Transplantation

Question 1

1. What is a graft between different members of the same species termed?

A Autograft

B Isograft

C Xenograft

D Allograft

E None of the above

Answer 1

D Allograft

Question 2

2. Which of the following statements is NOT TRUE? Rejection of a second (set) skin graft from the same allogeneic donor:

A Can be blocked by azathioprine (an antimitotic agent)

B Proceeds at the same speed as the first graft rejection

C Shows specificity for the graft donor

D Can be transferred to a naive recipient with lymphocytes

E Involves recognition of MHC differences

Answer 2

B Proceeds at the same speed as the first graft rejection

Question 3

3. Which of the following statements is TRUE of the human major histocompatibility complex (MHC)?

A MHC provokes the most intense allograft reactions

B MHC is termed H-2

C MHC contains only class I and class II genes

D MHC is not expressed as codominant antigens on the cell surface

E MHC encodes the human leukocyte antigens (HLA) expressed only on leukocytes

Answer 3

A MHC provokes the most intense allograft reactions

Question 4

4. Mitosis occurs when mixing lymphocytes of two individuals:

A In presence of mitomycin C

B In presence of anti-CD4

C Who are identical twins

D Of differing MHC class II haplotype

E Of differing MHC class I, but identical MHC class II, haplotype

Answer 4

D Of differing MHC class II haplotype

Question 5

5. Graft vs host disease occurs on injecting adult T-cells of strain A into:

A F1 (A × B) animals

B Unirradiated strain B

C Irradiated strain A

D Strain A fetuses

E Cultures of lymphocytes from strain B

Answer 5

A F1 (A × B) animals

Question 6

6. Non-specific suppression of graft rejection can be achieved with:

A Ricin A chain

B Anti-IL-5

C Anti-NFκB

D Anti-CD34

E Anti-CD3

Answer 6

E Anti-CD3

Question 7

7. What is the target of the monoclonal antibody basiliximab used to help suppress allograft rejection?

A CD3

B CD40L

C LFA-1

D ICAM-1

E CD25

Answer 7

E CD25

Question 8

8. Why have pigs have been proposed as a source of organs for xenotransplantation to humans?

A They do not pose a risk of zoonoses

B Their cell surface glycoproteins bear galactose α-1,3-galactose structures

C They lack endogenous virus sequences

D Their hearts are an appropriate size and the pigs can be genetically modified to limit the possibility of hyperacute rejection

E Their organs are not susceptible to hyperacute rejection because they become coated with the natural antibodies normally present in humans

Answer 8

D Their hearts are an appropriate size and the pigs can be genetically modified to limit the possibility of hyperacute rejection

Question 9

9. What is the approximate 1-year survival rate for cadaver kidneys grafted into individuals with no DR mismatches?

A >95%.

B 80–90%

C 55–65%

D 40–50%

E <40%

Answer 9

B 80–90%

Question 10

10. Graft vs host disease often accompanies transplantation of:

A Cartilage

B Kidney

C Bone marrow

D Heart

E Pancreas

Answer 10

C Bone marrow

Question 11

11. Which of the following statements is TRUE of HLA-G?

A HLA-G is an MHC class II molecule

B HLA-G is present on extravillous cytotrophoblast

C HLA-G stimulates NK cell-mediated lysis

D HLA-G activates DAF

E HLA-G stimulates IL-10 synthesis

Answer 11

B HLA-G is present on extravillous cytotrophoblast

Question 12

12. The very rapid response to a second allogeneic graft is:

A Specific for antigens of the major histocompatibility complex (MHC)

B Dependent on minor histocompatibility antigens

C Transferred by macrophages to a naive recipient

D Transferred by platelets

E Transferred by IgA

Answer 12

A Specific for antigens of the major histocompatibility complex (MHC)

Question 13

13. Concerning MHC class II antigen differences between two individuals, which of the following is NOT TRUE?

A They produce mixed lymphocyte reactions

B They stimulate formation of helpers to generate cytotoxic T-cells

C They cause graft vs host disease

D For sibling pairs, they will only exist on average in one in four cases

E None of the above

Answer 13

D For sibling pairs, they will only exist on average in one in four cases

Question 14

14. Hyperacute graft rejection is caused by:

A Preformed antibody

B CD4 lymphocytes

C CD8 lymphocytes

D Platelets

E Circulating immune complexes

Answer 14

A Preformed antibody

Question 15

15. Which of the following does NOT minimize allogeneic graft rejection?

A Cyclosporine

B Disodium cromoglycate

C Azathioprine

D Cross-matching for ABO and MHC

E Anti-CD4

Answer 15

B Disodium cromoglycate

Question 16

16. Which of the following allogeneic grafts does NOT require immunosuppression?

A Kidney

B Heart

C Liver

D Bone marrow

E Cornea

Answer 16

E Cornea

Question 17

17. The fetus can be protected from maternal transplantation attack by:

A Luteinizing hormone

B Presence of HLA class I on the fetus

C HLA-G on the extravillous cytotrophoblast

D C3 convertase on the syncitiotrophoblast

E Local production of IL-2

Answer 17

C HLA-G on the extravillous cytotrophoblast

Question 18

18. The single best chance of a tissue graft being accepted in a human recipient is if it is:

A An isograft

B An allograft given under the cover of potent immunosuppression

C A xenograft from a pig in which the gene for α-1,3-galactosyltransferase has been “knocked-out” and therefore the Galα-1,3-Gal epitope eliminated

D Given to a recipient that is treated with anti-CD3

E From a living sibling donor

Answer 18

A An isograft

Question 19

19. Which of the following is the single best defining description of the murine MHC?

A Murine MHC is involved in skin transplant rejection

B Murine MHC is encoded on chromosome 17

C Murine MHC is called H-2

D Murine MHC is polymorphic

E Murine MHC encodes a heterodimeric cell surface molecule

Answer 19

C Murine MHC is called H-2

Question 20

20. Of the following, which is the cadaveric organ with the best survival 5-years post-transplant?

A Lung

B Pancreas

C Liver

D Intestine

E Heart and lung

Answer 20

C Liver