ctbs

Question 1

What is an automatic deferral for heart valve donation? a. History of Cancer b. Obesity c. Cardiomyopathy d. Idiopathic Disorders

Answer 1

c. Cardiomyopathy

Question 2

AATB standards require that tissue banking maintain SOPs encompassing all of the following except: a. Donor suitability criteria and record management policies b. FDA regulations that apply to tissue banking c. Procedures for monitoring in-process controls d. Procedures describing criteria for exceptional release of tissue

Answer 2

b. FDA regulations that apply to tissue banking

Question 3

During skin processing what is the maximum amount of time that skin can be exposed to temperatures above 10 degrees Celsius? a. 2hrs b. 1hr c. 8hr d. 4hr

Answer 3

a. 2 hours

Question 4

At what temperature shall cardiovascular tissue be stored? a. -50 degree celsius or colder b. -1 degree celsius or colder c. -25 degree celsius or colder d. -100 degree celsius or colder

Answer 4

d. -100 degree Celsius or colder

Question 5

What must be considered for pediatric heart donors that have been breastfed in the 12 months prior to donation? a. Length of time donor was fed b. Mother’s blood must be used for serology testing c. Analysis of mother’s risk for transmissible disease d. Analysis of mother’s nutritional habits

Answer 5

c. Analysis of mother’s risk for transmissible disease

Question 6

Pre-processing cultures are: a. Used to detect pathogenic yeast viruses & bacteria b. Required by AATB standards c. Reviewed by the medical director designee d. Preformed immediately after tissue exposure to antibiotics

Answer 6

b. Required by AATB standards

Question 7

Which of these blood cells produced in the trabecular area of long bones is responsible for fighting infection? a. Red Blood Cells b. White Blood Cells c. Platelets d. Macrophages

Answer 7

b. White Blood Cells

Question 8

When recovering bone from the lower extremities which bone should be removed last? a. Tibia b. Iliac Crest c. Femur d. Calcaneous

Answer 8

b. Iliac Crest

Question 9

Which of the following organisms cultured from skin shall make skin not suitable for transplantation? a. Cornebacterium Sp. b. Coagulase-Negative Staphylococcuss c. Staphylococcuss Aureus d. Streptococcuss Viridans

Answer 9

c. Staphylococcuss Aureus

Question 10

What is the correct temperature for short-term storage frozen tissue? a. -30 degree celsius or colder b. -4 degree celsius or colder c. -20 degree celsius or colder d. -40 degree celsius or colder

Answer 10

c. -20 degree celsius or colder

Question 11

A 54yo married female with adult children is a potential donor. Who must give consent for donation? a. Mother b. Brother or Sister c. Adult Son or Daughter d. Husband

Answer 11

d. Husband

Question 12

For in process controls what percentage of grafts must be swabbed for testing? a. 100% b. 20% c. 10% d. 50%

Answer 12

a. 100%

Question 13

What is the maximum amount of time that a donor can remain unrefrigerated prior to the commencement or recovery? a. 24hrs b. 12hrs c. 15hrs d. 8hrs

Answer 13

c. 15 hours

Question 14

Which of the following is a cryoprotectant a. Isotonic Saline b. Glycerol c. RPMI d. Typticase Soy Broth

Answer 14

b. Glycerol

Question 15

The upper time limit from retrieval to processing of heart valves is a. There is no time limit as long as aseptic technique is maintained during the recovery b. Total ischemic time must not exceed 48hrs c. Cold ischemic time must not exceed 48hrs d. Warm ischemic time must not exceed 48hrs

Answer 15

b. Total ischemic time must not exceed 48hrs

Question 16

All tissues not already transplanted which are subject to recall shall be located and quarantined pending resolution of the recall (T/F)?

Answer 16

TRUE

Question 17

Which of the following is not a colloid solution? a. Fresh Frozen Plasma b. Ringers Lactate c. Dextran d. Albumin

Answer 17

b. Ringers Lactate

Question 18

What is the most common STD in the US? a. HIV b. Syphilis c. Genital Herpes d. Gonorrhea

Answer 18

c. Genital Herpes

Question 19

What is the most common bloodbourne pathogen in the US today? a. HIV b. Hepatitis B c. Hepatitis A d. Hepatitis C

Answer 19

b. Hepatitis B

Question 20

What is the minimum classed environment needed for processing of cardiovascular tissue? a. Not Applicable b. Class 10 or Cleaner c. Class 500 or Cleaner d. Class 100 or Cleaner

Answer 20

d. Class 100 or Cleaner

Question 21

What tissue transplant is most closely associated with CJD? a. Iliac Crest b. Femur c. Dura Mater d. Skin

Answer 21

d. Dura Mater

Question 22

Serological testing on a potential donor reveals a positive HIV antibody screening test. The screening test is positive on repeat testing but the confirmatory test result is negative. What happens to the tissue. a. May not be used; discrepant results obtained b. May be used; HIV antibody test is not a required test c. May be used; confirmatory test is negative d. May not be used; results of confirmatory test cannot override a screening test

Answer 22

d. May not be used; results of confirmatory test cannot override a screening test

Question 23

Which of the following is not a cause for deferral? a. A Positive PPD Test for TB b. Untreated Syphilis c. Systemic Mycosis d. Evidence of Sepsis

Answer 23

a. A Positive PPD Test for TB

Question 24

Which of the following transplants is most commonly associated with spread of prion related disease? a. Skin b. Dura Mater c. Bone d. Blood Transfusion

Answer 24

b. Dura Mater

Question 25

Which of the following is NOT capable of osteoinduction? a. Demineralized Allograft b. Demineralized Xenograft c. Demineralized Allopast d. Demineralized Autograft

Answer 25

c. Demineralized Allopast

Question 26

How long should donor records be held? (not including Dura mater) a. 20yrs Beyond Date of Final Disposition b. 5yrs Beyond the Date of Final Disposition c. Not a Requirement d. 10yrs Beyond Date of Final Disposition

Answer 26

d. 10yrs Beyond Date of Final Disposition

Question 27

Name the first civilian regional tissue bank established in the US. a. University of Miami b. Florida State University c. United States Navy d. University of Florida

Answer 27

a. University of Miami

Question 28

Which of the following does NOT have to be included on graft package inserts? a. Instruction for Opening the Package or Container b. Date of Processing of the Graft c. A Statement Indicating That the Tissue may Transmit Infectious Agents d. Type of Antibiotics Used in Processing

Answer 28

b. Date of Processing of the Graft

Question 29

During heart for valve for recovery the aorta is cut 1 cm distal to the a. Pulmonary Artery b. Brachiocephalic Artery c. Carotid Artery d. Subclavian Artery

Answer 29

d. Subclavian Artery

Question 30

Which of the following would NOT be a viral hepatitis rule out? a. Incarceration in Prison or Jail for Greater Than 72hrs in the Preceding 12 mos. b. Close Contact With a Person Having Viral Hepatitis in the Preceding 12 mos. c. Documented Hepatitis A Cytomegalovirus or Epstein Barr Virus d. Perutaneous Exposure to Blood Thought to be High Risk for Carrying Hepatitis in the Preceding 12mos

Answer 30

c. Documented Hepatitis A Cytomegalovirus or Epstein Barr Virus

Question 31

If skin is to stored >96 hrs prior to processing how often must skin storage media be change? a. Every 24hrs b. Every 96hrs c. Every 72hrs d. Every 12hrs

Answer 31

c. Every 72hrs

Question 32

Wolf’s Law describes a. Fracture Repair in Long Bones b. The Amount of Pressure a Bone can Take Before Fracture c. The Relationship Between Form and Function in Bone. d. Bone Regeneration

Answer 32

d. Bone Regeneration

Question 33

AN example of the immune response is a. Low pH on the skin b. Itching from a bee sting c. Normal flora of the intestines d. Flushing action of tears

Answer 33

b. Itching from a bee sting

Question 34

Which of the following would be used for an osteochondral graft? a. Patellar Tendon b. Tri-Cortical Iliac Wedge c. Crushed Cancellous/Cortical Chips d. Distal Femur

Answer 34

d. Distal Femur

Question 35

At what temp should hearts be transported to the processing facility? a. 4 degree celsius b. 1-10 degree celsius c. 2-10 degree celsius d. Temp doesn’t matter as long as the heart is on ice

Answer 35

b. 1-10 degree celsius

Question 36

Which organism if present requires discarding of skin grafts? a. Staphylococcus Sicuri b. Streptococcus Sanguis c. Streptococcus Viridans d. Staphylococcus Aureus

Answer 36

d. Staphylococcus Aureus

Question 37

Cryopreserved allograft saphenous veins are NOT used in which procedure? a. AV Fistulas for use as Dialysis Conduits b. Peripheral Vascular Surgery c. Temporary Limb Revascularization in Traumatic Vessel Loss. d. Carotid Endarterectomies

Answer 37

d. Carotid Endarterectomies

Question 38

Quality control is described by all of the following EXCEPT: a. Is one Dimension of Quality Assurance b. Provides for the Creation of Standard Operating Procedures c. Provides Microbiological Testing of Tissue at Pre-Sterilization and at Final Packaging Stages. d. Provides Tests to Monitor Specific Processes

Answer 38

b. Provides for the Creation of Standard Operating Procedures

Question 39

Is Albumin a crystalloid or colloid?

Answer 39

Colloid

Question 40

Which of the following organisms found on pre-processing culture from bone shall be a deferral of that tissue? a. Nuisancesis Kasprinis b. E.Coli c. Cornebacterium Sp. d. Clostridium Sp. e. Staphylococcus

Answer 40

Any of these are correct: E.Coli Clostridium Sp Staphlococcus

Question 41

A donor has a verbal history of hepatitis. The donor is acceptable if the hepatitis was before what age? a. 12 b. 13 c. 14 d. 11

Answer 41

d. 11

Question 42

Is a plasma dilution algorithm required for a 10yo donor with no history of blood loss? (Y/N)

Answer 42

No

Question 43

At what temp should refrigerated skin be stored? a. 30-40 degree celsius b. 10-20 degree celsius c. -5 to -10 degree celsius d. 1-10 degree celsius

Answer 43

d. 1-10 degree celsius

Question 44

The right ventricular outflow tract contains the ___valve and conduit and the left ventricular outflow tract contains the ___valve and conduit. a. Tricuspid Mitral b. Aortic Pulmonary c. Mitral Tricuspid d. Pulmonary Aortic

Answer 44

d. Pulmonary Aortic

Question 45

The most probable origin of bacteria contaminating a heart procurement is: a. Lungs b. Skin c. Upper Respiratory Tract d Blood

Answer 45

a. Lungs

Question 46

Optimal freezing rate for allograft heart valve is: a. 1 deg celsius/minute b. 5 deg celsius/second c. 5 deg celsius/minute d. 1 deg celsius/second

Answer 46

a. 1 deg celsius/minute

Question 47

Total ischemic time in heart for valve recovery should not exceed: a. 24hrs b. 36hrs c. 12hrs d. 48hrs

Answer 47

d. 48hrs

Question 48

What is the maximum time recovered musculoskeletal tissue shall remain at wet ice temp before either processing or freezing? a. 12hrs b. 15hrs c. 72hrs d. 24hrs

Answer 48

c. 72hrs

Question 49

Processing and packaging of cardiovascular grafts must take place under: a. class 100/1000 conditions b. class 1000/100 conditions c. class 100/100 conditions d. class 1000/1000 conditions

Answer 49

c. class 100/100 conditions

Question 50

To grow on laboratory media anaerobic organisms require: a. Reduced Oxygen b. Increased Oxygen c. Reduced Nitrogen d. Increased Hydrogen

Answer 50

a. Reduced Oxygen

Question 51

The most common means of sterilization for musculoskeletal tissue is the use of: a. Ethylene Oxide b. Ionizing Radiation c. Carbon Dioxide d. Pressurized Steam

Answer 51

b. Ionizing Radiation

Question 52

Which bone(s) is not in the foot? a. Metacarpal Bones b. Metatarsal Bones c. Phalanges d. Lateral Cuneiform Bone

Answer 52

a. Metacarpal Bones

Question 53

Early data suggests that cryopreservation of the cardiac allografts made them superior to both porcine and mechanical valves in terms of freedom from ____ and _____. a. Blood Thinners/Carbon Plated Support Ring b. Dysfunction/Noise c. Re-operation/Infection d. Degeneration/High Cost

Answer 53

a. Blood Thinners/Carbon Plated Support Ring

Question 54

Is TPN a crystalloid or colloid?

Answer 54

Crystalloid

Question 55

When swab cultures are taken immediately prior to final packaging what culture protocol will be use? a. 7 day 4 media 2 temp b. 14 day 2 media 2 temp c. 14 day 4 media 2 temp d. 7 day 2 media 2 temp

Answer 55

b. 14 day 2 media 2 temp

Question 56

Who has the ultimate responsibility of determining donor suitability? a. Medical Designee b. Medical Examiner c. Both a and b are Correct d. CEO

Answer 56

a. Medical Designee

Question 57

Which process does not require bone to be present? a. Osteoinduction b. Osteogenesis c. Hematopoiesis d. Osteoinduction

Answer 57

c. Hematopoiesis

Question 58

The horizontal plane is a plane that passes thru the body at right angels to the ___ and ___planes. a. Medial and Oblique b. Coronal and Medial c. Coronal and Lateral d. Coronal and Oblique

Answer 58

b. Coronal and Medial

Question 59

What is assigned to a donor to facilitate tracing of individual grafts to that donor? a. SSN b. Unique Identifier c. Random Number d. Barcode

Answer 59

b. Unique Identifier

Question 60

An informed consent should include a statement that blood samples from the donor will be tested for certain transmissible diseases? a. False b. True c. It isn’t necessary if an OPO gets the consent

Answer 60

b. True

Question 61

Processing of skin that is to be frozen/cryopreserved shall be initiated within how many days of recovery? a. 7 days b. 2 days c. 10 days d. 20 days

Answer 61

c. 10 days

Question 62

What is the shelf life for tissue stored at temperature below -40 deg celsius? a. 1yr unless a longer expiration date has been validated b. 5 yrs unless a longer expiration date has been validated c. not applicable d. 20 yrs unless a longer expiration date has been validated

Answer 62

b. 5 yrs unless a longer expiration date has been validated

Question 63

A patient has a fever elevated white count and positive blood cultures for E.coli according to AATB standards what action should be taken with musculoskeletal tissue? a. Accept Bone Defer Tendons b. Accept but Radiate c. Accept d. Defer

Answer 63

d. Defer

Question 64

All of the following are advantages of using allograft heart valves except: a. Non-Obstructive Flow b. Catastrophic Failures are Rare c. Anticoagulation Therapy is not Needed d. Supply is Unlimited Compared to Xenographs

Answer 64

d. Supply is Unlimited Compared to Xenographs

Question 65

Which best describes the flow of blood through the heart? a. Right atrium right ventricle pulmonary artery pulmonary vein left atrium left ventricle b. Left atrium left ventricle pulmonary vein right atrium right ventricle c. Right atrium right ventricle pulmonary vein pulmonary artery left atrium left ventricle. d. Left atrium left ventricle pulmonary artery pulmonary vein right atrium right ventricle

Answer 65

a. Right atrium right ventricle pulmonary artery pulmonary vein left atrium left ventricle

Question 66

Which of the following is NOT an adequate transport solution characteristic for the recovered heart? a. Isotonic b Cryoprotectant c. Cold d. Sterile

Answer 66

b. Cryoprotectant

Question 67

Which of the following is not a structural allograft? a. Femoral Cortical Strut b. Iliac Crest Wedge c. Cloward Dowel d. Ground Corticocancellous

Answer 67

d. Ground Corticocancellous

Question 68

You have consent for skin and musculoskeletal tissue but the donor has rheumatoid arthritis. According to AATB standards is the donor a deferral? a. No skin could be recovered b. Yes musculoskeletal tissue can be recovered c. No musculoskeletal tissue can be recovered d. AATB has no guidance in this tissue

Answer 68

a. No skin could be recovered

Question 69

During heart valve dissection processed cardiac tissue is placed in antibiotic solution resulting in a ____ graft. a. Viable b. Clean c. Sterilized d. Decontaminated

Answer 69

d. Decontaminated

Question 70

In anatomical position and direction the term LATERAL refers to something that is a. Farther from the middle of the body than another structure. b. Superficial to another structure c. On the opposite side of the body d. Between two structures

Answer 70

a. Farther from the middle of the body than another structure.

Question 71

The angel of the dermatome blade to the skin surface during skin recovery is a. 45 degrees b. 30 degrees c. 60 degrees d. 15 degrees

Answer 71

a. 45 degrees

Question 72

If skin storage media is not changed processing shall be initiated within how many hours of recovery? a. 24hrs b. 72hrs c. 48hrs d. 96hrs

Answer 72

d. 96hrs

Question 73

According to the Karl Fisher analysis lyophilized allograft tissue may not have a residual moisture exceeding. a. 5% b. 6% c. 8% d. 7%

Answer 73

b. 6%

Question 74

Cryoprotectant is absorbed by tissue cells thru the process of: a. Infusion b. Osmosis c. Diffusion d. Perforation

Answer 74

b. Osmosis

Question 75

Cryoprotectants are used for all of the following except: a. To prevent cell shrinkage b. To prevent intercellular ice formation c. To prevent extracellular ice formation d. To minimize osmotic imbalances

Answer 75

c. To prevent extracellular ice formation

Question 76

AATB standards require that tissue processing be preformed by: a. CTBS technicians b. Staff member with a medical background c. Staff member with sufficient background experienced and training d. Staff member with 2-4 yr degree

Answer 76

c. Staff member with sufficient background experienced and training

Question 77

Which of the following is used for quality control of gamma irradiation? a. Bacillis subtilis spore strips b. Bacillis pumilus spore strips c. Bacillis cereus spore strips d. Chemical indicator sport strips

Answer 77

b. Bacillis pumilus spore strips

Question 78

Donors with a history of exposure to or ingestion of toxic substances should be: a. Deferred as a tissue donor b. Accepted as a tissue donor depending on the ID of the substance c. Considered as suitable if the tissue bank specialist adheres to universal precautions d. Evaluated by the medical director for transplant suitability

Answer 78

d. Evaluated by the medical director for transplant suitability

Question 79

A donor has systemic lupus according to AATB standards which of the following tissues must be deferred? a. Femoral Artery b. Achilles Tendon c. Heart Valves d. Skin

Answer 79

d. Skin

Question 80

The 2 heart valves most often used in cardiac surgery are the a. Mitral Tricuspid b. Ventricle Atrium c. Pulmonary Aortic d. Bicuspid Mitral

Answer 80

c. Pulmonary Aortic

Question 81

AATB requirements for serological testing include all of the following except a. HBsAg b. RPR c HIV I&II d. HIV Ag

Answer 81

d. HIV Ag

Question 82

Which of the following diseases is caused by a spirochete? a. HCV b. Syphilis c. CJD d. HIV

Answer 82

b. Syphilis

Question 83

What is the name of the incision used for musculoskeletal tissue recovery? a. Harris approach b. McFarland & Osborne approach c. Modified Watson Jones d. Hardinge Approach

Answer 83

c. Modified Watson Jones

Question 84

All of the following vessels are transected during heart for valve recovery except: a. Left Coronary Artery b. Left Common Carotid c. Brachiocephalic d. Left Subclavian

Answer 84

a. Left Coronary Artery

Question 85

What was the first established tissue bank? a. University of Florida Tissue Bank b. US Naval Tissue Bank c. University of Miami Tissue Bank d. US FDA Tissue Bank

Answer 85

b. US Naval Tissue Bank

Question 86

Over what age is an algorithm no longer necessary if there is no bleed and the donor has been infused? a. 10 b. 12 c. 14 d. 8

Answer 86

b. 12

Question 87

Retrieved musculoskeletal tissue will be wrapped aseptically with at least ___moisture barriers? a. 2 b. 4 c. 3 d. 1

Answer 87

d. 1

Question 88

AATB states all of the following agents are unacceptable for disinfection of musculoskeletal grafts except: a. Formaldehyde b. Ethanol c. Mercurials d. Chloroform

Answer 88

b. Ethanol

Question 89

What is the defined time frame for long term tissue storage? a. >18 months b. >6 months c. > 2yrs d. > 12 months

Answer 89

b. >6 months

Question 90

The largest organ of the human body is? a. Skin b. Heart c. Liver d. Kidney

Answer 90

a. Skin

Question 91

For cardiovascular tissue total warm time and cold ischemic time shall not exceed how many hours? a. 24hrs b. 48hrs c. 72hrs d. 12hrs

Answer 91

b. 48hrs

Question 92

What is the upper age limit for cardiovascular tissue? a. 70yrs b. 62yrs c. 60yrs d. no age limit

Answer 92

c. 60yrs

Question 93

To fill an osseous defect all of the following may be used except: a. Corticocancellous b. DFDBA c. Semitendinosis d. Cancellous

Answer 93

c. Semitendinosis

Question 94

What is the primary healing mechanism after allograft implantation? a. Osteoclastic Degeneration b. Re-Vascularization c. Osteoblastic Regeneration d. Creeping Substitution

Answer 94

d. Creeping Substitution

Question 95

Which of the following diseases is probably caused by a prion? a. HTLV-1 b. CJD c. HIV d. Hepatitis C

Answer 95

b. CJD

Question 96

Which of the following tests are not required by AATB? a. HIV p24 anitgen b. Anti-HTLV-1 c. HIV NAT d. Anti-HIV -1

Answer 96

b. Anti-HTLV-1

Question 97

Is HIV/NAT testing required by AATB standards? (Y/N)

Answer 97

Yes

Question 98

The warmest temp allowable for storage of cryopreserved heart valve is a. -100 degrees celsius b. -80 degrees celsius c. -196 degrees celsius d. -40 degrees celsius

Answer 98

a. -100 degrees celsius

Question 99

You have recovered the heart valves from a 4 month old who died as a result of SIDS. In SIDS cases an autopsy must be performed to determine: a. The Cause of Death b. True Age of Donor c. Time of Death d. None of these

Answer 99

a. The Cause of Death

Question 100

The prefix of a medical term will usually tell you: a. The Action b. The Condition c. The Part Effected d. The Location

Answer 100

c. The Part Effected

Question 101

What is the term for cells and/or tissues intended for transplant into another individual of the same species? a. Tissue b. Zenograft c. Autograft d. Allograft

Answer 101

d. Allograft

Question 102

The technique implementing the use of a unicortical dowel for spinal infusions is referred to as the: a. Cloward Procedure b. Smith-Jones Procedure c. Smith-Barr Procedure d. Patsy Cline Procedure

Answer 102

a. Cloward Procedure

Question 103

During the dehydration of grafts what is the maximum allowable temp per AATB standards? a. 40 degrees celsius b. 80 degrees celsius c. 20 degrees celsius d. Whatever temperature set by the SOP manual

Answer 103

d. Whatever temperature set by the SOP manual

Question 104

Which area of the heart carries oxygenated blood? a. Right Atrium b. Aortic Arch c. Right Ventricle d. Pulmonary Artery

Answer 104

b. Aortic Arch

Question 105

Which type of allograft is not used in the resection of a mandibular tumor? a. Mandible b. DFDBA c. LeFort Wedge d. Rib

Answer 105

c. LeFort Wedge

Question 106

Musculoskeletal tissue excision must commence within: a. 15hrs if the body was not refrigerated within 8hrs of death b. 24hrs provided body was refrigerated within 12hrs of death c. 24hrs of death d. 36 hrs as long as body was refrigerated within 4 hrs of death

Answer 106

b. 24hrs provided body was refrigerated within 12hrs of death

Question 107

The maximum residual ETO level in a 100 gram tissue must not exceed a. 10ppm b. 100ppm c. 1000ppm d. 50ppm

Answer 107

b. 100ppm

Question 108

The layers of the heart from inside to outside are a. Epicardium Pericardium Myocardium b. Myocardium Endocardium Exocardium c. Endocardium Myocardium Epicardium d. Endocardium Myocardium Exocardium

Answer 108

c. Endocardium Myocardium Epicardium

Question 109

What muscle is transected at the quadriceps tendon during the tissue recovery? a. Vastus Quadralis b. Rectus Femoris c. Iliotibial Band d. Semitendinosis

Answer 109

b. Rectus Femoris

Question 110

Potential donors who have received pituitary derived human growth hormone should be excluded from tissue donation due to the possibility of transmission of: a. Dwarfism b. Alzheimer’s Disease c. Encephalitis d. CJD

Answer 110

c. Encephalitis

Question 111

Assuring and verifying confidence in the quality of the process used for finished tissue and documenting that the entire process conforms with AATB standards for tissue banking is called: a. Quality Control b. Quality Assurance c. Quali- Temps d. Quality Systems

Answer 111

b. Quality Assurance

Question 112

During heart for valve recovery which of the following vessels should be left at maximum length? a. Pulmonary Artery b. Pulmonary Vein c. Superior Vena Cava d. Inferior Vena Cava

Answer 112

b. Pulmonary Vein

Question 113

Quality assurance is required to investigate all adverse outcomes and: a. Employee Complaints of Unfair Treatment b. Employee Complaints Regarding a Client c. Employee Complaints of Sexual Harassment d. Employee Accidents

Answer 113

d. Employee accidents

Question 114

A potential donor’s history includes rheumatoid arthritis that required prolonged systemic steroid use. You should: a. Call the family physician b. Proceed with recovery c. Defer the donation d. Get medical director opinion

Answer 114

c. Defer the donation

Question 115

In what instance would an elevated WBC count no necessarily indicate an infectious process? a. Long term ventilator assisted breathing b. Head trauma c. Prolonged elevated body temp d. Pneumonia

Answer 115

b. Head trauma

Question 116

Documentation of a telephone consent with the next of kin must include: a. Recording or monitoring by the requestor and a witness b. Self signed donor document or photocopy c. Telegram documenting next of kin consent d. Signature of next of kin and a witness

Answer 116

a. Recording or monitoring by the requestor and a witness

Question 117

An agent that kills microorganisms on inanimate objects is: a. A disinfectant b. A bacteriostat c. An antiseptic d. A sterilizer

Answer 117

a. A disinfectant

Question 118

For what serological test may a confirmatory test be used to override a screening test result? a. RPR b. CMV c. HIV I & II d. HTLV I & II

Answer 118

a. RPR

Question 119

Examination of the body should look for evidence of which of the following? a. All of these b. Lymph Nodes c. Genital Ulcerative Disease d. Oral Thrush

Answer 119

a. All of these

Question 120

All of the following allografts can be used for ACL repairs except: a. Patellar Tendon b. Achilles Tendon c. Semitendinosus d. Round Ligament

Answer 120

d. Round Ligament

Question 121

For tissue less than 10 grams in size the acceptable residual level of ETO in parts per million is: a. 250 b. 5000 c. 25 d. 100

Answer 121

a. 250

Question 122

The lateral malleolus is part of which bone? a. Fibula b. Distal Femur c. Metatarsal d. Tibia

Answer 122

a. Fibula

Question 123

There are ___ bones in the human body a. 406 b. 306 c. 206 d. 106

Answer 123

c. 206

Question 124

The cruciate ligament attaches which two bones? a. femur tibia b. humerus radius c. tibia fibula d. femur acetabulum

Answer 124

Femur and Tibia

Question 125

Microbiology procedures NOT required by AATB standards are: a. Pre-Disinfection Cultures b. Environmental Cultures c. Procurement Cultures d. Pre-Packaging Cultures

Answer 125

a. Pre-Disinfection Cultures

Question 126

What does the term ‘ window period’ mean in reference to testing for an infectious disease? a. The time of the first immunoglobulin response b. The time of infection with the virus c. The amount of viral load detected d. The time from infection to a detectable level

Answer 126

d. The time from infection to a detectable level

Question 127

According to AATB standards refrigerated skin can be stored: a. At 10 degrees celsius for 12 days b. At 14 degrees celsius for 10 days c. At 8 degrees celsius for 16 days d. At 12 degrees celsius for 14 days

Answer 127

d. At 12 degrees celsius for 14 days

Question 128

If a chart review of potential donor who has expired from a gun shot wound to the head reveals a WBC count of 31 000 you should: a. Take note of the results and report them to the medical director b. Decline the donation the high WBC indicated infection c. Take note of the WBC count and decline the donation unless the tissue is urgently needed d. Ignore this value since this is often seen in head injuries

Answer 128

d. Ignore this value since this is often seen in head injuries

Question 129

According to AATB standards monetary compensation of a donor may be given when: a. Incentives will influence loved ones to donate b. Donor families need funds for burial expenses c. A donor’s estate request it d. Living donors incur costs for their donation

Answer 129

d. Living donors incur costs for their donation

Question 130

A donor was last seen by spouse at 6pm phoned home at 7pm flushed toilet at 8pm was found asystolic by ambulance staff and pronounced at 11pm. What time is used for last know alive? a. 11pm b. 8pm c. 6pm d. 7pm

Answer 130

b. 8pm

Question 131

There are approximately ___cubic centimeters in one fluid ounce a. 16 b. 36 c. 12 d. 30

Answer 131

d. 30

Question 132

At what temp should frozen musculoskeletal tissue be stored for >6months? a. -20 degrees celsius or colder b. -40 celsius or colder c. -60 degrees celsius or colder d. -10 degrees celsius or colder

Answer 132

b. -40 celsius or colder

Question 133

AATB standards require that donor retrieval processing storage and distribution records be maintained ___after last tissue is distributed a. 5 yrs b. 7 yrs c. Indefinitely d. 10yrs

Answer 133

d. 10yrs

Question 134

According to the Uniform Anatomical Gift Act the order of priority of family members who are considered legal next of kin is: a. Parents Spouse Siblings Guardian b. Spouse Children Parents Guardian c. Spouse Guardian Siblings Parents d. Children Parents Siblings Spouse

Answer 134

b. Spouse Children Parents Guardian

Question 135

Which of the following is not an automatic deferral? a. Repeat reactive HBsAg b. Repeat reactive anti-HTLV-1 c. Repeat reactive RPR d. Repeat reactive anti-HIV-1

Answer 135

c. Repeat reactive RPR

Question 136

According to AATB standards which of the following is NOT required? a. An adverse reaction file b. Tissue retrieval within 12hrs of asystole c. Donor and recipient confidentiality d. Records documenting facility and equipment monitoring

Answer 136

c. Donor and recipient confidentiality

Question 137

A patient receives one tablespoon and 2 tsp of medicine. How many cc’s were administered? a. 20 b. 25 c. 15 d. 30

Answer 137

b. 25

Question 138

In what year was the AATB established? a. 1976 b. 1986 c. 1996 d. 1979

Answer 138

a. 1976

Question 139

Most allografts that failed to transmit disease in the Simonds study were? a. Osmolized b. Freeze dried c. Characterized by having all cellular elements removed d. Demineralized

Answer 139

d. Demineralized

Question 140

Which of the following results in automatic deferral? a. Repeat reactive anti-HIV-1 b. Repeat reactive HBsAg c. Initially reactive anti-HTLV-1 d. Confirmed positive syphilis

Answer 140

All these are correct: a. Repeat reactive anti-HIV-1 b. Repeat reactive HBsAg c. Initially reactive anti-HTLV-1

Question 141

When preserving grafts by controlled rate freezing which of the following must be closely monitored? a. Temperature change over time b. Time at which -40 degrees celsius is reached c. Latent heat of fusion d. Package integrity

Answer 141

c. Latent heat of fusion

Question 142

Which of the following allograft types is not used in total hip revision? a. Femoral Head b. Distal Femur c. Proximal Osteoarticular d. Proximal Head

Answer 142

c. Proximal Osteoarticular

Question 143

AATB allows for the release of tissue without complete tissue results. In such circumstances all of the following documentation is required except: a. End user waiver form b. Medical director release c. Documented clinical need d. Recipient approval

Answer 143

c. Documented clinical need

Question 144

What procurement technique best reduces the risk of transport bio-burden (transporting microorganisms with the heart)? a. Keeping the heart at required temp after recovery b. Surgical hand scrub c. Thorough rinsing of the heart with sterile solution d. Shortened transport time

Answer 144

c. Thorough rinsing of the heart with sterile solution

Question 145

Donor suitability records for dura mater donors shall be retained for what period of time? a. Indefinitely b. Not a requirement c. 1 yr d. 5 yrs

Answer 145

a. Indefinitely

Question 146

Bone resulting from the use of demineralized human graft materials probably forms by: a. Autogenesis b. Guided tissue regeneration c. Endochondral formation d. Intramembranous formation

Answer 146

b. Guided Tissue regeneration

Question 147

Which of the following statements about disease transmission is false? a. Heart valves commonly transmit bacterial infection b. Corneas can transmit CJD c. Tuberculosis infection from transplanted kidneys is an emerging problem d. Corneas are poor transmitters of microorganisms

Answer 147

c. Tuberculosis infection from transplanted kidneys is an emerging problem

Question 148

Skin and musculoskeletal recovery shall commence within how many hours of asystole if the body was not refrigerated: a. 8hrs b. 4hrs c. 15hrs d. 12hrs

Answer 148

c. 15hrs

Question 149

On what date did the GTPs go into effect? a. May 25 2204 b. May 14 2004 c. May 14 2005 d. May 25 2005

Answer 149

d. May 25 2005

Question 150

If a donor is in the prone position is the donor face up or face down?

Answer 150

Face down

Question 151

According to AATB standards how often must a comprehensive internal audit be done? a. Quarterly b. Annually c. Monthly d. Semi-annually

Answer 151

b. Annually

Question 152

The Ross procedures uses pulmonary heart valve allografts to replace: a. The mitral valve which is then used to replace the semilunar valve b. The aortic valve which is then used to replace the pulmonary valve c. The tricuspid valve which is then used to replace the mitral valve d. The pulmonary valve which is then used to replace the aortic valve

Answer 152

d. The pulmonary valve which is then used to replace the aortic valve

Question 153

Which of the following blood cells produced in the trabecular area of long bone is responsible for fighting infection? a. Red blood cells b. White blood cells c. Platelets d. Macrophages

Answer 153

b. White blood cells

Question 154

Which of the following is not a deferral criteria for cardiovascular tissue? a. Bacterial Endocarditis b. Diabetes Mellitus c. Rheumatic Fever d. Idiopathic Cardiomyopathy

Answer 154

b. Diabetes Mellitus

Question 155

Which of the following is the site of growth in long bones? a. Diaphyis b. Metaphysis c. Epiphysis d. Periosteum

Answer 155

c. Epiphysis

Question 156

What year did the FDA issue the interim rule for human tissue for transplantation? a. 1987 b. 1993 c. 1986 d. 1992

Answer 156

b. 1993

Question 157

At what age is a hemodilution algorithm required if the donor has been transfused or infused at all? a. 15yrs b. 10yrs c. 14yrs d. 16yrs

Answer 157

b. 10yrs

Question 158

During aseptic recovery a long bone tissue involved in an open fracture: a. May be recovered if the bone is soaked in antibiotics b. May be recovered if normal cryopreservation techniques are used c. May never be recovered d. May be recovered if it has been submerged in alcohol for 10min prior to wrapping

Answer 158

c. May never be recovered

Question 159

Refrigerated MS tissue must be retrieved aseptically and placed in an isotonic or nutrient medium with suitable antibiotics at no more than: a. 15 degrees C b. 20 degrees C c. 25 degrees C d. 10 degrees C

Answer 159

d. 10 deg C

Question 160

Age limits for MS tissue donation are determined by: a. The requesting physician b. The donor family c. The medical director d. The medical history of the donor

Answer 160

c. The medical director

Question 161

The major weight baring bone between the ankle and the knee is the: a. Tarsus b. Fibula c. Femur d. Tibia

Answer 161

d. Tibia

Question 162

Bone resulting from the use of demineralized human graft materials probably forms by: a. Endochondral Formation b. Guided Tissue Regeneration c. Intramembranous Formation d. Autogenesis

Answer 162

b. Guided Tissue Regeneration

Question 163

Which of the following cells is the most prevalent in the remodeling of bone: a. Osteoclasts b. Osteocytes c. Mesenchymal Cells d. Osteoblasts

Answer 163

d. Osteoblasts

Question 164

Massive intercalary allografts are used primarily for: a. Bone Induction Process b. Structural Support in Long Bones c. Placing in Infected Wounds d. Grinding into Chips for Filling Defects

Answer 164

b. Structural Support in Long Bones

Question 165

Retrieved MS tissue must be wrapped in an aseptic fashion with at least ___moisture barriers a. 3 b. 2 c. 1 d. 4

Answer 165

b. 2

Question 166

MS tissue excision must begin within: a. 36hrs of systole if body was refrigerated within 4hrs of asystole b. 24hrs of systole c. 15hrs of systole if body was refrigerated within 8hrs of asystole d. 24hrs of asystole if the body was refrigerated within 12 hours of systole

Answer 166

d. 24hrs of asystole if the body was refrigerated within 12 hrs of systole

Question 167

When recovering patellar tendons to be used in anterior cruciate reconstruction: a. Sufficient bone should be left on the tibial insertion of the tendon to allow for bony fixation b. The bone should be removed from the tibial insertion of the tendon c. The tendon should be split into fourths d. The patella should be completely removed from the tendon

Answer 167

a. Sufficient bone should be left on the tibial insertion of the tendon to allow for bony fixation

Question 168

The lesser trochanter is a landmark on the: a. Femur b. Humerus c. Ulna d. Tibia

Answer 168

a. Femur

Question 169

When recovering the femur the incision should begin: a. Anteriorly over the patellar tendon b. At the anterior-superior iliac spine c. At the lateral aspect of the femur d. At the greater trochanter

Answer 169

b. At the anterior-superior iliac spine

Question 170

Osteochondral allograft refers to bone that has been treated primarily to cryopreserve the: a. Haversion System b. Cartilate of Articular Surfaces c. Cortical Bone Matrix d. Bone Morphogenic Proteins

Answer 170

c. Cortical Bone Matrix

Question 171

If any additional processing of refrigerated MS tissue is necessary the total wet ice/refrig time must not exceed ___ from time of retrieval a. 5 days b. 72hrs c. 24hrs d. 4 days

Answer 171

b. 72hrs

Question 172

If the donor body has not been refrigerated tissue excision must begin within____hrs of asystole a. 15 b. 24 c. 12 d. 10

Answer 172

a. 15

Question 173

Skin should be procured to depth of: a. 6-11 thousands of an inch b. 19-35 thousands of an inch c. 1-5 thousands of an inch d. 12-18 thousands of an inch

Answer 173

d. 12-18 thousands of an inch

Question 174

Which of the following medications could possibly mask an infection process and may contribute to thin brittle skin? a. Antihypertensive b. Topical lotions containing para amino benzoic acid c. Long term high dosages corticosteroids d. Anti-depressants

Answer 174

c. Long term high dosages corticosteroids

Question 175

When skin grafts are removed the use of tissue culture media such as RPMI or DMEM is: a. Selected because they contain a pH indicator not present in normal saline b. Because of the nutrient support it provides to the skin cells c. Due to the unique dilutent properties they possess with glycerol for freezing d. Because of nutrient support for the stratum corneum

Answer 175

b. Because of the nutrient support it provides to the skin cells

Question 176

In order to maintain optimal cellular viability skin grafts may be maintained prior to freezing: a. In sterile water b. In tissue culture media at 1 degree C to 10 degrees C c. At 25 degrees C d. Indefinitely at 4 degrees C

Answer 176

b. In tissue culture media at 1 degree C to 10 degrees C

Question 177

While shaving the donor for skin recovery the technician: a. Must shave only if the donor is very hairy b. Should shave carefully to remove all hair that may trap bacteria or debris in the graft area. c. Should use only an electric razor to avoid nicks in the skin. d. Need not be concerned about nicks as they will be removed during processing

Answer 177

b. Should shave carefully to remove all hair that may trap bacteria or debris in the graft area.

Question 178

Following skin recovery the tissue: a. Should be maintained at -40 degrees C until placed in liquid nitrogen. b. Must be placed into cryopreservation media immediately to prevent cellular damage c. Must be immediately placed into sterile solution d. Should be soaked in antibiotic solution

Answer 178

c. Must be immediately placed into sterile solution

Question 179

Split thickness allograft skin may be used for all of the following EXCEPT: a. Testing the suitability of the wound bed for autografting b. Permanent coverage of small full thickness wounds. c. Overlay of widely meshed skin d. Temporary coverage of excised wounds

Answer 179

b. Permanent coverage of small full thickness wounds.

Question 180

Which of the following statements regarding rewarming of skin is NOT true? a. A major goal is the maintenance of tissue viability b. The temp of the rewarming bath should be 10-37 deg c. It should be removed from it’s package prior to rewarming d. Significant structural damage can occur during rewarming

Answer 180

c. It should be removed from it’s package prior to rewarming

Question 181

Which of the following is NOT a true statement regarding shipment of skin to the processing center: a. The volume of transport solution must completely cover skin b. The courier needs to be certified c. The skin transportation container must be transported at wet ice temp d. The skin transportation container must be fluid tight

Answer 181

b. The courier needs to be certified

Question 182

Processing of skin that is to be frozen/cryopreserved must be initiated within ___days of retrieval provided the skin is placed in tissue storage media which is replaced every ____hrs. a. 5 days/48hrs b. 10 days/72 hrs c. 15 days/24 hrs d. 3 days/24 hrs

Answer 182

b. 10 days/72 hrs

Question 183

The physical examination of the donor must include a documented assessment of factors that may affect the quality and quantity of skin retrieved: a. On every donor b. Only if the family requests it c. Only if you don’t feel like recovering skin d. Only when there is obvious trauma to skin

Answer 183

a. On every donor

Question 184

Frozen or cryopreserved skin must be stored at temp of ____or cooler a. -20 degrees C b. -10 degrees C c. -5 degrees C d. -40 degrees C

Answer 184

d. -40 degrees C

Question 185

Skin may be stored refrigerated for no longer than ___days a. 12 b. 5 c. 10 d. 14

Answer 185

d. 14

Question 186

The stratum corneum stratum lucidum and stratum granulosum are all found in what layer of the skin? a. Dermis b. Epidermis c. Sweat Gland d. Fascia

Answer 186

b. Epidermis

Question 187

An exceptional release of the skin requires written approval of the: a. President/CEO b. Donor Family c. Trained Requestor d. Medical Director

Answer 187

d. Medical Director

Question 188

Skin damaged by scraping or rubbing: a. Bruise b. Cut c. Abrasion d. Avulsion

Answer 188

c. Abrasion

Question 189

Small dark sometimes raised congenital growth on the human skin sometimes with a hair or hairs growing from it: a. Wart b. Mole Nevus c. Pimple d. Birthmark

Answer 189

b. Mole Nevus

Question 190

A swelling on the skin that contains fluid: a. Contusion b. Nevus c. Mole d. Blister

Answer 190

d. Blister

Question 191

On average adult skin covers ____square feet a. 40 b. 19 c. 20 d. 15

Answer 191

b. 19

Question 192

Cold ischemic time for vascular tissue is defined as: a. The time interval from systole to subjecting cardiac tissue to cold rinse (or transport) solution at retrieval b. The time interval from subjecting vascular tissue to transport solution and wet ice temp at retrieval to the beginning of disinfection c. The time interval from systole to subjecting vascular tissue to transport solution and wet ice temp at retrieval. d. The time interval from subjecting cardiac tissue to cold rinse (or transport) solution at retrieval to the beginning of disinfection

Answer 192

d. The time interval from subjecting cardiac tissue to cold rinse (or transport) solution at the retrieval to the beginning of disinfection

Question 193

Which of the following are NOT considered to be pathogenic highly virulent microorganisms that result in skeletal tissue discard: a. Sabouraud’s Dextrose Agar b. Staphylococcus Aureus c. Enterococcus Sp d. Gram Negative Bacillis e. Strepococcus Pyogenes f. Fungi (Yeast/Molds)

Answer 193

a. Sabouraud’s Dextrose Agar

Question 194

To prevent additional warm ischemia and potential cellular or matrix damage caused by temp cycling methods shall be employed that maintain the tissue or solutions above 1-10 deg for longer than: a. 24hrs b. 2 hrs c. 1hr d. 48hrs

Answer 194

b. 2 hrs

Question 195

Residual moisture analysis shall not exceed ___% of initial weight by nuclear magnetic resonance spectrometry: a. 8% b. 6% c. 2% d. 10%

Answer 195

a. 8%

Question 196

What is the storage conditions temp for commonly transplanted human tissue: cardiac and vascular: a. 1-10 degrees C b. -100 degrees C c. 10-10 degrees C d. -20to 4-10 degrees C

Answer 196

b. -100 degrees C

Question 197

Processing which includes dissection and packaging of cardiac and vascular tissue shall be preformed in a certified and qualified Class ___( or cleaner) laminar flow: a. 1000 b. 500 c. 100 d. 200

Answer 197

c. 100

Question 198

To prevent additional warm ischemia and potential cellular or matrix damage caused by temp cycling methods shall be employed that maintain the tissue and solutions: a. 1-40 degrees C b.1-10 degrees C c. -1- -5 degrees C d. 5 -10 degrees C

Answer 198

b.1-10 degrees C

Question 199

Reagents shall be stored in accordance with AATB and FDA instructions (T/F)

Answer 199

TRUE

Question 200

Allograft heart valve grafts shall be inspected evaluated and sized by internal valve annulus diameter and recorded in ___ a. Inches b. Centimeters (cm) c. Millimeters (mm) d. Not Applicable

Answer 200

c. Millimeters (mm)

Question 201

Processing of exposed skin shall be performed in a bacteriological and laminar flow environment (T/F)

Answer 201

TRUE

Question 202

Cardiac and vascular tissue processing shall include an antibiotic disinfection period followed by what 3 activities? a. Recovery b. Irradiation c. Packaging d. Preservation e. Sterilization f. Storage g. Rinsing

Answer 202

c. Packaging d. Preservation and f. Storage

Question 203

Warm ischemic time for cardiac tissue is defined as: a. The time interval from subjecting vascular tissue to transport solution and wet ice temp at retrieval to the beginning of disinfection b. The time interval from subjecting cardiac tissue to cold rinse (or transport) solution at retrieval to the beginning of disinfection c. The time interval from asystole to subjecting cardiac tissue to cold rinse (or transport) solution at retrieval d. The time interval from asystole to subjecting vascular tissue to transport solution and wet ice temp at retrieval

Answer 203

c. The time interval from asystole to subjecting cardiac tissue to cold rinse (or transport) solution at retrieval

Question 204

The total ischemic time shall not exceed ____hrs of cardiac and vascular a. 24 b. 48 c. 12 d. 72

Answer 204

a. 24

Question 205

Vascular grafts shall be inspected evaluated and sized by diameter and recorded in ____. a. Millimeters (mm) b. Not Applicable c. Centimeters (cm) d. Inches

Answer 205

c. Centimeters (cm)

Question 206

The processing of osteoarticular tissue shall be completed within ___ days of recovery a. 3 days b. 5 days c. 10 days d. 14 days

Answer 206

b. 5 days

Question 207

What are the acceptable residual levels of ethylene oxide for medium sterilized bone grafts? a. 100 b. 25 c. 250 d. 2 500

Answer 207

a. 100

Question 208

Musculoskeletal tissue shall be processed in a bacteriological and climate controlled environment (T/F)

Answer 208

TRUE

Question 209

What are the acceptable residual levels of ethylene glycol for small bone grafts? a. 2 500 b. 100 c. 250 d. 25

Answer 209

a. 2 500

Question 210

The most common sources of radiation are: a. Cobalt 60 b. Bio-cleanse c. X-ray d. Cobalt 40 e. Tutoplast f. Electro Beam

Answer 210

a. Cobalt 60 c. X-ray f. Electro Beam

Question 211

The length of the aortic conduit main pulmonary artery and right and left pulmonary artery remnants shall be recorded in centimeters (cm) as measured along the inferior (T/F)

Answer 211

TRUE

Question 212

How long can skin be stored at refrigerated temp? a. No longer than 24 hrs b. No longer than 7 days c. No longer than 14 days d. No longer than 5 days

Answer 212

c. No longer than 14 days

Question 213

The presence of wet ice or a transport solution temp range of ___to ___ degrees C shall be documented prior to acceptance of cardiac tissue a. 5 10 b. 1 10 c. 5 40 d. 10 40

Answer 213

b. 1 10

Question 214

Residual moisture analysis shall not exceed ____% of initial weight by gravimetric or Karl Fischer analysis: a. 8% b. 6% c. 10% d. 4%

Answer 214

b. 6%

Question 215

Which of the following are considered to be pathogenic highly virulent mircroorganisims that result result in cardiac and vascular tissue discard: a. Clostridium b. Gram Negative Bacilli c. Enterococcus Sp d. Streptococcus Pyogenes e. Staphylococcus Aureus f. Fungi (Yeast/Mold)

Answer 215

a. Clostridium b. Gram Negative Bacilli f. Fungi (Yeast/Mold)

Question 216

Warm ischemic time for vascular tissue is defined as: a. The time interval from subjecting cardiac tissue to cold rinse or transport solution at retrieval to the beginning of disinfection b. The time interval from subjecting vascular tissue to transport solution and wet ice temp at retrieval to the beginning of disinfection c. The time interval asystole to subjecting cardiac tissue to cold rinse or transport solution at retrieval d. The time interval from asystole to subjecting vascular tissue to transport solution and wet ice temp at retrieval

Answer 216

d. The time interval from asystole to subjecting vascular tissue to transport solution and wet ice temp at retrieval

Question 217

According to AATB standards a cardiovascular quality assurance program needs to ensure that the microbiologic growth media used in the processing of CV cultures can support the growth of all of the following types of organisms EXCEPT: a. Anaerobic b. Fungus c. Acid Fast Bacillis d. Aerobic

Answer 217

c. Acid Fast Bacillis

Question 218

Regarding heart valve when must info such as temp condition of transport device and date/time of movement into storage at the processing facility be documented? a. Immediately upon retrieval of the heart b. Prior to transport of the heart to the processing facility c. Upon receipt of the heart at the processing facility d. Immediately following cryopreservation of the valves

Answer 218

d. Immediately following cryopreservation of the valves

Question 219

Name the 2 properties required for the solution used for rinsing and packaging the procured heart for valves: a. Isotonic Sterile b. Hypertonic Cold c. Hypotonic Sterile d. Sterile Colloid

Answer 219

a. Isotonic Sterile

Question 220

In which of the following is the length of procured vessel crucial for future clinical conduit utilization? a. Superior Vena Cava b. Pulmonary Veins c. Inferior Vena Cava d. Pulmonary Arteries

Answer 220

d. Pulmonary Arteries

Question 221

To prevent possible cellular tissue and matrix degeneration CV tissue should be kept __ and between ___at all times during the dissection process: a. Aseptic and 0 degrees C to 10 degrees C b. Sterile and 0 degrees C to 11 degrees C c. Moist and 1 degrees C to 10 degrees C d. Cyopreserved and 1 degrees C to 10 degrees C

Answer 221

c. Moist and 1 degrees C to 10 degrees C

Question 222

Which of the following is NOT required documentation concerning the heart transport/packaging solution? a. Solution Expiration Date b. Solution Lot Number c. Volume of Solution in the Package d. Type of Solution

Answer 222

c. Volume of Solution in the Package

Question 223

According to AATB standards the minimum recommended weight for heart valve donors is: a. 6 lbs b. 5 lbs c. 7 lbs d. 4 lbs

Answer 223

a. 6 lbs

Question 224

If the donor has been maintained in a cold refrigerated environment the maximum warm ischemic time is: a. 24 hrs b. 10 hrs c. 12 hrs d. 4 hrs

Answer 224

a. 24 hrs

Question 225

The maximum allowable total ischemic time for a heart valve donor who has been maintained at room temp prior to heart recovery is: a. 24hrs b. 12hrs c. 39hrs d. 48hrs

Answer 225

c. 39hrs

Question 226

Package inserts for cardiovascular tissue will contain all of the following EXCEPT: a. Donor heart warm ischemic time b. Date of dissection or cryopreservation c. Donor heart cold ischemic time d. Donor heart total ischemic time

Answer 226

a. Donor heart warm ischemic time

Question 227

When procuring a heart for valve use it is important to maximize the best aortic conduit length by transecting the arch distal to the: a. Superior vena cava b. Brachiocephalic artery c. Left common carotid artery d. Left subclavian artery

Answer 227

d. Left subclavian artery

Question 228

All of the following criteria regarding the post retrieval packaging and transport of cardiovascular tissue must be EXCEPT: a. The donor ID# and type of tissue enclosed must be clearly visible on the transport container b. The transport container must be fluid tight and allow for aseptic delivery if the tissue to the processing center c. The transport receptacle must indicate that human tissue is enclosed d. The transport solution must be of sufficient quantity to keep the tissue moist during transport

Answer 228

a. The donor ID# and type of tissue enclosed must be clearly visible on the transport container

Question 229

All hearts procured for valve donation must be placed in antibiotic disinfection media prior to cryopreservation within ___ hrs before asystole a. 24 b. 12 c. 48 d. 6

Answer 229

c. 48hrs

Question 230

Packaging of cardiovascular tissue must be performed in a certified and qualified ____of cleaner laminar flow environment a. Class 100 b. Class 1000 c. Class 74 d. Class 10

Answer 230

a. Class 100

Question 231

How quickly must an organization involved in collection and processing be notified of positive test results? a. Within 1 hr of receiving the results b. Within 30 days of receiving the results c. Within 1 working day of receiving the results d. Within 5 working days of receiving the results

Answer 231

c. Within 1 working day of receiving the results

Question 232

If a donor has systemic lupus according to AATB standards which of the following tissues must be deferred? a. Achilles Tendon b. Skin c. Femoral Artery d. Heart Valves

Answer 232

a. Achilles Tendon

Question 233

When approximately is allograft skin debrided and reapplied to a burn site? a. 2 weeks b. 1 week c. 3 days d. never

Answer 233

a. 2 weeks

Question 234

What year did the FDA issue the Interim Final Rule for Human Tissue? a. 1993 b. 1997 c. 1995 d. 2001

Answer 234

b. 1997

Question 235

The minimal weight for a cardiovascular donor is generally: a. 1 lb b. 6 lbs c. 10 lbs d. Determined by the Medical Examiner

Answer 235

b. 6 lbs

Question 236

Split thickness skin is generally recovered at what thickness? a. .012 to .018 inches b. .018 to .035 inches c. Determined by program SOP d. None of the above

Answer 236

a. .012 to .018 inches

Question 237

Techniques for preserving musculoskeletal tissue include: a. Lyophilization b. Dehydration c. Freezing d. All of the above

Answer 237

d. All of the above

Question 238

Serological testing on a potential cadaver donor reveals a reactive anti-HIV2 antibody screening test. The screening test is positive on repeat testing but the confirmatory test is negative. What happens to the tissue? a. May be used; confirmatory test is negative b. May be used; HIV antibody is not a required test c. May not be used; discrepant results obtained d. May not be used; results of confirmatory test can’t override multiple positive screening test.

Answer 238

d. Repeated positives from cadaver or living donor on screening for HIV 2 antibody may not be used regardless of negative on confirmatory testing.

Question 239

If there is a compound fracture at approximately the location of the lesser trochanter which bone will be affected? a. Tibia b. Fibula c. Femur d. Ulna

Answer 239

c. Femur

Question 240

What is the insertion site for the patella ligament? a. Gerdy’s tubercle b. Tibio-fibular tubercle c. Tibial tubercle d. Patella

Answer 240

c. Tibial tubercle

Question 241

How many 3’ x 8’ pieces of skin are required to make one square foot? a. 4 b. 6 c. 8 d. 10

Answer 241

b. 6

Question 242

Which is not a sterilizing agent/process? a. Irradiation b. Autoclave c. Ethylene oxide d. Glutaraldehyde

Answer 242

d. Glutaraldehyde

Question 243

Which of the following would not allow for the donation of cardiovascular tissues? a. Bacterial endocarditis b. Hypertension c. Irregular heart beat d. Hepatitis A

Answer 243

a. Bacterial endocarditis Heart donors shall have no history of bacterial endocarditis rheumatic fever or semilunar valvular disease or cardiomyopathy of viral of idiopathic etiology.

Question 244

Which of the following is not a part of the minimum serological blood test required by AATB standards? a. HIV 1 and 2 b. West Nile Antibody c. RPR d. HTLV-1

Answer 244

d. HTLV 1-2 is not required however the hepatitis b surface antigen (HbsAg) test is required along with HbcAb (hepatitis b core antibody) RPR and tests for antibodies to HIV 1-2 and HCV.

Question 245

How long should archived samples be retained for after the recovery or collection date? a. 4 years b. 6 years c. 10 years d. 12 years

Answer 245

c. Archived samples shall be retained for 10 years after recovery or collection date. If a donor is determined to be unsuitable archived serum plasma or hematopoietic tissue samples should still be retained for use for possible unforeseen future investigational purposes.

Question 246

What abbreviation stands for a common cryopreserved orthoaedic allograft? a. SK b. DMSO c. OA d. HV

Answer 246

c. OA - Osteoarticular Graft.

Question 247

Which serological tests below are not required on surgical banked tissue? a. Anti-HBc b. HTLlV-I c. HCV d. Hepatitis A

Answer 247

d. Hepatitis A is not on the list.

Question 248

Tissue storage dating (expiration date) begins at? a. Initial processing b. Final culture results completed c. Release date from quarantine d. Each reprocessing date

Answer 248

a. Initial processing. Maximum is 5 years unless validated for longer.

Question 249

Allograft tissue may not be released if evidence of the following disease processes is detected except? a. Septicemia b. Active tuberculosis c. Diabetes d. Systemic viral disease

Answer 249

c. Diabetes is not on the exclusion list

Question 250

Donor age criteria for tissue is up to _____ years of age. a. 60 b. 75 for males 65 for females c. 75 d. There is no set age criteria

Answer 250

d. There is no set age criteria

Question 251

The Governing Body of a tissue bank may consist of all of these except? a. Medical Advisory Committee b. Board of Trustees c. Board of Directors d. Board of Governors

Answer 251

a. Medical Advisory Committee does not have a definition in the standards.

Question 252

Freeze-dried tissue under vacuum has a shelf life of? a. Undetermined b. Indefinite c. 5 years d. 10 years

Answer 252

c. 5 years is the maximum shelf life for freeze-dried tissue unless validated for longer.

Question 253

What are common sources of ionizing irradiation for tissue sterilization? a. X-ray b. Heat c. Cobalt 60 d. Electron beam

Answer 253

b. Heat is not a form of irradiation sterilization.

Question 254

Universal Precautions as defined by OSHA will be implemented and enforced to reduce the risk of exposure to infectious disease. True or False?

Answer 254

False. Universal Precautions were originally defined by the CDC (not FDA) and the guidelines have been adopted.

Question 255

Information involving recalls include all of the following but? a. Final disposition of tissue b. Notification of donor legal next of kin c. Steps taken to retrieve recalled tissue d. Corrective actions recommended and implemented

Answer 255

b. Notification of donor legal next of kin is not on the list of recall requirements.

Question 256

The time interval between cardiac asystole and placement of tissues in antibiotic solution is known as the? a. Cold ischemic time b. Disinfection time c. Total ischemic time d. Warm ischemic time

Answer 256

c. Total Ischemic Time

Question 257

Uniform Anatomical Gift Act of 1968 provided for? a. Legality of donation b. Brain death standardization c. Financial assistance for recovery programs d. Established waiting lists for organs

Answer 257

a. Legality of Donation. Legality of donation was established with the Uniform Anatomical Gift Act of 1968.

Question 258

Routine Inquiry legislation in 1985 established that routine inquiry and request for donation take place for all deaths at hospitals. True or False?

Answer 258

True Routine Inquire legislation in 1985 established that routine inquiry and request for donation take place for all deaths at hospitals.

Question 259

Before 1978 death for a patient was essentially only when the heart stopped beating. True or False?

Answer 259

True Before 1978 death for a patient was essentially only when the heart stopped beating.

Question 260

A heart valve or vein that is run as a control during the controlled-rate freezing of grafts is known as? a. Destructive b. Sample c. Surrogate d. Control

Answer 260

c. Surrogate

Question 261

Advantages of allograft heart valves over xenograft valves include all but? a. No need for anticoagulants (blood thinners) b. Prolonged durability c. Availability d. Resistant to bacterial endocarditis

Answer 261

c. Availability Xenografts are more readily available than allografts.

Question 262

All allograft heart valves must be processed in Class ___ environment or better with final packaging taking place in Class ____ environment or better. a. 100 100 b. 100 1000 c. 100 10 d. 1000 10

Answer 262

a. 100 100 Cardio Vascular (CV) processing must be done in class 100 or better and packaging must be done in class 100 or cleaner.

Question 263

At the time of valve dissection processed cardiac tissues are placed in an antibiotic solution. This method will result in a ____allograft heart valve. a. Disinfected b. Sterilized c. Pasteurized d. Clean

Answer 263

a. Disinfected

Question 264

Early data suggested that cryopreservation of cardiac allografts produced valve replacement that were superior to porcine (pig) valves and mechanical valves in terms of freedom from ____ and ____. a. Dysfunction noise b. Re-operation infection c. Degeneration high cost d. Lactated ringers

Answer 264

b. Re-operation infection Early data from Cryopreservation of cardiac allografts produced valve replacements that were superior to porcine valves and mechanical valves in terms of re-operation and infection.

Question 265

Optimal freezing rate for allograft heart valves is? a. 1C/Sec. b. 1C/Min c. 5C/Sec. d. 5C/Min

Answer 265

b. 1C/Min The optimal freezing rate for allograft heart valves is 1C/ Min.

Question 266

Tissue shall be procured within 24 hours if the donor is placed in a refrigerated room within ___hours of death. a. 4 b. 8 c. 12 d. 15

Answer 266

c. 12 hours

Question 267

What is the intention of Recovery? a. Human transplantation b. Therapy c. Research/education d. All of the above

Answer 267

d. All of the above

Question 268

Which gloving technique is the most aseptic? a. Open b. Closed c. Assisted d. Gown before glove

Answer 268

b. Closed

Question 269

What is the weight bearing bone form the knee to the ankle? a. Fibula b. Tibia c. Femur d. Humerus

Answer 269

b. Tibia

Question 270

Donor records must be formatted using all of the follwing except? a. Legible b. Indelible c. Accurate d. Black ink

Answer 270

d. Black ink

Question 271

An autopsy is required on all skin donors True or False?

Answer 271

FALSE

Question 272

A 55 year old woman is a potential donor. Her medical record states she had a past history of hypertension and breast cancer. Can this donor be accepted? a. No because of history of breast cancer b. No because of history of hypertension c. Yes unconditionally as is past history d. Must be evaluated by Medical Director for individual tissue bank SOPM

Answer 272

d. Must be evaluated by Medical Director for individual tissue bank SOPM

Question 273

What is the maximum warm ischemic time when the body is kept at room temperature? a. 48 hours b. 12 hours c. 15 hours d. 24 hours

Answer 273

c. 15 hours

Question 274

CBC with differential is important to detect a. Carcinoma b. Septicemia c. Hepatitis d. Australian Ag

Answer 274

b. Septicemia

Question 275

A child who is less than 12 years of age was admitted to the hospital. There was no blood sample taken upon arrival. The child cannot be considered as a donor without using an algorithm if: a. They have received a transfusion of 2000ml of colloids within the last hour b. They have received a transfusion of 1000 ml of crystalloids within the last hour c. They have received an infusion of 1000ml of blood within the last hour d. All of the above

Answer 275

d. All of the above

Question 276

Which of the following retrieved tissue shall be wrapped in an aseptic fashion with at least one moisture barrier? a. Heart b. Skin c. Femur d. None of the above

Answer 276

c. Femur

Question 277

Which of the following shall be processed in a class 100 environment or cleaner? a. Skin b. Cardiovascular c. Autologous d. Musculoskeletal

Answer 277

b. Cardiovascular

Question 278

All instruments used in the processing of musculoskeletal tissue shall be: a. Sterile b. Cleaned & Disinfected between donors c. Discarded after use d. A & B

Answer 278

d. A & B

Question 279

Personnel involved in the retrieval processing preservation or packaging of tissue shall wear attire that includes personal protective devices to minimize the spread of transmissible pathogens among and between: a. Donors b. Tissue c. Staff d. All of the above

Answer 279

d. All of the above

Question 280

A reported or suspected adverse outcome of tissue transplantation shall be: a. Investigated thoroughly b. Reviewed by the Medical Director c. A & B d. Maintained with calibration records.

Answer 280

c. A & B

Question 281

Hair shall be removed from a donor for the retrieval of which tissue? a. Skin b. Heart valves c. Musculoskeletal d. All of the above

Answer 281

d. All of the above

Question 282

The saphenous vein is recovered from the: a. Leg b. Heart c. Arm d. Chest

Answer 282

a. Leg

Question 283

What is one of the clinical applications of the saphenous vein. a. Coronary bypass b. Facial surgery c. Reconstruction for burn victims d. Repair of damaged heart tissue

Answer 283

a. Coronary bypass

Question 284

A physical examination shall be performed on: a. A donor for cardiovascular tissue only b. A donor for musculoskeletal tissue only c. A donor for skin only d. All donors

Answer 284

d. All donors

Question 285

The transport package label shall include all of the following except: a. Name address and telephone number of the distribution facility b. Identification of contents as human tissue c. Special handling instructions d. Warnings of possible significant adverse reactions

Answer 285

d. Warnings of possible significant adverse reactions

Question 286

Which of the following is not an item on the list of 12 recovery site suitability items? a. Lighting b. Size/Shape c. Cleanliness d. Temperature of the room must be monitored.

Answer 286

d. Temperature of the room must be monitored.

Question 287

Musculoskeletal tissue shall be sterilized or disinfected by one of the following except: a. Irradiation b. Ethylene oxide c. Formaldehyde d. UV radiation

Answer 287

c. Formaldehyde

Question 288

Dehydrated tissue requires a residual moisture test: a. Only when requested by the surgeon b. By gravimetric methods or NMR c. To be less than 10% d. To be less than 5%

Answer 288

b. By gravimetric methods or NMR

Question 289

What are the layers of the skin and the correct order? a. Dermis Epidermis Subdermis b. Dermis Subdermis Epidermis c. Epidermis Dermis d. Epidermis Dermis Subdermis

Answer 289

c. Epidermis Dermis The skin is made of two layers the outer is the epidermis and the inner layer is the dermis.

Question 290

What are the different kinds of bone? a. Cancellous & Periosteum b. Cancellous & spongy c. Cortical & compact d. Cortical & cancellous

Answer 290

d. Cortical & cancellous

Question 291

Where does the femur articulate with the pelvis? a. Acetabulum b. Tibial plateau c. Scapula d. Greater trochanter

Answer 291

a. Acetabulum Acetabulum is the cup shaped socket into which the femur head fits when articulated with the pelvis.

Question 292

A 22-year-old male is referred to a recovery agency. The cause of death was suicide by hanging. In which of the following circumstances found during a physical examination would the tissue be rejected: a. A new tattoo upon closer exam found to be covering needle tracks b. Oral thrush c. Autopsy performed in an infectious disease control room d. All of the above

Answer 292

d. All of the above

Question 293

In which situation would the tissue from a donor not be rejected? a. Known exposure of the donor within the last 12 months to HIV b. Documented diagnosis of Hepatitis A c. Current diagnosis of Hepatitis B d. Donor known to have received transplant of human dura mater.

Answer 293

b. Documented diagnosis of Hepatitis A

Question 294

Processing and preservation records shall include the following except: a. Tissue measurements b. Final disposition of each tissue retrieved and/or processed c. Expiration dates d. Statement that indicates that the tissue may transmit infectious agents

Answer 294

d. Statement that indicates that the tissue may transmit infectious agents

Question 295

Human tissue shall be quarantined until the following criteria are satisfied: a. Infectious disease testing completed b. Donor screening indicates freedom from risk factors c. Donor infectious disease tests are negative d. All of the above e. B & C

Answer 295

d. All of the above

Question 296

Laboratory test records shall include all of the following except: a. Tissue identification number b. Identification of person performing the test c. Type of tissue being tested d. Test date

Answer 296

c. Type of tissue being tested

Question 297

Processing and preservation records shall include the following except: a. Identification of technicians processing and preserving the tissue b. Expiration dates of the tissue c. Type lot number manufacturer and expiration date of supplies & reagents used d. None of the above.

Answer 297

d. None of the above.

Question 298

Allograft heart valves shall be sized by the ______diameter in mm. a. Internal valve b. External valve c. Internal valve annulus d. External valve annulus

Answer 298

c. Internal valve annulus

Question 299

The length of the aortic conduit shall be measured along the ______midline in cm. a. Posterior b. Anterior c. Lateral d. Medial

Answer 299

b. Anterior

Question 300

Processing of skin that is to be frozen shall be initiated within ____days of retrieval provided the skin is placed in tissue storage media which is replaced at least every___hours. a. 14 96 b. 14 72 c. 10 96 d. 10 72

Answer 300

d. 10 72

Question 301

What is the maximum temperature for dehydration. a. 50 C b. 100 C c. Shall be established by facility d. 75 C

Answer 301

c. Shall be established by facility

Question 302

Each lyophilization cycle shall be monitored for: a. Shelf temperature b. Condenser temperature c. Vacuum d. All of the above

Answer 302

d. All of the above

Question 303

Frozen or Cryopreserved skin shall be stored at an ultra-low temperature of: a. 30 C or below b. 0 C or below c. - 30 C or below d. - 100 C or below

Answer 303

c. - 30 C or below

Question 304

Tissue from a donor is recovered at ABC hospital. ABC Hospital requires the following information: a. Date of recovery b. Name of donor c. Age of donor d. Name of recovery agency e. All of the above

Answer 304

e. All of the above

Question 305

A 35 year old man is admitted to ABC hospital ER after an automobile accident at 6:00pm Friday. There is blood loss and 2000 cc of blood is administered. The man dies at 7:00 pm on Sunday. The body is not refrigerated. The recovery team is called and commences recovery at 7:30 am on Monday. On these facts alone will this tissue from this donor be accepted? Yes or No?

Answer 305

Yes the recovery commenced within 15 hours for the un-refrigerated cadaver this meets acceptable criteria.

Question 306

What are acceptable means for obtaining Informed Consent? a. In person b. By telephone c. Via fax d. Electronic transmission e. All of the above

Answer 306

e. All of the above

Question 307

The confirmatory assay used for syphilis is: a. RPR b. Syphilis-specific c. Treponemal-specific d. Trepenomal-specific

Answer 307

c. Treponemal-specific

Question 308

The following can provide a med/soc history on a cadaveric donor: a. Mother b. Life partner c. Daughter d. Room mate e. All of the above f. a & c g. a & b & c

Answer 308

e. All of the above

Question 309

A 55 year old female is about to undergo a total hip replacement. The nurse has given the patient a relaxant to lower her anxiety about the procedure. The doctor approaches the patient and asks her if she would like to donate the bone that will be removed from her hip to be used in allograft transplants. The transplant would help the quality of life for another individual. The patient consents. All of the patients’ blood tests are negative. Can this bone be used for an allograft transplantation? Yes or No?

Answer 309

No

Question 310

A tissue identification number can contain the following: a. Numbers b. Letters c. Symbols d. All of the above

Answer 310

d. All of the above

Question 311

A departure from AATB standards that is pre-approved by the AATB Board of Governors prior to implementation is: a. An error b. A variance c. A resolution d. A waiver

Answer 311

b. A variance

Question 312

Epiphysis is found: a. In between the metaphysis and diaphysis b. In the long part of the bone c. At the end of the bone d. Just above the medial condyle

Answer 312

c. At the end of the bone

Question 313

Disposition of a tissue includes all of the following except: a. Transplantation b. Discard c. Distribution d. Research

Answer 313

c. Distribution

Question 314

The Achilles tendon is attached to which bone? a. Calcaneus b. Fibula c. Talus d. Tibia

Answer 314

a. Calcaneus

Question 315

Refrigerated skin may be returned to inventory if it has been maintained in a closed container at: a. - 20°C to - 40°C b. - 40°C or colder c. 1°C to 10°C d. Ambient temperature

Answer 315

c. 1°C to 10°C

Question 316

The MOST accurate way to test for the presence of contamination of tissue allografts is by: a. A gram stain of the graft taken prior to final packaging b. Cultures of blood and of the excised tissue of the donor at the time of recovery c. Incubation of spore strips in bacterial growth media d. Incubation of selected grafts or samples in bacterial growth media

Answer 316

a. A gram stain of the graft taken prior to final packaging

Question 317

Receiving permission to obtain tissue from living or non-living donors in a manner that provides the donor or donor’s next-of-kin information in clear and understandable terms is referred to as: a. Durable power of attorney b. Advance directive c. Informed consent d. Required request

Answer 317

c. Informed consent

Question 318

When preparing a donor for aseptic bone recovery the extremities should be prepped: a. From clean areas to dirty areas b. From dirty areas to clean areas c. From proximal to distal d. After draping

Answer 318

a. From clean areas to dirty areas

Question 319

A negative test results means that the agent or substance being tested for is NOT: a. Active b. Present c. Detected d. Able to be tested

Answer 319

c. Detected

Question 320

All reagents used in MS tissue processing must be: a. Sterile b. Isotonic c. Approved by the medical director d. AATB approved

Answer 320

a. Sterile

Question 321

Which of the following is NOT considered an acceptable method of sterilizing tissue for implantation? a. Steam autoclave b. Election beam irradiation c. Gamma irradiation d. Ethylene oxide

Answer 321

a. Steam autoclave

Question 322

Information that a potential donor has received 12 units of packed red blood cells in the OR prior to death should be considered: a. Relevant to HIV testing b. Relevant to the dilutional effect on all antigen/antibody testing c. Relevant to HBsAg testing d. Irrelevant because transfused blood is screened

Answer 322

b. Relevant to the dilutional effect on all

Question 323

Which of the following is MOST important for effective donor skin prep? a. Extended prep time and applied pressure b. Mechanical and extended prep time c. Friction and heat d. An antimicrobial solution

Answer 323

d. An antimicrobial solution

Question 324

Which of the following information MUST appear on the final tissue container label? a. Descriptive name of the tissue b. Preservatives used c. Tissue identification number d. Potential residuals of antibiotic solutions

Answer 324

c. Tissue identification number

Question 325

MS tissue may be obtained from living donors at the time of elective surgery and banked for future use. Permission for recovery of these tissues: a. Is implied in the standard permit for surgery b. Is only required in cases where the banked tissue is to be distributed outside the recovery hospital c. Must be documented and informed consent obtained d. Is not required because the tissue would otherwise be discarded

Answer 325

c. Must be documented and informed consent obtained

Question 326

Warm ischemic time for cardiac tissue shall NOT exceed how many hours? a. 12 hours b. 24 hours c. 36 hours d. 48 hours

Answer 326

b. 24 hours

Question 327

When preparing the extremities of a skin donor the surgical prep should be done: a. Only on the areas to be recovered b. Circumferentially on the area to be recovered c. Before shaving any hair d. Using clear solutions to avoid interfering with the visibility of the donor site

Answer 327

b. Circumferentially on the area to be recovered

Question 328

In order to obtain informed consent for tissue donation the consent MUST include the: a. Names of the persons present during the consent interview b. Tissues to be recovered c. Location of the recovery site d. Date of the donor’s death

Answer 328

b. Tissues to be recovered

Question 329

Which of the following is does NOT need to be considered a permanent part of the donor record? a. Donor’s medical/social history b. Informed consent c. Serology testing requisitions d. Tissue processing logs

Answer 329

c. Serology testing requisitions

Question 330

The PRIMARY purpose of adequate record keeping in tissue banking is to: a. Demonstrate the adequacy of donor screening b. Document the performance of all steps in tissue banking so that they can be clearly traced c. Assign each tissue a unique identification number d. Provide adequate records in case of litigation

Answer 330

b. Document the performance of all steps in tissue banking so that they can be clearly traced

Question 331

Following tissue retrieval the cadaveric donor body should be reconstructed in accordance with: a. Medical examiner requirements b. Standard operating procedures c. Funeral home requests d. AORN standard practices

Answer 331

b. Standard operating procedures

Question 332

The use of aseptic technique during tissue recovery: a. Ensures sterility b. Is possible only in an OR c. Ensures freedom from microbial contamination d. Reduces the potential of contamination

Answer 332

d. Reduces the potential of contamination

Question 333

Freeze-dried tissue packaged in evacuated containers has a storage life not longer than how many years (unless a longer expiration date has been validated)? a. 1 b. 2 c. 5 d. 10

Answer 333

c. 5

Question 334

MSDS sheets are part of OSHA’s Right to Know Program and provide information on all of the following EXCEPT: a. Carcinogenic properties of hazardous chemicals b. Acceptable levels of toxic exposure c. Appropriate disposal methods d. Guidelines to follow in the event of an exposure

Answer 334

b. Acceptable levels of toxic exposure

Question 335

Serological testing for cadaveric donors shall be performed by a lab appropriately certified by: a. AATB b. AMA c. CLIA d. JCAHO

Answer 335

c. CLIA

Question 336

To prevent possible cellular tissue and matrix deterioration cardiac tissue shall be kept moist and between what temperature throughout the dissection process? a. 1°C to 10°C b. 0°C to 10°C c. 2°C to 8°C d. 0°C to 8°C

Answer 336

b. 0°C to 10°C

Question 337

Required documentation regarding heart transport and packaging solution includes all of the following EXCEPT: a. Solution lot number b. Solution expiration date c. Type of solution d. Volume of solution

Answer 337

d. Volume of solution

Question 338

What is the MAIN advantage to using an allograft heart valve in a 16-year-old male who plays high school football? a. No anticoagulation is needed b. Hospitalization is shorter than for mechanical valve c. The graft is more durable that a mechanical valve d. Reoperation is rarely necessary

Answer 338

a. No anticoagulation is needed

Question 339

Which of the following must be made available to the transplanting physician upon request? a. Donor procurement records b. Donor medical history c. Donor consent d. Donor processing records

Answer 339

b. Donor medical history

Question 340

When should complaint regarding cells and/or tissue be investigated? a. Only if safety of the cells/tissue are at issue b. Only if the complaint is valid c. Only when requested by the director or medical director d. At all times even if received orally

Answer 340

d. At all times even if received orally

Question 341

Aseptic processing environments should be monitored for potential contamination sources. The monitoring should include: a. Work sites processing technicians and recovery cultures b. Particulate air sampling equipment/personnel monitoring and work surfaces c. Recovery sites and tissue cultures d. Processing cultures and biological indicators

Answer 341

b. Particulate air sampling equipment/personnel monitoring and work surfaces

Question 342

For how long must record from non-dura mater donor be retained? a. 1 year b. 5 years c. 10 years d. Indefinitely

Answer 342

c. 10 years

Question 343

All of the following information regarding processing reagents should be recorded in the tissue bank’s records EXCEPT the: a. Microbial testing results for reagent b. Expiration date of reagent c. Sterility of reagent d. Lot number of reagent

Answer 343

a. Microbial testing results for reagent

Question 344

Focused audits are conducted to monitor or evaluate all of the following EXCEPT: a. Critical areas b. Areas where problems have been encountered c. Quality control problems d. Organizations performing services for the tissue bank

Answer 344

c. Quality control problems

Question 345

The acceptable upper limit for residual moisture in freeze-dried tissue as measured by NMR analysis is: a. 6% b. 8% c. 10% d. 12%

Answer 345

b. 8%

Question 346

When an allograft bone provides a scaffold for cells to move into the area and create new bone the process is referred to as: a. Osteoinduction b. Osteoconduction c. Osteoblastosis d. Osteogenesis

Answer 346

b. Osteoconduction

Question 347

According to AATB Standards who is responsible for implementing policies for the Governing Body including compliance with all current federal state and/or local laws? a. Chairman of the Board b. Medical Director c. Director d. QA Program Director

Answer 347

c. Director

Question 348

The purpose of the surgical prep prior to recovery is to: a. Reduce soil and transient microbes b. Inhibit growth of aerobic microbes c. Kill anaerobic microbes d. Destroy proteins on and under the skin

Answer 348

a. Reduce soil and transient microbes

Question 349

Residual calcium levels of demineralized bone shall NOT exceed: a. 5% b. 6% c. 8% d. 10%

Answer 349

c. 8%

Question 350

Which of the following criteria is NOT cause for deferral of a heart valve donor? a. Coronary artery disease b. Viral cardiomyopathy c. Rheumatic fever d. Bacterial endocarditis

Answer 350

a. Coronary artery disease

Question 351

According to AATB Standards what is the maximum acceptable age for a heart valve donor? a. 50 b. 55 c. 60 d. 65

Answer 351

c. 60

Question 352

A medical/social/sexual history of both a donor child and mother shall be obtained if the child is less than what age? a. 6 months b. 12 months c. 18 months d. 24 months

Answer 352

c. 18 months

Question 353

A serological test result that is noted to be ‘repeat-reactive’ indicated the donor sample was: a. Initially reactive retested in duplicate and both results were reactive b. Initially reactive retested in triplicate and all results were reactive c. Initially reactive retested in duplicated and all results were non-reactive d. Initially reactive retested in triplicate and at least one result was reactive

Answer 353

a. Initially reactive retested in duplicate and both results were reactive

Question 354

According to AATB Standards MS tissue donation is contraindicated when the donor has a history of any of the following EXCEPT: a. Autoimmune disease b. Malignancy c. Active Tb d. Rheumatoid arthritis

Answer 354

b. Malignancy

Question 355

Which of the following positive lab test is an absolute contraindication to tissue transplantation? a. HTLV - I/II antibody b. CMV antibody c. RPR d. Hepatitis B surface antibody

Answer 355

a. HTLV - I/II antibody

Question 356

You are evaluating a potential donor with a history of hemophilia or related clotting disorder. This donor should be excluded: a. If the disorder was diagnosed prior to 1977 b. If the donor ever received human derived clotting factor concentrates c. Only as MS tissue donor d. Only as CV tissue donor

Answer 356

b. If the donor ever received human derived clotting factor concentrates

Question 357

A cardiac tissue donor’s time/date of death was 2100 on 03/19/06 and was placed into cold storage at 2300 on 03/19/06. The heart recovery began at 0320 on 03/20/06 and was placed into transport solution at 0445 on 03/20/06. The heart arrived at the processing facility at 1035 on 03/20/06 and was placed into disinfection solution at 1215 on 03/20/06. The grafts completed their controlled-rate freezing cycle at 1545 on 03/21/06. The cold ischemic time is: a. 2 hours b. 5 hours 45 minutes c. 7 hours 30 minutes d. 13 hours 15minutes

Answer 357

c. 7 hours 30 minutes

Question 358

A 38-year-old male was brought to the ER after having been found DOA as result of a suicide by hanging. In the donor evaluation process it will be important to determine the time: a. The body was refrigerated b. Of death based on when the victim was last known to be alive c. Of death estimated by the coroner or medical examiner d. Of death based on the time of arrival of paramedics

Answer 358

b. Of death based on when the victim was last known to be alive

Question 359

A blood sample from the natural mother shall be used for infectious disease testing for tissue donors less than: a. 1 month b. 4 months c. 12 months d. 18 months

Answer 359

a. 1 month

Question 360

If lab results are found to be repeat reactive for HBsAg the donor tissue is: a. Suitable for transplantation if confirmatory test results are non-reactive b. Suitable for transplantation if 2 confirmatory tests are non-reactive c. Suitable for transplantation without further testing d. Not suitable for transplantation

Answer 360

d. Not suitable for transplantation

Question 361

Which of the following medical conditions is NOT a contradiction to MS tissue donation? a. Hashimoto’s thyroiditis b. Rheumatoid arthritis c. Systemic lupus erythematosis d. Polyarteritis nodosa

Answer 361

a. Hashimoto’s thyroiditis

Question 362

A tissue bank and eye bank BOTH obtain serological tests on a multi-tissue donor. All results are non-reactive except for the HBsAg. The eye bank result is non-reactive but the tissue bank result is repeat reactive. When may the tissue be used? a. If a rerun of the tissue bank sample is negative b. If a confirmatory test run in duplicate is negative c. If a confirmatory test is negative d. Never

Answer 362

d. Never

Question 363

Unless otherwise directed by federal state and/or local laws confirmed positive HIV antibody test results on a cadaveric tissue donor: a. May be reported to any hospital personnel involved with the retrieval for safety reasons b. Must be reported to state or local health departments c. Are always reported to the Authorizing person d. Both B and C

Answer 363

d. Both B and C

Question 364

You are called to evaluate an 18-year-old male who had died as a result of a closed head injury. The family indicated an interest to the hospital staff in donating any organs or tissue that could be used. You meet with the family to obtain medical/social/sexual history and consent. Tissue donation would be precluded by a history of: a. Scarlet fever at age 10 b. Infectious mononucleosis at age 16 c. Injection of performance enhancing drugs during the previous year d. Occasional marijuana use

Answer 364

c. Injection of performance enhancing drugs during the previous year

Question 365

A potential pediatric donor was breast-fed. Documentation of the mother’s behavioral risk history would be required if breast feeding occurred within the past: a. 3 months b. 6 months c. 12 months d. 18 months

Answer 365

c. 12 months

Question 366

The goal of the surgical prep is: a. To get the drape to stick better b. To rid the skin of all microbes c. To rid the skin of most microbes d. To sterilize the field

Answer 366

c. To rid the skin of most microbes

Question 367

An agent that kill microorganisms on inanimate objects: a. Antiseptic b. Bacteriostatic c. Disinfectant d. Sterilant

Answer 367

d. Sterilant

Question 368

Cryopreservaton of an osteoarticular graft is intended to: a. Preserve chondrocytes b. Preserve osteocytes c. Extend long-term preservation d. Maintain sterility

Answer 368

a. Preserve chondrocytes

Question 369

Which of the following cell types is the most mature? a. Howship’s lacunae b. Osteoblasts c. Osteoclasts d. Osteocytes

Answer 369

d. Osteocytes

Question 370

Which of the following cells is most responsible for bone remodeling? a. Mesenchymal cells b. Osteoblasts c. Osteoclasts d. Osteocytes

Answer 370

c. Osteoclasts

Question 371

Potential cellular and matrix damage to valve tissue may be prevented by all of the following EXCEPT: a. Aseptic retrieval b. Maintenance of tissue and solutions between 1°C and 10°C c. Keeping tissue moist during dissection d. Use of cryoprotectants

Answer 371

a. Aseptic retrieval

Question 372

When performing skin recovery on a donor how often should the dermatome blade be changed? a. After every square foot of skin b. After every 2 square feet of skin c. When going from left to right side and from anterior to posterior surfaces d. As often as necessary to maintain cutting efficiency

Answer 372

d. As often as necessary to maintain cutting efficiency

Question 373

Skin should be recovered at a depth of how many thousandths of an inch: a. 1-5 b. 6-10 c. 10-20 d. 20-30

Answer 373

c. 10-20

Question 374

Wolff’s Law describes: a. Bone regeneration b. Fracture repair in long bones c. Repair of lamellar bone d. The relationship between form and function in bone

Answer 374

d. The relationship between form and function in bone

Question 375

Microbiology procedures not required by AATB standards are: a. Environmental cultures b. Pre-disinfection cultures c. Recovery cultures d. None of the above

Answer 375

a. Environmental cultures

Question 376

Stratum corneum stratum lucidum stratum granulosum stratum spinosum an stratum basale are the layers of cells contained in the: a. Superficial fascia b. Dermis c. Epidermis d. Subcutaneous tissue

Answer 376

c. Epidermis

Question 377

When preparing an autologous graft when should cultures be obtained? a. At recovery b. Before distribution c. Just after processing d. Just before processing

Answer 377

d. Just before processing

Question 378

What are the layers of the heart from inside to outside? a. Endocardium myocardium epicardium b. Endocardium myocardium exocardium c. Epicardium pericardium myocardium d. Myocardium endocardium exocardium

Answer 378

a. Endocardium myocardium epicardium

Question 379

One goal of cardiovascular tissue banking should be to preserve the _______ of the cells on/in the leaflet and the ________ of the valve matrix. a. Solubility’permeability b. Viability/integrity c. Viability/rigidity d. Volume/crystalline lattice

Answer 379

b. Viability/integrity

Question 380

Focused audits are conducted to monitor or evaluated all of the following EXCEPT: a. Critical areas b. Areas where problems have been encountered c. Quality control problems d. Organizations performing services for the tissue bank

Answer 380

d. Organizations performing services for the tissue bank

Question 381

Which of the following is an automatic deferral for heart valve donation? a. History of cancer b. Idiopathic disorders c. Viral cardiomyopathy d. Obesity

Answer 381

c. Viral cardiomyopathy

Question 382

What temperature should hearts be transported to the processing facility a. 1 - 10° C b. 2 - 10° C c. 4° C d. On ice - temperature does not matter e. 0-10° C

Answer 382

e. 0-10° C

Question 383

Basic elements for informed consent require: a. An description of the permitted use(s) of the tissue (i.e. transplant research or education) b. Advance directives for hospitals being made known c. The next-of-kin to be available d. HIPAA regulations to be followed

Answer 383

a. An description of the permitted use(s) of the tissue (i.e. transplant research or education)

Question 384

The upper time limit for retrieval to processing heart valves is: a. Cold ischemic time shall not exceed 48 hours b. There is no time limit c. Warm ischemic time shall not exceed 24 hours d. Warm ischemic time shall not exceed 48 hours

Answer 384

c. Warm ischemic time shall not exceed 24 hours

Question 385

What consideration must be given to pediatric donors who have been breastfed within the past 12 months? a. How long the infant has been breastfed b. SOP c. Funeral home requirements d. None of the above

Answer 385

d. None of the above

Question 386

Documentation of reconstruction shall be maintained in: a. The hospital chart b. The family thank you letter c. Funeral home letter d. Donor record

Answer 386

d. Donor record

Question 387

The quality of skin grafts may be optimized during recovery by: a. Checking the recovered skin frequently for uniform thickness b. Moving the dermatome from the upper to lower area c. Keeping the blade setting the same during the procurement d. Changing the dermatome blade as infrequently as possible

Answer 387

a. Checking the recovered skin frequently for uniform thickness

Question 388

According to AATB standards the maximum allowable time prior to tissue retrieval shall commence in a. 48 hours b. 36 hours c. 24 hours d. 18 hours

Answer 388

c. 24 hours

Question 389

Which organism is unacceptable on skin growth? a. Diptheroids b. Clostridium c. Nisseria d. Miscroccus

Answer 389

b. Clostridium

Question 390

The vein MOST commonly used as an allograft is the: a. Saphenous b. Umbilical c. Superficial femoral d. Cephalic

Answer 390

a. Saphenous

Question 391

Which of the following most accurately describes lyophilization? a. The evacuation of water through evaporating process b. Sublimation of water from tissue under vacuum c. Preservation of tissue in evacuated container d. Preservation of tissue by removal of all water and water materials

Answer 391

b. Sublimation of water from tissue under vacuum

Question 392

Each lyophilization cycle must be monitored for: a. Condenser temperature b. Chamber temperature c. Cold temperature pressure d. Ambient temperature

Answer 392

a. Condenser temperature d. Ambient temperature

Question 393

Sizing of processed tissue may NOT be performed by: a. X-ray b. Volume c. Physical measurements d. Comparisons to standards

Answer 393

a. X-ray

Question 394

The validated process of disinfection does not include: a. Detergent b. Ethanol c. Iodoform d. Acid

Answer 394

d. Acid

Question 395

Intense heat used in any stage of tissue processing will: a. Sterilize the tissue b. Improve mechanical quality c. Remove antigenic substance d. Destroy proteins

Answer 395

a. Sterilize the tissue

Question 396

Use of pre-processing irradiation does the following: a. Sterilizes the outer package of the tissue b. Kill candida species of organisms c. Reduces requirement for sterility testing d. Reduces the bioburden

Answer 396

b. Kill candida species of organisms

Question 397

Which of the following is not used for terminal sterilization of tissue? a. Ethylene oxide b. Irradiation c. Antibiotic solution d. Dry heat

Answer 397

a. Ethylene oxide

Question 398

An example of a substance that can minimize the osmotic imbalances of cells during freezing: a. Glycol b. Acid or iodoforum c. Liquid nitrogen d. None of the above

Answer 398

b. Acid or iodoforum

Question 399

Which statement is incorrect? a. Tendon attaches ligament to bone b. Ligament attach bone to bone c. Tendon attach muscle to bone d. All of the above

Answer 399

a. Tendon attaches ligament to bone

Question 400

All of the following are absolute contradictions to processing bone EXCEPT: a. Hemophilia b. Sarcoidosis c. Metabolic bone disease d. Diabetes

Answer 400

a. Hemophilia

Question 401

Fascia Lata: a. Connects articular end to the bone b. Connects muscle to the bone c. Connects all muscles d. Covers the anterior thigh muscles

Answer 401

d. Covers the anterior thigh muscles

Question 402

Which of the following is a contraindication for skin recovery? a. Prior bone recovery b. Disseminated acne c. Presence of a decubitus ulcer d. Chronic steroid use by the donor

Answer 402

c. Presence of a decubitus ulcer

Question 403

A bone involved at the ankle and the knee is called: a. Femur b. Tarsal c. Fibula d. Tibia

Answer 403

d. Tibia

Question 404

A large cortical allograft is: a. Osteogenic b. Osteoinductive c. Osteoconductive d. Osteopoketic

Answer 404

c. Osteoconductive

Question 405

Cancellous bone is composed of: a. Inactive osteoclasts b. Fibrocartilage and fibroconnective non-mielinated fibers that are irradiating in all directions c. Thin trabecular processes joined together forming three dimensional fibers work d. Four layers of haversian canals

Answer 405

c. Thin trabecular processes joined together forming three dimensional fibers work

Question 406

The greater trochanter is the bone work located on: a. Ulna b. Radius c. Tibia d. Femur

Answer 406

d. Femur

Question 407

The late delivery of the recovery cultures to the microbiology lab can result in: a. Proliferation of microbes which are in the tissue b. A loss of aerobic organisms c. An increased bioburden in the tissue d. Contamination of probes

Answer 407

b. A loss of aerobic organisms

Question 408

Tissue collected aseptically is: a. Sterile b. FREE of microorganisms c. More sterile than the tissue collected in clean procedures d. Still could be potentially contaminated with microorganisms

Answer 408

d. Still could be potentially contaminated with microorganisms

Question 409

Tissue recovered for fresh allografts should be: a. Sterilized and placed in a double plastic envelope b. Placed in sterile container on wet ice c. Treated with antibiotics and put on dry ice d. Placed in sterile container and maintained at room temperature

Answer 409

b. Placed in sterile container on wet ice

Question 410

Bone blocks can be left on both ends of what graft: a. Achilles tendon b. Posterior tibialis tendon c. Patellar ligament d. Fascia lata

Answer 410

c. Patellar ligament

Question 411

An adult donor who has been transfused/infused with 4 or more units of blood blood components colloid or crystalloids within 48 hours prior to death is an acceptable donor if: a. The serologic test results of the ‘units’ transfused are available for review b. The post-transfusion/infusion sample tests are negative and the donor has a history which assures freedom from high risk categories c. An adequate algorithm is used to ensure that there is not hemodilution that can alter test results d. A blood sample drawn following medical intervention is used to perform serologic tests

Answer 411

c. An adequate algorithm is used to ensure that there is not hemodilution that can alter test results

Question 412

When handling sterile drapes you must be sure that the drape is presented: a. To a sterile person who is scrubbed gowned and gloved b. Using quick movement when placed on the OR table c. Prior to the surgical prep of the donor d. After being sterilized using ETO

Answer 412

a. To a sterile person who is scrubbed gowned and gloved

Question 413

Pre-transfusion testing for a donor that received multiple blood products is important because: a. Additional blood product will increase systolic pressure and damage the skin b. Additional blood product can have a dilutional effect on donor blood effecting the detection of pre-existing antibodies and antigens c. Additional blood product can cross match on patient blood making unnecessary influence on pre-transfusion sample d. None of the above

Answer 413

b. Additional blood product can have a dilutional effect on donor blood effecting the detection of pre-existing antibodies and antigens

Question 414

According to AATB Standards STERILE is defined as: a. Absence of detectable viable contaminating microorganisms b. Freedom of potential pathogens c. Absence of viable contaminating microorganism as determined by sound microbiology protocol d. Reduction of statistical probability of the presence of contaminating microorganisms

Answer 414

a. Absence of detectable viable contaminating microorganisms

Question 415

The post RECOVERY management of the donor requires: a. An autopsy be performed b. Refrigeration of the body within 24 hours c. Notification of the coroner’s office of the retrieval process d. The dignity if the donor is maintained by the proper reconstruction of the body

Answer 415

d. The dignity if the donor is maintained by the proper reconstruction of the body

Question 416

Which tissue required a bone block on both proximal and distal sides? a. Patellar ligament b. Achilles tendon c. Gracillis tendon d. Semitendinous tendon

Answer 416

a. Patellar ligament

Question 417

Which of the following is a contraindication to donation? a. The donor had basal cell carcinoma of the skin 7 years ago (excised and healed) b. The donor had a systemic mycosis c. The donor had pneumonia d. A female donor had carcinoma in situ of the cervix

Answer 417

b. The donor had a systemic mycosis

Question 418

When recovering the lower body tissue the established order begins and ends with: a. Fascia ilium b. Ilium fascia c. Fascia Achilles d. Ilium tibia

Answer 418

a. Fascia ilium

Question 419

When recovering an Achilles tendon a segment of which bone is usually attached distally: a. Calcaneous b. Ethmoid c. Talus d. Medial epicondyle

Answer 419

a. Calcaneous

Question 420

The donor who was infused with blood and blood components in the last 48 hours is acceptable if: a. The serological test results of the units transferred are negative b. A blood sample drawn at midway throughout the medical intervention has a negative serology test c. There is no sufficient hemodilution prior to the test results d. An adequate algorithm is used to determine hemodilution

Answer 420

d. An adequate algorithm is used to determine hemodilution

Question 421

Which of the following statements are incorrect? a. Each donor shall be assigned a unique identification number b. Microbiology cultures sample was taken out of procurement c. If an autopsy is performed tissue recover cannot take place d. Culture results shall be documented on the donor record

Answer 421

c. If an autopsy is performed tissue recover cannot take place

Question 422

Recovery records should show: a. Expiration dates of supplies b. Name and address of the procurement agency c. A list of specific tissue retrieved d. All of the above

Answer 422

d. All of the above

Question 423

According to AATB standards for tissue banking all the agents used in MS tissue processing must be: a. Sterile b. Isotonic c. Approved by the Medical Director d. AATB approved

Answer 423

a. Sterile

Question 424

Prior to cryopreservation its necessary to rinse heart valves in tissue culture media to remove: a. The transport solution b. The 10% DMSO c. The antibiotic solution d. All of the above

Answer 424

c. The antibiotic solution

Question 425

Controlled rate freezing is conducted with which of the following conditions: a. The employment of computer assisted freezing b. The addition of cryoprotectant and freezing at a predetermined rate per minute c. Use of ethylene glycol in the freezing system d. Store in the liquid hydrogen

Answer 425

b. The addition of cryoprotectant and freezing at a predetermined rate per minute

Question 426

Which of the following is NOT required on a tissue graft label? a. Descriptive name of the tissue b. ABO blood type c. Acceptable storage conditions d. Reference to the package insert

Answer 426

b. ABO blood type

Question 427

Osteoinductive properties of bone matrix is not destroyed by: a. Alkaline b. Acid c. Oxidation d. Sulfidial reduction

Answer 427

b. Acid

Question 428

Minimum incubation time for anaerobic bacteria? a. 14 days b. 7 days c. 12 days d. 5 days

Answer 428

b. 7 days

Question 429

Short term storage of frozen tissue is defined as? a. 12 months or less at -40C b. 8 Months or less at -20C c. 6 Months or less at -20C d. 4 Months or less at -40C

Answer 429

c. 6 Months or less at -20C

Question 430

The minimum recommended dosage for gamma irradiation of tissue is? a. Validated and supported by data b. Determined only by AAMI/ISO11137 c. 1.5 megarads (15 kGy) d. Stated on the label or package insert.

Answer 430

c. 1.5 megarads (15 kGy)

Question 431

The maximum time that retrieved musculoskeletal tissue shall remain at wet ice temperatures prior to either processing or freezing is? a. 72 hours b. 48 hours c. 24 hours d. To be determined by each facility

Answer 431

a. 72 hours

Question 432

A copy of the informed consent form will remain on file 10 years beyond the date of processing. True/False

Answer 432

FALSE

Question 433

All of the following conditions exclude a potential donor with the exception of? a. Autoimmune disease b. Alcoholism c. Rheumatoid arthritis d. Unexplained jaundice

Answer 433

b. Alcoholism

Question 434

John Doe with no known family can be a donor by ward of the courts. True/False

Answer 434

TRUE

Question 435

Hypothermic storage temperatures for fresh skin allografts is? a. -1 to -10C b. 10 to 20C c. 1 to 10C d. -40C or colder

Answer 435

c. 1 to 10C

Question 436

A donor is considered too hemodiluted for transplant if they have received 2000cc or more of all of the following within 48 hours except? a. Red Blood Cells b. Colloids c. Crystalloids d. None of the above

Answer 436

d. None of the above

Question 437

Musculoskeletal and skin tissue excision shall be completed within 24 hours of cardiac death provided the body was placed at refrigerated temperatures within 12 hours of death? True/False

Answer 437

TRUE

Question 438

Any staff member with a serious infectious condition that may adversely affect the safety of the tissue shall be excluded from: a. Retrieval b. Packaging c. Processing d. Preservation e. All of the above f. Only a & c g. Only c & d.

Answer 438

e. All of the above

Question 439

Safety procedures shall include all of the following except: a. Instructions for contacting emergency personnel b. Procedures for management of worker exposure to blood-borne pathogens c. Steps to be followed in cleaning biohazardous spills d. Training on OSHA regulations e. Material Safety Data Sheets

Answer 439

d. Training on OSHA regulations

Question 440

Training files shall include: a. Annual review of policies and procedures for which the employee has been trained. b. Documentation of review and training prior to implementation or new SOPs. c. Dates and times training occurred for policies & procedures d. a & b.

Answer 440

d. a & b.

Question 441

The following applies to Standard Operating Procedures except: a. Current copies shall be in designated locations& available to staff at all times b. SOPs shall be updated to reflect modifications or changes c. Minor deviations from SOPs may be authorized by Supervisors d. A file of archived SOPs shall be maintained for 10 years after discontinuation.

Answer 441

c. Minor deviations from SOPs may be authorized by Supervisors

Question 442

Which of the following is true? a. Refrigerated skin may be returned to inventory if it has been maintained at 1C to 15C in a closed container. b. Refrigerated skin may be returned to inventory if it has been maintained at 1C to 10C in an open container c. Refrigerated skin may be returned to inventory if it has been maintained at less than 15C in a closed container d. Refrigerated skin may be returned to inventory if it has been maintained at 1C to 10C in a closed container

Answer 442

d. Refrigerated skin may be returned to inventory if it has been maintained at 1C to 10C in a closed container

Question 443

Tissue for research shall have all of the following except: a. Informed consent obtained from the donor or next of kin b. Request submitted in writing c. Tissue identification number d. Approval by the Director.

Answer 443

c. Tissue identification number

Question 444

Distribution records shall include all of the following except: a. Date of order placement b. Time of order placement c. Name of individual placing the order d. Name of staff member filling the order

Answer 444

b. Time of order placement

Question 445

Solutions needed to complete _________ allograft operative preparation procedure shall be made available to the utilizing facility. a. Musculoskeletal b. Skin c. Vascular

Answer 445

c. Vascular

Question 446

All of the following are contraindications for heart valve donation except? a. Pacemaker implant b. Rheumatic fever c. Semilunar valvular disease d. Bacterical endocarditis

Answer 446

a. Pacemaker implant is not listed as a contraindication for heart valve donation.

Question 447

Which solution is not isotonic and cannot be used as a transport media for human hearts? a. PlasmaLyte b. Sterile water c. Sterile Normal saline d. Lactated Ringers

Answer 447

b. Sterile water is not isotonic.

Question 448

The goal in processing cryopreserved allograft cardiovascular tissues is to? a. Produce durable grafts at the lowest cost b. Alter the tissue to create a superior graft c. Alter the tissue as little as possible d. Produce sterile grafts for clinical applications

Answer 448

c. The goal of cryopreserved allograft cardiovascular tissue is to alter the tissue as little as possible.

Question 449

A blood specimen from the mother may be substituted for serological testing on donors less than? a. 28 days or less b. 60 days or less c. 90 days or less d. 120 days or less

Answer 449

a. 28 days or less

Question 450

Documentation of the transport solution used for cardiovascular tissues should include all of the following except? a. Type b. Lot# c. Manufacturer d. Date/time solution opened

Answer 450

d. The date and time of opening the transport solution need not be documented.

Question 451

The most commonly used and most effective cryoprotectant utilized for preserving allograft cardiac tissues is? a. Glycerin b. Tissue culture media c. DMSO (dimethylsulfoxide) d. Liquid nitrogen

Answer 451

c. DMSO (dimethylsulfoxide) is the most commonly used and most effective cryoprotectant for preserving allograft cardiac tissue.

Question 452

The dissection of heart valves shall be maintained at a temperature range to prevent additional warm ischemia and potential cellular damage. Methods shall be employed to maintain the tissues or solutions at the following temperature range. a. 1-10C b. 2-10C c. 10-20C d.

Answer 452

a. Methods should be used to maintain the tissues at 1 to 10C.

Question 453

Quality assurance staff is responsible for all of the following except? a. Approve or reject tissue b. Discontinue processing if deviations of SOP’s are denoted c. Discontinue release of tissue if deviations of SOP’s are denoted d. Perform testing to ensure that equipment is operating within specifications

Answer 453

d. Quality assurance is not required to perform testing to ensure that equipment is operating within specifications.

Question 454

All heart valve and conduit tissue shall be measured in two ways. Valve diameter in ___ and conduit length in ___. a. Mandril cone Hegar dilator b. cm.mm. c. mm cm d. Obturator customizer

Answer 454

c. mm cm Allograft heart valve grafts shall be sized by internal valve annulus diameter in millimeters (mm) and the length of the conduit recorded in centimeters (cm) as measured along the anterior midline.

Question 455

What is the warmest allowable storage temperature for cryopreserved allograft heart valves? a. -40C b. -100C c. -196C d. -80C

Answer 455

b. Cardiovascular tissue is stored at -100C or colder.

Question 456

Wet ice temperatures are defined as: a. 1-10C b. -1 to -5C c. 1-5C d. Below 15C

Answer 456

a. Wet ice/refrigerated temperature is 0C to 10C.

Question 457

Relevant medical records contain the following except: a. Donor medical history interview b. Physical assessment c. Expiration dates of tissue d. Laboratory test results

Answer 457

c. Expiration dates of tissue are not part of donor medical records.

Question 458

Pig heart valves have often been used in transplants. This is called a: a. Allograft b. Autograft c. Xenograft d. Porcine device

Answer 458

c. A xenograft is one taken from a nonhuman species.

Question 459

All of the following shall be calibrated with the exception of: a. Measuring Instruments b. Gauges c. Water supply d. Recording devices

Answer 459

c. Water Supply Instruments gauges recording devices equipment and apparatus shall be qualified and routinely calibrated maintained etc.

Question 460

Cardiovascular allografts shall be maintained at: a. -50C and colder b. -100C and colder c. -150C and colder d. -40C and colder

Answer 460

b. Cardiovascular storage containers shall be able to withstand storage temperature requirements of -100C.

Question 461

The Medical Director can only be a licensed physician in the United States. True or False?

Answer 461

FALSE

Question 462

Which of the following would be accepted as a potential donor? a. Person injecting IV drugs for non-medical reasons in the past 3 years. b. Person living in a one-bathroom house with a friend who has viral hepatitis. c. Person whose mother has Creutzfeldt-Jakobs disease. d. Person who was incarcerated for 70 hours last month.

Answer 462

d. Person who was incarcerated for 70 hours would be accepted.

Question 463

What is not required in the file of a recalled tissue? a. Reason for recall b. Quarantining steps c. Condition of the tissue d. Steps taken to retrieve the tissue

Answer 463

c. The condition of the tissue is not on the list of recalled tissue file information.

Question 464

Cardiovascular Implantation records shall have: a. Recipient identity b. Identification Number of the graft c. Surgeons name and hospital d. A&B e. All of the above

Answer 464

e. All are on dispensing record.

Question 465

Tissue can be dispensed with: a. An order from a physician b. An order from a nurse c. An order from a physician’s assistant d. All of the above e. A&B & C if authorized

Answer 465

a. A physician or other authorized health professional.

Question 466

Container labels shall include the following except: a. Tissue identification number b. Expiration date including month and year c. Processing date including month and year d. Potential residues of processing agents

Answer 466

c. Processing Date The tissue identification number must be on the container label. It there is sufficient space the expiration date including month and year and potential residues of processing agents are listed for labeling information. The processing date is not required at all.

Question 467

An example of every label used by the tissue bank shall be maintained. True or False?

Answer 467

True One label shall be retained for the archives as each type of outdated or obsolete label is removed from inventory.

Question 468

Before transfer of cardiovascular tissue from quarantine to distribution inventory the following shall be reviewed approved and documented as acceptable except: a. Donor blood type b. Processing time limits c. Final label d. Microbiological test results

Answer 468

a. Donor Blood Type The processing final label and testing shall be reviewed before transfer blood type is not necessary.

Question 469

Tissue can be distributed for transplantation in an emergency situation or under special medical conditions if the following is documented. a. Processing information available at time of release b. Medical Director review of all information available c. Completion of pre-established release criteria based on tissue utility. d. Statement from end-user physician indicating their understanding the tissue is released prior to completion of suitability evaluation e. All the above f. b & c & d g. b & d

Answer 469

e. All of the above Tissue distributed in an emergency shall have documented urgency of the clinical need Medical Director review of all relevant information present processing information available at the time of release a written statement issued from the end-user physician indicating understanding the release is prior to completion of suitability evaluation.

Question 470

Final review of donor suitability shall be performed by the Medical Director. The review shall include the following except: a. Acceptability of consent b. Donor Risk Assessment Interview c. Physical exam results d. Time recovery started and completed

Answer 470

d. Recovery times Time of recovery start and completion are not included in the list of items reviewed by the Medical director.

Question 471

Which of the following tissues shall be refrigerated for no longer than 14 days? a. Skin b. Refrigerated musculoskeletal c. Refrigerated cardiovascular d. All of the above

Answer 471

a. Skin shall be stored refrigerated for no longer than 14 days.

Question 472

Is temperature monitoring required for lyophilized tissue a. Yes b. No c. On a monthly basis d. All of the above

Answer 472

b. Ambient temperature monitoring not required for lyophilized tissue see the table footnotes.

Question 473

What is the warmest allowable storage temperature for frozen musculoskeletal tissue? a. -40C b. -20C c. -45C d. -35C

Answer 473

b. -20C The warmest long term storage temperature is -40C. Short term storage of 6 months or less is -20C.

Question 474

Can dehydrated tissue be stored at -10C? a. Yes b. No c. Yes if monitored

Answer 474

a. Lyophilized or dehydrated tissue must be stored at ambient temperature or colder.

Question 475

If skin is stored in liquid nitrogen documented verification of the liquid nitrogen level must occur: a. Once a week b. Twice a week c. Once a day d. At interval specified in the SOPM

Answer 475

d. According to SOPM If storage utilizes liquid nitrogen either liquid nitrogen levels or temperature shall be monitored and documented at an interval specified in the SOPM.

Question 476

Which of the following is documented to have been transmitted through tissue transplants? a. Creutzfeldt-Jakob disease b. Parkinson’s disease c. Hodgkin’s disease d. Leukemia

Answer 476

a. Creutzfeldt-Jakob disease

Question 477

The last tissue to be recovered from the lower body is: a. Ilium b. Fascia c. Achilles tendon d. Tibia

Answer 477

a. Ilium

Question 478

Which of the following is an absolute contraindication to recovering bone from an individual? a. History of autoimmune disease b. Sarcoidosis c. Diabetes d. History of prostate cancer

Answer 478

b. Sarcoidosis

Question 479

A chart review of a potential donor who died from a gunshot wound to the head reveals a high white blood cell count (WBC = 31). You should: a. Note the WBC count but decline the donation unless the tissue is urgently required b. Note the results and report them to the medical director c. Decline the donation because the WBC count indicated infection d. Order a repeat WBC count on the potential donor

Answer 479

b. Note the results and report them to the medical director

Question 480

A 25-year-old-male involved in a high speed motorcycle single vehicle MVA is pronounced dead at the scene and his body is transported to the county coroner’s facility. When informed of his death the next-of-kin inquired about the possibility for donation. The coroner refers this request to you. What should be your response? a. You should ask the coroner if aseptic tissue recovery can precede the autopsy b. You should explain to the family that tissues cannot be donated because of the severe tissue damage related to motorcycle accidents c. You should delay tissue recovery until toxicology results are available d. You should explain to the family that tissues cannot be removed because the death is being investigated by the coroner

Answer 480

a. You should ask the coroner if aseptic tissue recovery can precede the autopsy

Question 481

The local OPO refers a 22-year-old with a gunshot wound to the head stating that consent has been obtained from the next-of-kin for kidneys heart liver and bone of the lower extremities skin and corneas. The tissue bank is informed that the donor has been hospitalized for 14 days prior to declaration of death. Organ recovery is scheduled for later this day. The most appropriate INITIAL action for the tissue bank employee handling this potential donor should be to: a. Arrange for sterile recovery of the tissues immediately following organ recovery b. Inform the OPO coordinator that this donor is unacceptable for tissue donation due to the length of hospitalization c. Review the donor’s hospital records for the presence of active infections d. Obtain a blood culture and order blood serology testing

Answer 481

c. Review the donor’s hospital records for the presence of active infections

Question 482

You are asked to evaluate a 56-year-old female who just died suddenly as result of a cerebrovascular accident (stroke). Medical history includes hypertension of a 7-year duration and breast cancer 4 years ago with no recurrence. Based on your preliminary findings you should: a. Decline donation based on the history of cancer b. Accept the donor for skin only c. Decline the donor based on her cause of death d. Accept the donation pending medical director review of the donor record

Answer 482

d. Accept the donation pending medical director review of the donor record

Question 483

When recovering the heart for valves aortic conduit length is maximized by transecting the aortic arch distal to the: a. Left common carotid artery b. Left subclavian artery c. Left pulmonary artery d. Brachiocephalic artery

Answer 483

b. Left subclavian artery

Question 484

Which of the following does NOT preclude MS tissue donation? a. Rheumatoid arthritis b. Systemic lupus erythematosus c. Myasthenia gravis d. Sarcoidosis

Answer 484

c. Myasthenia gravis

Question 485

Normal skin flora is found on the surface of the skin and in the hair follicles. True or False?

Answer 485

TRUE

Question 486

When retrieving donor skin the dermatome is set to a depth of? a. 0.010 to 0.018 in. b. 0.010 to 0.028 in. c. 0.012 to 0.018 in. d. 0.012 to 0.020 in.

Answer 486

c. 0.012 to 0.018 in.

Question 487

What is the best angle for the dermatome when recovering skin that falls in the recommended thickness range? a. 30 degrees b. 35 degrees c. 40 degrees d. 45 degrees

Answer 487

d. 45 degrees

Question 488

Skin grafts are unsuitable for transplantation if the cultures grow? a. Diptheroids **non pathogenic b. Micrococcus sp. **gram positive c. Staphlococcus coagulase negative ** nonpathogenic and not highly virulent d. Staphlococcus coagulase positive **pathogenic and highly virulent

Answer 488

d. Staphlococcus coagulase positive **pathogenic and highly virulent

Question 489

Recovered skin thickness is a function of forward movement speed of the dermatome. True or False?

Answer 489

TRUE

Question 490

The donor’s next-of-kin shall be notified about medically relevant confirmed positive serological tests in accordance with state and federal regulations True or False?

Answer 490

TRUE

Question 491

Recipients of cryopreserved allograft heart valves generally do not require anticoagulant therapy as do patients receiving mechanical valve replacements. True or False?

Answer 491

TRUE

Question 492

The time interval between placement of tissues in cold rinse following procurement and the beginning of disinfection interval is known as the? a. Cold ischemic time b. Disinfection time c. Transport time d. Warm ischemic time

Answer 492

a. Cold ischemic time

Question 493

A standardized and documented Med/Soc. Hx must be obtained on each donor. In the case of an infant less than ____ months old with a history of breast feeding in the past 12 months a Med/Soc. Hx must be obtained on the mother to evaluate for the risk of transmission of HIV. a. 16 b. 18 c. 15 d. 24

Answer 493

b. 18

Question 494

What must be taken into account during radiographis tissue sizing? a. Right or left b. Distal or proximal c. Magnification d. Donor age

Answer 494

c. Magnification A radiograph can be considered a shadow. The same magnification effect from moving closer to the source of light or away from the surface on which the shadow is cast can be applied to the position of the bone relative to the radiographic plate and the x-ray source.

Question 495

During the initial incision areas of skin that have abrasions or puncture wounds should be: a. Avoided and tissues affected not retrieved b. Prepped more thoroughly before initial incision c. Ignored d. None of the above

Answer 495

a. Avoided and tissues affected not retrieved. Areas that have abrasions or puncture wounds should be avoided.

Question 496

Which is not a residual product of ethylene oxide? a. Ethylene oxide b. Ethylene dioxide c. Ethylene chlorohydrin d. Ethyhlene glycol

Answer 496

b. Ethylene dioxide There are three residues listed in the standard: Ethylene Oxide Ethylene Chlorohydrin and Ethylene Glycol.

Question 497

Laboratory cultures on donor skin detect most common microorganisms with the exception of? a. Anaerobic bacteria b. Fungi c. Viruses d. Yeast

Answer 497

c. Viruses Viruses are very difficult to culture. They require living cells and are beyond the scope of common laboratory practices.

Question 498

What is the order in which tissue from the lower extremities is recovered? a. Fascia femur tib/fib ilium b. Fascia femur ilium tib/fib c. Ilium fascia femur tib/fib d. Fascia tib/fib femur ilium

Answer 498

a. Fascia femur tib/fib ilium

Question 499

On a tissue graft treated with ETO what is the allowable parts per million residual on a size of tissue less than 10 grams for ETO Ethylene Glycol Ethylene Chlorohydrin: a. 2500 2500 5000 b. 250 250 5000 c. 250 5000 250 d. 100 100 2000

Answer 499

c. 250 5000 250

Question 500

When dissecting the femur at the level of the hip the ligamentum teres tendon is transected severing its attachment to the . a. Acetabulum b. Patellar tubercle c. Greater trochanter d. Tibial plateau

Answer 500

a. Acetabulum