CCTC Exam Questions And Revised
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1) MELD score components - ANSWER Total bilirubin creatinine
INR Na and etiology of disease
2) MELD score range - ANSWER 6(less ill) to 40 (gravely ill)
3) PELD score - ANSWER Pediatric model for end stage liver
disease determines how urgent pt require liver in next 3 months
- ANSWER model for end stage liver disease determines how
urgent pt require liver in next 3 months
4) How often Lung Allocation Score (LAS) updated/ what info -
ANSWER Every 6 months with FVC, six minute walk distance,
creatinine,
5) How often Patients with known HCC have re-evaluation tests -
ANSWER Every 3 months per unos to receive meld exception
points
,6) EPTS (estimates post transplant survival score) - ANSWER
Receives After 18 years old, represents percentage of kidney
candidates in the nation with a longer expected post transplant
survival time.
7) How is EPTS calculated? - ANSWER Time on dialysis, DM, prior
transplant, age
8) Kidney Donor Profile Index (KDPI) - ANSWER Kidneys from
deceased donors are classified according to the KDPI. score derived
from kidney donor profile index which takes donors characteristics
into consideration: age ethnicity creat, h/o HTN, h/o dm, cause of
death, hgt wgt HCv status, donor type(DCD OR NOT)
9) Procedure for liver transplant - ANSWER Anastomosis of the
inferior vena cava, portal vein, hepatic artery, and the biliary
connection via a duct to duct anastomosis (
choledochocholeclochostomy)
10) Etiology of renal dysfunction immediately post op(liver tx) -
ANSWER Hypotensive episodes, blood loss, high renal vein
pressure intraoperatively and postoperatively due to
hemodynamically instability or sepsis.
,11) Leading cause of non graft related death for liver recipients -
ANSWER Cardiorespiratory failure
12) Which immunosuppressants cause HTN - ANSWER
Calcineurin inhibitors or corticosteroids
13) Which lab to monitor with fever post tx - ANSWER Crp- c
reactive protein because protein present with acute inflammation
and sepsis
14) Indicative of rejection - ANSWER Light stools and dark urine,
15) Indicative of poor graft function s/p liver transplant - ANSWER
High lactate and acidosis, high ALT/AST, PT >25 sec and
continues to rise after vit k and FFP
16) Type 2 diabetes - ANSWER 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.
17) Type 1 diabetes mellitus - ANSWER diabetes in which no
beta-cell production of insulin occurs and the patient is dependent
on insulin for survival
, 18) Goal of pancreas transplant - ANSWER To restore
normoglycemia, halt or prevent secondary complications of diabetes
18) Indications for pancreas transplant alone (PTA) or pancreas after
kidney (PAK) transplant - ANSWER 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 -
ANSWER Diagnosis of diabetes or pancreatic exocrine insufficiency
with renal insufficiency
Immunosuppressive medications are covered by which part of
Medicare? - ANSWER Medicare part B
Standard immunosuppressive for pancreas transplant recipients
typically includes: - ANSWER Tacrolimus(prograf, FK506),
mycophenolate mofetil (cellcept), prednisone(steroid)
Reason why native pancreas left in place during pancreas tx - ANSWER
Allows the exocrine function of native pancreas to be preserved.
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