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English 2 > Hematology/Oncology > Flashcards

Hematology/Oncology Flashcards

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1
Q

Heparin to Warfarin bridge

A

Prot C and S w/ shorter t1/2
II, VII, IX, X longer t1/2

Transient paradoxic hypercoag before anticoag

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2
Q

Heparin vs LMWH

A

Heparin: activ antithromb; ↑PTT
Antidote: protamine sulfate

LMWH: esp inhib Xa; No eff on PTT
No eff of prot sulf

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3
Q

Warfarin

A

Inhib synth vitK-dep coag fact
↑PT
Reversal: rapid w/ FFP; slow vitK
! teratogen

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4
Q

tPA

A

Help conv plasminog to plasmin (breaks fibrin)
↑PT; ↑PTT
If toxicity, give aminocap acid

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5
Q

Factor Xa inhibitors

Factor IIa inhibitors

A 
No monitoring (PT, PTT)
No reversal agent
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6
Q

Hemophilia (PE)

A 
X-linked; A=VIII; B=IX; C=XI
Rare acquir (autoimm, post-part)

Young boy; spont hge tissue/joint (intracereb/GI/…)
Hge after surg, trauma, dental proced
If not ttt, arthropathy/joint destruction

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7
Q

Hemophilia (dg, ttt)

A

Dg: ↑PTT; normal PT/BT
Mixing study (#1): correct PTT
Specific fact assay (accur)

ttt: if sever bld or fact ≤1% (immediat transfu missing fact; cryoprecip)
If not sev and >1% (DDAVP releases VIII from endoth C)

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8
Q

von Willebrand disease (PE)

A

AD; #1 inherit bld ds
Defect or deficiency in vWF + ↓VIII
Types: 1 (mild-mod defic); 2 (qualit defect); 3 (No funct)

Child; recurr + prolong mucosal bld + bld after proced
⊕ fam Hx; sympt worse w/ ASA

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9
Q

von Willebrand disease (dg, ttt)

A

Dg: ↑BT; may ↑PTT (by ↓VIII); normal PT/PC
Accur: Ristocetin cofact assay + vWF Ag level

ttt: DDAVP (mild-mod); OCPs (if menorrhg); Avoid ASA and plt fct inhib

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10
Q

Bernard-Soulier syndrome

Glanzmann thrombasthenia

A

B-S: def GpIb (binds plt to endoth vWF)

G-T: def GpIIb/IIIa (binds 2 plts by fibrinogen)

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11
Q

ADP receptor inhibitors

GpIIb/IIIa inhibitors

A

ADP-R inh: clopidog/prasug/ticlopidine
No externaliz of GpIIb/IIIa

GpIIb/IIIa inh: abciximab/eptifibatide/tirofiban

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12
Q

Hypercoagulable states (etiologies)

A

Thrombophilias or prothrombotic states
Genet, acquir, physiol
3 main causes but same PE

  • F.V Leiden: f.V resist to inactiv by activ prot C (#1 hered thromboemb ds)
  • HIT: immuno react to heparin; Ab activates plt; bld clots + rapid ↓50% PC
  • APS: ass w/ SLE/RA; art+ven thrombi; spont abort
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13
Q

Hypercoagulable states (PE, dg)

A

Recurr thromb (DVT, PE, art thromb, MI, stroke, abort)
HIT: hospit ptt on anticoag then ↓PC
F.V.L: young caucas + pers/fam Hx thromb
APS: middle-age women + recurr miscarr/thromb

Dg: r/o acqu causes before hered workup
Hered: 2 abNl values while asympt/unttt + similar values in 2 fam memb
HIT: PF4 Ab + serotonin release assay
APS: lupus anticoag + anticardiol Ab

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14
Q

Hypercoagulable states (ttt)

A

DVT/PE: heparin then 3-6mo warfarin (1st epis); 6-12mo (2nd); lifelong (next)
If anticoag CI (hge, sev HTN, recent trauma) or refract: IVC filter

HIT: !d/c hep; start argatroban/lepirudin
F.V.L: avoid OCPs

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15
Q

Protein C or S deficiency (PE)

A

Skin or tissue necrosis after Warfarin

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16
Q

Disseminates intravascular coagulation (RF)

A

Acquir; deposit of fibrin in Vx → thromb + end-org dam
Deplet coag fact + plts → bleed

Ass w/ obstetr complic; sepsis; neopl; ApML; pancreatitis; massiv trauma; drug react; ARDS; …

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17
Q

Disseminates intravascular coagulation (PE, dg, ttt)

A

Acute: bld from venipunct/in org; ecchym, petech
Chronic: bruis, mucos bld; thrombophleb; renal dysfct; neuro sympt

Dg: clinic+lab; #dg liv ds (but DIC w/ VIII is depressed)
ttt: underl cause; transfuse RBCs/plts/FFP; manage shock

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18
Q

Thrombotic thrombocytopenic purpura (PE)

A

Inherit or acquir (after inf)

vWF-cleav enz def (ADAMTS-13 def) → large vWF → plts microthrombi → end-org dam
RBCs fragm by microT → hemolysis

TTP if 3/5⊕: ↓PC; microang hemol anemia; neuro chang; impair renal fct; fever

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19
Q

Thrombotic thrombocytopenic purpura (dg, ttt)

A

Dg: schistoc + ↓PC + ↑creat
HUS: simil to TTP; child w/ EcoliO157H7; renal fail, hemol anemia, ↓PC, No neuro sympt

ttt: #1 plasma exchange; steroids to ↓thromb
CI for plt transfu

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20
Q

3 causes of microangiopathic hemolytic anemia

A

HUS
TTP
DIC

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21
Q

Idiopathic thrombocytopenic purpura (PE, etiologies)

A

IgG against plts → plt/Ab complex destr by spleen → ↑plt prod by BM
#1 immuno ds in middle-age women
Ass w/ leukemia/lymphoma/SLE/HIV/HCV

Acute (aft viral inf; 2-6yo) or chronic (20-40yo, esp women)
Asympt; minor mucocut bld, easy bruis, petech, hematuria, melena

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22
Q

Idiopathic thrombocytopenic purpura (dg, ttt)

A 
Dg: of exclusion; r/o causes of thrombocytop then labs (Nl RBC morpho)
BM biopsy (only if atyp or >60yo): ↑megakaryoc

ttt: No ttt (if plt >30K + no bld)
CS or IVIG: if plt <30K or bleed/sympt
If refract: splenectomy +/- rituximab +/- TPO recept agonist

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23
Q

9 #dg of thrombocytopenia

A 
HIT
HUS
TTP
ITP
Medications
Splenomegaly
Hereditary (Wiskott-Aldrich sd)
Chemotherapy
Other (malignancy)
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24
Q

Iron deficiency anemia (etiologies, PE)

A

Normocytic then microcytic An
↑demand (pgncy, growth) or ↓iron (malnutr/malabs, bleed)
Esp toddlers, ado girls, women of childB age

Fatig, dyspn, tachycard, pica; asympt if slowly
Glossitis; conj pallor; cheilosis; koilonychia

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25
Q

Iron deficiency anemia (dg, ttt)

A

Dg: CBC; ↓iron, ↑TIBC/transferrin, ↓ferritin, ↑RDW; periph bld smear (hypochromic+microc w/ ↓reticulocyte count)

ttt: oral iron x4-6mo (!N, abdo pain, const/diarr)
CI antacids w/ iron
IV iron dextran (! anaphylaxis)

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26
Q

Anemia of chronic inflammation/disease

A

Chronic infl, inf, malign, RA, SLE
Body hides iron (limit bact prolif)
Normocytic then microcytic An

Dg: ↓iron, ↓TIBC/transf, ↑ferritin

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27
Q

Sideroblastic anemia

A

Microcytic An
Def in heme metab (hered; alcoh, lead poison, chloramph, INH, malign)

Dg: ↑iron; basoph stippl (periph smear); ringed sideroblasts (BM)

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28
Q

Megaloblastic anemia (etiologies, PE)

A

Macrocytic anemia
Impaired DNA synth (vitB9 def, vitB12 def, MTX, 6-MP)
-B12: intest malabs (Crohn/celiac/gastrect/panc insuff), pernicious An, vegetarian, Diph latum
-B9: alcoh, ↓diet folate, malabs, phenytoin

Fatig, pallor, diarr, ↓appet, headac
B12: demyelin (subacute comb degen of cord)

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29
Q

Megaloblastic anemia (dg, ttt)

A

Dg: CBC, smear w/ hypersegm neutroph (≥6 lobes)
MMA+homocysteine (↑both in B12 but MMA Nl in B9)
BM (giant+hyperseg neutro); Schilling test (for B12)

ttt: underl cause

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30
Q

Hemolytic anemia (etiologies)

A

Normocytic An
BM unable to compens for ↑destruc

  • Intrinsic: memb def (spheroc), enz def (G6PD def), HbC, SCD, parox noct hemoglobinuria
  • Extrinsic: autoimm, microangiop (HUS/TTP/DIC), macroangiop (mechan heart valv), inf (malaria), hypersplenism
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31
Q

Hemolytic anemia (PE, dg, ttt)

A

Pallor, fatig, tachycard, tachypn

Dg: jaund, ↑ind bili, ↑reticuloc, ↑LDH, ↓haptogl

ttt: underl cause; CS in immuno; iron to replace loss
If severe, splenectomy or transfusions

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32
Q

G6PD deficiency

A

X-linked; hemolyt An after oxidant stress
Episod dark urin + jaund
Trigger: sulfa drug, antimalar, inf, fava beans, metab acid

Dg: CBC, smear (bite cell, Heinz); G6PD level after 1mo
ttt: avoid trigg

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33
Q

Paroxysmal nocturnal hemoglobinuria

A

Def in GPI-anchor molec → No CD55/CD59 on RBCs → No protec ag complem-med hemolysis

Dg: An, dark urin, venous thromb, abdo pain; flow cytom w/o CD55/59 (accur)

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34
Q

Hereditary spherocytosis

A

AD def in spectrin/ankyrin
Spherical RBCs destroyed by spleen (extravasc hemol)

Dg: CBC + smear; osmotic fragil test (accur)
ttt: splenectomy (+pneumo/meningo/haemo vacc before)

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35
Q

Sickle cell disease (PE, complications)

A

AR; beta chain has Val (not Glu)
Trigg: dehydr, deoxyg, high altit, inf, cold
Dactylitis (child); An, jaund, pigm cholelith, ↑CO (CHF), delayed growth

  • Vaso-occlusion: isch org dam, splen infarc, acute chest sd, avasc hip necr, priapism, stroke
  • Splenic sequestr: hypovol; Nl/↑ plts
  • Aplastic crisis: by parvoB19; ↓plts
36
Q

Sickle cell disease (dg, ttt)

A

Dg: CBC w/ smear (sickle C, Howell-Jolly); Hb electroph (accur)

ttt: hydroxyurea (↑fetal Hb); if ineff, chronic transfu
Cholecystec if lithias; folate suppl; vaccines; penicill in <5yo
-VasoO crisis: pain manag, O2, IV hydr, AB
-Acute chest sd: aggr hydr, spirom, transfu

37
Q

Autoimmune hemolytic anemia

A

AutoAb: warm (IgG ass w/ SLE, CLL, drugs) and cold (IgM ass w/ EBV, mycopl)

Dg: direct Coombs

ttt: no ttt (mild); steroids (severe warm); avoid cold+/-Rituximab (severe cold)

38
Q

Aplastic anemia

A

BM cells destruc → No bld cells
Hered (Fanconi An); autoimm; viral (HIV, parvoB19); toxins; radiation; drugs

Pancytop: pallor, weak, ↑inf, petech, bruis, bleed
Dg: CBC; BM biopsy w/ hypocell + fat (accur)
ttt: transfu + SCT; ttt inf aggress; if no donor, immunosupress to prevent autoimm BM destr

39
Q

Thalassemias (etiologies, PE)

A

Heredit; ↓/No prod of nl globin
Alpha: mut of ≥1 of 4 genes for alpha-Hb
Beta: mut of ≥1 of 2 genes for beta-Hb

Africa, middle east, Asia
PE depends on nb of genes; asympt; fatig w/ microcyt An + Nl iron studies

40
Q

Thalassemias (dg, ttt)

A

Dg: Hb electroph and DNA studies

ttt: most, no ttt
Beta-T major (0/2 beta) and HbH ds (1/4 alpha): transfu-dep + iron chelator

41
Q

Polycythemias (etiologies, PE)

A

Erythrocytosis: -absolute (↑RBC prod: hypoxia, lung ds, smok, altit; neopl, EPOtumor; PCV) or relative (↓plasma, hypovol and hemoconcentr)

↑Ht; ↓tissu bld flow+O2; ↑card work
Hyperviscosity sd: easy bleed/bruis; blurred vis*; neuro def; prurit aft warm bath; thromb; CHF; HSM

42
Q

Polycythemias (dg, ttt)

A

Dg relative erythro: ↑Ht, ↑/Nl EPO, O2 often ↓ compared to PCV

ttt relative eryth: underl cause; phlebotomy (↓sympt)

43
Q

Polycythemia vera

A

Clonal prolif of a pluripotent marrow stem cell
All marrow cell lines ↑, esp RBCs
Older ptt

Dg: CBC, ↑RBCs, ↑WBCs, ↑plts; ↓EPO, Nl O2, ↑Ht >60%
JAK2 mutation⊕
ttt: phlebotomy + aspirin (↓sympt + prev thromb); hydroxyurea + IFN (↓cells)

44
Q

Febrile nonhemolytic transfusion reaction

A

Cytokine format* in storage
Fever/chill, malaise; aft 1-6h
ttt: stop transfu + give acetamino

45
Q

Allergic transfusion reaction

A

Ab ag donor prot; usual aft plasma-contain prod
Prominent urticaria
ttt: antihist; if severe, stop transfu + give epinephrine

46
Q

Hemolytic transfusion reaction

A

Preformed (acute) or formed (delayed) Ab ag donor RBCs
ABO mismatch; Rh and Duffy Ag
Fever/chilld, N, flush, burn at IV site, tachycard, hypoTN direcly aft transfu

ttt: stop transfu immediately + vigorous IV fluids + monitor urine

47
Q

Porphyria (etiologies, dg, ttt)

A

Inherit ds, abNl heme prod
Accumul of porphyrins
Acute intermitt porph; erythropoietic porph; porphyria cutanea tarda

Dg: urin+plasm porphyrin lev; mutat*/enz analysis (accur)
ttt: avoid trigg; sympt ttt in attacks + high dose glucose

48
Q

Porphyria (PE)

A

Photodermatitis, neuropsych, visceral sympt (colic abdo pain), seizures
Tachycard, skin erythema, blisters, areflexia

-Erythrop porph: hemolyt An, urine pink/black
Attacks ass w/ ↑heme synthesis (fasting, chemic expo, alcoh, barbit, OCPs)

-Acute interm porph: abdo pain, red urin, polyneurop, psychol disturb; by CYP450 inducers/alcoh/fasting

49
Q

Acute leukemias (PE)

A

Clonal disord of blasts → unregul WBCs in BM
BM overwhelmed → anemia/fatig, inf, hge/petech/purpu
DIC (AML); bone pain (ALL)

Child + adult; rapid onset+progr
Leukemic infiltr: HSM; swoll/bld gums; skin; CNS

50
Q

Acute leukemias (dg)

A

Dg: CBC w/ smear (AML: myeloblasts; ALL: lymphoblasts); BM biopsy (accur) + flow cytom
AML: Auer rods, myeloperoxidase ⊕

↑WBCs but dysfct or neutropenia
If WBCs >100K, leukostasis (vaso-occl)

51
Q

Acute leukemias (ttt)

A

AML/ALL: chemotherapy; if unfavor genetics, BMT
Leukostasis sd: hydroxyu +/- leukapheresis

Poor pg: -ALL (<1 or >10yo; WBC>50K; t(9:22); CNS)
-AML (>60yo; ↑LDH; complex karyotype)

52
Q

CLL (PE)

A 
Dysfct lymphocytes in BM/bld/LN/spleen/liv
Older adults (65yo; M=2F)

Asympt; fatig, malaise, inf
Lymphadenopathy; SMG

53
Q

CLL (dg)

A

Dg: CBC+diff; smear (lymphocytosis + smudge cells)
Flow cytom w/ CD5 on B cells (accur)

Granulocytop, anem, thrombocytop, hypogammaglobulin
Rarely BM done

54
Q

CLL (ttt)

A

Palliative; ttt given when symptomatic (recurr inf/sev LNpathy/SMG/An/thrombocytop)

Chemoth: fludarabine + chlorambucil
No cure; ds-free intervals w/ adequate ttt

55
Q

CML (PE)

A

Clonal prolif myeloid progen cells + BCR-ABL transloc
Philad chrm t(9,22); middle-aged ptt

↑granulocytes and basophils; maybe ↑RBCs and plts
Asympt; anem, SMG w/ LUQ pain, anorex/fev/chil/↓weight
3 phases: chronic, accelerated, blast crisis

56
Q

CML (dg)

A

Philad chrm (accur) by PCR/FISH
CBC (WBCs >100K to 500K); ↓LAP
↑ LDH, uric ac, B12
#dg: leukemoid reaction (↑neutro w/ left shift; ↑LAP)

57
Q

CML (ttt)

A

Chronic: imatinib (Gleevec)
Young ptt: allogen SCT

Blast crisis: chemotherapy; dasatinib + SCT

58
Q

Leukemia based on age (~)

A

<13yo: ALL
13-40yo: AML
40-60yo: CML
>60yo: CLL

59
Q

Hairy cell leukemia (PE)

A

Ds of well-diff B lymphoc
Older men

Pancytop, BM infiltr, SMG
Weak, fatig, petec, bruis, ing, abdo pain, ↓weight
Rare LNpathy (#CLL)
60
Q

Hairy cell leukemia (dg, ttt)

A 
Dg: CBC w/ smear (hairy C w/ TRAP stain)
Flow cytom (accur)

ttt: cladribine; splenectomy; IFN-alpha

61
Q

Non-Hodgkin lymphoma (PE)

A

1 hematopoietic neopl

Group of mature B (85%) and T cell neopl
>50yo; aggress in child

Painless periph LNpathy + extranodal (#HL)
B sympt (fev, night swt, ↓weight)
62
Q

Non-Hodgkin lymphoma (dg, ttt)

A

Dg: excisional LN biopsy; Ann Arbor staging
CSF exam if HIV, neuro sympt, 1*CNS lymphoma

ttt: based on histopath (not stage) → radioth, chemoth, x2
Low grade: palliative
High-grade: aggress ttt

63
Q

4 types of B cell NHL

A
  • Follic: adult; low grd; painless wax/wan LN; radioth if local
  • DLBC: middle-age/elder; interm grd; single rapid grw mass; R-CHOP ttt
  • Burkitt: child/ado; high grd; starry sky; jaw/Afr; abdo/USA; EBV; t(8;14); aggress ttt
  • Mantle cell: elder men; rare
64
Q

2 types of T cell NHL

A
  • Adult T-cell: adult; high grd; progr to ALL; cutan les*; by HTLV; ass w/ IVDA
  • Mycosis fungoides: adult; skin; eczema-like + prurit; cerebriform cells; progr to Sezary sd (leukemia)
65
Q

Tumor lysis syndrome

A

Hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalemia; renal insuff

Prevent: gd hydrat + allopur or rasbur

66
Q

Hodgkin lymphoma (PE)

A

Predomin B-cell; ass w/ EBV
Bimodal age: 30yo (nodular sclerosing type); 60yo (lymphocyte-depleted type)

Above diaphragm (cervic LNpathy); if under D = dissem
Systemic B symptoms, prurit, HSMG
Rare: Pel-Ebstein fevers and alcohol-induced pain

67
Q

Hodgkin lymphoma (dg, ttt, pg)

A

Dg: excisional LN biopsy (Reed-Sternb C = giant B C)
Stage: nb of nodes, if B sympt, if both sides of diaph

ttt: stage-dep; chemoth and radiation
5-yr pg: stage I/II 90%; III 84%; IV 65%
Lymphocyte-predomin HL: best pg

68
Q

Multiple myeloma (RF, PE)

A

Clonal prolif of plasma C w/ excess monoclon Ig (A/G) or Ig fragm (kappa/lambda light chains)
Elder
RF: radiation; MGUS; petrolium; pesticides

Bone pain/pathol fx; anem; hyperCa; renal abnl
Inf (monoclon Ig ineffect); ↑monoclon M prot

69
Q

Multiple myeloma (dg, ttt)

A

Dg: serum prot electroph (IgG/IgA spike)
BM biop (>10% monoclon CD138+ plasma cells)
CBC w/ smear (rouleaux); ↑prot:album
Urinal (Bence Jones prot); skeletal survey

ttt: autolog BMT (if <70yo); melphalan+prednis (if >70yo)

70
Q

Cryoglobulinemia vs cold agglutinins

A

IgM Ab

Cryog: in HCV, joint pain, renal involv

Cold agg: in EBV, mycoplasma, Waldenstrom macroglob; numbness on cold expo,

71
Q

Waldenstrom macroglobulinemia (PE)

A

B cells; malign monoclonal gammopathy
↑IgM; hyperviscosity sd
Coag abNl, cryoglobul, cold agglutinin ds, amyloidosis

Lethargy, ↓weight, Raynaud phen, neuro prob, organomeg, org dysfct
MGUS is precursor

72
Q

Waldenstrom macroglobulinemia (dg, ttt)

A

Dg: BM biopsy/aspirate (abNl plasma cells w/ Dutcher bodies); prot electroph+immunofixation; ↑ESR, uric ac, LDH, ALP

ttt: chemo; plasmapheresis

73
Q

Amyloidosis (PE)

A

Extracell deposit of amyloid prot fibrils
Elder
PE: dep on type, amount, distrib (esp kidney, heart, liv)
Alzheimer ds: deposit just in brain

74
Q

Amyloidosis (dg, ttt)

A

Dg: tissue biopsy w/ Congo red (apple green birefr) (accur)
Immunohistochemistry

ttt: 1* amyl: experimental chemoth + autologous SCT
2* amyl: underl cause

75
Q

5 types of amyloidosis

A
  • AL: monoclonal light-chain fragm; ass w/ MM + Walden macroglob
  • AA: amyloid A; ass w/ chron infl ds/inf/neopl
  • Dialysis related: Beta2-microglobulin, pt on long-term dialysis
  • Heritable: deposit of abnl gene prod (transthyretin)
  • Senile-systemic: deposit of Nl transthyretin
76
Q

Neutropenia (etiologies)

A

ANC <1500/mm3
Acquired or intrinsic

↓prod; migrat* from Vx; ↑destruct; utilization
Adult: #1 by inf; #2 by drugs; leuk/lymph; aplast anem; B12/B9 def

77
Q

Neutropenia (PE)

A

↑R of inf
Acute: S aureus; Pseudom; E coli; Proteus; Klebs sepsis
Chron + AI: recurr sinusitis; stomatitis; gingivitis; perirectal ing
+/- SMG

78
Q

Neutropenia (dg)

A

Dg: CBC w/ smear; Hx (drug/toxin/ing/AI/neopl)
Follow w/ CBC+ANC
If ↓plts/RBCs, BM biopsy/aspirate
Immuno eval; ANA lev; collagen vasc ds

79
Q

Neutropenia (ttt)

A

ttt inf
Neutropenic fever = emergency; broad AB (cefepime) +/- antifungal
G-CSF shortens durat* of neutrop
Rare: IVIG; allogen BMT

80
Q

Eosinophilia (etiologies, PE)

A

AEC >350/mm3
Trigg: overprod of cytokines/chemokines
1* or 2* to allergy, parasitic inf

Hx travel, med, atopic, leuk/lymph, diet
Hypereosino sd: fever, anem, cardiac findings), other org

81
Q

Eosinophilia (dg, ttt)

A

Dg: CBC w/ diff
CSF w/ eosino: drug react* or inf (coccidio, helminth)
Hematuria w/ eosino: schistosom

ttt: cardiac find, eos >100K, drug react w/ systemic sympt → early dg + steroids + stop off agent

82
Q

3 types of tissue transplantation

A
  • Autologous: ptt to him/herself
  • Allogenic: donor to genet diff ptt; ABO and HLA match; but match + immsuppr and still get rejection
  • Syngeneic: btw/ identical twins (genet identical)
83
Q

3 types of solid organ transplant rejection

A

-Hyperacute: min; preform Ab; Vx thrombi; tissu isch
Prevent (check ABO); ttt (cytotoxic agent)

  • Acute: 5d-3mo; T-cell med; tissu destr (↑GGT/ALP/LDH/ BUN/creat); No prevent; confirm w/ biopsy then ttt (CS, OKT3, tacrolimus, MMF)
  • Chronic: mos-ys; imm react* to fibrosis; gradual loss of fct; No prevent; No ttt (biopsy to r/o treatable acute react*)
84
Q

GVHD

A

Specif to allogeneic BMT
Donor T cells attack host tissues
Acute (<100d) or chronic (>100d)
Esp skin, liv, GI (by minor histocomp Ag)
Skin changes, cholest liv dysfct, obstr lung ds, GI probl
ttt: high-dose CS

85
Q

Typical posttransplant immunosuppression and infection prophylaxis

A

Imm: prednisone, MMF, tacrolimus
Proph: TMP-SMX, ganciclovir, ketoconazole

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