Transplant Immunology and Pharmacology Flashcards
7 cards from real CCTC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Transplant Immunology and Pharmacology flashcards as text
Which cytokine is primarily responsible for driving the differentiation of naive CD4+ T cells into Th17 cells?
Answer: TGF-β combined with IL-6
TGF-β combined with IL-6 drives naive CD4+ T cells toward the Th17 lineage, which produces IL-17 and contributes to certain rejection pathways.
A transplant recipient on tacrolimus develops new-onset diabetes mellitus. What is the most likely mechanism?
Answer: Direct pancreatic beta-cell toxicity reducing insulin secretion
Tacrolimus causes direct pancreatic beta-cell toxicity that impairs insulin secretion, leading to post-transplant diabetes mellitus (PTDM).
What is the mechanism by which belatacept prevents T-cell activation compared to calcineurin inhibitors?
Answer: It inhibits the CD28-B7 costimulatory pathway
Belatacept is a CTLA4-Ig fusion protein that blocks CD28-B7 costimulation, preventing the second signal required for full T-cell activation.
Which HLA mismatch is most strongly associated with hyperacute rejection?
Answer: Preformed donor-specific antibodies against HLA class I
Preformed donor-specific antibodies (DSAs) against HLA class I antigens bind the graft endothelium immediately upon reperfusion, triggering complement activation and hyperacute rejection.
A kidney transplant patient on mycophenolate mofetil (MMF) is started on ciprofloxacin. Which pharmacokinetic interaction is most concerning?
Answer: Ciprofloxacin reduces enterohepatic recirculation of MPA, lowering drug exposure
Fluoroquinolones alter gut flora that normally hydrolyze MPA-glucuronide conjugates, reducing enterohepatic recirculation and lowering mycophenolic acid (MPA) exposure by up to 30%.
Which complement pathway is primarily activated by antibody-mediated rejection?
Answer: Classical pathway via C1q binding to antigen-antibody complexes
In antibody-mediated rejection, donor-specific antibodies form immune complexes on graft endothelium that bind C1q, activating the classical complement pathway.
What is the primary reason sirolimus (rapamycin) is often avoided in the early post-transplant period for kidney recipients?
Answer: It impairs wound healing and increases risk of lymphocele formation
Sirolimus inhibits mTOR-dependent cell proliferation required for wound healing, increasing rates of wound complications and lymphocele formation in the early post-transplant period.