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

Calcineurin inhibitors such as tacrolimus and cyclosporine block calcineurin, preventing IL-2 transcription and T-cell activation.

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

Reversible causes including dehydration, drug toxicity, and obstruction should be excluded before proceeding to biopsy.

Question 3

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

Accepted Answer

Banff II AMR

Answer

Banff II AMR (antibody-mediated rejection) is characterized by microvascular inflammation and C4d deposition with donor-specific antibodies.

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

ERCP with balloon dilation and stenting is the standard first-line treatment for post-transplant biliary anastomotic strictures.

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

MMF selectively inhibits IMPDH, blocking de novo purine synthesis required for lymphocyte proliferation.

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC Transplantation Management 2