CCTN Heart Transplant Exam Questions
with Correct Solutions
what do you make sure with pre heart transpalnt patients if they're getting a blood transfusion?
- ANSWER -Leukocyte depleted blood
-ask blood bank to use leukocyte removing filter
-if pt is CMV negative, need to use CMV negative blood
How often do you get heart biopsy after transplant? - ANSWER -First month = weekly
-month 2-3 = q2weeks
-months 5-6= q4weeks
-months 7-12 = q6weeks
-year 1-2 = q3months
-years 2-3=q6 months
-After that, prn
Heart Allograft Grading for Rejection
0, 1A, 1B, 2, 3A, 3B, 4 - ANSWER 0= no rejection
1A= infiltrate, no necrosis
1B= sparse infiltrates, no necrosis
2= 1 focus; myocyte damage
,3A=multifocal
3B=diffuse inflammation, NECROSIS
4=aggressive infiltrate, NECROSIS, edema, bleeding, vasculitis
What is a bioptome? - ANSWER -catheter/gripping
device -get biopsy
*enter*
-R internal jugular vein or femoral artery
-> R atrium, into R ventricle
S/sx of early heart rejection? - ANSWER *-
fatigue -SOB
-low grade fever
-mood changes*
ALSO,
-arrhythmias
-ECHO changes
-exercise intolerance
-jugular vein distension
-lung crackles
-new hypotension
-new edema
-pericardial rub
-new S3/S4
, -weight gain
What is Quility Effect (QE)? - ANSWER -tissue lesion on endocardium from
lymphocytic infiltration
-strong association/suspicion with ACUTE REJECTION
*you get QE from cyclosporin*
Quility A= non invasive infiltration, no effect
Quility B= invasive infiltration/ associated with myocyte damage
Which organ is the most common site of infection post heart transplant? - ANSWER LUNGS
Which virus is the most common cause of viral infection? - ANSWER CMV
then HHV
When do you see TORCHES syndrome? What does TORCHES stand for? - ANSWER -newborns=
small, feed poorly, jaundiced, petechiae, hepatosplenomegaly
Toxoplasmosis
Other agents
Rubella
CMV
Herpes
EBV
Syphilis
with Correct Solutions
what do you make sure with pre heart transpalnt patients if they're getting a blood transfusion?
- ANSWER -Leukocyte depleted blood
-ask blood bank to use leukocyte removing filter
-if pt is CMV negative, need to use CMV negative blood
How often do you get heart biopsy after transplant? - ANSWER -First month = weekly
-month 2-3 = q2weeks
-months 5-6= q4weeks
-months 7-12 = q6weeks
-year 1-2 = q3months
-years 2-3=q6 months
-After that, prn
Heart Allograft Grading for Rejection
0, 1A, 1B, 2, 3A, 3B, 4 - ANSWER 0= no rejection
1A= infiltrate, no necrosis
1B= sparse infiltrates, no necrosis
2= 1 focus; myocyte damage
,3A=multifocal
3B=diffuse inflammation, NECROSIS
4=aggressive infiltrate, NECROSIS, edema, bleeding, vasculitis
What is a bioptome? - ANSWER -catheter/gripping
device -get biopsy
*enter*
-R internal jugular vein or femoral artery
-> R atrium, into R ventricle
S/sx of early heart rejection? - ANSWER *-
fatigue -SOB
-low grade fever
-mood changes*
ALSO,
-arrhythmias
-ECHO changes
-exercise intolerance
-jugular vein distension
-lung crackles
-new hypotension
-new edema
-pericardial rub
-new S3/S4
, -weight gain
What is Quility Effect (QE)? - ANSWER -tissue lesion on endocardium from
lymphocytic infiltration
-strong association/suspicion with ACUTE REJECTION
*you get QE from cyclosporin*
Quility A= non invasive infiltration, no effect
Quility B= invasive infiltration/ associated with myocyte damage
Which organ is the most common site of infection post heart transplant? - ANSWER LUNGS
Which virus is the most common cause of viral infection? - ANSWER CMV
then HHV
When do you see TORCHES syndrome? What does TORCHES stand for? - ANSWER -newborns=
small, feed poorly, jaundiced, petechiae, hepatosplenomegaly
Toxoplasmosis
Other agents
Rubella
CMV
Herpes
EBV
Syphilis
