CCTC Immediate Postoperative Care 2

Question 1

A kidney transplant recipient in the ICU has urine output of 800 mL/hr in the first postoperative hour. What is the most appropriate initial management?

Accepted Answer

Replace urine output mL-for-mL with IV fluids

Answer

Administer furosemide to reduce output

Answer

Restrict fluids to prevent fluid overload

Answer

Notify the surgeon immediately for re-exploration

Question 2

Which electrolyte abnormality is most commonly associated with a large diuresis in the immediate post-kidney transplant period?

Accepted Answer

Hypokalemia

Answer

Hyperkalemia

Answer

Hypernatremia

Answer

Hypercalcemia

Question 3

A liver transplant patient develops a sudden decrease in bile output from the T-tube on postoperative day 1. What should the transplant coordinator suspect first?

Accepted Answer

Hepatic artery thrombosis

Answer

Normal physiologic response

Answer

Biliary anastomotic leak

Answer

Acute cellular rejection

Question 4

What is the target mean arterial pressure (MAP) goal typically maintained in the immediate post-transplant ICU period?

Accepted Answer

Above 65 mmHg

Answer

Above 50 mmHg

Answer

Above 90 mmHg

Answer

Above 110 mmHg

Question 5

A heart transplant recipient is noted to have a heart rate of 48 bpm on postoperative day 1. Which medication is used to increase heart rate in the denervated transplanted heart?

Accepted Answer

Isoproterenol

Answer

Atropine

Answer

Digoxin

Answer

Metoprolol

Question 6

In the immediate postoperative period, which immunosuppressive agent is most commonly associated with nephrotoxicity?

Accepted Answer

Calcineurin inhibitors (tacrolimus/cyclosporine)

Answer

Mycophenolate mofetil

Answer

Prednisone

Answer

Azathioprine

Question 7

A lung transplant patient develops increasing hypoxia with bilateral infiltrates on CXR within 72 hours of transplant. What is the most likely diagnosis?

Accepted Answer

Primary graft dysfunction (PGD)

Answer

Acute cellular rejection

Answer

Pulmonary embolism

Answer

Ventilator-associated pneumonia