CCTC review Exam with complete
solutions 2024/2025
A liver recipient, 2-month postoperative, presents to a clinic with the following
complaints of 48-hour duration: temperature of 38.5°C (101.3°F), chills, and
cough. He reports dark-colored urine, light-colored stools, yellow skin, and a loss
of appetite. The transplant coordinator should anticipate the following course of
events in what order?
A. hospital admission, blood cultures, routine blood work, CXR, abdominal
ultrasound, liver biopsy
B. liver biopsy, blood cultures, routine blood work, CXR, abdominal ultrasound
C. IV antibiotics, blood cultures, routine blood work, CXR, ERCP, abdominal
ultrasound, hospital admission
D. liver biopsy, blood cultures, IV antibiotics, CXR, routine blood work, hospital
admission - ANSWER-A. hospital admission, blood cultures, routine blood work,
CXR, abdominal ultrasound, liver biopsy
The transplant coordinator should do less invasive test first: blood cultures are
needed to rule out sepsis given the patient has a temperature of 38.5°C (101.3°F),
routine blood work is needed to know what the patient's WBC, liver function test,
and creatinine levels are. CXR is needed to rule out pneumonia because the
patient has chills and a cough. Abdominal ultrasound is needed because the
patient has had a liver transplant and has dark urine, light stools, and yellow skin.
If infection has not been ruled out, the coordinator should check for liver
rejection.
When teaching a candidate about living-related donor transplantation, which of
the following concepts are important to include?
1. Transplantation is a cure.
2. Less immunosuppression is typically required.
,3. expected length of the operation
4. potential for graft loss
A. 1 and 2 only
B. 1 and 4 only
C. 2 and 3 only
D. 3 and 4 only - ANSWER-D. 3 and 4 only
A transplant coordinator is educating a liver transplant recipient who is hepatitic
C virus (HCV)-positive about potential complications. Which of the following
should be discussed?
A. Antirejection medications are usually lowered during episodes of rejection.
B. Signs of rejection include fatigue and light colored stools.
C. Infections after transplant can be common due to antihypertensive
medications.
D. The risk of recurrent hepatitis C is very low after a liver transplant. - ANSWER-
B. Signs of rejection include fatigue and light colored stools.
Anti Rejection medications are increased, not lowered during episodes of
rejection. Infections are common due to antirejection medications, not
antihypertensive medications. The recipient is still HCV-positive even after the
liver transplantation and treatment may be necessary
A patient received a living-related donor kidney transplant 2 days ago. Urine
output has abruptly stopped. A stat renal ultrasound confirmed renal vein
thrombosis. The patient is rushed back to the operating room for allograft
nephrectomy. Which of the following should the transplant coordinator
immediately anticipate?
1. anticoagulation therapy
2. UNOS listing for retransplant
3. need for dialysis
4. ineligibility for future living donor transplant
A. 1 and 3 only
B. 1 and 4 only
C. 2 and 3 only
D. 2 and 4 only - ANSWER-C. 2 and 3 only
When renal venous thrombosis occurs, the kidney cannot be salvaged. The
patient will be required to return to dialysis and retransplanted.
A heart transplant recipient is being prepared for an endomyocardial biopsy.
Which of the following should the transplant coordinator explain to the recipient?
A. An echocardiogram is needed following the biopsy.
, B. Endomyocardial tissue is obtained from the atrium.
C. An overnight stay at the hospital is needed for observation.
D. The internal jugular vein is the most common approach. - ANSWER-D. The
internal jugular vein is the most common approach.
A right ventricular biopsy is performed to determine rejection. The most common
venous access is through the right internal jugular vein.
In most transplant centers, the recommended frequency of panel-reactive
antibody (PRA) testing in a transplant candidate with a PRA of 15% is
A. every 3 months.
B. monthly.
C. every 2 weeks.
D. only with organ offer. - ANSWER-B. monthly.
Patients with a PRA greater than 10% are usually retested on a regular basis,
monthly, or with a ventricular assist device (VAD) weekly.
A heart candidate is clinically deteriorating in the ICU, and the transplant team
anticipates placing a ventricular assist device within 72 hours. In the interim, a
right heart catheterization was performed and a Swan Ganz catheter and intra-
aortic balloon pump (IABP) were placed. The transplant coordinator should verify
the candidate's UNOS listing as
A. 1A.
B. 1B.
C. 2.
D. 7. - ANSWER-A. 1A.
Adult patients awaiting a heart transplant are given a status code based on how
medically urgent it is for them to receive a transplant. Status 1A candidates are
medically urgent and are listed as having: (1) mechanical circulatory support for
acute homodynamic decompensation that includes at least 1 of the following: left
and/or right ventricular assist device implanted, total artificial heart, intra-aortic
balloon pump or extracorporeal membrane oxygenate; (2) mechanical
thromboembolism, device infection, mechanical failure, and/or life-threatening
ventricular arrhythmias; (3) continuous mechanical ventilation; or (4) continuous
infusion of a single high-dose intravenous isotope or multiple intravenous
isotopes, in addition to continuous hemodynamic monitoring of left ventricular
filling pressures. Status 1B patients have at least 1 of the following devices or
therapies in place: left and/or right ventricular assist device implanted or
continuous infusion of intravenous inotropes. Status 2 are all other patients
awaiting a heart who do not meet the criteria for status 1A or 1B. Status 7 patients
are temporarily inactive on the list.