Aani Immuno: Transplant & Immune therapies COPY

Question 1

Mnemonic for remembering the anti-proliferative immune therapies?

ie the ones that inhibit dna synthesis

Answer 1

Aaniya Can't Make More
Azathioprine
Cyclophosphamide
Methotrexate
Mycophenolate Sodium/Mofetil

Question 2

What is methotrexate used for?

Answer 2

RA
Psoriasis
Crohn’s

Question 3

Side effect of methotrexate?

Answer 3

Reduces folate –> Megaloblastic anaemia

Question 4

What is Mycophenolate Sodium/Mofetil used for?

Answer 4

Transplantation and vasculitis

Question 5

Side effect of mycophenolate mofetil?

Answer 5

Herpes virus reactivation

Question 6

What is azathioprine used for?

Answer 6

Transplantation, autoimmune/inflamm diseases

Question 7

Contraindications to azathioprine?

Answer 7

Allopurinol use

TPMT Polymorphism

Question 8

Cyclophosphamide indication?

Answer 8

Anti cancer agent
Vasculitis
Connective Tissue disease

Question 9

S/E of cyclophosphamide

Answer 9

Infertility & hair loss

Question 10

Mnemonic for T-Cell Signalling Inhibitors

Answer 10

ST CAT
Sirolimus
Tacrolimus
Cyclosporin
Apremilast
Tofacitinib

Question 11

Sirolimus indications? And mechanism?

Answer 11

Rejection prophylaxis

Blocks T Cell proliferation

Question 12

Tacrolimus indications? And mechanism?

Answer 12

Rejection prophylaxis

Inhibits calcineurin which reduces IL2 so it reduces T cell function

Question 13

Cyclosporin indications? And mechanism?

Answer 13

Rejection prophylaxis

Inhibits calcineurin which reduces IL2 so it reduces T cell function

Question 14

Which is the least nephrotixic of the T cell signalling inhibitor drugs?

Answer 14

Sirolimus

Question 15

S/E of Tacrolimus?

Answer 15

Nephrotoxicity

Question 16

S/E of Cyclosporin?

Answer 16

Nephrotoxicity

Gym Hypertrophy

Question 17

Apremilast indication and mechanism?

Answer 17

Psoriasis & psoriatic arthritis

Inhibits PDE4

Question 18

Tofacitinib mechanism? Indication?

Answer 18

JAK inhibitor

Rheumatoid arthritis

Question 19

Cell surface antigen drugs used in transplant rejection prophylaxis?

Answer 19

Basiliximab
Daclizumab
MuromonabCD3
Anti-Thymocyte Globulin (ATG)

Question 20

What does Basiliximab do?

Answer 20

Inhibits CD25 via IL2 receptor

Question 21

Indications and S/Es of Basiliximab?

Answer 21

Used in rejection prophylaxis

Can cause injection or infusion reaction

Question 22

Daclizumab mechanism? Indication ?

Answer 22

Anti- CD25 via IL2 receptor

Good for organ transplantation

Question 23

Anit Thymocyte Globulin (ATG) indications? Mechanism?

Answer 23

Allograft rejection

Inhibits migration of T Cells

Question 24

What does Natalizumab do? Indications?

Answer 24

Anti-alpha-4 integrin via VCAM1 and MadCAM1 so inhibits T Cell migration. Used in Relapsing MS and Crohns

Question 25

S/E of Natalizumab?

Answer 25

Hepatotoxic | Hyperlipidaemia

Question 26

What does Abatacept do?

Answer 26

Anti- CTRL4 Ig so inhibits T Cell migration

Question 27

What is abatacept used for?

Answer 27

Rheumatoid arthirits

Question 28

Abatacept S/E?

Answer 28

Cough

Question 29

Tocilizumab indications?

Answer 29

Castleman syndrome & RA

Question 30

Tocilizumab mechanism?

Answer 30

Anti IL6 causing low T cells, low B cells, low macrophages and low neutrophils

Question 31

Alemtuzumab indications?

Answer 31

Graft rejection CLL MS

Question 32

Rituximab indications?

Answer 32

Lymphoma RA SLE

Question 33

Alemtuzumab mechanism?

Answer 33

Anti CD52

Question 34

S/E of alemtuzumab?

Answer 34

CMV infection

Question 35

Treatment of CLL?

Answer 35

Chlorambucil Fudarabine Alemtuzumab

Question 36

Rituximab mechanism?

Answer 36

Anti CD20. Depletes mature B Cells

Question 37

MuromonabCD3 mechanism? Indication?

Answer 37

Anti CD3 on t cells. Allograph rejection (mouse Ab)

Question 38

Efalizumab mechanism?

Answer 38

Anti CD2a | Reduces T Cell migration

Question 39

Mnemonic for TNF alpha inhibitors?

Answer 39

``` I'm A Cool Girl. Alpha mums, like Ada and Goli, certainly inflict pain Infliximab Adalimumab Certolizumab Golimumab ```

Question 40

Infliximab mechanism?

Answer 40

TNF alpha inhibitor

Question 41

Indications for TNF alpha inhibitors?

Answer 41

``` RA Psoriasis Psoriatic arthritis IBS Ankylosing Spondylitis ```

Question 42

Ustekinumab mechanism? Indications?

Answer 42

IL12 & IL23 inhibitor | Used in psoriasis & psoriatic arthritis

Question 43

Secukinumab mechanism? Indications?

Answer 43

IL17A inhibitor | Used in psoriasis & psoriatic arthritis

Question 44

Etanercept mechanism? Indications?

Answer 44

TNF alpha Br p75IgG | Used in psoriasis & psoriatic arthritis

Question 45

Denosumab mechanism? Indications?

Answer 45

Anti-Rank Osteoporosis MM Bony Mets

Question 46

S/E of denosumab

Answer 46

Avascular necrosis of the jaw

Question 47

Which drug should be prescribed in osteoporosis?

Answer 47

Denosumab

Question 48

TNFa inhibitor used in ankylosing spondylitis. It may cause lupus-like syndromes and demyelination as a side effect.

Answer 48

Etarnacept

Question 49

A 63 year old man received a renal transplant 5 years ago. He has now started to develop herpes infections and on recent investigations bone marrow suppression is seen. Which drug is responsible?

Answer 49

Mycophenolate Mofetil

Question 50

Which treatment is the most appropriate for x-linked agammaglobulinaemia?

Answer 50

Antibody replacement therapy

Question 51

A 2 month old child presents with recurrent infections, failure to thrive, persistent diarrhoea and reticular dysgenesis (low neutrophil, lymphocytes, macrophage, platelets). What is the treatment of choice?

Answer 51

Bone Marrow Transplant

Question 52

Anti-TNF alpha antibody used to treat inflammatory bowel disease?

Answer 52

Infliximab/Adalimumab/Certolizumab/Golimumab