the superior vena cava. If pulsus paradoxus is discovered, blood pressure data should be reassessed to guarantee accuracy.

Question 5

Which of the following criteria is true when weaning patients off of artificial ventilation during the early postoperative period?

Accepted Answer

Chest tube drainage of 40 mL/hr

Answer

The criteria ( 50 mL/hr) for weaning from ventilation in the initial postoperative period are met by chest tube drainage of 40 mL/hr. Awakens without stimulation and a sufficient reversal of neuromuscular inhibition are further requirements. The ideal core temperature is greater than 35.5°C. With a cardiac index of over 2.2 L/min/m2, a systolic blood pressure of 100–140 mm Hg, a heart rate of less than 120 bpm, and no arrhythmias, hemodynamic status should be stable. The pH of the blood should be between 7.30 and 7.50, the partial pressure of carbon dioxide should be under 50 torr, the partial pressure of oxygen in the arterial blood should be over 75 torr, and the fraction of inspired oxygen (FiO2) should be at or above 0.5.

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Practice Test

Free Cardiac Surgery Trivia Questions and Answers