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CCTC EXAM REVIEW EXAM
QUESTIONS WITH ANSWERS.
Most reliable indication of CNS infection - correct answer -
Simultaneous presence of unexplained fever and headache
because changes in LOC may be subtle. Warrant immediate
neurological exam and assessment
Preferred test to dx CMV - correct answer -CMV RNA or DNA-
indicative of active infection
CMV prophylaxis - correct answer -Valganciclovir/Valcyte
(monitor leukopenia) 3-6 mos, except for Lung 12 mos
Gancyclovir /cytovene Oral & IV (monitor leukopenia and disease
resistance
CMV treatment - correct answer -Gangciclovir(IV only),
valganciclovir
Valacyclovir-Kidney only (Neurotoxic)
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BK virus risk factors - correct answer -Older, male recipient,
stents, low BK titers, HLA mismatch, deceased donation, female
donor, high BK iris specific AB titers
Sx of BK virus - correct answer -fever, hematuria, elevated
creatinine
BK virus screening - correct answer -every 3 months first 2 years
then annually until 5th post tx year
Gold standard for BK virus dx - correct answer -Biopsy
JC virus (Polyomavirus) - correct answer -Affects brain, CNS
clinical manifestations (classic triad dementia, hemiparesis,
hemianopsia) Treatment steroids, interferons,
Risk factors Lung infection post tx - correct answer -impaired
cough reflex, poor mucosal clearance, abnormal lymph drainage,
single lung tx, airway inflammation, ischemia and perfusion injury,
CF
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Sx of pneumonia in heart or lung tx - correct answer -persistent
respiratory failure, failure to wean from vent, fever, purulent
secretions, lung consolidation
Dx respiratory tract cx, CT scan
cholangitis - correct answer -bile duct infection. Sx Fever,
leukocytosis, RUQ pain, Rebound tenderness, high bilirubin, high
transaminases, high all phos. Chongiogram, LFTs too diagnose.
Treatment-Obstruction-ERCP w/dilation. No obstruction-Abx
Prevention-antimicrobial prophylaxis before any manipulation of
biliary tract
Lymphocele post kidney tx - correct answer -collection of fluid
between bladder and allograft.
Sx-fever, graft tenderness, unilateral leg edema on side of
transplanted kidney, incontinence, decrease uo, decrease kidney
function, increase BUN/creatinine
treatment-drainage
How is toxoplasmosis diagnosed? - correct answer -
endomyocardial biopsy
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Cryptosporidium parvum - correct answer -Protozoan parasite
transmitted by contaminated water, causes severe, persistent
watery diarrhea
Avoid well water, boil water x1 minute, bottled distilled water,
avoid ice cubes, fountain dfroinks made with tap water, use water
filter
Drug interactions/side effects - correct answer -antimicrobials can
increase/decrease tac or cyclosporine levels and cause added
nephrotoxicity
OPTN Policy 15.1 Identification of transmissible disease - correct
answer -Each program must have pt safety contact available
24hrs/day, receive notification from UNOS of potential disease,
communicate to recipients medical staff ASAp, no later than
24hrs, facilitate communication about clinical status of recipient
OPTN policy 15.2 potential candidate screening requirements -
correct answer -potential candidate tested for HIV, Hep B, Hep C
and offered counseling if positive
CCTC EXAM REVIEW EXAM
QUESTIONS WITH ANSWERS.
Most reliable indication of CNS infection - correct answer -
Simultaneous presence of unexplained fever and headache
because changes in LOC may be subtle. Warrant immediate
neurological exam and assessment
Preferred test to dx CMV - correct answer -CMV RNA or DNA-
indicative of active infection
CMV prophylaxis - correct answer -Valganciclovir/Valcyte
(monitor leukopenia) 3-6 mos, except for Lung 12 mos
Gancyclovir /cytovene Oral & IV (monitor leukopenia and disease
resistance
CMV treatment - correct answer -Gangciclovir(IV only),
valganciclovir
Valacyclovir-Kidney only (Neurotoxic)
, Page | 2
BK virus risk factors - correct answer -Older, male recipient,
stents, low BK titers, HLA mismatch, deceased donation, female
donor, high BK iris specific AB titers
Sx of BK virus - correct answer -fever, hematuria, elevated
creatinine
BK virus screening - correct answer -every 3 months first 2 years
then annually until 5th post tx year
Gold standard for BK virus dx - correct answer -Biopsy
JC virus (Polyomavirus) - correct answer -Affects brain, CNS
clinical manifestations (classic triad dementia, hemiparesis,
hemianopsia) Treatment steroids, interferons,
Risk factors Lung infection post tx - correct answer -impaired
cough reflex, poor mucosal clearance, abnormal lymph drainage,
single lung tx, airway inflammation, ischemia and perfusion injury,
CF
, Page | 3
Sx of pneumonia in heart or lung tx - correct answer -persistent
respiratory failure, failure to wean from vent, fever, purulent
secretions, lung consolidation
Dx respiratory tract cx, CT scan
cholangitis - correct answer -bile duct infection. Sx Fever,
leukocytosis, RUQ pain, Rebound tenderness, high bilirubin, high
transaminases, high all phos. Chongiogram, LFTs too diagnose.
Treatment-Obstruction-ERCP w/dilation. No obstruction-Abx
Prevention-antimicrobial prophylaxis before any manipulation of
biliary tract
Lymphocele post kidney tx - correct answer -collection of fluid
between bladder and allograft.
Sx-fever, graft tenderness, unilateral leg edema on side of
transplanted kidney, incontinence, decrease uo, decrease kidney
function, increase BUN/creatinine
treatment-drainage
How is toxoplasmosis diagnosed? - correct answer -
endomyocardial biopsy
, Page | 4
Cryptosporidium parvum - correct answer -Protozoan parasite
transmitted by contaminated water, causes severe, persistent
watery diarrhea
Avoid well water, boil water x1 minute, bottled distilled water,
avoid ice cubes, fountain dfroinks made with tap water, use water
filter
Drug interactions/side effects - correct answer -antimicrobials can
increase/decrease tac or cyclosporine levels and cause added
nephrotoxicity
OPTN Policy 15.1 Identification of transmissible disease - correct
answer -Each program must have pt safety contact available
24hrs/day, receive notification from UNOS of potential disease,
communicate to recipients medical staff ASAp, no later than
24hrs, facilitate communication about clinical status of recipient
OPTN policy 15.2 potential candidate screening requirements -
correct answer -potential candidate tested for HIV, Hep B, Hep C
and offered counseling if positive
