Donor Assessment and Evaluation Flashcards
Which of the following findings is not indicative of pericardial tamponade?
- -Pulsus parodoxus
- -Distended neck veins
- -Widening pulse pressure
Pulsus parodoxus
Upon examining a patient the Organ Recovery Coordinator finds a weakened pulse, distant heart sounds, and very diminished lung sounds. The CXR showed a black area with no visible lung markings. Which of the following most accurately reflects the condition of the patient?
- -Atelectasis
- -Hemothorax
- -Pneumothorax
Hemothorax
The physical assessment of the donor should be completed prior to doing which of the following?
- -Obtaining consent from family for donation
- -Going to the OR
- -Making organ offers
Making organ offers
The donor’s serologies came back with the following results: HBsAg non-reactive, HBcAbIgM non-reactive, HBcAbIgG reactive, HBsAb reactive. Should the Organ Recovery Coordinator still proceed with the case?
- -Yes, these results indicate the donor is in the recovery state and is not contagious.
- -Maybe, the donor may be in the recovery stage, or they may have chronic active hepatitis. Therefore, repeat testing must be done.
- -No, the donor is in the convalescent state and may still be infectious.
Yes, these results indicate the donor is in the recovery state and is not contagious.
A number of physiologic changes occur with brain death. What is the physiological change that causes endocrine abnormalities?
- -Upon brain death the release of endogenous catecholamines, commonly referred to as a “catecholamine storm” occurs and this causes endocrine disruptions.
- -Upon brain death rapid disturbances occur that affect the hypothalamus and pituitary gland, which creates endocrine abnormalities.
- -Upon brain death hypothermia occurs and contributes to endocrine instability.
Upon brain death rapid disturbances occur that affect the hypothalamus and pituitary gland, which creates endocrine abnormalities
To determine a patient’s blood type, the laboratory looks for which of the following?
- -The O antigen found on the red blood cell
- -The A and B antigens found on the red blood cell
- -The A and B antibodies found on the white blood cells
The A and B antigens found on the red blood cell.
If the donor’s Hcg test is positive, what would the MOST appropriate next action be?
- -Notify medical director and plan to have abdominal ultrasound done to verify pregnancy.
- -Rule out patient for all donation.
- -Notify all transplant centers that patient is pregnant.
Notify medical director and plan to have abdominal ultrasound done to verify pregnancy.
Upon examining a patient the Organ Recovery Coordinator finds no visible evidence of any trauma to the patient. However, it is known that this patient was in a MVA. What should the Organ Recovery Coordinator do with the information he/she has available?
- -The Coordinator should thoroughly read the accident report to find as much information as possible and keep in mind all possible internal injuries during the evaluation process.
- -Nothing. There is no visible damage, so the case should continue as normal.
- -There is no telling what injuries could have been sustained, so the case needs to be shut down.
The Coordinator should thoroughly read the accident report to find as much information as possible and keep in mind all possible internal injuries during the evaluation process.
While interviewing the significant other of your donor, you learn that the donor was vaccinated for Hepatitis B virus. Will this vaccination provide protection from all forms of hepatits?
- -No. Hepatitis A, B, and C are different viruses, requiring different vaccinations.
- -Yes. There is one vaccine for all forms of hepatitis.
- -Yes, but the entire series of vaccinations must be completed.
No. Hepatitis A, B, and C are different viruses, requiring different vaccinations.
Which two serology results, if positive, requires and immediate consultation with the Medical Director before organ placement continues?
- -HBcAb and HCV
- -HBsAb, and HCV
- -HBcAb and HBsAg
HBcAb and HBsAg
Which lab results are most indicative of the donor being in rhabdomyolysis?
- -Elevated creatinine, elevated CPK, normal troponin
- -Elevated sodium, elevated creatinine, normal CPK
- -Elevated troponin, elevated CPK, normal sodium
Elevated Creat, Elevated CPK, Normal Troponin
During lung auscultation, what are inspiratory crackles indicative of?
- -The patient has atelectasis and needs increased ventilatory volume
- -The patient has fluid build-up in lungs and needs diuresis.
- -The patient’s airway is constricted and needs nebulizer treatment
The patient has fluid build-up in lungs and needs diuresis
The patient is a 50 yr old female, she has a BP of 60/40, pulse 125, and her UOP is about 30 ml/hr. Her Na is 138, glucose 105, and Cr 2. What type of IV fluid should the organ recovery coordinator hang?
- -0.45% Saline
- -0.9% saline (NSS)
- -LR
NSS
What are the most important abnormalities in gas exchange that lead to respiratory failure?
- -Hyperventilation and pulmonary edema
- -Aspirations, chest trauma, and sepsis
- -V/Q mismatch, intrapulmonary shunt and hypoventilation
V/Q mismatch, intrapulmonary shunt, and hypoventilation
In many brain dead patients, hormonal resuscitation will result in which of the following:
- -Stabilization of temperature regulation and urine output
- -Cardiovascular stability and increased organ perfusion
- -Stabilization of blood sugar and insulin levels
Cardiovascular stability and increased organ perfusion
Vasopressor infusions are commonly used to treat which cardiovascular system change encountered during clinical management of the organ donor:
- -Dysrhythmias
- -Hypotension
- -Hypertension
HYPOtension
A Hcg test should be run on female donors who are of child-bearing age to detect which of the following:
- -High risk lifestyle
- -Presence of choriocarcinoma
- -Presence of kidney stones
Presence of choriocarcinoma
Which of the following is a sign of tension pneumothorax?
- -Tracheal deviation
- -Expiratory wheezes
- -Inspiratory crackles
Tracheal deviation
Which electrolyte abnormality produces peaked T waves and widened QRS complex?
Hyperkalemia
Which of the following antibody categories is responsible for the initial immune response to most antigens?
- -IgA
- -IgG
- -IgM
IgM
A patient is hypotensive, has a low UOP and a fast HR. The organ recovery coordinator suspects hypovolemia and assess the CVP. The CVP reads 2 cmH2O. Which of the following is the best way to go about replacing fluids?
- -Give a small amount of fluid and stop once the CVP is 3.
- -Replace the fluid until there is a sustained rise in CVP to normal limits.
- -Do nothing because the CVP is within normal range.
Replace the fluid until their is a sustained rise in CVP to normal limits.
Preoperative immunologic testing of donor and transplant recipients includes what two things?
ABO and HLA compatibility
A 44 yr old female admitted with a diagnosis of “sepsis” two weeks ago. What is the MOST important information to obtain before proceeding with organ donation?
- -The source of the sepsis.
- -What abx she’s been on.
- -How much down time she had.
Source of the sepsis
What is the primary mode of transmission of hepatitis C?
- -sexual contact
- -feces and the enteric (fecal-oral) route
- -blood
Blood
A patient has a history of drug abuse and is currently hypokalemic. His/her EKG shows a normal waveform with normal conduction. However, the organ recovery coordinator sees additional QRS complexes that are not accompanied by P waves and they appear wide. What arrhythmia does the patient have and how should the coordinator treat it?
- -The pt exhibits signs of VTach, which should be treated with cardioversion and procaniamide.
- -The pt exhibitis signs of VFib, which should be treated with cardioversion, epi, and lidocaine.
- -The pt exhibits signs of PVCs, which should be treated with lidocaine.
The pt exhibits signs of PVCs, which should be treated with lidocaine
Your donor is the breastfed infant whose mother is a recovering IV drug addict. Should serology testing be performed on the infant?
Yes, serology testing should be done on all consented donors.
What is the most common cause of metabolic acidosis?
Impaired cell metabolism due to impaired tissue perfusion.
What is the primary reason that a quantitative pregnancy test is done on females between the ages of 12 and 55?
To decrease the incidence of transmission of cancer to recipients who recieve organs from a female donor.
Your donor is noted to have a large, raised, irregular shaped growth in their underarm area. You should:
- -Leave it alone.
- -Have it removed ASAP so it doens’t affect organ placement
- -Disclose the information and findings during all organ offers.
Disclose the information and findings during all organ offers.
The result of your donors CBC reveals a Hgb of 9.5 and a Hct of 34.6 You anticipate transfusing blood. What should you do first?
Type and crossmatch a blood sample before proceeding with a transfusion.
Which of the following would likely be a rule out for potential organ donation?
- -Bacteremia treated w/abx for 48hrs
- -Existence of carcinoma, with the exception of low-grade skin or brain tumors.
Existence of carcinoma, with the exception of low-grade skin or brain tumors
A 25 year old patient has been declared brain dead and the organ recovery coordinator has begun the case. All of a sudden the patient’s righ arm begins to move. It repetitively moves up and down about 5 times in the same motion and then the movement stops. What should the organ recovery coordinator do after witnessing this movement?
Continue the case as normal. The movement seen was due to spinal reflexes.
What is the most common method used for serology testing?
ELISA
If your donor develops a tension pneumothorax, what is an EARLY sign you can expect to see?
Increase in peak inspiratory pressure
You have been working for several hours on a young, healthy donor with an isolated head injury. The patient suddenly starts having frequent, wide, irregular QRS waves on his ECG. If the patient’s BP is stable what is the course of action?
Check labs for any electrolyte imbalances
A decreasing hematocrit and hemoglobin, a drop in platelets and an increase in Pt and PTT indicates a donor may be going into which condition?
DIC
