CCTC Transplantation Management 2

Question 1

Which immunosuppressive drug class works primarily by inhibiting calcineurin to block IL-2 production?

Accepted Answer

Calcineurin inhibitors

Answer

mTOR inhibitors

Answer

Antimetabolites

Answer

Corticosteroids

Question 2

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?

Accepted Answer

Rule out reversible causes such as dehydration and drug toxicity before biopsy

Answer

Immediately increase tacrolimus dose

Answer

Obtain a kidney biopsy without further workup

Answer

Start empiric antirejection therapy

Question 3

Which Banff classification grade represents active antibody-mediated rejection in a kidney allograft?

Accepted Answer

Banff II AMR

Answer

Banff 1a

Answer

Banff 2b

Answer

Banff 3

Question 4

A liver transplant recipient develops biliary anastomotic stricture 6 months post-transplant. Which intervention is typically first-line?

Accepted Answer

Endoscopic retrograde cholangiopancreatography (ERCP) with dilation and stenting

Answer

Surgical revision of the anastomosis

Answer

Retransplantation

Answer

Increased immunosuppression

Question 5

What is the mechanism of action of mycophenolate mofetil (MMF) in transplant immunosuppression?

Accepted Answer

Inhibits inosine monophosphate dehydrogenase, reducing lymphocyte proliferation

Answer

Inhibits mTOR signaling pathway

Answer

Blocks T-cell calcineurin activation

Answer

Depletes B-cell populations via CD20 targeting

Question 6

Which post-transplant complication is most closely associated with BK virus infection?

Accepted Answer

BK nephropathy in kidney transplant recipients

Answer

Post-transplant lymphoproliferative disorder

Answer

CMV colitis

Answer

Aspergillus pneumonia

Question 7

A transplant coordinator is counseling a patient about tacrolimus. Which instruction is most important regarding grapefruit consumption?

Accepted Answer

Grapefruit should be avoided as it inhibits CYP3A4 and can significantly increase tacrolimus levels

Answer

Grapefruit juice enhances renal clearance of tacrolimus

Answer

Grapefruit has no interaction with tacrolimus

Answer

Grapefruit juice can be consumed in moderation with dose adjustment