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M3 > Nphro - transplant > Flashcards

Nphro - transplant Flashcards

1
Q

treatment of choice for advanced chronic renal failure

A

transplantation

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2
Q

deceased donor grafts 1 year survival

A

92%

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3
Q

living donor grafts 1 year survival

A

97%

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4
Q

Mortality rate after transplantations are highest

A

within the first year, ages >=50 to 60 years

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5
Q

Non-heart-beating donor donation after cardiac death

category I

A

Brought in dead

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6
Q

Non-heart-beating donor donation after cardiac death

category II

A

Unsuccessful resuscitation

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7
Q

Non-heart-beating donor donation after cardiac death

category III

A

awaiting cardiac arrest

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8
Q

Non-heart-beating donor donation after cardiac death

category IV

A

cardiac arrest after brainstem death

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9
Q

Non-heart-beating donor donation after cardiac death

category V

A

cardiac arrest in a hospital patient

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10
Q

scoring to quantify potential risk of graft failure after kidney transplant based on 10 donor factors

A

KDPI

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11
Q

KDPI <20% kidneys are allocated to what kind of recipients?

A

potential recipients with highest expected post transplant survival

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12
Q

KDPI >85% given to

A

usually older patients who are expected to fare less well on dialysis

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13
Q

current standard of cares is that a candidate for transplant to be put on a deceased organ wait list should have a life expectancy of

A

> 5 years

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14
Q

Immunologic contraindications to transplantation

A

ABO incompatibility
HLA Class I (A, B, C)
HLA class II (DR, DQ, DP)

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15
Q

Donor selection: survival rates favor what donor?

a. 3/6 mismatched family donor
b. 6/6 mismatched family donor
c. random cadaver donor

A

A

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16
Q

True of donor selection EXCEPT

a. it is important to evaluate risk of developing DM
b. renal arteriography should be performed on donors
c. deceased donors with malignant neoplastic disease can still be given provided they are on remission
d. Hep C and HIV positive organs may be used in previously infected recipients under certain circumstances

A

C; should not be given

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17
Q

Increased risk of graft failure when donor is

A

elderly
or has acute renal failure
prolonged ischemia of kidney

18
Q

preferred ischemic time

A

<24 hrs. although could be for up to 48 h on cold pulsatile perfusion or with simple flushing and cooling

19
Q

Depleting agent targeting CD52 protein

A

alemtuzumab

20
Q

Two types of immunosuppressive agents given for induction

A

depleting agents

nondepleting agents

21
Q

examples of depleting agents

A

anti thymocyte globulin

alemtuzumab

22
Q

examples of non depleting agents

A

target IL-2 receptor

23
Q

Examples of antimetabolites

A

Azathioprine

mycophenolate mofetil

24
Q

Cycloporine is a/n

a. TOR inhibitor
b. Steroid
c. antimetabolite
d. Calcinuerin inhibitor

A

D

25
Q

Tacrolimus is what kind of drug?

A

Calcineurin inhibitor

26
Q

Example of TOR inhibitor

A

Sirolimus

27
Q

CD80 CD86 inihibitor

A

Belatacept

28
Q

Presentation of rejection episode

A

rise in serum crea

reduction in urine vol

29
Q

T/F are fever swelling, tenderness over the allograft common manifestations of rejection episodes?

A

no

30
Q

These drugs have an afferent arteriolar constrictor effect on the kidney and may produce permanent vascular and interstitial injury after sustained high dose therapy

A

Calcineruin inhibitors

31
Q

This is useful in ascertaining changes in renal vasculature and in renal blood flow

A

doppler utz

32
Q

Treatment for first rejection episode

A

IV methylprednisolone 50-100 mg daily for 3 days

33
Q

Treatment for first rejection episode is IV methylprednisolone 50-100 mg daily for 3 days. What is given if patient fails to respond?

A

ATG

34
Q

CMV and P. jirovecci pneumonia are common opportunistic infections in immunosuppressed patients. Prophylaxis for these infections should be given for how long?

A

6-12 months

35
Q

Infections most common during the 1st month (peritransplant)

A

wound infections
herpes virus
oral candidiasis
UTI

36
Q

Infections most common during the 1-6 mos. (early)

A 
P. carinii
Legionella
Listeria
CMV
HepB
HpC
37
Q

Infections most common during the >6 mos (late)

A 
Aspergillus
Nocardia
BK virus (polyoma)
Herpes zoster
Hep B
Hep C
38
Q

most common malignant lesions in immunosuppressed

A 
cancer of the
skin
lips
cervix
lymphomas
39
Q

True of complications of kidney trnasplant EXCEPT

a. higher incidence of death from MI and Stroke
b. more than 50% of renal recipient mortality is associated with Cardiovascular disease
c. CCBs are more frequently used initially for hypertension in posttransplant patients
d. Hypercalcemia may develop after transplant and may indicate failure of hyperplastic thyroid glands to regress

A

NOTA, all are true

40
Q

Anemia can develop post transplant attributable to

A

bone marrow suppressan immunosuppressive medications such as

SAM
Sirolimus
Azathioprine
Mycophenolate

M3 (66 decks)

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