Absite Topic Review General Surgery

Nir Hus, MD, PhD. Mount Sinai Medical Center Miami Beach

Transplantation

Q1 – Two weeks s/p renal transplant, a pt. developes res. Insufficiency requiring adm. To ICU. CXR shows diffuse infiltrates & BAL show cells w/ inclusion bodies. The most appropriate therapy is:

A.  Gangcyclvir B.  Acyclovir C.  Bactrim D.  PCN

Q2 – Hyperacute rejection following organ trans. Is most often due:

A.  ABO incompatibility B.  Rh incompatibility C.  Previously sensitized T cells D.  Macrophages

Q3 – Hyperacute rejection is an example of hypersensitivity reaction type:

A.  Type I B.  Type II C.  Type III D.  Type IV

Q4 – Successful Tx of hyperacute rejection usually involves

A.  Steroids B.  Removal of the organ & re-trans. C.  OKT3 D.  Rapamycin

Q5 – The machanism of cyclosporin is:

A.  Binds FK binding protein B.  Binds cyclophilin protein C.  Inhibits purine synthesis by way of 6-

mercaptopurine intermidiate. D.  Binds antigen on T cells

Q6 - The mechanism of azathioprine is:

A.  Binds FK binding protein B.  Binds cyclophilin protein C.  Inhibits purine synthesis by way of 6-

mercaptopurine intermidiate. D.  Binds antigen on T cells

Q7 – The most common malignancy following transplantation is:

A.  Lung CA B.  Prostate CA C.  Breast CA D.  Skin CA

Q8 – A positive cross-match means:

A.  There are no immunologic problems so one may proceed w/ the trans.

B.  Will likely result in only mild rejection sometimes after the 1st week.

C.  The recipient has preformed AB to donor Ag. D.  Both the donor and recipient are CMV positive.

Q9 – A cross-match is performed by:

A.  Mixing donor lymphocytes w/ recipient serum

B.  Mixing recipient lymphocytes w/ donor serum

C.  Mixing donor plasma w/ recipient serum D.  Mixing recipient plasma w/ donor serum.

Q10 – Post-transplant lymphoproliferative disorder has been most commonly linked to:

A.  HSV B.  RSV C.  EBV D.  Influenza viruses

Q11 - A 35 yo man POD#6 from a cadaveric renal trans. Developes a rise in Cr. The most appropriate next step is:

A.  Emergent reop B.  Angiography C.  OKT3 D.  US

Q12 – in the previous pt. the US shows flow acceleration of the renal artery. The next appropriate step is:

A.  Emergent reop B.  Angiography C.  OKT3 D.  US

Q13 – in the previous pt. the US is normal. The next appropriate step is:

A.  Emergent reop B.  Angiography C.  OKT3 D.  Biopsy

Q14 - in the previous pt. the Bx. shows acute tubulitis. This is consistent w/:

A.  Acute rejection B.  UTI C.  Chronic rejection D.  Renal vein thrombosis.

Q15 – New proteinnuria in a pt. following renal trans. Is most consistent w/:

A.  Acute rejection B.  UTI C.  Chronic rejection D.  Renal vein thrombosis.

Q16 – Most common cause of acute death in a living related renal trans. Is:

A.  PE B.  Hemorrhage C.  MI D.  Infection

Q17 – Most common cause of acute death following renal trans. In a recipient is:

A.  PE B.  Hemorrhage C.  MI D.  Infection