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PSGS PBS Refresher Course > Immunology and Transplant > Flashcards

Immunology and Transplant Flashcards

1
Q

Class I HLA antigens are expressed on the membrane of:

A. All nucleated cells
B. B lymphocytes
C. Monocytes
D. Dendritic cells

A

A. All nucleated cells

B-D express Class II HLA antigens

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2
Q

Which of the following immunosuppressive drugs inhibits IL-2 synthesis?

A. Azathioprine
B. Mycophenolate mofetil
C. Tacrolimus
D. Sirolimus

A

C. Tacrolimus

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3
Q

Cyclosporine inhibits T-cell activation by:

A. Directly binding to T-cell surface membrane B. Increasing production of IL-2
C. Decreasing production of IL-10
D. Inhibiting calcineurin

A

D. Inhibiting calcineurin

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4
Q

The most significant side effect of sirolimus is:

A. Nephrotoxicity
B. Thrombocytopenia
C. Glucose intolerance
D. Leukopenia

A

B. Thrombocytopenia

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5
Q

Cyclosporine levels may be decreased in patients who are also taking:

A. Phenytoin
B. Erythromycin
C. Cimetidine
D. Fluconazole

A

A. Phenytoin

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6
Q

Bowel removed from a living donor for small bowel transplant is most commonly:

A. Proximal jejunum
B. Mid to distal jejunum
C. Proximal ileum
D. Mid to distal ileum

A

D. Mid to distal ileum

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7
Q

The most appropriate treatment of a lymphocele following renal transplantation is:

A. Observation until resolution
B. Percutaneous aspiration
C. Laparoscopic or open peritoneal window
D. Open exploration with sclerotherapy

A

B. Percutaneous aspiration

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8
Q

The major cause of death following renal transplantation is:

A. Rejection with acute renal failure
B. Vascular (myocardial infarction or stroke)
C. Malignancy
D. Sepsis

A

D. Sepsis

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9
Q

The leading cause of graft loss following renal transplantation is:

A. Recipient death
B. Acute rejection
C. Chronic nephropathy
D. Pyelonephritis

A

A. Recipient death

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10
Q

The most common etiology of liver failure in patients undergoing liver transplantation is:

A. Alcoholic cirrhosis 
B. Metabolic disease 
C. Chronic hepatitis 
D. Fulminant (acute) liver failure
e
A

C. Chronic hepatitis

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11
Q

Following biopsy which shows no vascular or lymphatic invasion, which of the following patients with hepatocellular carcinoma would be considered a candidate for liver transplantation?

A. A single tumor in the left lobe 5.5 cm in diameter
B. Two tumors, both in the right lobe, 3.5 cm and 2.5 cm in diameter
C. Three tumors, in the right and left lobes, 2.5 cm, 2.8 cm, and 1.0 cm in diameter
D. None of the above

A

C. Three tumors, in the right and left lobes, 2.5 cm, 2.8 cm, and 1.0 cm in diameter

Milan criteria

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12
Q

Which of the following is an indication for liver transplantation in a patient with acute liver failure?

A. INR >6.5
B. Age < 40
C. Creatinine > 2.0
D. Duration of jaundice >3 days rior to onset of encephalopathy

A

A. INR >6.5

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13
Q

Which of the following is one of the variables of the MELD score?

A. Creatinine
B. Age
C. Degree of encephalopathy
D. Cause of hepatic failure

A

A. Creatinine

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14
Q

The most common vascular complication after liver transplantation is:

A. Hepatic vein thrombosis
B. Portal vein thrombosis
C. Hepatic artery thrombosis
D. Inferior vena cava thrombosis

A

C. Hepatic artery thrombosis

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15
Q

PTLD (posttransplant lymphoproliferative disorder) is caused by:

A. Poorly controlled immunosuppression B. Induction of lymphocyte antigens by immunosuppression
C. Cytomegalovirus infection
D. Epstein-Barr virus infection

A

D. Epstein-Barr virus infection

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16
Q

The most common indication for pediatric liver transplantation is:

A. Wilson’s disease
B. Alagille’s syndrome
C. Biliary atresia
D. Tryosinemia

A

C. Biliary atresia

17
Q 
Following transplantation, patients are at increased risk for which of the following malignancies? 
A. Melanoma 
B. Kaposi's sarcoma 
C. Colon cancer 
D. Follicular carcinoma of the thyroid
A

A. Melanoma

18
Q

The imminent and most devastating postoperative infection is caused by?

A. Staphylococcus aureus
B. E. coli
C. Cytomegalovirus (CMV)
D. HIV

A

C. Cytomegalovirus (CMV)

19
Q

Which of the following is an absolute contraindication to pediatric orthotopic liver transplantation?

A. Portal vein thrombosis
B. Three previous reoperative portoenterostomies for biliary atresia
C. Bilobar hepatoblastoma with pulmonary metastasis
D. A diagnosis oxalosis with concomitant acute renal failure

A

C. Bilobar hepatoblastoma with pulmonary metastasis

20
Q

Which of the following immunosuppressive agents specifically inhibits interleukin-2 production by T-lymphocytes?

A. Azathioprine
B. Prednisone
C. Cyclophosphamide
D. Tacrolimus

A

D. Tacrolimus

21
Q

The initial study used to evaluate posttransplant renal allograft dysfunction developing 24 hours after transplantation should be?

A. Arteriography
B. Perfusion scan
C. Duplex ultrasonography
D. Percutaneous biopsy

A

C. Duplex ultrasonography

22
Q 
Immunosuppression in transplant recipients increases the risk of each of the following EXCEPT?
A. Bacterial infections 
B. Malignancy 
C. Anemia 
D. Malnutrition
A

D. Malnutrition

23
Q

Unilateral ankle swelling after kidney transplantation can be caused by all of the following EXCEPT?
A. Lymphocele
B. Ureteral leak
C. Femoral vein thrombosis
D. Position of the kidney in the iliac fossa

A

D. Position of the kidney in the iliac fossa

24
Q

Cyclopsorine administration is associated with all of the following EXCEPT?

A. Elevated serum creatinine
B. Hypertension
C. Hyperkalemia
D. Leukopenia

A

D. Leukopenia

25
Q

Ten hours earlier, a 35-year old man received a cadaveric kidney transplant. Initially, his urine output was 100-200 ml/hr and was bloody. In the most recent one-hour period, his urine output was 5 mL and continues to be bloody. The most likely problem is?

A. Acute rejection
B. Thrombosis of the renal artery
C. Renal vein thrombosis
D. Blood clots in the bladder

A

C. Renal vein thrombosis

26
Q

A positive crossmatch means

A

The recipient has preformed antibodies to donor antigens

PSGS PBS Refresher Course (6 decks)

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