Test 1 content-Quizzes

Question 1

The American Diabetic Association and the American College of Endocrinology classify pre diabetics as those individual with fasting blood glucose levels within the ________ mg/DL range, while those with fasting blood glucose levels greater than_______mg/DL are considered to have diabetes mellitus.

Answer 1

(1) 100-125 mg/dl

(2) -126 mg/dl

Question 2

2) Type I, or juvenile diabetes, represents _______% of all patients diagnosed with diabetes.

Answer 2

5-10%

Question 3

3) Type II diabetes represents ______% of all patients with the diagnosis of diabetes

Answer 3

90-95%

Question 4

4) What percentage of patients with diabetes will undergo coronary bypass grafting surgery?

Answer 4

28%

Question 5

5) There is an increased risk of which of the following for diabetic patients following cardiac surgery?
a. Morbidity and mortality
b. Stroke
c. Renal Failure
d. Sternal wound infections
e. All of the above

Answer 5

All of the above

Question 6

6) In the study done by Bhamidipati et al he stratified the diabetics into 3 management groups. Which group had the lowest mortality?

Answer 6

Moderate group

Question 7

In the 1980’s a body of evidence was developed that linked poor glucose control in diabetics to __________?

Answer 7

Poor wound healing and increased rates of infection

Question 8

8) In the Leuven surgical trial reduced 12 month mortality among critically ill patients with diabetes was demonstrated when blood glucose levels were maintained in what range?

Answer 8

80-110 mg/dL

Question 9

9) TRUE or FALSE: The NICE-SUGAR study found that the intensive control group actually experienced a greater incidence of all cause mortality at 90 days after surgery.

Answer 9

True

Question 10

The 2009 Society of Thoracic Surgeons Class I recommendations suggest that all patients with diabetes undergoing cardiac surgical procedures should maintain serum glucose levels below ______ mg/dL.

Answer 10

180

Question 11

Renal function is adversely affected in _____% of patients undergoing CABG surgery?

Answer 11

30-40

Question 12

2) What percentage of CABG patients develops acute renal failure?

Answer 12

1-3%

Question 13

Allows maintenance of glomerular capillary pressure by preventing tubular obstruction

Answer 13

Mannitol

Question 14

Increases cardiac output

Answer 14

Dopamine

Question 15

Decreases renal perfusion

Answer 15

Dopamine

Question 16

Reduces plasma levels of hydrogen peroxide free oxygen radicals

Answer 16

Mannitol

Question 17

Lowers ischemia associated protein leakage from renal vasculature

Answer 17

Mannitol

Question 18

Maintains renal perfusion

Answer 18

Dopamine

Question 19

Results in diuresis

Answer 19

Dopamine

Question 20

Prevents renal injury_

Answer 20

Mannitol

Question 21

TRUE or FALSE. The etiology of kidney dysfunction occurring after cardiac surgery is multi-factorial and is generally explained on the basis of perioperative low cardiac output or effects of CPB.

Answer 21

True

Question 22

List 4 of the 5 listed bypass related risk factors frequently referred to in the literature according to this article(added all 5):

Answer 22

1. CPB exceeding 70 minutes
2. Normothermic vs hypothermic bypass
3. Bypass surgery without a pump
4. Cross clamp time
5. pulsatile vs. non-pulsatile bypass flow

Question 23

A recent survey of perfusionists found that in more than ____ % of centers, mildly hypothermic perfusion of 32 degrees Celsius to 34 degrees Celsius is routinely used.

Answer 23

90

Question 24

What temperature measurement location is recognized as being the gold standard for cerebral temperature?

Answer 24

Jugular Bulb

Question 25

The study by Nussmeier et al. demonstrated that all body sites _____________ jugular bulb temperature during cooling and _____________ jugular bulb temperature during rewarming.

Answer 25

Overestimated / underestimated

Question 26

The study by Newland et al. found that when they reviewed 4 different oxygenator’s arterial outlet ports the temperature measurement from the oxygenator’s __________ the reference temperature probe that they had placed distal to the oxygenator in the circuit.

Answer 26

Underestimated

Question 27

It is recommended in the article that the following temperature recordings are reasonable for core temperature measurement:

Answer 27

Pulmonary artery and nasopharyngeal

Question 28

True or False: Newland et al. found that an arterial outlet temperature higher than 37 degrees Celsius is an independent predictor of acute kidney injury.

Answer 28

True

Question 29

Temperature gradients between the arterial outlet and venous inflow on the oxygenator during CPB cooling should not exceed ____ degrees Celsius to avoid generation of gaseous emboli.

Answer 29

10 degrees

Question 30

Scheffer and Sanders findings support slow rewarming because:

a. It helps avoid excess cerebral oxygen extraction and jugular venous desaturation
b. It increases time for better distribution of heat
c. It improved maintenance of the relationship between cerebral blood flow and the cerebral metabolic rate of oxygen
d. All of the above

Answer 30

All the above

Question 31

To achieve the desired temperature for separation of bypass it is reasonable to maintain a rewarming rate of _______ degree Celsius/minute or less.

Answer 31

0.5 deg C

Question 32

A study by Insler et al. found that patients separating from bypass with core temperatures lower that 36 degrees Celsius had which of the following upon arrival in the ICU:

Answer 32

Increased intubation times and increased mortality