transplants

Question 1

atherosclerotic disease is an absolute contraindication, not a relative contraindication T/F

Answer 1

False - it is absolute if the disease is uncorrected and not amenable to revascularization, and relative if the canditate is at risk

Question 2

A candidate has had extensive chest surgery for the removal of a malignancy 4 years ago. This patient has a

(a) relative contraindication
(b) absolute contraindication
(c) no contraindication
(d) is the ideal candidate for a lung transplant

Answer 2

(b) absolute contraindication - while extensive chest surgery is a relative contraindication, malignancies within the past 2-5 years is an absolute contraindication

Question 3

Your patient wants a lung transplant, but it worried since he has an infection of the highly resistant C. Difficile. Your patient has a:

(a) relative contraindication
(b) absolute contraindication
(c) no contraindication
(d) is the ideal candidate for a lung transplant

Answer 3

(a) relative contraindication - highly virulent or resistant infections are only an absolute contraindication if they are chronic infections.

Question 4

Which of the following infections is a ABSOLUTE contraindication?

(a) HIV
(b) Hepatitis B or C
(c) mycobacterium abscessus
(d) mycobacterium tuberculosis

Answer 4

(d) tuberculosis - the other three are relative contraindications

Question 5

Which of the following is a RELATIVE contraindication?

(a) severe, symptomatic osteoporosis
(b) documented non-adherence
(c) absence of a social support system
(d) substance addiction

Answer 5

(a) osteoporosis

Question 6

Which of the following is NOT a relative contraindication?

(a) severely limited functional status with poor rehab potential
(b) progressive or severe malnutrition
(c) obesity class 1
(d) mechanical ventilation or extracorporal life support

Answer 6

(a) severely limited functional status - is an absolute contraindication

Question 7

If a candidate walks below ____ in the 6MW test, they are considered to have inadequate endurance

(a) 150 m
(b) 200 m
(c) 250 m
(d) 300 m

Answer 7

(b) 200 m is minimum, although our lecture guest prefers 250 to be safe…

Question 8

What is NOT a decisive factor of whether or not someone goes on the emergency list?

(a) RV function
(b) FEV1
(c) PAP/PAH
(d) hypoxemia at exertion/O2 needs

Answer 8

(b) FEV1

Question 9

In a heart-lung transplant, which of the following are anastomosed?

(a) Main Bronchi
(b) Pulmonary Artery
(c) Left Atrium
(d) Right Atrium

Answer 9

(d) right atrium - the other three are anastomosed in a single lung transplant. This makes sense when you think about what attaches to what.

The heart lung will need the system hooked up at the end of the left heart cycle (aorta) and the beginning of the right heart (right atrium) and the trachea as both lungs are coming in. With just one lung, you need the artery going to it (pulmonary artery), where the oxygenated blood goes back to the heart (left atrium), and the mainstem bronchi since it’s only one lung.

Question 10

To remove one lung, the incision will be:

a) anterolateral
(b) thoracotomy (clam shell
(c) posterolateral
(d) median along sternum

Answer 10

(c) posterolateral

Question 11

Which of the following are NOT common medications delivered immediately following lung transplantation?

(a) Propofol
(b) Lasix
(c) Solumedrol
(d) Flolan
(e) all of the above

Answer 11

(e) all of the above

Question 12

What percent of donor lungs are rejected?

(a) 20%
(b) 50%
(c) 70%
(d) 80%

Answer 12

(d) 80%