Transplants, Immunology, Oncology

Question 0

What is the purpose of a crossmatch?

Answer 0

To determine whether the recipient has circulated antibodies against donor HLA antigens.

These antibodies do not occur naturally, result of prior sensitization during pregnancy, blood transfusion, or previous transplantation

Question 1

What is the primary cytokine responsible for gram-negative shock and sepsis related organ damage? What is the origin of this peptide?

Answer 1

Tumor necrosis factor

Monocytes/macrophages

Question 2

How is a crossmatch performed?

Answer 2

Donor lymphocytes are added to recipient Sarah him and complement

If specific anti-donor antibodies are present, antibody binding results in complement fixation and cell lysis. This is the detected by addition of a dye, resulting in a positive crossmatch.

Question 3

What is a positive cross match?

Answer 3

The recipient has circulating antibodies that are cytotoxic to donor strain lymphocytes. This incompatibility almost always leads to an acute humoral rejection of the graft

Question 4

One does acute rejection occur? What is the treatment?

Answer 4

One week to three months posttransplantation. High-dose steroids and an anti-T cell antibody, OKT3

Question 5

What is the most common posttransplantation viral infection?

Answer 5

CMV virus. May cause pneumonitis, ulceration and hemorrhage in the stomach, duodenum, or colon. Hepatitis, esophagitis, retinitis, encephalitis, pancreatitis

Question 6

What makes up the MELD score?

Answer 6

Total bilirubin
International normalized ratio
Creatinine

Question 7

What is the treatment of choice for severe acute rejection that does not respond to steroid treatment?

Answer 7

Muromonab-CD3– A monoclonal antibody against the CD3 antigen complex on mature T cells

Question 8

Next step in management of an isolated a large cervical lymph node?

Answer 8

Fine needle aspiration cytology to obtain histologic confirmation of suspected cancer.

Isolated cervical lymph nodes in adults are malignant 80% of the time.

Question 9

What is the difference between grading and staging of cancer?

Answer 9

Histologic grading reflects the degree of anaplasia of tumor cells. Staging is based on the extent of spread rather than histologic appearance.

Question 10

Which type of tumors is histologic grading a prognostic value?

Answer 10

Soft tissue sarcoma, transitional cell cancers of the bladder, astrocytoma, chondrosarcoma