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H&D > Quiz 2 additional > Flashcards

Quiz 2 additional Flashcards

1
Q

How are T cells activated in direct allograft recognition?

A
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2
Q

How are T cells activated in indirect allograft recognition?

A
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3
Q

What type of allograft recognition is more common during acute rejection? What response is triggered?

A

Direct allograft recognition

Allospecific CTLs directly kill donor cells

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4
Q

What type of allograft recognition is more common in the form of chronic rejection? What response is triggered?

A

Indirect allograft recognition

Inflammation induced by Th1 cells promotes slow tissue destruction and organ dysfunction

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5
Q

What are the three types of allograft rejections?

A

Hyperacute
Acute
Chronic

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6
Q

What characterizes a hyperacute allograft reaction?

A

Occurs in minutes to hours

Requires previous exposure; is mediated by pre-existing antibody to alloantigen (i.e. ABO, Rh)

Rare due to pre-screening

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7
Q

What type of allograft rejection are blood transfusion reactions classified as?

A

Hyperacute rejection

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8
Q

What characterizes an acute allograft rejection?

A

Occurs in days to weeks

Mediated by T cells, chiefly CTL mediated damage & massive inflammation (Th1 and alloantibodies can participate)

Necrotizing vasculitis, interstitial lymphocyte infiltrate, endothelitis

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9
Q

What characterizes a chronic allograft rejection?

A

Occurs in months to years

Largely Th1 and macrophage mediated (some alloantibody)

Thickening of vascular wall, interstitial fibrosis, vesicle occlusion

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10
Q

Frequency and magnitude of what event predicts likelihood and time of onset of chronic rejection?

A

Acute rejection

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11
Q

Which two drugs are classified as Calcineurin inhibitors?

A

Cyclosporine

Tacrolimus (FK-506)

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12
Q

Which two dugs are inhibitors of IL-2R signaling?

A

Rapamycin (sirolimus)

Basiliximab (anti-IL2R)

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13
Q

Which drug is responsible for inhibition of costimulation (B7:CD28)?

A

Belatacept (CTLA4-Ig)

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14
Q

Which two drugs are classified as proliferation inhibitors?

A

Azathioprine

Mycophenolate mofetil

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15
Q

Which two drugs are responsible for T cell depletion?

A

Thymoglobulin (anti-CD3)
Alemtuzumab (anti-CD52)

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16
Q

Which two drugs are responsible for T cell depletion?

A

Thymoglobulin (anti-CD3)
Alemtuzumab (anti-CD52)

17
Q

What is the general mechanism of calcineurin inhibitors?

A

CNIs block NFAT activation, which is critical as a TF in T cell activation

18
Q

Which of the HLA alleles are tested for matches before transplants?

A

HLA-A
HLA-B
HLA-DR

19
Q

What characterizes graft versus host disease (GVHD)?

A

Donor T cells can react to host (acute and chronic activation) *Can exhibit graft vs tumor effect

Most often occurs in hematopoietic SC/BM transplants

20
Q

What are the 3 hallmarks of GVHD?

A

Skin: Macropapular rash

Liver: Hepatomegaly & jaundice

Gi tract: Diarrhea

H&D (10 decks)

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