QUESTIONS WITH SOLUTIONS GRADED A+
• ad lib.
Answer: as desired
• You are mentoring a new kidney transplant coordinator. Which of the
following symptoms support a diagnosis of rejection in a kidney transplant
recipient: 1. Malaise 2. 1.3 (3 pound) weight gain in 24 hours 3. Graft
tenderness 4. Increased urinary frequency a. 1, 2 and 3 only b. 1, 2 and 4
only c. 1, 3 and 4 only d. 2, 3 and 4 only.
Answer: 1. Malaise 2. 1.3 (3 pound) weight gain in 24 hours 3. Graft
tenderness **Also includes decreased urinary frequency
• A 56 year old male heart transplant candidate. Which of the following data
are required on the listing candidate registration TIEDI form? A. Ethnicity,
incidence of malignancy, and address B. Ethnicity, citizenship and
functional status C. Functional status, incidence of malignancy and
medications D. Primary diagnosis, insurance and referring physician.
Answer: B. Ethnicity, citizenship and functional status
• You are training a new transplant coordinator and will be drawing transplant
labs on a new patient for evaluation. One of the labs includes Panel Reactive
Antibody (PRA). As you are explaining PRA, you would include everything
except: A. This can determine the likelihood of developing acute/chronic
rejection following transplant B. The PRA must be zero to proceed with
transplant C. Serum of prospective recipient is tested against a panel of
lymphocytes for presence of circulating antibodies reactive against HLA
antigens D. The higher the PRA, the higher the sensitization and more
difficult it can be to find a donor match.
Answer: B. The PRA must be zero to proceed with transplant
• A 21 year old female kidney recipient 10 years post transplant was seen in
your post transplant clinic. She has been on cyclosporine for the past 10
, years. After reviewing her history/labs, you note that she has a creatinine of
1.2 and a cyclosporine level of 250. She also has worsening gingival
hyperplasia. You have a long discussion about options. Your next initial step
will be to: 1. Switch from cyclosporine to a non CNI as this is causing
ongoing renal therapy 2. Start referral and evaluation for kidney
re-transplant due to rise in creatinine 3. Lower cyclosporine dose and repeat
labs within one week 4. Referral to oral surgeon for gingival hyperplasia.
Answer: 3. Lower cyclosporine dose and repeat labs within one week
Normal levels of cyclosporine at 10 years post-txp should be 100-150.
• Name the stages of the NY Heart Association Classification for listing on
the heart txp waitlist? What is the classifications based on ?.
Answer: Stage 1 - cardiac disease, no limit in physical activity Stage 2 -
slight limitations in physical activity but resolve with rest Stage 3 - marked
limitations, usually comfortable at rest Stage 4 - inability to carry on
physical activity without symptoms, even at rest **Based on symptoms, can
be reversible
• You are discharging a 40 year old transplant candidate from the
med/surgical unit. You are providing discharge education regarding kidney
allocation and wait list time. Priority when offering deceased donor kidneys
is: a. pediatric patients, longest waiting patients, highly sensitized patients b.
patient's who are 0 mm with donor, pediatric patients, longest waiting
patients c. highly sensitized patients, patients who are 0 mm with donor,
pediatric patients.
Answer: c. highly sensitized patients, patients who are 0 mm with donor,
pediatric patients **living donor is also prioritized
• You are discussing medications with a 35 year old post heart transplant
recipient. He has brought his wife to the clinic appointment. He has
expressed concerns regarding impotence post transplant. You are reviewing
his medication list. Which medication is known to have the side effect of
impotence? A. Lisinopril B. Amlodipine C. Atenolol D. Lasix.
Answer: C. Atenolol (beta blocker)
,• C/O; c/o.
Answer: complains of
• RLQ.
Answer: right lower quadrant
• VS; vs.
Answer: vital signs
• abd.
Answer: abdomen
• A 30 year old liver recipient, 6 months post transplant, presents to clinic
with the following complaints : temp of 39.0C, chills, fatigue. He appears
jaundice. You draw laboratory studies which show bili = 10, ALT = 500,
AST = 600, GGT =700, CRP =25. The transplant coordinator should
anticipate the following orders for which diagnosis? A. Rejection, high dose
steroids, blood culture, abdominal US, hospital admission, liver biopsy B.
Rejection, high dose steroids, IV antibiotics, blood cultures, routine blood
work, abdominal US, hospital admission, liver biopsy C. Cholangitis, IV
antibiotics, blood cultures, abdominal US, hospital admission D.
Cholangitis, blood cultures, IV antibiotics, hospital admission, ERCP.
Answer: D. Cholangitis, blood cultures, IV antibiotics, hospital admission,
ERCP **Cholangits- need ERCP due to issue with bile duct Symptoms
showing issue with increased bili
• BRP.
Answer: bathroom privileges
• FBS.
Answer: fasting blood sugar
• GU.
Answer: genitourinary
• BID.
Answer: twice a day
, • SOB.
Answer: shortness of breath
• c with the line over it.
Answer: with
• Transplant coordinator education during the evaluation phase should include
information about transplantation including all of the following except: A.
Results of physical exam, labs and tests B. Determining best option based
on evaluation, surgical risks and potential complications C. Suitability for
transplant D. Relevance of psychosocial issues E. Expected survival rates.
Answer: B. Determining best option based on evaluation, surgical risks and
potential complications **This is a committee decision and not during the
evaluation phase
• You are caring for a 39 year old heart transplant recipient in the
intermediate/transplant step-down unit who has been admitted for
assessment and treatment for possible cryptococcal meningitis. Which of the
following manifestations would you expect to observe in your patient? A.
Mental status changes B. Stiff neck C. Headache D. All of the above.
Answer: D. All of the above
• DX.
Answer: diagnosis
• cath.
Answer: catheter
• What is Status 1A for heart transplant for PEDIATRICS?.
Answer: Ventilator, mechanical assistance, ductal dependent pulmonary or
systemic circulation maintained by stent/prostaglandins, congenital heart
disease on inotropes in hospital
• You have a 20 year old intestinal transplant recipient on cyclosporine. He
has severe gingival hyperplasia when you see him in clinic. The
recommendation with severe gingival hyperplasia with gum overgrowth is: