CCTC REVIEW EXAM (ACTUAL EXAM)
QUESTIONS WITH VERY ELABORATED
ANSWERS CORRECTRY WELL ORGANIZED
LATEST 2024 – 2025 ALREADY GRADED A+
Myocardial Ischemia in denervated(transplanted) heart - ANSWERS-SOB, Fatigue,
Decreased ability to do tasks
LVAD (left ventricular assist device) - ANSWERS-Provides circulatory support for
the failing left ventricle in patients with advanced chronic systolic heart failure
CMs criteria for LVAD - ANSWERS-Bridge to Tx as long as long on list.
Destination therapy Class 4...
LVAD post op complication - ANSWERS-infection at driveline site, pump pocket or
pump itself
,Ethical principle-Autonomy (living donors) - ANSWERS-right to act intentionally,
with understanding and without internal or external influences
Which lab to monitor with fever post tx - ANSWERS-Crp- c reactive protein
because protein present with acute inflammation and sepsis
Indicative of rejection - ANSWERS-Light stools and dark urine,
Indicative of poor graft function s/p liver transplant - ANSWERS-High lactate and
acidosis, high ALT/AST, PT >25 sec and continues to rise after vit k and FFP
type 2 diabetes - ANSWERS-More common, occurs in adulthood, characterized by
insulin resistance. As resistance rise, beta cells are eventually unable to produce
necessary amount of insulin to lower and maintain normal blood glucose levels.
type 1 diabetes mellitus - ANSWERS-diabetes in which no beta-cell production of
insulin occurs and the patient is dependent on insulin for survival
Goal of pancreas transplant - ANSWERS-To restore normoglycemia, halt or
prevent secondary complications of diabetes
Procedure for liver transplant - ANSWERS-Anastomosis of the inferior vena cava,
portal vein, hepatic artery, and the biliary connection via a duct to duct
anastomosis ( choledochocholeclochostomy)
,Etiology of renal dysfunction immediately post op(liver tx) - ANSWERS-
Hypotensive episodes, blood loss, high renal vein pressure intraoperatively and
postoperatively due to hemodynamically instability or sepsis.
Leading cause of non graft related death for liver recipients - ANSWERS-
Cardiorespiratory failure
Which immunosuppressants cause HTN - ANSWERS-Calcineurin inhibitors or
corticosteroids
Indications for pancreas transplant alone (PTA) or pancreas after kidney (PAK)
transplant - ANSWERS-Type 1 DM manifested by poor metabolic control,
especially hypoglycemic unawareness for many years. On insulin and C-peptide at
or < 2 ng/ml or on insulin and C-peptide at or greater than 2ng/mg and BMI at or
less than maximum allowable BMI (currently 28) and pancreatic exocrine
insufficiency.
Indications for Simultaneous pancreas-kidney (SPK) transplant - ANSWERS-
Diagnosis of diabetes or pancreatic exocrine insufficiency with renal insufficiency
Immunosuppressive medications are covered by which part of Medicare? -
ANSWERS-Medicare part B
, Standard immunosuppressive for pancreas transplant recipients typically
includes: - ANSWERS-Tacrolimus(prograf, FK506), mycophenolate mofetil
(cellcept), prednisone(steroid)
Reason why native pancreas left in place during pancreas tx - ANSWERS-Allows
the exocrine function of native pancreas to be preserved.
Enteric Drainage( ED) post pancreas transplant - ANSWERS-More common,
difficult to detect rejection, donor portal vein anastomosed to recipients
SMV(superior mesenteric vein), donor duodenal segment attached to recipients
jejunum, pancreases produces 2L of fluid drainage, pancreatic enzymes excreted
thru the stool
Advantages of Enteric drain (ED) post pancreas transplant - ANSWERS-More
physiologic, fewer metabolic imbalances because pancreatic secretions are
reabsorbed, less post-op complications
Bladder Drainage (BD) post pancreas transplant - ANSWERS-Easier to monitor for
rejection with urine amylase, may cause dehydration and cystitis. Direct
monitoring of graft exocrine function, easier to perform biopsy, less invasive if
complications arise.
Disadvantages of Bladder Drainage (BD) post pancreas transplant - ANSWERS-
Dehydration, cystitis, UTIs, metabolic acidosis, urine leak, hematuria, 35% go on
to need enteric conversion, pancreatitis
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