Download Heart Transplant Tutoring

By Alaina Darby
a.
Angina requiring multiple stents
b.
Angina requiring pharmacotherapy
c.
Myocardial infarction
d.
CHF with preserved ejection fraction
 Vessel function
 Comorbidities
 Hypertension
 Diabetes
 Clogging
 Metabolic syndromes
 Valves
 Pregnancy
 Increased work of the heart
 Tachycardias
 Arrhythmias
 Drugs/Alcohol
 Cocaine
 EtOH
 Tobacco
 Chemotherapy
 Steroids
 Cancers
 Immunological
 Hormones
 Inflammation
 Age
 Heredity
 Congenital defects
a.
A
b.
B
c.
C
d.
D
a.
EF 35%
b.
Peak VO2 13 ml/kg/min
c.
STEMI requiring PCI
d.
Dobutamine dependence
a.
Left heart catheterization
b.
Right heart catheterization
c.
ECG
d.
ECHO
a.
Potential for left sided HF in the old heart
b.
Potential for right sided HF in the old heart
c.
Potential for left sided HF in the new heart
d.
Potential for right sided HF in the new heart
Test
Method for the madness…
CPX
Exercise
ECHO
Imaging
ECG
Rhythm
Right heart cath
Pulmonary
Prognostic scoring
Survival
a.
Flu
b.
Hep B
c.
Varicella
d.
Pneumococcal
a.
HLA composition
b.
Immune sensitization
c.
PRA screening
d.
Anti-HLA antibodies
a.
Previous pregnancies
b.
Past blood transfusion
c.
Having to wait 4 months for the transplant
d.
Previous kidney transplant
e.
History of HIV/AIDS
f.
2 of the above
g.
3 of the above
h.
4 of the above
i.
All of the above
a.
VAD-related infection
b.
COPD
c.
BMI 34
d.
Current tobacco use
a.
IABP
b.
LVAD
c.
RVAD
d.
BiVAD
a.
Pulsatile VAD
b.
Continuous flow VAD
c.
ECMO
d.
IABP
a.
Pulsatile VAD as destination therapy
b.
Continuous flow VAD as destination therapy
c.
VAD as a bridge to transplant
d.
Immediately transplant
a.
Reduced ventricular output
b.
A fib
c.
Lactic acidosis
d.
Multiple CABG procedures
a.
Renal failure
b.
Ischemic stroke
c.
A fib
d.
Age
a.
Destination therapy
b.
Bridge to transplant
c.
Bridge to decision
d.
Improve secondary organ function
a.
H/o ischemic stroke
b.
Mitral regurgitation
c.
Pulmonary hypertension
d.
A fib
a.
VAD for 60 days with thromboembolism and high dose dobutamine
b.
VAD for 25 days with thromboembolism and high dose dobutamine
c.
VAD for 25 days with high dose dobutamine
d.
No current VAD with high dose dobutamine
a.
Methylprednisolone
b.
Mycophenolate
c.
Vancomycin
d.
Tacrolimus
a.
Calcinurin inhibitor
b.
Anti-T cell antibodies
c.
Corticosteroids
d.
Mycophenolate
a.
Renal failure
b.
3 HLA mismatches
c.
First transplant
d.
CMV mismatch
a. Valagancyclovir for CMV prophylaxis
b. APAP for infusion reactions
c. Mycophenolate for renal sparing
d. Azathioprine for additional immunosuppression
a.
Tacrolimus
b.
Mycophenolate
c.
Cyclosporine
d.
Corticosteroids
a.
Bradycardia
b.
Pulmonary hypertension
c.
Decreased oxygen saturation
d.
Bleed
a.
Atropine
b.
Dobutamine
c.
Isoproterenol
d.
Epinephrine
a.
Sildenafil
b.
Sodium nitroprusside
c.
Nitroglycerine
d.
Milrinone
a.
D+/R+
b.
D+/R-
c.
D-/R+
d.
D-/D-
a.
WBC
b.
SCr
c.
RBC
d.
LFTs
a.
Dapsone
b.
Atovaquone
c.
Bactrim
d.
Pentamidine
a.
ACR 1R
b.
ACR 3R
c.
AMR 1
d.
AMR 3
a.
IV steroid pulse with taper
b.
PO steroid pulse with taper
c.
IV high dose steroids
d.
IV high dose steroids with rATG
a.
IV steroid pulse with taper
b.
PO steroid pulse with taper
c.
IV high dose steroids
d.
IV high dose steroids with rATG
a.
IV steroid pulse with taper
b.
PO steroid pulse with taper
c.
IV high dose steroids
d.
IV high dose steroids with rATG
a.
Rituximab
b.
IVIg
c.
Bortezomib
d.
Eculizumab
a.
Aspirin
b.
Clopidogrel
c.
Pravastatin
d.
Methotrexate
a.
Sirolimus immediately
b.
Sirolimus after 8 months
c.
Tacrolimus immediately
d.
Tacrolimus after 8 months