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Chapter 3. Transplant and Immunology

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Pancreatic transplantation is considered a lifesaving procedure in which of the following patients?

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A. 32-year-old F on dialysis secondary to diabetic nephropathy

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B. 46-year-old M with high insulin requirements to maintain normoglycemia

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C. 37-year-old F with episodes of severe hypoglycemic unawareness

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D. 21-year-old F with brittle diabetes

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37-year-old F with episodes of severe hypoglycemic unawareness. Over time, patients with multiple episodes of hypoglycemia may not experience typical symptoms. Therefore, hypoglycemia can become severe resulting in neurologic injury.

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Which virus is associated with PTLD?

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A. EBV

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B. HSV

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C. RSV

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D. HIV

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EBV. Immunosuppression allows B cells that are infected with EBV to proliferate.

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Which of the following is a complication of calcineurin inhibitors that is LESS pronounced in sirolimus?

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A. Hyperlipidemia

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B. Thrombocytopenia

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C. Rash

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D. Nephrotoxicity

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Nephrotoxicity. Sirolimus can be used for immunosuppression in patients with renal transplants if there is evidence of caclineurin inhibitor induced nephropathy on biopsies.

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If a patient has tertiary hyperparathyroidism, when should he/she undergo total parathyroidectomy with autotransplantation?

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A. In 3 months if moderate hypercalcemia persists

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B. In 12 months if hypercalcemia and elevated PTH levels persist

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C. In 6 months if PTH levels are twice normal

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D. Immediately after transplant if PTH levels are greater than normal

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In 12 months if hypercalcemia and elevated PTH levels persist. A diagnosis of tertiary hyperparathyroidism warrants surgical correction so that consequences (osteomalacia and renal osteodystrophy) of the disease do not ensue.

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Which of the following are the most common indications for liver transplantation in adults and children, respectively?

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A. Autoimmune hepatitis and inborn errors of metabolism

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B. Malignant neoplasms and biliary atresia

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C. Cholestatic cirrhosis and viral hepatitis

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D. Noncholestatic cirrhosis and biliary atresia

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Noncholestatic cirrhosis (65%) in adults—includes viral hepatitis (B and C), alcoholic and cryptogenic cirrhosis; biliary atresia (58%) in children.

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Although the diseases listed above are ...

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