CCTC Long-Term Recipient Management 4

Question 1

A post-transplant patient is prescribed fluconazole for a fungal infection. The transplant coordinator should anticipate the need to:

Accepted Answer

Decrease the tacrolimus dose due to CYP3A4 inhibition

Answer

Fluconazole is a potent CYP3A4 inhibitor that significantly increases tacrolimus levels; the dose must be reduced and levels monitored closely.

Question 2

Post-transplant osteoporosis is MOST commonly caused by long-term use of which immunosuppressive drug class?

Accepted Answer

Corticosteroids

Answer

Corticosteroids are the primary driver of post-transplant bone loss through inhibition of osteoblast function and increased calcium excretion.

Question 3

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:

Accepted Answer

Tacrolimus neurotoxicity

Answer

Supratherapeutic tacrolimus levels (>15 ng/mL) are associated with neurotoxicity including tremors, confusion, and posterior reversible encephalopathy syndrome (PRES).

Question 4

Which intervention is recommended to reduce cardiovascular mortality in long-term kidney transplant recipients?

Accepted Answer

Statin therapy for dyslipidemia management

Answer

Cardiovascular disease is the leading cause of death in kidney transplant recipients; statin therapy reduces dyslipidemia and cardiovascular events in this population.

Question 5

A transplant recipient asks about dietary restrictions at their 3-year follow-up visit. Which food interaction remains a lifelong concern with calcineurin inhibitors?

Accepted Answer

Grapefruit juice increasing drug levels via CYP3A4 inhibition

Answer

Grapefruit and grapefruit juice inhibit intestinal CYP3A4, significantly increasing tacrolimus and cyclosporine blood levels.

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC Long-Term Recipient Management 4