MAC Fluid Management & Blood Products 2

Question 1

On thromboelastography (TEG), a prolonged R-time (reaction time) beyond the normal reference range indicates:

Accepted Answer

Clotting factor deficiency requiring FFP

Answer

Fibrinolysis

Answer

Fibrinogen deficiency

Answer

Platelet dysfunction

Question 2

Intraoperative cell salvage (autotransfusion) is CONTRAINDICATED in which of the following clinical situations?

Accepted Answer

Active bacterial contamination of the operative field

Answer

Total hip arthroplasty

Answer

Hepatic resection for benign liver disease

Answer

Ruptured abdominal aortic aneurysm repair

Question 3

A patient who has received 10 units of pRBCs develops continued surgical bleeding with PT/aPTT > 1.5 times normal and platelet count of 85,000/μL. The most appropriate first-line treatment is:

Accepted Answer

Fresh frozen plasma (FFP) 10-15 mL/kg

Answer

Protamine sulfate 50 mg IV

Answer

Platelet transfusion 1 apheresis unit

Answer

Recombinant activated Factor VIIa (rFVIIa)

Question 4

According to recent FDA hemovigilance reports, which is the LEADING cause of transfusion-related fatality in the United States?

Accepted Answer

TACO (transfusion-associated circulatory overload)

Answer

ABO incompatibility hemolytic reactions

Answer

TRALI (transfusion-related acute lung injury)

Answer

Bacterial sepsis from platelet transfusion

Question 5

The minimum acceptable platelet count recommended before performing neuraxial anesthesia (spinal or epidural) in a non-emergent elective setting is:

Accepted Answer

80,000/μL

Answer

20,000/μL

Answer

50,000/μL

Answer

150,000/μL

Question 6

The most serious cardiovascular adverse reaction to rapid protamine sulfate administration following cardiopulmonary bypass is:

Accepted Answer

Severe systemic hypotension and acute pulmonary hypertension

Answer

Hyperkalemia and complete heart block

Answer

Hypoglycemia and seizures

Answer

Methemoglobinemia and cyanosis

Question 7

In a patient with chronic renal failure undergoing cardiac surgery, which blood product poses the greatest risk of causing life-threatening hyperkalemia?

Accepted Answer

Stored packed red blood cells (> 14 days old)

Answer

Freshly collected packed red blood cells (< 5 days old)

Answer

Fresh frozen plasma

Answer

Leukoreduced apheresis platelets