Cardiopulmonary Bypass Quiz Questions

1. Which of the following best explains why cardioplegic solution helps maintain myocardial tissue viability?

a. It provides glucose for oxidative metabolism.b. It helps preserve ATP stores and decreases intramyocardial acidosis.c. It provides potassium for myocardial muscle contraction.d. It bathes the myocardial tissue in vital nutrients.e. It helps block Na/K pumps thus allowing decreased ATP use.

2. The primary objectives of cardiopulmonary bypass (CPB) are to provide adequate ventilation as well as maintain circulation and perfusion, and temperature regulation.

a. Trueb. False

3. Which of the following is NOT a primary responsibility of the perfusionist during

CPB?a. ensure circuit tubing is free of air prior to going on CPBb. ensure tubing is connected to pumps to avoid venous air-lockc. ensure correlation between aortic and radial arterial pressuresd. maintain adequate level of anesthesia with narcotic administratione. maintain adequate level of anesthesia with potent inhaled anesthetics

4. Which of the following is a primary concern for the anesthesiologist during CPB when cardioplegic solution is administered by the perfusionist?

a. It may cause critically elevated blood glucoseb. It may cause fluid overloading which can manifest as pulmonary edema

later.c. It may cause ischemia and dysrthymias because it’s cold and has low O2

content.d. It may dilute coagulation factor concentrations to critically low levels.e. It may cause neuronal damage.

5. Which of the following is the correct mechanism of action of cardioplegic solution on the myocardium?

a. It provides excess potassium ions which abolish transmembrane gradient and inhibit repolarization.

b. It provides a source of potassium ions for the heart to maintain Na/K pump function.c. It inhibits cellular uptake of glucose and potassium ions.d. It reversibly binds to transmembrane cellular proteins thus inhibiting them.e. It stops the formation of ATP.

6. How is unexpected electrical activity of the heart dealt with during complete CPB?

a. Excess blood is squeezed out of the heart by hand.b. The surgeon asks the anesthesiologist to administer additional muscle

relaxant.c. The surgeon asks the perfusionist to administer additional cardioplegic

solution.d. The heart is shocked at 200 J.e. The surgeon repositions the retrograde arterial cannula.

7. Which of the following urine output values indicates potentially poor renal perfusion?

a. Less than 13 ml/kg/hrb. Less than 10 ml/kg/hrc. Less than 5 ml/kg/hrd. Less than 4 ml/kg/hre. Less than 1 ml/kg/hr

8. At what point during CPB is it appropriate to turn off ventilation of the lungs?a. After cardioplegic solution is begun by the perfusionist b. Following clamping of the aorta c. Following insertion of the SVC cannula.d. Following adminstration of heparin.e. After the aminocaproic acid infusion finishes.

9. During myocardial fibrillation energy stores are used more quickly than if the heart was in sinus rhythm.

a. Trueb. False

10. Which of the following best explains the importance of retrograde cardioplegia?a. It allows perfusion of the entire heart.b. It helps stop the heart from beating by delivering cardioplegic solution

backwards through the coronary arteries.c. It helps protect the heart from ischemia by preserving ATPd. It helps the surgeon by washing out blood which accumulates in the

ventricles thus clearing the surgical field.e. None of the above.

Answers: 1B, 2True, 3D, 4C, 5A, 6C, 7E, 8B, 9True, 10B