CCTC COMPREHENSIVE EXAM 2026 QUESTIONS AND
SOLUTIONS RATED A+
✔✔Indications for lung tx - ✔✔Non a-1 Antitrypsin disease, COPD, interstitial lung
disease, bronchiectasis associated with CF, pulmonary htn, COPD associated with a-1
Antitrypsin disease
✔✔How often is lung recipients LAS updated? - ✔✔Every 6 months
✔✔When is simultaneous Heart/ lung tx indicated? - ✔✔Concurrent end stage heart
and lung disease or with severe, fixed pulmonary htn, idiopathic pulmonary artery HTN,
sarcoidosis with pulmonary and cardiac manifestations, CF, and acquired heart disease
✔✔MELD score components - ✔✔Total bilirubin creatinine INR Na and etiology of
disease
✔✔MELD score range - ✔✔6(less ill) to 40 (gravely ill)
✔✔PELD score - ✔✔Pediatric model for end stage liver disease determines how urgent
pt require liver in next 3 months
✔✔ - ✔✔model for end stage liver disease determines how urgent pt require liver in
next 3 months
✔✔How often Lung Allocation Score (LAS) updated/ what info - ✔✔Every 6 months with
FVC, six minute walk distance, creatinine,
✔✔How often Patients with known HCC have re-evaluation tests - ✔✔Every 3 months
per unos to receive meld exception points
✔✔EPTS (estimates post transplant survival score) - ✔✔Receives After 18 years old,
represents percentage of kidney candidates in the nation with a longer expected post
transplant survival time.
✔✔How is EPTS calculated? - ✔✔Time on dialysis, DM, prior transplant, age
✔✔Kidney Donor Profile Index (KDPI) - ✔✔Kidneys from deceased donors are
classified according to the KDPI. score derived from kidney donor profile index which
takes donors characteristics into consideration: age ethnicity creat, h/o HTN, h/o dm,
cause of death, hgt wgt HCv status, donor type(DCD OR NOT)
✔✔Common indications for heart/lung transplant? - ✔✔COPD, idiopathic, pulmonary
fibrosis, cystic fibrosis, idiopathic pulmonary artery htn, and CF most common for
heart/lung
, ✔✔reason for VQ scan during lung tx evaluation - ✔✔to determine which lung has
better air and blood. helps decide which lung to tx.
✔✔Patients with LAS >50 must have which variables updated every 2 weeks? -
✔✔functional status, o2 requirements, diabetes status, assisted ventilation.
✔✔what assessment must be updated every 6 months for lung recipient? - ✔✔PFTs, 6
min walk, serum creatinine
✔✔what is LAS (lung allocation score) - ✔✔LAS is a tool to estimate medical urgency. it
does not predict how long a pt will survive without tx. calculated 0-100. higher score,
sicker the patient and greater chance of receiving organ. updated every 6 months
unless LAS > 50 then every 2 weeks.
✔✔If LAS >50 how often is updated? - ✔✔every 14 days
✔✔what is veno-venous ECMO for lung candidates? - ✔✔extracorporeal life support,
bridge to recovery immediately post tx
✔✔Lung transplantation surgical procedure - ✔✔incision is clamshell approach
standard and modified. during removal careful to protect phrenic, vagus, and laryngeal
nerve on left.
✔✔Cause of cardiac dysrhythmias post lung tx - ✔✔irritation of pericardium during
surgery or electrolyte imbalances related to diuretics and fluid shifts.
✔✔Treatment for AMR post lung tx - ✔✔plasmapheresis, Valcade, IVIG, RITUXIMAB
✔✔Lung Tx acute rejection s&s - ✔✔low grade temp, non-specific respiratory sx, SOB,
Tachypnea, fatigue, pleural effusion, chest pressure-TREATMENT HIGH DOSE
STEROIDS,THYMOGLOBULIN
✔✔Dx of rejection/infection post lung tx - ✔✔bronchoscopy, PFT, x-ray, biopsy
✔✔Post Op bronchoscopy s/p lung tx - ✔✔usually done day #1 or as condition warrants
to examine anastomosis, prior to extubation, evaluate pulmonary edema, swelling
infiltrates, or any abnormalities. Bronchoalveolar Lavage(BAL) for gram stain and
cultures.
✔✔Bronchiolitis obliterans syndrome (BOS) - ✔✔Chronic rejection lung tx
✔✔how to detect rejection in lung tx - ✔✔PFTs, Spirometry,
Bronchoscopy(differentiates infection from rejection)
SOLUTIONS RATED A+
✔✔Indications for lung tx - ✔✔Non a-1 Antitrypsin disease, COPD, interstitial lung
disease, bronchiectasis associated with CF, pulmonary htn, COPD associated with a-1
Antitrypsin disease
✔✔How often is lung recipients LAS updated? - ✔✔Every 6 months
✔✔When is simultaneous Heart/ lung tx indicated? - ✔✔Concurrent end stage heart
and lung disease or with severe, fixed pulmonary htn, idiopathic pulmonary artery HTN,
sarcoidosis with pulmonary and cardiac manifestations, CF, and acquired heart disease
✔✔MELD score components - ✔✔Total bilirubin creatinine INR Na and etiology of
disease
✔✔MELD score range - ✔✔6(less ill) to 40 (gravely ill)
✔✔PELD score - ✔✔Pediatric model for end stage liver disease determines how urgent
pt require liver in next 3 months
✔✔ - ✔✔model for end stage liver disease determines how urgent pt require liver in
next 3 months
✔✔How often Lung Allocation Score (LAS) updated/ what info - ✔✔Every 6 months with
FVC, six minute walk distance, creatinine,
✔✔How often Patients with known HCC have re-evaluation tests - ✔✔Every 3 months
per unos to receive meld exception points
✔✔EPTS (estimates post transplant survival score) - ✔✔Receives After 18 years old,
represents percentage of kidney candidates in the nation with a longer expected post
transplant survival time.
✔✔How is EPTS calculated? - ✔✔Time on dialysis, DM, prior transplant, age
✔✔Kidney Donor Profile Index (KDPI) - ✔✔Kidneys from deceased donors are
classified according to the KDPI. score derived from kidney donor profile index which
takes donors characteristics into consideration: age ethnicity creat, h/o HTN, h/o dm,
cause of death, hgt wgt HCv status, donor type(DCD OR NOT)
✔✔Common indications for heart/lung transplant? - ✔✔COPD, idiopathic, pulmonary
fibrosis, cystic fibrosis, idiopathic pulmonary artery htn, and CF most common for
heart/lung
, ✔✔reason for VQ scan during lung tx evaluation - ✔✔to determine which lung has
better air and blood. helps decide which lung to tx.
✔✔Patients with LAS >50 must have which variables updated every 2 weeks? -
✔✔functional status, o2 requirements, diabetes status, assisted ventilation.
✔✔what assessment must be updated every 6 months for lung recipient? - ✔✔PFTs, 6
min walk, serum creatinine
✔✔what is LAS (lung allocation score) - ✔✔LAS is a tool to estimate medical urgency. it
does not predict how long a pt will survive without tx. calculated 0-100. higher score,
sicker the patient and greater chance of receiving organ. updated every 6 months
unless LAS > 50 then every 2 weeks.
✔✔If LAS >50 how often is updated? - ✔✔every 14 days
✔✔what is veno-venous ECMO for lung candidates? - ✔✔extracorporeal life support,
bridge to recovery immediately post tx
✔✔Lung transplantation surgical procedure - ✔✔incision is clamshell approach
standard and modified. during removal careful to protect phrenic, vagus, and laryngeal
nerve on left.
✔✔Cause of cardiac dysrhythmias post lung tx - ✔✔irritation of pericardium during
surgery or electrolyte imbalances related to diuretics and fluid shifts.
✔✔Treatment for AMR post lung tx - ✔✔plasmapheresis, Valcade, IVIG, RITUXIMAB
✔✔Lung Tx acute rejection s&s - ✔✔low grade temp, non-specific respiratory sx, SOB,
Tachypnea, fatigue, pleural effusion, chest pressure-TREATMENT HIGH DOSE
STEROIDS,THYMOGLOBULIN
✔✔Dx of rejection/infection post lung tx - ✔✔bronchoscopy, PFT, x-ray, biopsy
✔✔Post Op bronchoscopy s/p lung tx - ✔✔usually done day #1 or as condition warrants
to examine anastomosis, prior to extubation, evaluate pulmonary edema, swelling
infiltrates, or any abnormalities. Bronchoalveolar Lavage(BAL) for gram stain and
cultures.
✔✔Bronchiolitis obliterans syndrome (BOS) - ✔✔Chronic rejection lung tx
✔✔how to detect rejection in lung tx - ✔✔PFTs, Spirometry,
Bronchoscopy(differentiates infection from rejection)
