Post: Perfusionist
Department: Medical Education Service
Category Code: 363/17
Qualification: Degree in BSc Perfusion Technology + Registration with the Kerala Paramedical Council
Date of Test: 04-07-2018
If you find mistakes, comment below
- Which of the following does not reduce the inflammatory effects of cardiopulmonary bypass?
- Red cell transfusion
- Biocompatible circuits
- Leucocyte filters
- Centrifugal Pumps
- The following are cardiac chambers except
- Right Atrium
- Right Ventricle
- Left Ventricle
- Left superior vena cava
- The following are advantages of miniaturised circuits except
- Decreased transfusions
- Less air embolism
- Lower troponin release
- Less blood activation
- Active venous drainage may be done with all except
- Centrifugal pump
- Vacuum assist
- Roller pump
- Both "Centrifugal pump" and "Vacuum assist"
- All of the following are common venting sites except
- Right superior pulmonary vein
- Root of aorta
- Pulmonary artery
- Right atrium
- The following are true of retrograde cardioplegia except
- Delivery rate is usually 200 ml/min
- Pressure should not exceed 40 mm Hg
- Provides good myocardial protection to the right ventricle
- Can be delivered continuously into the coronary sinus
- The pore size of an arterial filter is usally
- 0.1 micrometre
- 40 micrometre
- 200 micrometre
- 100 micrometre
- Intraaortic balloon pump uses
- Helium
- Carbon dioxide
- Nitrogen
- Any of these
- The commonest cause of stroke on cardiopulmonary bypass is
- Microembolism
- Air embolism
- Low perfusion pressure
- Events during cannulation and clamping
- In atherosclerotic aorta the best cannulation site is
- Ascending aorta
- Right innominate artery
- Right subclavian artery
- Femoral artery
- Distal ischemia during peripheral cannulation can be prevented by
- Using a large cannula
- Cannulating via a side arm graft
- Avoiding a separate distal perfusion cannula
- Looping and snaring the artery that is cannulated
- Mitral valve surgery commonly uses
- Bicaval cannulation
- Atriocaval cannulas
- Single atrial cannula
- Circulatory arrest
- All are true regarding Activated Clotting Time (ACT) except
- In offpump CABG ACT of 250 sec may be satisfactory
- Correlates better with heparin concentration than high dose thrombin time
- Usually measured 3 to 5 minutes after heparin administration
- Normally should be above 480 seconds on CPB
- Systemic flow rates at normothermia are usually
- 1.5 ltr/min/m2
- 1.2 ltr/min/m2
- 2.4 ltr/min/m2
- 2.0 ltr/min/m2
- All are true of retrograde autologous priming except
- Reduces haemodilutional effect of priming solution
- An alpha agonist is used
- Drainage of prime is from venous line
- Most useful in large and over weight patients
- Adequate tissue oxygen delivery is assessed by all except
- Residual nitrogen saturation
- Venous oxygen saturation
- Blood lactate levels
- Inline carbon dioxide monitoring
- All the following are used to combat low systemic vascular resistance except
- Terlipressin
- Phenylephrine
- Methylene blue
- Dobutamine
- Heart distension on bypass can produce all except
- Pulmonary barotrauma
- Ventricular cooling
- Myocardial fibre stretching
- Increased pulmonary artery pressures
- Cold hemagglutinin disease is
- Caused by lg G antibodies
- Occurs in about 2% of general population
- A cause of myocardial infarction
- Aggravated by hemodilution
- Indications for deep hypothermic circulatory arrest are all except
- Type A dissection
- Distal descending thoracic aneurysms
- IVC tumour resections
- Porcelian aorta
- Retrograde Cerebral perfusion is
- Administered at 500 ml/min
- Pressures upto 40 mm Hg are used
- Best for long procedures under deep hypothermic circulatory arrest
- Effective in providing nutrition to the brain
- In PADCAB perfusion is provided to
- Right ventricle
- Cerebral circulation
- Coronary circulation
- Renal arteries
- All of the following in cardioplegia prevent cell damage except
- Aspartate
- Glutamate
- Calcium channel blockers
- CPD
- Controlled cross circulation was developed by
- Lillehei
- Gibbon
- Cohen
- De Wall
- Cardioplegia was first used by
- Martin
- Kirklin
- Drew
- Melrose
- The following factors influence venous drainage except
- Flow Characteristics
- Pressure applied to the venous reservoir
- Tip style of cannula
- None of these
- Which size tubing is not commonly used in cardiopulmonary bypass
- 1/4 inch
- 3/8 inch
- 3/16 inch
- 1/8 inch
- Centrifugal pumps are all except
- more expensive
- afterload dependant
- Reduce priming volume
- Is non occlusive
- Ultrafiltration rates in continuous ultrafiltration are significantly affected by all except
- Oncotic pressures
- True membrane pressures
- Haematocrit
- Filter characteristics
- Carbogen is used in
- pH stat strategy
- Alpha stat strategy
- Both "pH stat strategy" and "Alpha stat strategy"
- None of these
- True membrane oxygenators use
- Polymethyl methacrylate
- Polypropylene
- Microporous polypropylene
- Silicone
- Protein denaturation occurs above
- 40° C
- 42° C
- 38° C
- 40.5° C
- Which oxygenator has the smallest priming volume?
- Lilliput 1
- Lilliput 2
- Termo capiox baby Rx 05
- Terumo capiox Sx 10
- All are important buffers except
- Bicarbonate
- Phosphate
- Chloride
- Haemoglobin
- Ectotherm physiology is used in
- Alpha stat
- pH stat
- Hemodilution
- Rewarming
- All are advantages of deep hypothermic circulatory arrest in children except
- Improved exposure
- Avoidance of multiple cannulas
- Better organ preservation
- Reduced oedema
- Advantages of iliac cannulation are all except
- Can be performed prior to surgery
- Easier dissection than femoral artery
- Larger cannula than femoral artery can be used
- Cannulation in a clean area
- Which valve is not normally tricuspid?
- Aortic
- Mitral
- Tricuspid
- Pulmonary
- All are true of left superior venacave except
- Most commonly opens into the coronary sinus
- Runs anterior to the heart
- May be cannulated
- Does not cause volume overload of the heart
- Aortic cross clamping is done early in
- Significant aortic regurgitation
- Truncus arteriosus
- Aortopulmonary window
- All of these
- The oxygenator initially used by Gibbon was a
- Bubble oxygenator
- Film oxygenator
- True membrane oxygenator
- Microfibre oxygenator
- Heparin was discovered by
- Bigelow
- De Bakey
- Lillehei
- McLean
- All the following changes happen on cardiopulmonary bypass except
- Increased ACTH in nopulsatile CPB
- Growth hormone increases
- Elevation of stress hormones
- Hyperglycemia
- Tissue oxygen delivery is easily measured by
- Mixed venous oxygen saturation
- 2, 3 diphosphoglycerate
- Oxygen dissociation curve
- Catecholamine assay
- Heparin is safe as an anticoagulant for extracorporeal circulation beacause of
- Short duration for maximal action
- Long half life
- Absence of monitoring systems
- Platelet aggregation
- All are true of magnesium except
- It is a membrane stabiliser
- Stimulates catecholamine release
- Has important role in aerobic metabolism
- Helps maintain cellular integrity
- All are phosphodiesterase type 3 inhibitors except
- Amrinone
- Milrinone
- Enoximone
- Dopexamine
- Which of the following increases cerebral emboli?
- Arterial filter
- Cardiotomy
- Moderate hypothermia
- Alpha stat strategy
- Which of the following is a contraindication to early extubation?
- Hemodynamic stability
- Minimal bleeding
- Hypothermia
- Neurological stability
- All are parts of a gas flow path except
- Scavenging facility
- Oxygenator
- Gas blender
- Heat exchanger
- All are sites of temperature measurement except
- Colon
- Tympanic membrane
- Bladder
- Oesophagus
- Heparin resistance is caused by all except
- Endocarditis
- Antithrombin 3 deficiency
- Preoperative heparin therapy
- Obesity
- Alternate pathway of complement activation begins with
- C1
- C2
- C3
- C4
- Tissue oxygen consumption in pulsatile CPB when compared to non pulsatile is
- Less
- More
- Same
- Not known
- Hyperglycemia in CPB causes
- Favourable neurological outcome
- Adverse neurological outcome
- No significant change in neurological outcome
- None of these
- Which of the following is a neuroprotective strategy?
- Multiple cross clamping
- Vein grafts in CABG
- Aortic cannulation
- Hypothermia
- To avoid uneven cooling the gradient between water and blood should be less than
- 10° C
- 12° C
- 14° C
- 16° C
- Neutral human pH at temperature of 20° C is
- 7.7
- 7.4
- 7.2
- 7.5
- Which of the following is a myocardial protection strategy?
- Systematic hypothermia
- Cardioplegic arrest
- Topical hypothermia
- All these
- A one way valve placed in the arterial line is designed to prevent
- Forward flow
- Retrograde flow
- Sucking air from cannulation site
- Overpressurisation
- The minimum acceptable range of haematocrit on CPB is
- 18-21%
- 16-18%
- 21-24%
- more than 25%
- When using a centrifugal pump one must always maintain?
- forward flow and positive pressure
- forward flow and negative pressure
- forward flow at 4000 rpm
- forward flow except in RAP
- Which of the following is observed when an oxygenator begins to clot?
- A low membrane pressure gradient
- High arterial line pressure
- High MAP
- High membrane pressure gradient
- To ensure proper communication with surgeon a perfusionist must always
- answer promptly
- repeat surgeons orders
- talk to anaesthesiologist
- document all orders
- The best method to monitor cerebral oxygen delivery is
- Cerebral oximetry
- Venous oxygen saturation
- Inline blood gas monitoring
- Arterial saturation monitor
- Which aortic cannula has embolism protection?
- Embol
- Biomedicus
- EOPA
- Femflex
- What is not true of left dominant circulation?
- Seen in about 20% population
- Left circumflex artery supplies PDA
- Left circumflex artery gives off obtuse marginal
- Left circumflex artery may originate from right coronary sinus
Question Error
- Which of the following is not an indication for CABG?
- LMCA disease more than 60%
- Proximal LAD disease
- Double vessel disease with normal LAD
- Triple vessel disease with low ejection fraction
- All are advantages of roller pump except
- Simple
- Low priming volume
- Afterload independent cardiac output
- Less cavitation if inflow occluded
- Venous drainage can be improved by all except
- Aortic cardiopplegia
- Surgeon adjusting venous cannuls
- Raising operating table
- Suction on venous reservoir
- Cardioplegia is administered into the main pulmonary artery in
- Aortic regurgitation
- Anomalous left coronary artery origin from pulmonary artery
- Patent ductus arteriosus
- Hypoplastic left heart
- Cardioplegia entering systemic circulation causes
- Reduced SVR
- Increased SVR
- No change in SVR
- None of these
- Where are drugs administered in CPB?
- Central venous line
- CPB circuit
- Cardioplegia circuit
- Arterial monitoring line
- The level of which of the following falls during CPB?
- Calcium
- Magnesium
- Both Calcium and Magnesium
- None of these
- Oedema is caused by
- Decreased capillary pressure
- Decreased plasma colloid osmotic pressure
- Decreased tissue colloid osmotic pressure
- Increase plasma oncotic pressure
- Vitamin K dependant clotting factors are all except
- II
- V
- VII
- X
- In a Waterston shunt the connection is between
- Aorta and MPA
- SVC and RPA
- Aorta and RPA
- Aorta and LPA
- All are types of VSD except
- Subaortic
- Subpulmonic
- Inlet
- Secondum
- In a proper IABP placement the tip is
- in ascending aorta
- just distal to left subclavian origin
- at aortic bifurcation
- in main pulmonary artery
- Retrograde cardioplegia is contraindicated in
- Aortic regurgitation
- Aortopulmonary window
- Aortic stenosis
- Unroofed coronary sinus
- The Social reformer Mannath Padmanabhan delivered the 'Muthukulam Speech' in the year of
- 1946
- 1947
- 1948
- 1949
- Who was considered as the first Martyr of Kerala Renaissance?
- Arattupuzha Veleyudha Paniker
- Subhananda Gurudevan
- Kuruban Daivathan
- Vagbadanandan
- On the Background of Malabar Rebellion of 1921 Kumaranasan wrote the poem
- Veenapoovu
- Prarodhanam
- Pushpavadi
- Duravastha
- The 'Silent Ambassador' of a Country is
- Currency
- Press
- Postal Stamp
- People
- Name the Indian State where GST is firstly implemented
- Assam
- Kerala
- Tamil Nadu
- Maharashtra
- Town Farooq was built by
- Haidar Ali
- Zamorin of Calicut
- Kunhali Marakkar
- Tippu Sulthan
- The Island is situated in the South of Lakshadweep
- Kavaratti
- Amini
- Minicoy
- Anthroth
- 'Kochi as the Queen of Arabian sea' is firstly called by
- Raja Kesavadas
- Divan R. K. Shanmukan Shetti
- Veluthambi Dalava
- Col. Mantro
- The name of the cyclone 'Ochi' is given by
- Oman
- Pakistan
- Sri Lanka
- Bangladesh
- The Back Bone of Himalaya is
- Himachal
- Sivalic
- Himadri
- Everest
- Which colour is commonly used to identify the General Category of Ration Card in Kerala?
- White
- Pink
- Blue
- Yellow
- Name the social reformer of Kerala prohibited the custom 'Ettu - Mattu'
- Chattampi Swamikal
- Vagbadanandan
- Sree Narayana Guru
- Ayyankali
- The 'Kerala Napoleon' is
- Pazhasi Raja
- K.P. Karuppan
- Poykayil Yohannan
- Barrister G. P. Pillai
- Who is the Chairperson of the National Commission for Women?
- Rekha Sharma
- Jayanthi Patnaik
- Lalitha Kumaramangalam
- Mamtha Sharma
- The first fully blood donated Panchayath in Kerala is
- Plicode
- Vattavada
- Puthige
- Madikai
- The Revolt of 1857 led at Kanpur by
- Jhansi Rani Laxmi Bai
- Nanasahib
- Tantia Topy
- Kunvar Sing
- The Vice President of USA is
- Joe Biden
- Dick Cheney
- Mike Pence
- Hillary Clinton
- In the Second Nationalization of commercial banks ________ banks were nationalized.
- 4
- 6
- 5
- 7
- A land mass bounded by sea on three sided referred as
- Peninsula
- Island
- Coast
- None of these
- Mahatma Gandhi Marine National Park situated in
- Gujarath
- Maharashtra
- Lakshadweep
- Andaman Nicobar Island
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