Cctc Certification Review Study Guide With Complete Solutions

CCTC CERTIFICATION REVIEW STUDY GUIDE WITH COMPLETE SOLUTIONS 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. EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 2/8 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 EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 3/8 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, gra