Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

850 Exam #4 > Organ Transplant > Flashcards

Organ Transplant Flashcards

1
Q

Indications for a Kidney transplant

A
  • Diabetes
  • Hypertension
  • Lupus
  • PCKD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Indications for a liver transplant

A
  • Alcoholic cirrhosis
  • NASH
  • HBV
  • HCC
  • APAP toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Indications for Pancreas transplant

A
  • Diabetes

- Congenital abnormalitites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Indications for Heart transplant

A
  • Ischemic heart disease
  • Congenital abnormalities
  • Idiopathic cardiomyopathy
  • Valvular diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Indications for Lung transplant

A
  • CF
  • Pulmonary HTN
  • Pulmonary fibrosis
  • COPD
  • Emphysema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Goals of Immunosuppression

A
  • Prevent rejection
  • Avoid complications
  • Patient and graft survival
  • Patient adherence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Phases of Immunosuppression

A
  • Desensitization
  • Induction
  • Maintenance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Least to most immunogenic organs

A
  • Liver
  • Kidneys
  • Pancreas
  • Heart
  • Lungs
  • Colon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Induction Therapy Goal

A
  • Prevent early acute graft rejection

- Decrease T cells and/or B cells for months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Drugs that can be used for induction therapy

A
  • Basiliximab
  • Antithymocyte globulin
  • Alemtuzumab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Basliximab (Simulect) Mechanism of Action

A
  • Blocks T cell proliferation
  • Via interleukin 2 (IL-2)
  • Anti CD25 antibodies
  • Used in lowest immunologic risk patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antithymocyte Globulin (Thymoglobulin) Mechanism of Action

A
  • Binds to T cell surface antigens
  • leading to depletion of T cells
  • Used in moderate to high immunologic risk
  • Increased risk of CMV, BKV, and PJP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Alemtuzumab (Campath) Mechanism of action

A
  • Binds to CD52 on T cells, B cells, NK cells, and monocytes/macrophages
  • “AIDs” in a bottle
  • 1+ year for CD4/8 counts to recover
  • Associated with many opportunistic infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Maintenance Therapy Goal

A
  • Prevent graft rejection

- Life long immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Drugs that can be used for Maintenance Therapy

A
  • Corticosteroids
  • Calcineurin inhibitors
  • Antimetabolites
  • mTOR inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Corticosteroids mechanism of action

A
  • Inhibit cytokine gene expression
  • Modify lymphocyte distribution and function
  • Anti inflammatory
    ex. prednisone 5-10mg/day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Corticosteroid long term side effects

A
  • Osteoporosis
  • Adrenal insufficiency
  • pancreatitis
  • Amenorrhea
  • Diabetes mellitius
18
Q

Corticosteroid short term side effects

A

-Mood change
-Hyperglycemia
-Hypertension
-Insomnia
-Acne
increased appetite

19
Q

Tacrolimus (FK506) and Cyclosporine (Calcineurin inhibitors) Mechanism of action

A
  • Inhibit T cell activity through inhibition of IL-2 production
  • Has crummy bioavailability and variable half life
20
Q

Therapeutic range of Tacrolimus (FK506)

A

-5 to 15ng/mL

21
Q

Tacrolimus interactions

A
  • Ketoconazole, diltiazem,
  • Phenytoin, rifampn
  • P glycoprotein substrate
  • Antacids
22
Q

Cyclosporine Therapeutic Range

A

-50 to 200ng/mL

23
Q

Cyclosporine drug interactions

A
  • Ketoconazole, diltiazem
  • Phenytoin, rifampin
  • P glycoprotein
  • Food (keep it consistent)
24
Q

Tacrolimus monitoring

A

-Trough levels

25
Q

Cyclosporine monitoring

A
  • Trough levels

- C2 levels

26
Q

Calcineurin Inhibitors adverse effects

A
  • More severe with Tacrolimus than cyclosporine
  • Nephrotoxicity
  • Hyperglycemia
  • HTN
  • Electrolyte abnormalities
27
Q

Mycophenolate

A
  • Antiproliferative
  • Prodrug of mycophenolic acid (MPA)
  • Prevents T and B lymphocytes proliferation
28
Q

Mycophenolate in pregnancy

A
  • NO
  • Must have negative pregnancy test prior to starting
  • Use two methods of contraception
29
Q

Azathioprine

A
  • Antiproliferative
  • Prodrug of 6MP
  • Prevents T and B cell proliferation
  • Only used in patients who are intolerant to mycophenolate
30
Q

Azathioprine Drug interactions

A
  • 6MP

- Allopurinol

31
Q

Sirolimus

A
  • mTOR inhibitor

- Suppresses cytokine mediated T cell proliferation

32
Q

Everolimus

A
  • mTOR inhibitor
  • Suppresses cytokine mediated T cell proliferation
  • Used in renal transplant rejection prophylaxis
33
Q

Belatacept

A
  • Binds to CD80 and 86 on APCs blocking stimulation of T cells
  • Used for maintenance immunosuppression in renal transplant recipients
34
Q

Adverse effects of Belatacept

A 
-Post transplant lymphoproliferative disorder 
^Black box warning 
-GI 
-HTN
-Edema
35
Q

Immunosuppression considerations

A
  • Rejection
  • Toxicity
  • Adverse effects
  • Infection
  • Cost
  • Interactions
  • Cancer
36
Q

Cardiovascular Complications

A
  • Leading cause of mortality in renal transplant recipients
  • HTN
  • Hyperlipidemia
  • Diabetes
37
Q

Infectious Complications

A
  • Highest risk immediately following transplant and rejection treatment
  • Atypical organisms
  • Opportunistic infections
  • Prophylaxis
38
Q

Malignancy Complications

A
  • Related to degree of immunosuppression
  • Increased risk of lymphomas and lymphoproliferative disorders
  • Renal, skin, and Kaposi’s sarcoma
39
Q

Sensitization and Risk Factors for Rejection

A

a) Sensitization
- Previous pregnancy
- Blood transfusion
- Previous transplant
- HLA mismatch
b) Risk factors
- Delayed graft function
- Rejection episodes
- African american

40
Q

Barriers to adherence

A
  • System
  • Motivation
  • Understanding
  • Recall
  • Financial

850 Exam #4 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions