CCTN Infection Prevention and Management in Transplant Recipients 1

Question 1

Which prophylactic medication is routinely prescribed to prevent Pneumocystis jirovecii pneumonia (PCP) in solid organ transplant recipients?

Accepted Answer

Trimethoprim-sulfamethoxazole (TMP-SMX)

Answer

TMP-SMX (Bactrim) is the first-line prophylactic agent for PCP in immunocompromised transplant patients due to its proven efficacy and broad coverage.

Question 2

In a CMV donor-positive/recipient-negative (D+/R-) transplant scenario, what is the recommended management strategy?

Accepted Answer

Universal prophylaxis with valganciclovir for 3–6 months

Answer

D+/R- is the highest-risk CMV serostatus combination, requiring universal antiviral prophylaxis (valganciclovir) for 3–6 months post-transplant to prevent primary CMV disease.

Question 3

Which live vaccines are contraindicated in solid organ transplant recipients on maintenance immunosuppression?

Accepted Answer

MMR (measles-mumps-rubella) and varicella zoster live vaccine

Answer

Live attenuated vaccines such as MMR and live varicella zoster vaccine carry the risk of vaccine-strain infection in immunocompromised patients and are contraindicated post-transplant.

Question 4

BK polyomavirus nephropathy is a significant concern primarily in which type of solid organ transplant recipient?

Accepted Answer

Kidney transplant recipients

Answer

BK virus predominantly replicates in the urothelium and tubular epithelium, making kidney transplant recipients the population most at risk for BK nephropathy and graft loss.

Question 5

A transplant recipient presents with fever, productive cough, and CT findings showing bilateral ground-glass opacities three months post-transplant. Which organism should be highest on the differential?

Accepted Answer

Pneumocystis jirovecii

Answer

Ground-glass opacities on CT combined with fever and cough in the 1–6 month post-transplant window are classic for PCP, especially if prophylaxis was discontinued or inadequate.

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN Infection Prevention and Management in Transplant Recipients 1