ABCP REVIEW EXAM QUESTIONS & ANSWER CORRECT 100%

Which of the following is not true regarding peak aortic blood flow acceleration? a) it is significant primarily in patients with aortic stenosis b) it is a sensitive indicator of changing contractility state and secondary to hypoxia c) it is highly sensitive to inotropic changes d) it is minimally affected by preload changes e) 2 of the above - Answer it is significant primarily in patients with aortic stenosis In doppler assessment of aortic valve gradient: a) the degree of stenosis is better indicated by the peak gradient than the mean gradient as it is less flow dependent b) patients with coexisting aortic insufficiency may have higher gradients for the same degree of stenosis than patients with pure aortic stenosis c) the result is not very accurate as it cannot be directly measured and must be calculated using a simplified bernoulli equation d) 2 of the above e) all of the above - Answer patients with coexisting aortic insufficiency may have higher gradients for the same degree of stenosis than patients with pure aortic stenosis Which of the following statements is false regarding echocardiography? a) surface echo is an excellent method of detecting the amount of normal ventricle remaining in a patient with a left ventricular aneurysm b) TEE is a much more accurate method of evaluating a descending thoracic aneurysm than is surface echo c) As 70% of ascending dissections arise in the proximal area, surface echo is a good diagnostic tool for these cases d) echocardiography is of little value in diagnosing sinus of valsalva aneurysms as the view of this anatomy is obscured by the aortic valve apparatus e) all of the above - Answer echocardiography is of little value in diagnosing sinus of valsalva aneurysms as the view of this anatomy is obscured by the aortic valve apparatus Which of the following statement is/are true regarding transesophageal echocardiography? a) TEE is more sensitive to evaluation of mitral regurgitation than surface echo b) TEE is not accurate method of calculating the aortic valve area c) TEE is superior in evaluating intracardiac tumors d) Left atrial thrombus is often poorly visualized with TEE e) 2 of the above - Answer 2 of the above The use of 2D echo in teh assessment of coronary artery disease: a) is restricted to the evaluation of left ventricular function b) may approximate the location of coronary obstruction c) is limited by the inability to detect the difference between ischemia and infarction d) while providing good prognostic indicators is of little use in diagnosing patient with stress induced abnormalities e) 2 of the above - Answer may approximate the location of coronary obstruction Assessment of the degree of aortic insufficiency may include all but which of the following? a) mapping turbulence patterns in the left ventricle b) measurement of cross sectional area of the regurgitant jet at its most proximal point c) measurement of the rate of equilibrium of the aortic and left ventricular pressure during diastole d) examining the abdominal aorta for holodiastolic reversal e) all of the above may be used to evaluate aortic insufficiency - Answer all of the above may be used to evaluate aortic insufficiency A paradoxical split S2: a) may indicate left ventricular failure b) occurs normally with deep inspiration c) is usually a result of pulmonary hypertension d) occurs secondary to functional mitral annular dilation e) 2 of the above - Answer may indicate left ventricular failure A mild systolic crescendo- decrescendo murmurs radiating to the carotid arteries is indicative of: a) ventricular septal defect b) mitral regurgitation c) mitral stenosis d) aortic insufficiency e) aortic stenosis - Answer aortic stenosis A mitral stenosis patient: a) has systolic ejection murmurs b) has atrial systolic ejection intensification of the murmurs c) has a muffled s1 d) has a lenghtened s2 -OS interval e) 2 of the above - Answer has atrial systolic ejection intensification murmurs A split heart sound: a) indicated right ventricular distension usually RV failure b) Is normal, occurring because right ventricular emptying takes longer than left ventricular emptying c) indicated left ventricular volume distension such as that resulting from aortic insufficiency d) is usually magnified by respiration e) 2 of the above - Answer 2 of the above Which of the following can cause an increase in myocardial oxygen consumption with a normal heart: a) calcium ions b) digitalis c) epinephrine d) all of the above - Answer all of the above Which of the following conditions results in a dilated and depressed myocardium and an A-V block of electrical impulse: a) hypernatremia b) hyperkalemia c) hypokalemia d) none of the above - Answer hyperkalemia What percentage of the total blood volume is contained in the pulmonary circulation? a) 0.1 b) 0.65 c) 0.3 d) 0.45 - Answer 0.1 Systemic vascular resistance is approximately _________ time higher than pulmonary vascular resistance. a) 2 to 3 b) 6 to 7 c) 10 to 15 d) 20 to 30 - Answer 6 to 7 _________ Law states that the resistance of blood flow in a vessel is directly proportional to the blood viscosity and length of the vessel, but it is inversely proportional to the fourth power of the radius. a) Starling's b) Laplace's c) Poiseullie's d) Reynold's - Answer Poiseullie's Which if the following is/ are normal responses to hypokalemia? a) prolonged P-R interval b) flat or inverted t wave c) alkalosis d) b and c - Answer b and c Molecules with a molecular mass below 10,000 Daltons gave a sieving coefficient of ______? a) 0 b) 1 c) 2 d) 3 - Answer 1 Which of the following molecules would be removed during ultrafiltration? a) glucose b) potassium c) fibrinogen d) and b - Answer a and b Which of the following can cause orthostatic hypotension? a) dantrolene sodium b) prazosin c) ketamine d) pancuronium - Answer prazosin Which of the following are considered as cannulation sites for liver transport? a) portal vein b) axillary vein c) femoral d) all of the above - Answer all of the above In which of the following conditions may there be a presence of a U wave? a) cardiomyopathy b) decreased serum calcium c) decreased potassium d) all of the above - Answer all of the above Which of the following is the half dose hammersmith for aprotinin that is recommended for pump prime? a) 250,000 kiu b) 500,000 kiu c) 1,000,000 kiu d) 2,000,000 kiu - Answer 1,000,000 kiu Which of the following is not considered a diuretic? a) diamox b) edecrin c) lasix d) trimethaphan - Answer trimethaphan Which of the following potentiates the toxic effects of digitalis? a) sodium b) calcium c) magnesium d) none of the above - Answer calcium Which of the following beta antagonists is/are primarily metabolized in the kidney? a) atenolol b) metoprolol c) acetbutolol d) b and c - Answer atenolol Which of the following beta antagonist has the shortest half life? a) pindolol b) esmolol c) propranolol d) a and c have the same short half life - Answer esmolol Which of the following terms refer to cardiac conduction velocity? a) dromotropism b) inotropism c) chronotropism d) b and c - Answer dromotropism Which of the following calcium channel blockers is the most potent causing the greatest amount of coronary and systemic vasodilation? a) verampil b) dilitiazem c) nifedipine d) lidoflazine - Answer nifedipine Which of the following is/ are treatments of cyanide toxicity due to high dose administration of sodium nitroprusside? a) administration of amyl nitrate b) infusion of sodium nitrite c) sodium thiosulfate d) all of the above - Answer all of the above What is the half- life of aprotinin? a) 2 hours b) 3 to 4 hours c) 4 to 6 hours d) greater than 6 hours - Answer 2 hours A rise in RA sats by 8 - 10% would indicate: a) left to right shunt at the atria level b) left to right shunt at the PA level c) right to left shunt d) poor ventilation - Answer left to right shunt at the atria level The impedance of blood flow through a vascular bed is: a) cyanosis b) resistance c) fick principle d) heart failure - Answer resistance The Fick princple states the rate of diffusion of a gas is proportional to the partial pressure gradient of the gas in the direction of diffusion. a) true b) false - Answer true Central cyanosis is described as a normal O2 saturation measurement in the central aorta with blood becoming sluggish in the distal capillary beds, usually in the extremities. a) true b) false - Answer false Which of the following are commonly cyanotic lesions? a) right to left shunts, ASD, and PDA b) right to left shunts and ASD c) right to left shunts and pulmonary stenosis d) pulmonary stenosis, ASD, and PDA - Answer right to left shunts and pulmonary stenosis Which of the following are commonly acyanotic lesions? a) pulmonary stenosis, ASD, and PDA b) right to left shunt and pulmonary stenosis c) left to right shunts, ASD and PDA d) right to left shunts and pulmonary stenosis - Answer left to right shunts, ASD, and PDA AV canal defect is most commonly associated with which syndrome? a) Trisomy 13 b) Trisomy 21 c) Turner's Syndrome d) Noonan's Syndrome e) Marfan's Syndrome - Answer Trisomy 21 Aortic Aneurysms are most commonly associated with which syndrome ? a) Trisomy 13 b) Trisomy 21 c) Turner's Syndrome d) Noonan's Syndrome e) Marfarn's Syndrome - Answer Marfan's Syndrome Balloon atrial septostomy best describes this palliative/ corrective procedure? a) Blalock Hanlon b) Waterson shunt c) Potts d) Hemifontan - Answer Blalock Hanlon Descending aorta to left pulmonary best describes this palliative/ corrective surgical procedure? a) Blalock Hanlon b) Waterson shunt c) Potts d) Hemifontan - Answer Potts Ascending aorta to right pulmonary artery best describes this palliative/ corrective surgical procedure? a) Blalock Hanlon b) Waterson shunt c) Potts d) Hemifontan - Answer Potts SCV ligation and direct anastomosis to RPA best describes this palliative/ corrective surgical procedure? a) Waterson shunt b) Hemifontan c) Glenn shunt d) Rastelii - Answer Glenn Shunt Right ventricle to pulmonary artery best describes this palliative/ corrective surgical procedure? a) glenn shunt b) rastelli c) blalock taussing shunt d) blalock hanlon - Answer rastelli Right subclavian to pulmonary artery best describes this palliative/ corrective surgical procedure? a) blalock taussing shunt b) blalock hanlon c) glenn shunt d) hemifontan - Answer blalock taussing shunt SVC to right pulmonary artery best describes this palliative/ corrective surgical procedure? a) hemifontan b) blalock taussing shunt c) blalock hanlon d) glenn shunt - Answer hemifontan Which of the following is not a calcium channel blocker? a) diltiazem b) felodipine c) verapamil d) nifedipine e) famotidine - Answer famotidine Verapamil and Dilitazem do not act to: a) slow the ventricular rate in atrial fibrillation or flutter b) facilitate the conversion of SVT to normal sinus rhythm c) open the slow channels of myocardial and vascular smooth muscle cells to increase intracellular calcium concentrations d) as adjunctive therapy to treat migraine headache, peripheral vascular disorders, and esophageal spasms - Answer open the slow channels of myocardial and vascular smooth muscle cells to increase intracellular calcium concentrations An insulin dependent diabetic may not benefit from a cabg involving LIMA and RIMA because a) the added time on bypass to take down both arteries b) the decrease in circulation to the chest wall, resulting in suboptimal wound healing c) IMA grafts suffer poor patency in diabetics d) insulin supplied to the chest wall is necessary for patency of the saphenous vein grafts - Answer the decrease in circulation to the chest wall, resulting in suboptimal wound healing Unlike IMA graft, the saphenous vein graft is susceptible to occulsion by: a) omentation b) venous blood c) myoblasts d) intimal hyperplasia during tissue remodeling - Answer intimal hyperplasia during tissue remodeling Dypyridamole: a) maybe categorized as both a coronary vasodilator and a platelet aggregation inhibitor b) can potentiate the effects of oral anticoagulants and heparin c) affects platelets by decreasing their number d) used to treat angina and prevent deep vein thrombosis e) all are correct except c - Answer all are correct except c Difficulties in patient encounters in using persantine as a home medication: a) 2 to 3 months of therapy may be required to achieve a clinical response b) needs to be taken one hour before meals and absorption is variable and slow c) causes orhtostatic hypotension d) both A and B are correct choices - Answer both A and B are correct choices Rank the occurrence of the following thoracic aneurysms from the most to least frequent: (1) transverse arch (2) descending thoracic (3) ascending aorta (4) thoracoabdominal a) 3,2,1,4 b) 4,1,3,2 c) 2,4,1,3 d) 4,2,1,3 - Answer 3,2,1,4 Rifampin: a) is used to prevent development and treat active turberculosis b) induces liver enzymes responsible for inactivation of numerous medications including diltiazem, verapamil, oral anticoagulants, and cyclosporin c) may impart a red-orange color to urine, sputum, sweat, and tears d) all of the above - Answer all of the above Nystatin: a) is an antifungal antibiotic used for topical treatment of oropharyangeal candidiasis (swish and swallow) in transplant patients b) like hyperstat, exhibits antihyperetnsive effects c) like simvvastatin is used to decrease elevated serum total cholesterol d) is available as a yellow powder for oral suspension and IM injection - Answer is antifungal antibiotic used for topical treatment of oropharyngeal candidiasis (swish and swallow) in transplant patients The left mainstem bronchus arises in a direct line with the trachea compared to the right bronchi a) true b) false - Answer false The trachea bifurcation at the carina is also the anatomical landmark where the great vessels branch from the aorta a) true b) false - Answer true The linguala is located in the left lung which consists of only two lobes a) true b) false - Answer true An aortic dissection involving only the ascending aorta is a DeBakey type II dissection a) true b) false - Answer true Arterial filters are used in ventricular assist device circuits a) true b) false - Answer false The venous cannulation site for the left ventricular assist device include the left ventricle apex, left atrium, or retrograde across the aortic valve a) true b) false - Answer true If the patient is on bypass and a left ventricular assist device needs to be used, the same aortic cannula can be used, a) true b) false - Answer true Biventricular assisr requires the use of two pumps and two circuits a) true b) false - Answer true The intake cannula for the right ventricular assist device can be the bypass venous cannula left in place a) true b) false - Answer true The right ventricle must be able to pump enough blood to the left heart in order for the left ventricular assist device to provide adequate systemic cardiac output a) true b) false - Answer true Right heart failure is occurring if the central venous pressure is low and the pulmonary artery wedge pressure is high a) true b) false - Answer false The patients left atrial pressure on the left ventricular assist device is kept between 5 and 15mmHG a) true b) false - Answer true ACTs should be increased to 200 to 250 seconds if flows are reduced to wean the ventricular assist a) true b) false - Answer true Removal of the ventricular assist device should be attempted after the heart has rested for 24 hours and begun to eject a) true b) false - Answer true ACTs are maintained at a greater than 480 seconds on left ventricular assist device a) true b) false - Answer false Rising pCO2 on ECMO may be an indication of oxygenation failure a) true b) false - Answer true The patient on v-v ECMO must have a beating heart because no cardiac support is provided a) true b)false - Answer true Carbon dioxide transfers through membrane lungs is 12 times greater than oxygen a) true b) false - Answer false ACTs on ECMO should be performed every 30 minutes a) true b) false - Answer true According to Snider et al what is the desired ACT range for ECMO a) 140 to 160 b) greater than 300 sec c) 160 to 240 d) 300 to 360 - Answer 160 to 240 Heparin anticoagulates primarily by its interaction with: a) vWF b) fibrinogen c) AT-III d) Factors II, VII, IX and X - Answer AT-III The USP requires porcine mucosa heparin have no less than ___ unit of activity per mg and beef lung heparin to have no less than ___ units of activity per mg a)100, 120 b) 130, 140 c) 140,130 d) 140,120 - Answer 140,120 Another name for Factor III is: a) tissue thrombin b) hageman factor c) tissue factor d) tissure fibrin - Answer tissue factor Which of the following drugs may affect platelet function: (1) cocaine (2) warfarin (3) aspirin a) 2 and 3 b) 1 and 3 c) 3 only d) 1,2,and 3 - Answer 1, 2 and 3 A prolonged PT may be caused by a deficiency of: a) factor V and VII b) factor X c) fibrinogen and prothrombin d) all of the above - Answer all of the above An acceptable range for a PTT is : a) 10 to 17 sec b) 22 to 37 sec c) 24 to 35 sec d) less than 20 sec - Answer 24 to 35 sec Normal plasma concentration of fibrinogen is: a) 2500 to 3000 b) 200 to 250 c) 2.5 to 3.0 d) 2000 to 2500 - Answer 2500 to 3000 The kinase drugs streptokinase: (1) enhance fibrinogen cinversion to fibrin (2) lyse thrombus (3) catalyze plasminogen to plasmin a) 1 only b) 2 and 3 c) 3 only d) all of the above - Answer 2 and 3 Protamine sulfate: (1) is a strong base (2) has a low molecular weight (3) is derived of salmon gill mucosa: a) 1 only b) 2 and 3 c) 1 and 2 d) both b and C are correct - Answer both B and C are correct Heparin was discovered by: a) Lewis and Clark b) Gibbons c) Howell and Holt d) Lilllehei - Answer Howell and Holt Factor VI is also known as: a) plasma accelerator factor b) calcium inhibitor factor c) procoagulin d) none of the above - Answer none of the above Amicar: (1) inhibits the conversion of fibrinogen to fibrin (2) accelerates fibrinolysis (3) inhibits the conversion of plasminogen to plasmin. a) 1 only b) 3 only c) 1 and 3 d) 2 and 3 - Answer 3 only