Transplant Flashcards
7 cards from real CMSRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Transplant flashcards as text
A patient is being evaluated for kidney transplant candidacy. Which finding is an absolute contraindication?
Answer: Active metastatic malignancy
Active malignancy is an absolute contraindication to transplant due to the risk of accelerated tumor growth under immunosuppression.
Which post-transplant malignancy is most strongly linked to Epstein-Barr virus (EBV) reactivation?
Answer: Post-transplant lymphoproliferative disorder (PTLD)
PTLD is primarily driven by EBV reactivation under immunosuppression and ranges from benign hyperplasia to aggressive lymphoma.
A renal transplant recipient is started on fluconazole for a fungal infection. The nurse anticipates which medication adjustment?
Answer: Decrease tacrolimus dose due to CYP3A4 inhibition
Fluconazole inhibits CYP3A4, dramatically increasing tacrolimus levels and requiring a significant dose reduction to avoid toxicity.
In deceased-donor organ allocation, which criterion gives highest priority for kidney offers to a recipient on the waiting list?
Answer: Zero HLA mismatch with the donor
Zero HLA antigen mismatch (full-house match) confers mandatory sharing across UNOS regions due to superior long-term outcomes.
A living-related donor is being evaluated for kidney donation. Which finding would disqualify the donor?
Answer: Bilateral kidney stones with residual nephrocalcinosis
Bilateral nephrolithiasis with nephrocalcinosis places the remaining kidney at risk post-donation and disqualifies the candidate.
The nurse assesses a lung transplant patient on post-op day 7 who has new hypoxemia, bilateral infiltrates, and decreased FEV1. No fever or leukocytosis is present. This presentation suggests:
Answer: Acute cellular rejection
Acute cellular rejection in lung transplant classically presents with dyspnea, hypoxemia, and radiographic infiltrates without infection markers, typically within days to months post-transplant.
Which medication used for transplant rejection prophylaxis works by blocking IL-2 receptor (CD25) to prevent T-cell proliferation?
Answer: Basiliximab
Basiliximab is a monoclonal antibody targeting CD25 (IL-2 receptor alpha chain), used as induction therapy to block early T-cell activation.