Transplant

Question 1

Day 0 - 30 post SCT
What is happening
Risk for what infection

Answer 1

B cell engraftment

Gram negative sepsis

Question 2

Day 31-100
Immunodeficit
Risk of what infection

Answer 2

Delayed T Cell recovery
Defective NK immunity

Aspergillosis & invasive fungal

Question 3

Invasive aspergillus
HRCT findings
Treatment

Answer 3

Halo sign - seen in neutropenia

Air crescent (seen when not neutropenic, cavitation)

Question 4

Polyenes
Action
Examples

Answer 4

Make holes in cell membranes
Amphoteracin, nystatin

Amphoteracin toxic +

Question 5

Azoles
Action
Examples

Examples are Treatment for..

Answer 5

Interfere w cell membrane synthesis
Fluconazole, voriconazole

Voriconazole first line for invasive aspergillus

Fluconazole - candida

Question 6

Echocandins
Action
Example
Doesn’t penetrate

Answer 6

Inhibits cell wall synthesis
Caspofungin
Csf & urine

Question 7

PTLD
Affect s who
aetiology
Rx

Answer 7

Solid organ transplant
Latent EBV in B cell
T cell suppression leads to uncontrolled EBV lymphoblast proliferation
Rituximab (targets CD20 expressing cells)
Low dose chemotherapy

Question 8

CMV
Rate of infection in pregnancy 
Proportion asymptommatic at birth 
Rate of SNHL in first decade 
Features of symptomatic newborns

Answer 8

1 in 300
90% asymptommatic: 1/10 of these develop SNHL within 7 y
IUGR, microcephaly, thrombocytopenia, anaemia, HSM, retinitis, microcalcifications