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

The TEG R-time represents the latency period for initial clot formation driven by enzymatic coagulation factors; a prolonged R-time indicates factor deficiency and is treated with fresh frozen plasma.

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

Cell salvage is contraindicated with bacterial contamination (e.g., bowel spillage) because reinfusing contaminated blood risks sepsis, and it is relatively contraindicated in malignancy due to potential cancer cell reinfusion.

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

Massively transfused patients develop dilutional coagulopathy with factor depletion reflected by prolonged PT/aPTT; FFP at 10-15 mL/kg provides multiple clotting factors and is the first-line treatment for this pattern.

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

Since approximately 2016, TACO has surpassed TRALI as the leading reported cause of transfusion-related mortality in the US, partly due to improved TRALI mitigation through male-predominant plasma donation strategies.

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

Most major anesthesiology societies recommend a minimum platelet count of 80,000/μL for elective neuraxial procedures to reduce the risk of epidural hematoma, although thresholds can be individualized.

MAC - Maintaining Anesthesia Certification Practice Test

MAC - Maintaining Anesthesia Certification Practice Test

MAC Fluid Management & Blood Products 2