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Chapter 3. Transplant and Immunology

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

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

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

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

D. 21-year-old F with brittle diabetes

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.

Which virus is associated with PTLD?

A. EBV

B. HSV

C. RSV

D. HIV

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

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

A. Hyperlipidemia

B. Thrombocytopenia

C. Rash

D. Nephrotoxicity

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

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

A. In 3 months if moderate hypercalcemia persists

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

C. In 6 months if PTH levels are twice normal

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

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.

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

A. Autoimmune hepatitis and inborn errors of metabolism

B. Malignant neoplasms and biliary atresia

C. Cholestatic cirrhosis and viral hepatitis

D. Noncholestatic cirrhosis and biliary atresia

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

Although the diseases listed above are ...

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