Transplant

Question 1

Define bronchiolitis obliterans syndrome

Answer 1

Allograft dysfunction w/ persistent decline in FEV1 not caused by known or potentially reversible causes

Question 2

Possible CT findings of BOS

Answer 2

Air trapping (expiratory mosaicism), bronchiectasis, ground glass

Question 3

To dx BOS, decrement in PFT results must be seen in ___ sets of spirometry at least ___ weeks apart.

Answer 3

2; 3

Question 4

Pathological finding of BOS

Answer 4

Obliterative bronchiolitis (rarely seen on transbronchial biopsy)

Question 5

What is restrictive allograft dysfunction?

Answer 5

Chronic rejection in a restrictive pattern w/ upper-lobe fibrosis

Question 6

Initial therapy for BOS

Answer 6

Azithro 250 mg x 5 days, then 250 mg 3x/week x 3 months

Question 7

1st differential Dx for prolonged air leak or PTX in a recent lung transplant recipient

Answer 7

Dehiscence of anastamosis

Question 8

Gold standard diagnostic technique for anastomotic dehiscence in lung transplant

Answer 8

Bronchoscopy

Question 9

Disease that recurs most commonly after lung transplant

Answer 9

Sarcoidosis

Question 10

Diffuse pulmonary infiltrates & hypoxemia within 72 hrs of transplantation

Answer 10

Primary graft dysfunction