CCTC UPDATED COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS SURE A+
✔✔Induction therapy - ✔✔Intense prophylactic therapy at time of transplant when risk of
rejection is highest, used immediately after transplant to neutralize the initial T cell
mediated response.
✔✔How does induction therapy decrease risk of rejection - ✔✔Deplete T cells, and/ or
interrupt T cell activation and proliferation
✔✔maintenance therapy - ✔✔CNI, Antimetabolites, Corticosteroids
✔✔Rescue therapy - ✔✔Intense therapy utilized in response to rejection episodes-may
include adjustments of maintenance therapy plus antibodies plasmapheresis IVIG
✔✔Side effects of IVIG - ✔✔Back pain headache chills fever hypotension
bronchospasm
✔✔When should you change dose of sirolimus - ✔✔7-12 days after last dose
✔✔Most common side effects of CNI - ✔✔Headache
✔✔Symptom of tac toxicity - ✔✔Tremors especially in hands
, ✔✔Leukoencephalopathy - ✔✔Toxicity associated with tac it causes mental status
changes treatment: stop or decrease med
✔✔contraindication to kidney transplant - ✔✔Primary oxalosis, active malignancy,
active infection, significant PVD, untreated End stage of other organs, active
inflammatory disease, non compliance, active substance abuse, untreated psych
illness, peptic ulcer disease, irreversible rehab potential,
✔✔Hyperacute rejection - ✔✔B CELL, occurs within minutes to hours. No treatment,
transplant nephrectomy, cytotoxic B cells attack new kidney, graft becomes cyanosis,
can rupture
✔✔Acute rejection - ✔✔T CELL days to weeks, fever myalgia/arthralgias, gross
hematuria, abdominal pain tenderness over site, high cr and bun, weight gain
hypertension, decreased urine output
✔✔Chronic rejection - ✔✔Month to years etiology not well defined, chronic renal failure,
high bun cr, edema, abnormal electrolytes, hypertension weight gain, decreased urine
output, no treatment, retransplant
✔✔s/s of rejection (kidney transplant) - ✔✔High cr and bun, decreased urine output,
weight gain, pain at kidney site, fatigue leg swelling, fever >100
✔✔Long term effects of immunosuppressants post kidney transplant - ✔✔DM HTN
HYPERLIPIDEMIA OSTEOPENIA RENAL DYSFUNCTION, LEAD TO RENAL
FAILURE NEED ANOTHER TRANSPLANT
✔✔CVP goal post kidney TX - ✔✔6-12
✔✔Induction therapy for intestine transplant - ✔✔Use of preconditioning protocols with
antilymphoid medications such as alemtuzumab and anti thymocyte globulin
✔✔The most important intervention for preventing and treating TPN induced cholestasis
- ✔✔Enteral Nutrition
✔✔Interventions to improve or preserve liver function in patients who are TPN
dependent - ✔✔Decrease dextrose and lipid load, TPN cycling with enteral feedings,
patients with normal intestinal motility should receive enteral nutrition to avoid intestinal
stasis
✔✔Intestinal Failure defination - ✔✔The reduction of gut function below minimum
necessary for the absorption of macronutrients and/or water and electrolytes, such that
intravenous supplementation is required to maintain health and/or growth
QUESTIONS AND ANSWERS SURE A+
✔✔Induction therapy - ✔✔Intense prophylactic therapy at time of transplant when risk of
rejection is highest, used immediately after transplant to neutralize the initial T cell
mediated response.
✔✔How does induction therapy decrease risk of rejection - ✔✔Deplete T cells, and/ or
interrupt T cell activation and proliferation
✔✔maintenance therapy - ✔✔CNI, Antimetabolites, Corticosteroids
✔✔Rescue therapy - ✔✔Intense therapy utilized in response to rejection episodes-may
include adjustments of maintenance therapy plus antibodies plasmapheresis IVIG
✔✔Side effects of IVIG - ✔✔Back pain headache chills fever hypotension
bronchospasm
✔✔When should you change dose of sirolimus - ✔✔7-12 days after last dose
✔✔Most common side effects of CNI - ✔✔Headache
✔✔Symptom of tac toxicity - ✔✔Tremors especially in hands
, ✔✔Leukoencephalopathy - ✔✔Toxicity associated with tac it causes mental status
changes treatment: stop or decrease med
✔✔contraindication to kidney transplant - ✔✔Primary oxalosis, active malignancy,
active infection, significant PVD, untreated End stage of other organs, active
inflammatory disease, non compliance, active substance abuse, untreated psych
illness, peptic ulcer disease, irreversible rehab potential,
✔✔Hyperacute rejection - ✔✔B CELL, occurs within minutes to hours. No treatment,
transplant nephrectomy, cytotoxic B cells attack new kidney, graft becomes cyanosis,
can rupture
✔✔Acute rejection - ✔✔T CELL days to weeks, fever myalgia/arthralgias, gross
hematuria, abdominal pain tenderness over site, high cr and bun, weight gain
hypertension, decreased urine output
✔✔Chronic rejection - ✔✔Month to years etiology not well defined, chronic renal failure,
high bun cr, edema, abnormal electrolytes, hypertension weight gain, decreased urine
output, no treatment, retransplant
✔✔s/s of rejection (kidney transplant) - ✔✔High cr and bun, decreased urine output,
weight gain, pain at kidney site, fatigue leg swelling, fever >100
✔✔Long term effects of immunosuppressants post kidney transplant - ✔✔DM HTN
HYPERLIPIDEMIA OSTEOPENIA RENAL DYSFUNCTION, LEAD TO RENAL
FAILURE NEED ANOTHER TRANSPLANT
✔✔CVP goal post kidney TX - ✔✔6-12
✔✔Induction therapy for intestine transplant - ✔✔Use of preconditioning protocols with
antilymphoid medications such as alemtuzumab and anti thymocyte globulin
✔✔The most important intervention for preventing and treating TPN induced cholestasis
- ✔✔Enteral Nutrition
✔✔Interventions to improve or preserve liver function in patients who are TPN
dependent - ✔✔Decrease dextrose and lipid load, TPN cycling with enteral feedings,
patients with normal intestinal motility should receive enteral nutrition to avoid intestinal
stasis
✔✔Intestinal Failure defination - ✔✔The reduction of gut function below minimum
necessary for the absorption of macronutrients and/or water and electrolytes, such that
intravenous supplementation is required to maintain health and/or growth
