CCTN Infection Prevention and Management in Transplant Recipients 2

Question 1

A kidney transplant recipient is found to have rising BK viremia on routine surveillance. What is the most appropriate initial intervention?

Accepted Answer

Reduce immunosuppression, particularly the antimetabolite dose

Answer

Initiate high-dose intravenous acyclovir therapy

Answer

Add fluoroquinolone antibiotics to suppress viral replication

Answer

Immediately begin cidofovir infusions

Question 2

Which antifungal agent is most commonly used for prophylaxis against Candida infections in high-risk solid organ transplant recipients during the early post-transplant period?

Accepted Answer

Fluconazole

Answer

Amphotericin B deoxycholate

Answer

Micafungin

Answer

Itraconazole

Question 3

A lung transplant recipient develops bronchiolitis obliterans syndrome (BOS). How does BOS increase infection risk?

Accepted Answer

Impaired mucociliary clearance and airway structural changes create a favorable environment for bacterial colonization

Answer

BOS directly suppresses neutrophil function and phagocytosis

Answer

BOS causes T-cell exhaustion, increasing viral reactivation risk

Answer

BOS triggers autoimmune destruction of bronchial-associated lymphoid tissue

Question 4

Which screening test should be performed on all transplant candidates to detect latent tuberculosis prior to transplantation?

Accepted Answer

Tuberculin skin test (TST) or interferon-gamma release assay (IGRA)

Answer

Chest X-ray alone is sufficient for TB screening

Answer

Sputum AFB culture from three consecutive samples

Answer

Bronchoscopy with BAL for mycobacterial culture

Question 5

A transplant nurse is educating a recipient about food safety. Which food should be specifically avoided to prevent Listeria monocytogenes infection?

Accepted Answer

Unpasteurized soft cheeses and ready-to-eat deli meats

Answer

Well-cooked poultry and pasteurized dairy products

Answer

Canned vegetables and commercially bottled juices

Answer

Fresh fruits that are washed before consumption

Question 6

What is the significance of donor-derived Strongyloides stercoralis infection in solid organ transplant recipients?

Accepted Answer

It can cause fatal hyperinfection syndrome due to immunosuppression enabling unchecked larval dissemination

Answer

It is a benign self-limiting infection that resolves without treatment

Answer

It primarily causes graft dysfunction without systemic symptoms

Answer

It is easily prevented by standard post-transplant antifungal prophylaxis

Question 7

In a febrile solid organ transplant recipient, why is empiric broad-spectrum antibiotic therapy typically initiated promptly before culture results are available?

Accepted Answer

Immunosuppressed patients lack the typical inflammatory response and can deteriorate rapidly from occult bacteremia

Answer

Standard fever management guidelines recommend antibiotics for all patients with temperatures above 38°C

Answer

Antibiotics reduce the risk of triggering acute rejection episodes associated with infection

Answer

Early antibiotic therapy prevents opportunistic fungal superinfection in all transplant patients