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nephro Boards > Kidney Transplant > Flashcards

Kidney Transplant Flashcards

1
Q

The risk for BK nephropathy is highest at ___ months post-transplant?

A

2-6 months

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2
Q

can a recipient who is Hepatitis C negative receive a kidney that is HepC positive?

A

yes. Then treat the recipient with hep C antivirals with weekly HepC titers (monitored weekly)

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3
Q

which commonly used immunosuppressants are contraindicated in pregnancy?

A

MMF and mTOR inhibitors. These should be changed to azathioprine. There are no data on belatacept, so it is not used at this time

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4
Q

what complication can develop if azathioprine is combined with allopurinol?

A

decrease in azathioprine metabolism (higher AZT levels) which can lead to pancytopenia

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5
Q

what is the 1st line treatment for posttransplant erythrocytosis?

A

ACEi or ARB

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6
Q

what are the common signs and symptoms of BK viremia

A

None. it does not cause symptoms

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7
Q

what is the most common cause of death after transplant?

A

cardiovascular disease

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8
Q

what will happen to cyclosporin levels if patient is on phenytoin?

A

cyclosporin levels will decrease

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9
Q

a patient who is 3 years posttransplant is asx but has a urine culture with > 50,000 cfu/mL of E. coli. what is the best management?

A

no treatment for asx bacteriuria in uncomplicated renal transplant

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10
Q

what is the common posttransplant cancer?

A

squamous cell cancer

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11
Q

what is the first change in management after lymphoproliferative disease?

A

decrease immunosuppression

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12
Q

what is a positive long term outcome after taking belatacept?

A
  1. decreased risk of CVE vs CNIs
  2. improved GFR
  3. adherence may improve (no need for drug monitoring)
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13
Q

can a transplant patient receive recombinant zoster vaccine?

A

Yes. Live vaccines should be avoided but this vaccine does not pose increased risks. Vaccines to avoid are MMR, rotavirus, smallpox, varicella, intranasal flu, and yellow fever

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14
Q

if a transplant patient has new onset proteinuria with a stable creatinine value, what would you do next?

A

transplant biopsy. there has been significant rejection or GN in these situations. Use of RAAS blockade is also important, but the biopsy should NOT be forgotten

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15
Q

who has a higher risk of rejection, a patient who develops de novo DSAs or one with pretransplant DSA

A

a patient with de nova DSA has a higher risk

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16
Q

if patient has a sulfa allergy, what is the ppx for PCP pneumonia

A

pentamidine or atovaquone

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17
Q

what is the effect of tacrolimus on hair?

A

hair loss; Cyclosporin = hair growth

18
Q

a transplant patient has new onset tremor. what meds is implicated?

A

Tacrolimus

19
Q

true or false, rates of graft rejection increase during pregnancy?

A

true

20
Q

name meds that are appropriate for the treatment of graft rejection during preg

A

steroids, rituximab, IVIG, tacrolimus

21
Q

what is the risk created by combining cyclosporin or gemfibrozil with statins?

A

rhabdomyolysis
Pravastatin is preferred; simvastatin & atorvastatin are not recommended

22
Q

which immunosuppressive med is most likely to cause hyperlipidemia?

A

mTOR inhibitors; but CsA and prednisone can also cause it

23
Q

what de novo GN can develop after transplantation in patients with Alport’s disease?

A

anti-GBM disease but without the pulmonary hemorrhage

24
Q

what renal disease can recur within hours of receiving a renal transplant?

A

Primary FSGS. thought to be related to a circulating factor.

25
Q

what CNI is more likely to cause glucose intolerance, TAC or Csa

A

tacrolimus

26
Q

name 3 parts to the criteria for ABMR?

A
  1. histologic evidence: peritubular capillaritis, TMA, ATN
  2. Ab activation: C4d stain or microvascular inflammation
  3. donor specific Abs
  4. validated transcripts/classifiers
27
Q

what eGFR qualifies an adult patient for transplant listing?

A

eGFR of 20 ml/min

28
Q

which drug affects spermatogenesis? Sirolimus or Tacrolimus?

A

Sirolimus

29
Q

How long can you wait for Transplant to occur after a cardiac balloon angioplasty?

A

1 month

30
Q

How long can you wait for Transplant to occur after placement of bare metal stent?

A

1 months

31
Q

How long can you wait for Transplant to occur after placement of a drug eluting stent?

A

6 months

32
Q

what is the waiting time for transplant if a patient has prostate cancer, < 5cm without tumor invasion?

A

2 years

33
Q

what is the waiting time for transplant if a patient has prostate cancer > 5 cm?

A

5 years

34
Q

what is the waiting time for transplant if a patient has prostate cancer of < 5 cm but with tumor invasion?

A

5 years

35
Q

what is the waiting time for transplant in patients with a history of Lymphoma, Invasive cervical CA or Colon CA?

A

5 years

36
Q

what is the waiting time for transplant in patients with a history of Invasive bladder cancer, Wilm’s tumor, or Uterine cancer?

A

2 years

37
Q

how long does a patient have to conceive after a kidney transplant?

A

wait one year after transplant before planning to conceive

38
Q

what is the most likely outcome of pregnancy in transplant patients?

A

Low birth weight, and early AOG (average is 35 weeks)

39
Q

What bladder capacity (mL) in ESKD patients is considered a risk factor for bladder atrophy?

A

< 300 mL

40
Q

Kaposi’s sarcoma is a/w what infection?

A

HHV-8

41
Q

Non Hodgkin Lymphoma is a/w what infection?

A

EBV

42
Q

EBV is associated with what cancers? (4)

A

PTLD, nHL, Hodgkin’s lymphoma and plasma cell neoplasm

nephro Boards (9 decks)

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