Long-Term Recipient Management Flashcards
7 cards from real CCTC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Long-Term Recipient Management flashcards as text
A renal transplant recipient presents 18 months post-transplant with fever, fatigue, and a CD4 count of 120 cells/µL. CMV viremia is negative. Which opportunistic infection should be highest on the differential?
Answer: Pneumocystis jirovecii pneumonia (PJP)
PJP prophylaxis is often discontinued at 6-12 months, leaving patients vulnerable; low CD4 count and fever in an immunosuppressed host strongly suggests PJP.
BK virus nephropathy in kidney transplant recipients is best managed initially by:
Answer: Reducing overall immunosuppression
The primary treatment for BK nephropathy is reduction of immunosuppression to allow immune reconstitution and viral clearance; no antiviral has proven efficacy.
A transplant coordinator is reviewing a 4-year post-liver-transplant patient's labs and notes eGFR of 35 mL/min/1.73m². Which immunosuppressant is most implicated in this long-term complication?
Answer: Calcineurin inhibitors (tacrolimus/cyclosporine)
Chronic calcineurin inhibitor (CNI) nephrotoxicity is a leading cause of chronic kidney disease in non-renal solid organ transplant recipients.
Which test is the recommended screening for post-transplant lymphoproliferative disorder (PTLD) in high-risk patients?
Answer: EBV viral load monitoring
EBV-negative recipients who receive EBV-positive organs are at highest risk for PTLD; serial EBV PCR monitoring allows early detection and immunosuppression reduction.
A kidney transplant recipient at 2 years post-transplant has proteinuria of 1.8 g/day on urinalysis. The BEST next step is:
Answer: Perform a kidney transplant biopsy
New-onset significant proteinuria requires allograft biopsy to distinguish recurrent glomerulonephritis, chronic rejection, and de novo glomerular disease.
Which annual screening is MOST important for female transplant recipients on long-term immunosuppression?
Answer: Annual Pap smear and HPV testing
Immunosuppression increases the risk of HPV-related cervical dysplasia and cancer; annual cervical screening is recommended for female transplant recipients.
A stable lung transplant recipient at 3 years post-transplant shows a progressive decline in FEV1 to 65% of baseline without infection. This pattern is consistent with:
Answer: Bronchiolitis obliterans syndrome (BOS)
Bronchiolitis obliterans syndrome is defined by persistent decline in FEV1 to <80% of best post-transplant value and represents the most common form of chronic lung allograft dysfunction.