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IMMUNOSERO LEC FINALS > M9 > Flashcards

M9 Flashcards

1
Q

process of transferring an organ, tissue, or cell from one place or another

A

Transplantation

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2
Q

surgical procedure in which a failing organ is replaced by a functioning one.

A

organ transplant

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3
Q

implanted in the same anatomic location in the recipient as it was in the donor.

A

Orthotropic

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4
Q

implanted in another location.

A

Heterotropic

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5
Q

represent the most reliable way to achieve euglycemia in patients with uncontrollable diabetes

A

Pancreas transplantation

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6
Q

normal response to glucose

A

Euglycemia

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7
Q

has become the standard of care for many patients with end-stage liver failure and/or liver cancer

A

Liver transplantation

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8
Q

“Saving lives together”

A

UNITED NETWORK FOR ORGAN
SHARING (UNOS)

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9
Q

first hospital in the Philippines accredited to perform kidney transplant

A

NKTI

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10
Q

Is a potentially lifesaving treatment for end-stage organ failure, cancers, autoimmune diseases, immune deficiencies, and a variety of other diseases

A

TRANSPLANTATION

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11
Q

largest immunologic barrier to successful allogeneic organ transplantation consist of cell surface proteins which play a central role in immune recognition and initiation of immune responses

A

HLA (Human Leukocyte Antigen) system

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12
Q

The HLA (Human Leukocyte Antigen) system’s largest immunologic barrier to successful _____ consist of cell surface proteins which play a central role in immune recognition and initiation of immune responses

A

allogeneic organ transplantation

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13
Q

Is a cluster of genes found on the short arm of chromosome 6 at band 21

A

Major histocompatibility complex (MHC)

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14
Q

key element in organ transplantation

A

Organ procurement

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15
Q

Typically, brain death is defined as the ___ of brain function, including the brainstem.

A

irreversible cessation

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16
Q

The presence of medical conditions that mimic brain death - _____- need to be excluded.

A

such as drug overdose, medication side effects, severe hypothermia, hypoglycemia, including coma, and chronic vegetative state

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17
Q

The clinical diagnosis of brain death consists of four essential steps:

A

Establishment of the proximate cause of the neurologic insult.

Clinical examinations to determine coma, absences of brainstem reflexes, and apnea.
Utilization of ancillary tests, such as electroencephalography (EEG), cerebral angiography, or nuclear scans, in patients who do not meet the clinical criteria.

Appropriate documentation. A similar guideline in determining brain death in pediatric patients was recently developed.

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18
Q

Given the severe shortage of donor organs, donation after cardiac death (DCD) - also known as the
___

A

donation by non-heart beating donors (NHBDs)

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19
Q

donation by non-heart beating donors (NHBDs) - was reintroduced to the transplant community in the __

A

1990s

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20
Q

The category of DCD (_____)was initially proposed at an international workshop and is now widely adopted for organ procurement.

A

Maastricht classification)

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21
Q

Most NHBDs in the United States meet __ that is, they have suffered a devastating injury with no chance of a meaningful recovery but do not meet the criteria for brain death.

A

Maastricht classification III;

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22
Q

With cardiac death (as opposed to brain death), _____ to organs can occur during the period between______ through perfusion of preservation solution.

A

warm ischemic injury, circulatory cessation and rapid core cooling

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23
Q

The maxim of medical ethics is ____ (first, do no harm), and for that reason living organ donation presents unique ethical and legal challenges

A

“primum non nocere”

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24
Q

Recipient should have a maximum benefit

A

Beneficence

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25
Q

The____ adopted by all states in the United States (with slight variations) provides the legal framework for competent adult living donors to decide whether to donate.

A

Uniform Anatomical Gift Act

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26
Q

For a nephrectomy (kidney), the estimated mortality risk is less than ___
For a partial hepatectomy (liver), about ___

A

0.05%, 0.2%

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27
Q

The guiding principle should be ___

A

minimization of risk to the donor.

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28
Q

Kidney
YEAR:
SURGEON:

A

YEAR: 1954
SURGEON: JOSEPH E. MURRAY

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29
Q

LIVER
YEAR:
SURGEON:

A

LIVER
YEAR: 1963
SURGEON: THOMAS E. STRAZL

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30
Q

LUNG
YEAR:
SURGEON:

A

LUNG
YEAR: 1963
SURGEON: JAMES D HARDY

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31
Q

PANCREAS
YEAR:
SURGEON:

A

PANCREAS
YEAR: 1966
SURGEON: RUCHARD C. LILLEHEI

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32
Q

HEART
YEAR:
SURGEON:

A

HEART
YEAR: 1967
SURGEON: CHRSTIAN N. BARNARD

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33
Q

SMALL INTESTINE
YEAR:
SURGEON:

A

SMALL INTESTINE
YEAR: 1967
SURGEON: RICHARD C LILLEHEI

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34
Q

HEART/LUNG
YEAR:
SURGEON:

A

HEART/LUNG
YEAR: 1981
SURGEON: BRUCE REITZ

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35
Q

MULTIVISCERAL
YEAR:
SURGEON:

A

MULTIVISCERAL
YEAR: 1989
SURGEON: THOMAS E. STARZL

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36
Q

Class I

A

(HLA-A, B, and C)

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37
Q

Class II

A

(HLA-DR, DQ, and DP) proteins

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38
Q

HLA genes are inherited as___from parental chromosomes

A

haplotypes

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39
Q

HLA genes are linked and inherited in __ as haplotypes.

A

MEDELIAN FASHION

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40
Q

_____molecules consist of an alpha chain, a highly polymorphic glycoprotein, encoded within the MHC on chromosome 6.

A

Class I HLA

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41
Q

This___ is noncovalently associated with beta-2 microglobulin, a non polymorphic glycoprotein, encoded by a nonHLA gene on chromosome 15.

A

alpha chain

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42
Q

Most nucleated cells

A

HLA CLASS A

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43
Q

To present endogenous antigen to helper T lymphocytes

A

HLA CLASS II

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44
Q

To present endogenous antigen to cytotoxic T lymphocytes

A

HLA CLASS I

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45
Q

B lymphocytes, macrophages, other antigen-presenting cells, activated T lymphocytes

A

HLA CLASS II

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46
Q

Class II HLA molecules are composed of____encoded within the MHC

A

alpha chains and beta chains

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47
Q

___molecules bear no clear relationship to class I and II molecules aside from their genetic linkage (presence of the gene in or near the MHC complex).

A

Class III

48
Q

Class III molecules are involved in immunologic phenomena because they represent components of the___

A

complement pathways.

49
Q

Complement System gene products such as____complement components are incomplete but these structures are defined by genes lying between or very near the HLA-B and HLA-DR loci.

A

C2, C4A, C4B, and Bf

50
Q

The presence of HLA was first recognized when___experienced transfusion reactions despite proper crossmatching.

A

multiple transfused patients

51
Q

It was discovered that these reactions were caused by ____rather than by antibodies directed against erythrocyte antigens.

A

leukocyte antibodies

52
Q

Transplants are rejected if performed against ___; thus, immunosuppressive therapy is required.

A

MHC barriers

53
Q

In organ transplantation, it is important to always consider ___

A

ABO compatibility and HLA testing

54
Q

The____ can also bind to self-antigens produced in the normal process of ___. Usually, these are not recognized by the T cell receptor (TCR; tolerance).

A

class I and class II molecules, cellular protein degradation

55
Q

In transplant patients, most immune responses are generated not from bacterial antigens, viral antigens, or self-antigens, but from the presentation of alloepitopes derived from the___

A

transplanted tissue to circulating T lymphocytes.

56
Q

In kidney allografts, all of the following are important determinants of early transplantation success or failure:

A

The method of organ preservation
The time elapsed between harvesting and transplanting
The number of pre-transplantation blood transfusions
The recipient’s age (the younger, the better)
The primary cause for kidney failure

57
Q

___ are added; will cool the organ to prevent damage

A

preservatives

58
Q

*Ankylosing spondylitis
Reiter’s syndrome

A

B27

59
Q

Psoriasis vulgaris

A

Cw6

60
Q

Rheumatoid arthritis

A

DR4

61
Q

Behcet’s disease

A

B5

62
Q

Type 1 diabetes

A

DR3

63
Q

Congenital adrenal hyperplasia

A

B47

64
Q

DR5

A

Gold-induced nephropathy
Chronic lymphatic leukemia
Kaposi’s sarcoma (Mediterranean)

65
Q

Transplantation of cells or tissues between two individuals is classified by the genetic relatedness of the donor and the recipient.

A

ALLORECOGNITION

66
Q

The transfer of tissue from one area of the body to another of the same individual.

A

AUTOGRAFT

67
Q

The transfer of cells or tissues between identical twins.

A

SYNGENEIC GRAFT

68
Q

The transfer of cells or tissue between two individuals of the same species.

A

ALLOGRAFT

69
Q

The transfer of tissue between two individuals of a different species.

A

XENOGRAFT

70
Q

Recipient T cells bind and respond directly to foreign (allo) HLA proteins on graft cells

A

DIRECT ALLORECOGNITION

71
Q

Second-pathway by which the immune system recognizes foreign HLA proteins

A

INDIRECT ALLORECOGNITION

72
Q

As it involves the uptake, processing, and presentation of foreign HLA proteins by recipient antigen-presenting cells to recipient T-cells

A

INDIRECT ALLORECOGNITION

73
Q

It plays a predominant role in the acute and chronic rejection

A

INDIRECT ALLORECOGNITION

74
Q

APC cause production of cytokines and antibody

A

INDIRECT ALLORECOGNITION

75
Q

Polymorphic genetic system that impacts allogeneic transplantation

A

KILLER IMMUNOGLOBULIN-LIKE RECEPTORS

76
Q

one of several types of cell surface molecules that regulate the activity of natural killer (NK) lymphocytes; NK cells attach to receptors.

A

KILLER IMMUNOGLOBULIN-LIKE RECEPTORS

77
Q

It is the acquisition of nonreactivity toward particular antigens.

A

IMMUNOLOGIC TOLERANCE

78
Q

Included among the functions of NK cells are secretion of ____

A

cytokines and non-MHC restricted cytotoxicity.

79
Q

Do not show a marked difference in tolerance at different stages of maturation

A

T CELL TOLERANCE

80
Q

Immature T cell clones may be aborted in a manner similar to that of B cells (e.g. apoptosis).

A

Clonal abortion

81
Q

The subsets of a mature T cell may be individually deleted, leading to the loss of only one of the functions of the T cell group (subsets are the only ones deleted).

A

Functional deletion

82
Q

T cell suppressors actively suppress the actions of other T cell subsets or B cells

A

T cell suppression

83
Q

A low concentration of multivalent antigen may cause the immature clone to abort.

A

Clonal abortion

84
Q

Clonal abortion
A low concentration of multivalent antigen may cause the immature clone to abort.

Tolerance of ____

A

immature B cells by this mechanism is high.

85
Q

Clonal exhaustion
Repeated antigen challenge with a T-independent antigen may remove all mature functional B cell clones.

Tolerance of ____

A

mature B cells is moderate.

86
Q

Functional deletion
The combined absence of the helper T subset and presence of T-dependent antigen (or with T suppressor cells), or an excess of T-independent antigen, prevents mature B cells from functioning normally.

The ability to tolerate___

A

B cells by this mechanism is moderate.

87
Q

Antibody-forming cell blockade
An excess of T-independent antigen interferes with the secretion of antibodies by antibody-forming cells.

____

A

B cell tolerance by this mechanism is low.

88
Q

Used because the CD3 surface membrane marker is found on all mature post-thymic T cells

A

MONOCLONAL ANTIBODIES

89
Q

Interaction between ___ and the surface of mature T lymphocytes causes T cell depletion

A

OKT3

90
Q

The use of OKT3 reverses almost all_____

A

acute renal transplant rejection

91
Q

Is indicated for the treatment of steroid-resistant rejection.

A

MONOCLONAL ANTIBODIES

92
Q

NULOJIX

A

Belatacept

93
Q

This type of drug is called a selective T cell costimulation blocker.

A

NULOJIX

94
Q

MYCOPHENOLATE MOFETIL

A

RS-61443

95
Q

MYCOPHENOLATE MOFETIL
Inhibits___

A

de novo guanosine synthesis

96
Q

By inhibiting inosine monophosphate dehydrogenase
This drug inhibits T and B lymphocyte proliferation and antibody formation by B lymphocytes

A

MYCOPHENOLATE MOFETIL

97
Q

Has been efficacious as prophylactic and rescue therapy in refractory renal allograft rejection in clinical trials.

A

MYCOPHENOLATE MOFETIL

98
Q

SIROLIMUS

A

Rapamune
Previously referred to as rapamycin

99
Q

Sirolimus is derived from the fungus ____ from the soil of Easter Island.
Inhibits the activation and proliferation of T lymphocytes and subsequent production of _____
Sirolimus also inhibits antibody production

A

Streptomyces hygroscopicus ,IL-2, IL-4, and IL-15.

100
Q

TACROLIMUS

A

A macrolide with mechanisms similar to cyclosporine, is derived from a fungus, Streptomyces tsukubaensis

101
Q

Its primary target appears to be the Th lymphocytes
With little effect on other aspects of the immune response.

A

TACROLIMUS

102
Q

TACROLIMUS

A

FK 506

103
Q

FK-506 acts early in the process of T cell activation and inhibits the production of ___

A

IL-2.

104
Q

Isolated in 1971 from the fungus Tolypocladium inflatum

A

CYCLOSPORINE (CYCLOSPORIN A)

105
Q

Has become the mainstay of immunosuppressive therapy in transplantation

A

CYCLOSPORINE (CYCLOSPORIN A)

106
Q

Cyclosporine blocks ____transcription pathway and the release of certain other lymphokines (e.g., IFN-γ).

A

calcineurin to the IL-2 gene

107
Q

Directly inhibit antigen-driven T cell proliferation

A

CORTICOSTEROIDS

108
Q

nhibit production of lymphokines by preventing monocytes from releasing IL-1

A

CORTICOSTEROIDS

109
Q

High doses of ___are used to treat acute rejection.

A

corticosteroids

110
Q

Post-transplantation steroid-induced hyperglycemia can produce physiologic conditions that negatively affect a graft.

A

Diabetes

111
Q

An increased blood cholesterol is a serious post-transplantation concern because of long-term vascular effects to the patient and engrafted organ. Hypercholesterolemia can result from the return of the patient’s appetite and the lifting of dietary restrictions.

A

Hypercholesterolemia

112
Q

The most common approaches for analysis include PCR amplification of HLA genes with panels of primer pairs, each of which amplifies specific alleles or related allele groups.

A

GENOTYPING

113
Q

only those primer pairs that bind to the target gene result in detection of an _____

A

amplification product

114
Q

The amplified gene is then subjected to hybridization with a ____ each specific for a unique HLA allele or allele group.
Only those probes that specifically hybridize to the amplified DNA will be detected.

A

Panel of DNA probes,

115
Q

The classic procedure for determining the HLA phenotype is the ___

A

complement-dependent cytotoxicity (CDC) test

116
Q

____ are used for HLA class I typing, while purified B lymphocytes are used for HLA class II typing.

A

Purified T lymphocytes

IMMUNOSERO LEC FINALS (3 decks)

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