perfusionist – medical education

PROVISIONAL ANSWER KEY
Question Paper Code: 35/2018/OL
Category Code: 363/2017
Exam: Perfusionist
Medium of Question: English
Date of Test 04-07-2018
Department Medical Education
Alphacode A
Question1:-The Social reformer Mannath Padmanabhan delivered the ‘Muthukulam Speech’ in the year of
A:-1946
B:-1947
C:-1948
D:-1949
Correct Answer:- Option-B
Question2:-Who was considered as the first Martyr of Kerala Renaissance ?
A:-Arattupuzha Veleyudha Paniker
B:-Subhananda Gurudevan
C:-Kuruban Daivathan
D:-Vagbadanandan
Correct Answer:- Option-A
Question3:-On the Background of Malabar Rebellion 1921 Kumaranasan wrote the poem
A:-Veenapoovu
B:-Prarodhanam
C:-Pushpavadi
D:-Duravastha
Correct Answer:- Option-D
Question4:-The ‘Silent Ambassador’ of a Country is
A:-Currency
B:-Press
C:-Postal Stamp
D:-People
Correct Answer:- Option-C
Question5:-Name the Indian State where GST is firstly implemented
A:-Assam
B:-Kerala
C:-Tamil Nadu
D:-Maharashtra
Correct Answer:- Option-A
Question6:-Town Farooq was built by
A:-Hidar Ali
B:-Zamorine of Calicut
C:-Kunhali Marakkar
D:-Tippu Sulthan
Correct Answer:- Option-D
Question7:-The Island is situated in the South of Lakshadweep
A:-Kavarathi
B:-Amini
C:-Minikoy
D:-Anthroth
Correct Answer:- Option-C
Question8:-‘Kochi as the Queen of Arabian sea’ is firstly called by
A:-Raja Kesavadas
B:-Divan R. K. Shanmukan Shetti
C:-Veluthambi Dalava
D:-Col. Mantro
Correct Answer:- Option-B
Question9:-The name of the cyclone ‘Ochi’ is given by
A:-Oman
B:-Pakistan
C:-Sri Lanka
D:-Bangladesh
Correct Answer:- Option-D
Question10:-The Back Bone of Himalaya is
A:-Himachal
B:-Sivalic
C:-Himadri
D:-Everest
Correct Answer:- Option-C
Question11:-Which colour is commonly used to identify the General Category of Ration Card in Kerala ?
A:-White
B:-Pink
C:-Blue
D:-Yellow
Correct Answer:- Option-A
Question12:-Name the social reformer of Kerala prohibited the custom ‘Ettu – Mattu’
A:-Chattampi Swamikal
B:-Vagbadanandan
C:-Sree Narayana Guru
D:-Ayyankali
Correct Answer:- Option-B
Question13:-The ‘Kerala Napoleon’ is
A:-Pazhasi Raja
B:-K.P. Karuppan
C:-Poykayil Yohannan
D:-Barrister G. P. Pillai
Correct Answer:- Option-C
Question14:-Who is the Chairperson of the National Commission for Women ?
A:-Rekha Sharma
B:-Jayanthi Patnaik
C:-Lalitha Kumaramangalam
D:-Mamtha Sharma
Correct Answer:- Option-A
Question15:-The first fully blood donated Panchayath in Kerala is
A:-Plicode
B:-Vattavada
C:-Puthige
D:-Madikai
Correct Answer:- Option-D
Question16:-The Revolt of 1857 led at Kanpur by
A:-Jansi Rani Laxmi Bai
B:-Nanasahib
C:-Tantia Topy
D:-Kunvar Sing
Correct Answer:- Option-B
Question17:-The Vice President of USA is
A:-Joe Biden
B:-Dick Cheney
C:-Mike Pence
D:-Hillary Clinton
Correct Answer:- Option-C
Question18:-In the Second Nationalization of commercial banks ________ banks were nationalized.
A:-4
B:-6
C:-5
D:-7
Correct Answer:- Option-B
Question19:-A land mass bounded by sea on three sided refrred as
A:-Peninsula
B:-Island
C:-Coast
D:-None of these
Correct Answer:- Option-A
Question20:-Mahatma Gandhi Marine National Park situated in
A:-Gujarath
B:-Maharashtra
C:-Lakshadweep
D:-Andaman Nicobar Island
Correct Answer:- Option-D
Question21:-Which of the following does not reduce the inflammatory effects of cardiopulmonary bypass ?
A:-Red cell transfusion
B:-Biocompatible circuits
C:-Leucocyte filters
D:-Centrifugal Pumps
Correct Answer:- Option-A
Question22:-The following are cardiac chambers except
A:-Right Atrium
B:-Right Ventricle
C:-Left Ventricle
D:-Left superior venacava
Correct Answer:- Option-D
Question23:-The following are advantages of miniaturised circuits except
A:-Decreased transfusions
B:-Less air embolism
C:-Lower troponin release
D:-Less blood activation
Correct Answer:- Option-B
Question24:-Active venous drainage may be done with all except
A:-Centrifugal pump
B:-Vacuum assist
C:-Roller pump
D:-Both A and B
Correct Answer:- Option-C
Question25:-All of the following are common venting sites except
A:-Right superior pulmonary vein
B:-Root of aorta
C:-Pulmonary artery
D:-Right atrium
Correct Answer:- Option-D
Question26:-The following are true of retrograde cardioplegia except
A:-Delivery rate is usually 200 ml/min
B:-Pressure should not exceed 40 mm Hg
C:-Provides good myocardial protection to the right ventricle
D:-Can be delivered continuously into the coronary sinus
Correct Answer:- Option-C
Question27:-The pore size of an arterial filter is usally
A:-0.1 micrometre
B:-40 micrometre
C:-200 micrometre
D:-100 micrometre
Correct Answer:- Option-B
Question28:-Intraaortic balloon pump uses
A:-Helium
B:-Carbon dioxide
C:-Nitrogen
D:-Any of the above
Correct Answer:- Option-A
Question29:-The commonest cause of stroke on cardiopulmony bypass is
A:-Microembolism
B:-Air embolism
C:-Low perfusion pressure
D:-Events during cannulation and clamping
Correct Answer:- Option-D
Question30:-In atherosclerotic aorta the best cannulation site is
A:-Ascending aorta
B:-Right innominate artery
C:-Right subclavian artery
D:-Femoral artery
Correct Answer:- Option-C
Question31:-Distal ischemia during peripheral cannulation can be prevented by
A:-Using a large cannula
B:-Cannulating via a side arm graft
C:-Avoiding a separate distal perfusion cannula
D:-Looping and snaring the artery that is cannulated
Correct Answer:- Option-B
Question32:-Mitral valve surgery commonly uses
A:-Bicaval cannulation
B:-Atriocaval cannulas
C:-Single atrial cannula
D:-Circulatory arrest
Correct Answer:- Option-A
Question33:-All are true regarding Activated Clotting Time (ACT) except
A:-In offpump CABG ACT of 250 sec may be satisfactory
B:-Correlates better with heparin concentration than high dose thrombin time
C:-Usually measured 3 to 5 minutes after heparin administration
D:-Normally should be above 480 seconds on CPB
Correct Answer:- Option-B
Question34:-Systemic flow rates at normothermia are usually
A:-1.5 ltr/min/`m^(2)`
B:-1.2 ltr/min/`m^(2)`
C:-2.4 ltr/min/`m^(2)`
D:-2.0 ltr/min/`m^(2)`
Correct Answer:- Option-D
Question35:-All are true of retrograde autologous priming except
A:-Reduces haemodilutional effect of priming solution
B:-An alpha agonist is used
C:-Drainage of prime is from venous line
D:-Most useful in large and over weight patients
Correct Answer:- Option-D
Question36:-Adequate tissue oxygen delivery is assessed by all except
A:-Residual nitrogen saturation
B:-Venous oxygen saturation
C:-Blood lactate levels
D:-Inline carbon dioxide monitoring
Correct Answer:- Option-A
Question37:-All the following are used to combat low systemic vascular resisance except
A:-Terlipressin
B:-Phenylephrine
C:-Methylene blue
D:-Dobutamine
Correct Answer:- Option-D
Question38:-Heart distension on bypass can produce all except
A:-Pulmonary barotrauma
B:-Ventricular cooling
C:-Myocardial fibre stretching
D:-Increased pulmonary artery pressures
Correct Answer:- Option-B
Question39:-Cold hemagglutinin disease is
A:-Caused by lg G antibodies
B:-Occurs in about 2% of general population
C:-A cause of myocardial infarction
D:-Aggravated by hemodilution
Correct Answer:- Option-C
Question40:-Indications for deep hypothermic circulatory arrest are all except
A:-Type A dissection
B:-Distal descending thoracic aneurysms
C:-IVC tumour resections
D:-Porcelian aorta
Correct Answer:- Option-B
Question41:-Retrograde Cerebral perfusion is
A:-Administered at 500 ml/min
B:-Pressures upto 40 mm Hg are used
C:-Best for long procedures under deep hypothermic circulatory arrest
D:-Effective in providing nutrition to the brain
Correct Answer:- Option-A
Question42:-In PADCAB perfusion is provided to
A:-Right ventricle
B:-Cerebral circulation
C:-Coronary circulation
D:-Renal arteries
Correct Answer:- Option-C
Question43:-All of the following in cardioplegia prevent cell damage except
A:-Aspartate
B:-Glutamate
C:-Calcium channel blockers
D:-CPD
Correct Answer:- Option-C
Question44:-Controlled cross circulation was developed by
A:-Lillehei
B:-Gibbon
C:-Cohen
D:-De Wall
Correct Answer:- Option-A
Question45:-Cardioplegia was first used by
A:-Martin
B:-Kirklin
C:-Drew
D:-Melrose
Correct Answer:- Option-D
Question46:-The following factors influence venous drainage except
A:-Flow Characteristics
B:-Pressure applied to the venous reservoir
C:-Tip style of cannula
D:-None of the above
Correct Answer:- Option-D
Question47:-Which size tubing is not commonly used in cardiopulmonary bypass
A:-1/4 inch
B:-3/8 inch
C:-3/16 inch
D:-1/8 inch
Correct Answer:- Option-C
Question48:-Centrifugal pumps are all except
A:-more expensive
B:-afterload dependant
C:-Reduce priming volume
D:-Is non occlusive
Correct Answer:- Option-C
Question49:-Ultrafiltration rates in continuous ultrafiltration are significantly affected by all except
A:-Oncotic pressures
B:-True membrane pressures
C:-Haematocrit
D:-Filter characteristics
Correct Answer:- Option-A
Question50:-Carbogen is used in
A:-pH stat strategy
B:-Alpha stat strategy
C:-Both of the above
D:-None of the above
Correct Answer:- Option-A
Question51:-True membrane oxygenators use
A:-Polymethyl methacrylate
B:-Polypropylene
C:-Microporous polypropylene
D:-Silicone
Correct Answer:- Option-D
Question52:-Protein denaturation occurs above
A:-40° C
B:-42° C
C:-38° C
D:-40.5° C
Correct Answer:- Option-B
Question53:-Which oxygenator has the smallest priming volume ?
A:-Lilliput 1
B:-Lilliput 2
C:-Termo capiox baby Rx 05
D:-Terumo capiox Sx 10
Correct Answer:- Option-C
Question54:-All are important buffers except
A:-Bicarbonate
B:-Phosphate
C:-Chloride
D:-Haemoglobin
Correct Answer:- Option-C
Question55:-Ectotherm physiology is used in
A:-Alpha stat
B:-pH stat
C:-Hemodilution
D:-Rewarming
Correct Answer:- Option-A
Question56:-All are advantages of deep hypothermic circulatory arrest in children except
A:-Improved exposure
B:-Avoidance of multiple cannulas
C:-Better organ preservation
D:-Reduced oedema
Correct Answer:- Option-C
Question57:-Advantages of iliac cannulation are all except
A:-Can be performed prior to surgery
B:-Easier dissection than femoral artery
C:-Larger cannula than femoral artery can be used
D:-Cannulation in a clean area
Correct Answer:- Option-B
Question58:-Which valve is not normally tricuspid ?
A:-Aortic
B:-Mitral
C:-Tricuspid
D:-Pulmonary
Correct Answer:- Option-B
Question59:-All are true of left superior venacave except
A:-Most commonly opens into the coronary sinus
B:-Runs anterior to the heart
C:-May be cannulated
D:-Does not cause volume overload of the heart
Correct Answer:- Option-B
Question60:-Aortic cross clamping is done early in
A:-Significant aortic regurgitation
B:-Truncus arteriosus
C:-Aortopulmonary window
D:-All of the above
Correct Answer:- Option-D
Question61:-The oxygenator initially used by Gibbon was a
A:-Bubble oxygenator
B:-Film oxygenator
C:-True membrane oxygenator
D:-Microfibre oxygenator
Correct Answer:- Option-B
Question62:-Heparin was discovered by
A:-Bigelow
B:-De Bakey
C:-Lillehei
D:-McLean
Correct Answer:- Option-D
Question63:-All the following changes happen on cardiopulmonary bypass except
A:-Increased ACTH in nopulsatile CPB
B:-Growth hormone increases
C:-Elevation of stress hormones
D:-Hyperglycemia
Correct Answer:- Option-A
Question64:-Tissue oxygen delivery is easily measured by
A:-Mixed venous oxygen saturation
B:-2, 3 diphosphoglycerate
C:-Oxygen dissociation curve
D:-Catecholamine assay
Correct Answer:- Option-A
Question65:-Heparin is safe as an anticoagulant for extracorporeal circulation beacause of
A:-Short duration for maximal action
B:-Long half life
C:-Absence of monitoring systems
D:-Platelet aggregation
Correct Answer:- Option-A
Question66:-All are true of magnesium except
A:-It is a membrane stabiliser
B:-Stimulates catecholamine release
C:-Has important role in aerobic metabolism
D:-Helps maintain cellular integrity
Correct Answer:- Option-B
Question67:-All are phosphodiesterase type 3 inhibitors except
A:-Amrinone
B:-Milrinone
C:-Enoximone
D:-Dopexamine
Correct Answer:- Option-D
Question68:-Which of the following increases cerebral emboli ?
A:-Arterial filter
B:-Cardiotomy
C:-Moderate hypothermia
D:-Alpha stat strategy
Correct Answer:- Option-B
Question69:-Which of the following is a contraindication to early extubation ?
A:-Hemodynamic stability
B:-Minimal bleeding
C:-Hypothermia
D:-Neurological stability
Correct Answer:- Option-C
Question70:-All are parts of a gas flow path except
A:-Scavenging facility
B:-Oxygenator
C:-Gas blender
D:-Heat exchanger
Correct Answer:- Option-D
Question71:-All are sites of temperature measurement except
A:-Colon
B:-Tympanic membrane
C:-Bladder
D:-Oesophagus
Correct Answer:- Option-A
Question72:-Heparin resistance is caused by all except
A:-Endocarditis
B:-Anthithrombin 3 deficiency
C:-Preoperative heparin therapy
D:-Obesity
Correct Answer:- Option-D
Question73:-Alternate pathway of complement activation begins with
A:-`C_(1)`
B:-`C_(2)`
C:-`C_(3)`
D:-`C_(4)`
Correct Answer:- Option-C
Question74:-Tissue oxygen consumption in pulsatile CPB when compared to non pulsatile is
A:-Less
B:-More
C:-Same
D:-Not known
Correct Answer:- Option-B
Question75:-Hyperglycemia in CPB causes
A:-Favourable neurological outcome
B:-Adverse neurological outcome
C:-No significant change inneurological outcome
D:-None of the above
Correct Answer:- Option-C
Question76:-Which of the following is a neuroprotective strategy ?
A:-Multiple cross clamping
B:-Vein grafts in CABG
C:-Aortic cannulation
D:-Hypothermia
Correct Answer:- Option-D
Question77:-To avoid uneven cooling the gradient between water and blood should be less than
A:-10° C
B:-12° C
C:-14° C
D:-16° C
Correct Answer:- Option-A
Question78:-Neutral human pH at temperature of 20° C is
A:-7.7
B:-7.4
C:-7.2
D:-7.5
Correct Answer:- Option-A
Question79:-Which of the following is a myocardial protection strategy ?
A:-Systematic hypothermia
B:-Cardioplegic arrest
C:-Topical hypothermia
D:-All the above
Correct Answer:- Option-D
Question80:-A one way valve placed in the arterial line is designed to prevent
A:-Forward flow
B:-Retrograde flow
C:-Sucking air from cannulation site
D:-Overpressurisation
Correct Answer:- Option-B
Question81:-The minimum acceptable range of haematocrit on CPB is
A:-18-21%
B:-16-18%
C:-21-24%
D:-more than 25%
Correct Answer:- Option-A
Question82:-When using a centrifugal pump one must always maintain ?
A:-forward flow and positive pressure
B:-forward flow and negative pressure
C:-forward flow at 4000 rpm
D:-forward flow except in RAP
Correct Answer:- Option-A
Question83:-Which of the following is observed when an oxygenator begins to clot ?
A:-A low membrane pressure gradient
B:-High arterial line pressure
C:-High MAP
D:-High membrane pressure gradient
Correct Answer:- Option-D
Question84:-To ensure proper communication with surgeon a perfusionist must always
A:-answer promptly
B:-repeat surgeons orders
C:-talk to anaesthesiologist
D:-document all orders
Correct Answer:- Option-B
Question85:-The best method to monitor cerebral oxygen delivery is
A:-Cerebral oximetry
B:-Venous oxygen saturation
C:-Inline blood gas monitoring
D:-Arterial saturation monitor
Correct Answer:- Option-A
Question86:-Which aortic cannula has embolism protection ?
A:-Embol
B:-Biomedicus
C:-EOPA
D:-Femflex
Correct Answer:- Option-A
Question87:-What is not true of left dominant circulation ?
A:-Seen in about 20% population
B:-Left circumflex artery supplies PDA
C:-Left circumflex artery gives off obtuse marginal
D:-Left circumflex artery may originate from right coronary sinus
Correct Answer:- Option-A
Question88:-Which of the following is not an indication for CABG ?
A:-LMCA disease more than 60%
B:-Proximal LAD disease
C:-Double vessel disease with normal LAD
D:-Triple vessel disease with low ejection fraction
Correct Answer:- Option-C
Question89:-All are advantages of roller pump except
A:-Simple
B:-Low priming volume
C:-Afterload independent cardiac output
D:-Less cavitation if inflow occluded
Correct Answer:- Option-D
Question90:-Venous drainage can be improved by all except
A:-Aortic cardiopplegia
B:-Surgeon adjusting venous cannuls
C:-Raising operating table
D:-Suction on venous reservoir
Correct Answer:- Option-A
Question91:-Cardioplegia is administered into the main pulmonary artery in
A:-Aortic regurgitation
B:-Anomalous left coronary artery origin from pulmonary artery
C:-Patent ductus arteriosus
D:-Hypoplastic left heart
Correct Answer:- Option-B
Question92:-Cardioplegia entering systemic circulation causes
A:-Reduced SVR
B:-Increased SVR
C:-No change in SVR
D:-None of the above
Correct Answer:- Option-A
Question93:-Where are drugs administered in CPB ?
A:-Central venous line
B:-CPB circuit
C:-Cardioplegia circuit
D:-Arterial monitoring line
Correct Answer:- Option-B
Question94:-The level of which of the following falls during CPB ?
A:-Calcium
B:-Magnesium
C:-Both of the above
D:-None of the above
Correct Answer:- Option-C
Question95:-Oedema is caused by
A:-Decreased capillary pressure
B:-Decreased plasma colloid osmotic pressure
C:-Decreased tissue colloid osmotic pressure
D:-Increase plasma oncotic pressure
Correct Answer:- Option-B
Question96:-Vitamin K dependant clotting factors are all except
A:-II
B:-V
C:-VII
D:-X
Correct Answer:- Option-B
Question97:-In a Waterston shunt the connection is between
A:-Aorta and MPA
B:-SVC and RPA
C:-Aorta and RPA
D:-Aorta and LPA
Correct Answer:- Option-C
Question98:-All are types of VSD except
A:-Subaortic
B:-Subpulmonic
C:-Inlet
D:-Secondum
Correct Answer:- Option-D
Question99:-In a proper IABP placement the tip is
A:-in ascending aorta
B:-just distal to left subclavian origin
C:-at aortic bifurcation
D:-in main pulmonary artery
Correct Answer:- Option-B
Question100:-Retrograde cardioplegia is comtraindicated in
A:-Aortic regurgitation
B:-Aortopulomonary window
C:-Aortic stenosis
D:-Unroofed coronary sinus
Correct Answer:- Option-D