Transplantation Management 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 Transplantation Management flashcards as text
Which immunosuppressive drug class works primarily by inhibiting calcineurin to block IL-2 production?
Answer: Calcineurin inhibitors
Calcineurin inhibitors such as tacrolimus and cyclosporine block calcineurin, preventing IL-2 transcription and T-cell activation.
A kidney transplant recipient presents with a serum creatinine rise of 25% above baseline at 3 months post-transplant. What is the most appropriate initial step?
Answer: Rule out reversible causes such as dehydration and drug toxicity before biopsy
Reversible causes including dehydration, drug toxicity, and obstruction should be excluded before proceeding to biopsy.
Which Banff classification grade represents active antibody-mediated rejection in a kidney allograft?
Answer: Banff II AMR
Banff II AMR (antibody-mediated rejection) is characterized by microvascular inflammation and C4d deposition with donor-specific antibodies.
A liver transplant recipient develops biliary anastomotic stricture 6 months post-transplant. Which intervention is typically first-line?
Answer: Endoscopic retrograde cholangiopancreatography (ERCP) with dilation and stenting
ERCP with balloon dilation and stenting is the standard first-line treatment for post-transplant biliary anastomotic strictures.
What is the mechanism of action of mycophenolate mofetil (MMF) in transplant immunosuppression?
Answer: Inhibits inosine monophosphate dehydrogenase, reducing lymphocyte proliferation
MMF selectively inhibits IMPDH, blocking de novo purine synthesis required for lymphocyte proliferation.
Which post-transplant complication is most closely associated with BK virus infection?
Answer: BK nephropathy in kidney transplant recipients
BK virus preferentially infects urothelial and tubular cells and is a leading cause of interstitial nephritis and allograft dysfunction in kidney recipients.
A transplant coordinator is counseling a patient about tacrolimus. Which instruction is most important regarding grapefruit consumption?
Answer: Grapefruit should be avoided as it inhibits CYP3A4 and can significantly increase tacrolimus levels
Grapefruit inhibits intestinal CYP3A4 metabolism, leading to unpredictably elevated tacrolimus blood levels and toxicity risk.