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CCTC CERTIFICATION REVIEW Exam with complete solutions 2024_2025
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CCTC CERTIFICATION REVIEW Exam with complete solutions 2024_2025
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CCTC CERTIFICATION REVIEW Exam withcomplete solutions 2024/2025
Absolute Contraindications for liver transplant - ANSWER-Severe
cardiopulmonary disease, uncontrolled HIV, poorly controlled Psych illness,
noncompliance, anatomical abnormalities precluding adequate surgical
reconstruction
Reason for not accepted for liver TX - ANSWER-Hepatocellular Carcinoma (HCC)
outside Milan Criteria
What is NAFLD? - ANSWER-Nonalcoholic Fatty Liver Disease- caused by obesity,
hyperglycemia, elevated serum lipids, and high BP
What is NASH? - ANSWER-Non-alcoholic steatohepatitis. Can lead to cirrhosis
3rd common indication for liver TX.
What is the MELD score? - ANSWER-MELD(Model for End Stage Liver Disease) is
a predictive model of death within a 3 month period. Ranks your degree of
sickness, shows how much you need a liver transplant. The higher the number,
the more urgent case is. Score ranges from 6-40.
*Score for HCC capped at 34.
Calculated using:
-INR
-Bilirubin
-Creatinine
-Sodium
MELD > 14 needed for liver transplant
, What can green drainage post liver TX indicate? - ANSWER-Bile leakage
What can a rise in ALP post liver tx indicate? - ANSWER-Can be a sign of biliary
complications or cholestasis
Lab changes are indicate of graft dysfunction. Which values will be elevated for
liver tx? - ANSWER-Elevated AST and ALT
Target levels for immunosuppressants are based on a number of factors
including: - ANSWER-Indication for tx, use of induction therapy, kidney function,
overall condition of pt.
What can lead to metabolic encephalopathy post liver transplant? - ANSWER-
Renal failure or sepsis
What can lead to hypoxic ischemic encephalopathy post liver transplant? -
ANSWER-Significant peri-operative hypotension
De Novo seizures can occur post liver transplant and can be caused by what? -
ANSWER-Electrolyte imbalances, reaction to cyclosporine or tacrolimus,
intracranial hemorrhage or cerebral infarction and intracerebral abscesses
What can cause a post liver transplant patient whose initial postop neurological
course is normal to develop sudden deterioration in neurological status? -
ANSWER-Intracranial bleed
Risk of primary non-function after liver transplant is: - ANSWER-4-6%
Factors related to primary nonfunction of new liver include: - ANSWER-Donor
age, prolonged cold ischemic time, prolonged donor hospital stay with periods of
hypotension, preservation injury during donor surgery, and donor steatosis(fat in
liver)
Early Indicators of non functioning liver: - ANSWER-decrease in bile production
extreme edema of organ
Abnormal color of organ upon reperfusion(mottled, gray, pale)
lack of reperfusion in OR
urine output <30ml/hr
hemodynamically unstable
glucose, k, and lactate abnormalities
Coagulopathy
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