ELSO Adult ECMO Certification Exam

Question 1

A patient on VA ECMO is managed with a continuous unfractionated heparin (UFH) infusion. The primary laboratory test that directly measures the functional effect of UFH by quantifying its inhibition of a specific clotting factor is the:

Activated Clotting Time (ACT) Prothrombin Time (PT/INR) Anti-Factor Xa assay Activated Partial Thromboplastin Time (aPTT)

Correct Answer:

Anti-Factor Xa assay

Question 2

A 48-year-old patient on VV ECMO for ARDS for the past week develops a sudden drop in platelet count from 160,000/µL to 55,000/µL. Simultaneously, new thrombus is visualized in the oxygenator. This clinical presentation is most suspicious for which of the following complications?

Hemodilution from fluid overload Heparin-Induced Thrombocytopenia (HIT) Disseminated Intravascular Coagulation (DIC) Sepsis-induced thrombocytopenia

Correct Answer:

Heparin-Induced Thrombocytopenia (HIT)

Question 3

A patient on ECMO develops significant bleeding from the cannulation site. Laboratory results show an aPTT of 120 seconds (goal 60-80s), hemoglobin of 7.0 g/dL, and platelets of 50,000/µL. Which of the following represents the most appropriate sequence of initial interventions?

Increase ECMO blood flow and administer protamine sulfate. Administer fresh frozen plasma (FFP) and request a surgical consult. Administer protamine sulfate and then transfuse platelets. Stop the heparin infusion, transfuse packed red blood cells and platelets.

Correct Answer:

Stop the heparin infusion, transfuse packed red blood cells and platelets.

Question 4

Unfractionated heparin achieves its anticoagulant effect in the ECMO circuit primarily through which mechanism of action?

Directly binding to and inhibiting thrombin (Factor IIa). Chelating calcium ions, which are essential for the coagulation cascade. Preventing the aggregation of platelets on the circuit surface. Binding to antithrombin, greatly accelerating its inactivation of thrombin and Factor Xa.

Correct Answer:

Binding to antithrombin, greatly accelerating its inactivation of thrombin and Factor Xa.

Question 5

Which of the following is a direct thrombin inhibitor commonly used as an alternative anticoagulant for patients on ECMO who have confirmed Heparin-Induced Thrombocytopenia (HIT)?

Bivalirudin Warfarin Fondaparinux Clopidogrel

Correct Answer:

Bivalirudin

Exam overview

About this Exam

Prepare with the ELSO Adult ECMO Certification Exam practice quiz. This question bank includes 120 questions covering ecmo, patient, circuit, blood, and patients. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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ELSO Adult ECMO Certification Exam

This practice set contains 120 questions from the matching question bank and focuses on ecmo, patient, circuit, blood, and patients. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

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ELSO Adult ECMO Certification Exam

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