Practice Test Geeks(CCP) Certified Clinical Perfusionist Practice Test
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Blood Gas & Acid-Base Interpretation Flashcards

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  1. Which of the following causes a LEFT shift of the oxyhemoglobin dissociation curve, increasing hemoglobin's affinity for oxygen?

    Answer: Alkalosis and hypothermia

    Alkalosis and hypothermia both increase hemoglobin's affinity for oxygen, shifting the dissociation curve to the left and impairing oxygen release to tissues.

  2. A perfusionist notes SvO2 dropping from 75% to 55% during stable CPB. Without changing pump flow, which blood gas change would MOST likely explain this?

    Answer: Falling hemoglobin from 9 to 6 g/dL

    A fall in hemoglobin reduces oxygen delivery (DO2 = CO × CaO2), forcing tissues to extract more oxygen and lowering SvO2.

  3. What is the anion gap in a patient with Na+ 140, Cl- 102, HCO3- 18 mEq/L?

    Answer: 20 mEq/L

    Anion gap = Na+ − (Cl- + HCO3-) = 140 − (102 + 18) = 20 mEq/L, which is elevated above the normal range of 8–12 mEq/L.

  4. During CPB, a blood gas taken from the arterial line shows PaO2 450 mmHg. The perfusionist should:

    Answer: Reduce FiO2 on the oxygenator to avoid hyperoxia-related free radical damage

    Excessive hyperoxia during CPB generates reactive oxygen species that contribute to reperfusion injury; FiO2 should be reduced to maintain PaO2 in an appropriate range (150-200 mmHg).

  5. A patient presents with pH 7.48, PaCO2 48 mmHg, HCO3- 35 mEq/L after prolonged NG suction. This is BEST described as:

    Answer: Metabolic alkalosis with partial respiratory compensation

    Loss of gastric HCl causes metabolic alkalosis; the elevated PaCO2 represents partial respiratory compensation (hypoventilation) to retain CO2.

  6. Base excess (BE) in a blood gas report indicates:

    Answer: The amount of acid or base (in mEq/L) needed to restore pH to 7.40 at normal PaCO2

    Base excess is the amount of strong acid (if positive) or strong base (if negative) required to restore 1 liter of blood to a pH of 7.40 at PaCO2 of 40 mmHg and 37°C.

  7. A blood gas during CPB shows PaO2 of 80 mmHg on FiO2 1.0. This most likely indicates:

    Answer: Significant oxygenator failure or severe shunting

    PaO2 of only 80 mmHg on 100% FiO2 indicates a large intrapulmonary shunt or oxygenator failure; expected PaO2 should exceed 400 mmHg on FiO2 1.0.