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 post-transplant patient is prescribed fluconazole for a fungal infection. The transplant coordinator should anticipate the need to:
Answer: Decrease the tacrolimus dose due to CYP3A4 inhibition
Fluconazole is a potent CYP3A4 inhibitor that significantly increases tacrolimus levels; the dose must be reduced and levels monitored closely.
Post-transplant osteoporosis is MOST commonly caused by long-term use of which immunosuppressive drug class?
Answer: Corticosteroids
Corticosteroids are the primary driver of post-transplant bone loss through inhibition of osteoblast function and increased calcium excretion.
A liver transplant recipient develops new-onset tremors and confusion 5 years post-transplant. Tacrolimus level is 18 ng/mL. The MOST likely cause is:
Answer: Tacrolimus neurotoxicity
Supratherapeutic tacrolimus levels (>15 ng/mL) are associated with neurotoxicity including tremors, confusion, and posterior reversible encephalopathy syndrome (PRES).
Which intervention is recommended to reduce cardiovascular mortality in long-term kidney transplant recipients?
Answer: Statin therapy for dyslipidemia management
Cardiovascular disease is the leading cause of death in kidney transplant recipients; statin therapy reduces dyslipidemia and cardiovascular events in this population.
A transplant recipient asks about dietary restrictions at their 3-year follow-up visit. Which food interaction remains a lifelong concern with calcineurin inhibitors?
Answer: Grapefruit juice increasing drug levels via CYP3A4 inhibition
Grapefruit and grapefruit juice inhibit intestinal CYP3A4, significantly increasing tacrolimus and cyclosporine blood levels.
When assessing medication adherence in a long-term transplant recipient, the MOST reliable indicator of non-adherence is:
Answer: Intra-patient variability in tacrolimus trough levels
High intra-patient variability (IPV) in tacrolimus troughs is the most objective marker of inconsistent medication adherence and is associated with worse graft outcomes.
A 6-year post-kidney-transplant recipient is found to have de novo donor-specific antibodies (dnDSA) on routine screening. The coordinator should understand these are associated with:
Answer: Increased risk of antibody-mediated rejection and graft loss
De novo DSA are associated with chronic antibody-mediated rejection, accelerated graft dysfunction, and decreased long-term survival even when initially asymptomatic.