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Host and Defense 2020 > 4/24/17 Transplantation PALOMA FINAL TEST > Flashcards

4/24/17 Transplantation PALOMA FINAL TEST Flashcards

1
Q

What are indications for needing a bone marrow transplant?

A
  • Leukemia
  • Lymphoma
  • Multiple Myeloma
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2
Q

What type of transplant is COPD, Cystic Fibrosis, Idiopathic pulmonary fibrosis an indication for?

A

-Lungs

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3
Q

What are indications for needing liver transplants?

A
  • Viral Hepatitis
  • Overdose
  • Alcohol
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4
Q

What type of transplant has the highest expected survival at 5 years?

A

-Kidney

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5
Q

What type of transplant has the lowest expected survival at 5 years?

A

-Lungs

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6
Q

What are the five major drug classes used during a transplant?

A
  • Calcineurin inhibitors
  • mTOR inhibitors
  • Antiproliferative agents
  • Antibodies
  • Corticosteroids
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7
Q

What type of immune response occurs in transplantation?

A

-Adaptive response

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8
Q

What is the major target during transplantation?

A

-allo-MHC on surface of donor cells

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9
Q

What are the two stages of rejection: host versus graft?

A
  • Sensitization stage

- Effector stage

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10
Q

What is the direct pathway of the sensitization stage?

A

-Host T cells recognize allo-MHC molecules as non-self

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11
Q

What is the indirect pathway of the sensitization stage?

A

-T cells recognize processed alloantigen presented by self APCs

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12
Q

What is the effector stage in rejection?

A
  • Inflammatory response to injury
  • B cell activation with Ab production
  • Further cell recruiting, NKs, apoptosis
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13
Q

SOT (Solid Organ) transplant has four stages, what are they?

A
  • Induction
  • Acute post-transplant
  • Maintenance
  • Rejection treatment
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14
Q

What are the four stages of HSCT (Stem cell transplant)?

A
  • Induction/conditioning
  • Consolidation/Intensification
  • Maintenance
  • GVHD treatment
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15
Q

What phase of post HSCT occurs during 0-30 days?

A

-Phase I

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16
Q

What occurs in phase I of post HSCT?

A
  • Prolonged neutropenia

- Damage to mucocutaneous barriers

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17
Q

What occurs in phase II (31-100 days) of post HSCT?

A
  • Impaired cell-mediated immunity

- GVHD

18
Q

What occurs in phase III (Day > 100) of post HSCT?

A

-Depends on immunosupression

19
Q

If a patients is going to receive a transplant when should dental prophylaxis and active disease be treated?

A

-Pre-transplant

20
Q

If a patient is going to receive a transplant when should you remove all non-restorable teeth?

A

-Pre-transplant

21
Q

What are four indications (if they can’t be fixed otherwise) for tooth extractions when considering transplant patients?

A
  • Teeth mobility (periodontal pocket > 5-6)
  • Teeth with endo-perio problem
  • Teeth with periapical lesions
  • Teeth with very deep or extensive caries
22
Q

What are the cumulative effects of transplants?

A
  • Poor dental health
  • Untreated dental disease
  • Increased susceptibility to infections
23
Q

If a person has sever leukopenia and thrombocytopenia what should a transplant patients avoid that is dentally related?

A

-Flossing

24
Q

If a person has dentures and is receiving a transplant what should be done?

A

-Make sure they disinfect dentures before each use and rinse before placing back in mouth

25
Q

What are the effects of radiation and chemotherapy?

A
  • Xerostomia

- Mouth ulcers

26
Q

T/F Topical therapy with infectious complication dealing with transplant patients is efficacious alone

A

False

-It is not sufficient alone

27
Q

What is the most frequent complication of post Bone marrow transplant?

A

-Mucositis

28
Q

When does mucositis peak after organ transplant?

A

-5-7 days

29
Q

When a person is taking cyclosporine for a transplant what may be a dentally related side effect?

A

-Gingival hyperplasia

30
Q

T/F Gingival hyperplasia is more common is men than women

A

True

31
Q

T/F Gingival hyperplasia is higher (more prevalent) in children

A

True

32
Q

Gingival hyperplasia from cyclosporine is worse if combined with what other drugs?

A

-Calcium-channel blockers

33
Q

How long after starting immunosuppressive drugs does gingival hyperplasia occur?

A

-1-3 months after starting drugs

34
Q

When location does gingival hyperplasia begin?

A

-Interdental papillae

35
Q

what immunosuppressive drug causes mucositis, oral ulcers, and poor wound healing?

A

-Sirolimus/Everolimus

36
Q

What immunosuppressive drug causes thrombocytopenia?

A

-Azathioprine

37
Q

What immunosuppressive drug causes stomatitis?

A

-Cyclosphamide

38
Q

When is the peak immunosuppression for transplant patients?

A

3-6 months

39
Q

How long after a transplant should you wait to treat a patient?

A

-6 months

40
Q

T/F Antibiotics should be considered for invasive procedures

A

True

41
Q

When treating a person with a heart transplant what should you avoid when using anesthesia?

A

-Epinephrine

42
Q

When treating a person with a lung transplant what should you avoid when prescribing drugs?

A

-Narcotics

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