Advanced-Level MCQs: Impella CP & ECMO

Which of the following is a contraindication to Impella CP placement?

• Cardiogenic shock due to acute myocardial infarction

• Severe peripheral artery disease

• High-risk PCI

• Acute decompensated cardiomyopathy

In transthoracic echocardiography (PLAX view), the correct positioning of the Impella is assessed by:

• The perpendicular angle of the pump to the aortic valve

• Alignment of the pump parallel to the anterior mitral leaflet

• Ensuring the angle between the pump and horizontal plane of mitral valve is correct

• Ensuring the inflow is in the aorta and outflow in the LV

One of the most serious complications of Impella CP use is:

• Mechanical hemolysis

• Pulmonary edema

• Pneumothorax

• Atrial fibrillation

Which of the following represents a key alarm in ECMO monitoring?

• High tidal volume alert

• Low circuit pressure alarm

• Oxygenator membrane gradient change

In VA ECMO, which of the following best describes the cannulation setup?

• Both access and return lines in femoral veins

• Drainage in a vein and return in an artery

• Drainage in artery and return in vein

• All lines via jugular veins

Which of the following best differentiates VA ECMO from VV ECMO?

• VV ECMO provides both respiratory and circulatory support

• VA ECMO provides only respiratory support

• VA ECMO provides circulatory and respiratory support

• VA ECMO has a single lumen cannula

Which of the following is true regarding sweep gas flow in ECMO?

• Increasing sweep gas flow increases arterial oxygenation

• Sweep gas flow controls CO2 clearance

• Sweep gas is only required in VV ECMO

• Sweep gas flow should be lower than blood flow

When initiating ECMO, heparin should be administered at what dose?

• 10 units/kg IV

• 50 units/kg IV

• 5000 units IV bolus

• 100 units/kg SC

In Impella support, systemic circulation is typically maintained at what flow range?

• 0.5–2.0 L/min

• 2.5–5.0 L/min

• 5.5–8.0 L/min

• 1.0–3.0 L/min

Which of the following is NOT a component of the ECMO circuit?

• Centrifugal pump

• Oxygenator

• LVAD controller

• Heat exchanger