Brain Death and Organ Donation

Question 1

Absence of brain stem reflexes is considered as brain death. Which of the following is a brain stem reflex that should be absent to declare a patient brain dead?
● A. Corneal reflex
● B. Oculovestibular reflex
● C. Oculocephalic reflex
● D. Oropharyngeal reflex
● E. All of the above

Answer 1

E. All of the above

Question 2

Apnea test is used as a confirmatory test for brain death. A patient is confirmed to be brain dead if he/she does not breathe for at least 2 minutes when PaCO2 is kept above what?
● A. 80 mmHg
● B. 70 mmHg
● C. 60 mmHg
● D. 20 mmHg above baseline
● E. Both C and D

Answer 2

E. Both C and D

Question 3

A patient cannot be declared as brain dead in the absence of brain stem reflexes if which of following criteria is met?
● A. Core body temperature less than 36 degrees Celsius
● B. Blood alcohol content more than 0.08%
● C. Neuromuscular blocking agents given to the patient
● D. Systolic blood pressure more than 100 mmHg
● E. A, B, and C

Answer 3

E. A, B, and C

Question 4

Following are ancillary confirmatory tests for brain death except?
● A. Cerebral angiography
● B. EEG
● C. Cerebral radionuclide angiogram (CRAG)
● D. ECG
● E. None of the above

Answer 4

D. ECG

Question 5

Cerebral radionuclide angiogram (CRAG) is an ancillary confirmatory test for brain death. In which of the following setting is this test useful?
● A. When complicating conditions are present such as hypotension, hypothermia
● B. In patients with severe facial trauma where evaluation of ocular findings is difficult
● C. In patients with severe COPD or CHF where apnea test may not be valid
● D. To shorten the observation period
● E. All of the above

Answer 5

E. All of the above

Question 6

Hollow skull phenomenon where there is lack of blood uptake in the ACA and MCA distributions is seen in which test?
● A. CT angiography of brain
● B. MR angiography of brain
● C. CRAG
● D. Transcranial Doppler
● E. All of the above

Answer 6

C. CRAG

Question 7

There can be movement of body parts after brain death which is due to spinal cord discharges as it undergoes cell death. Following features of these movements differentiate them from normal movements except?
● A. These movements are repetitive
● B. Decerebrate posturing
● C. These movements are stereotypical
● D. These do not change with changing stimuli
● E. Finger tremors

Answer 7

B. Decerebrate posturing

Question 8

What is the most reliable means of diagnosis of brain death in term newborns, infants, and children?
● A. Clinical diagnosis
● B. Ancillary tests
● C. Single apnea test
● D. EEG
● E. All of the above

Answer 8

A. Clinical diagnosis

Question 9

Following are the physiologic aberrations that occur in a brain-dead patient which need to be corrected in order to preserve body organs for transplantation except?
● A. Hypotension
● B. Diabetes insipidus
● C. Hypothermia
● D. Electrolytes imbalance
● E. None of the above

Answer 9

D. Electrolytes imbalance

Question 10

Which of the following are requirements of organ donation?
● A. Ventilator-dependent patient
● B. Family agreed to withdraw support
● C. Medical team suspects that the patient would go into asystole in less than 60 minutes after stopping the support
● D. The transplant team cannot participate in end-of-life care or declaration of death
● E. All of the above

Answer 10

E. All of the above