Immunosuppression Medications Quiz

Question 1

Nephrotoxicity, which may include structural kidney damage, is the most common adverse effect of:

A) Combination low dose, monophasic oral contraceptives
B) Calcineurin inhibitors
C) Topical corticosteroids
D) Low molecular weight heparins

Answer 1

B - calcineurin inhibitors

Question 2

T or F: Dexamethasone is the preferred glucocorticoid for replacement therapy in patients with adrenal insufficiency.

Answer 2

False

Question 3

Which statement does not describe a side effect of systemic corticosteroids?

A) Impaired wound healing
B) Fluid retention
C) Improvement in hearing
D) Hyperglycemia
E) Gastritis
F) Hypokalemia
G) Myopathy
H) Osteoporosis

Answer 3

C - improvement in hearing

Question 4

Match the correct response:

Hydrocortisone
Dexamethasone

Short acting systemic corticosteroid
Long acting systemic corticosteroid

Answer 4

Hydrocortisone - short
Dexamethasone - long

Question 5

A 26-year-old woman underwent kidney transplantation. A week later, she developed alloantibody-mediated acute rejection (acute humoral rejection). She was successfully treated with tacrolimus and a second drug that targets both B and T lymphocytes. Which of the following is an immunosuppressant that suppresses both B and T lymphocytes via inhibition of de novo synthesis of purines?

A) Cyclophosphamide
B) Mycophenolate mofetil
C) Prednisone
D) Gemtuzimab

Answer 5

B - mycophenolic acid, formed from myocphenolate mofetil, inhibits inosine monophosphate dehydrogenase, the rate limiting enzyme in the de novo pathway of purine synthesis. This action suppresses both B and T lymphocyte activation

Question 6

Which of the following most accurately describes the immunosuppressant action of cyclosporine?

A) Inhibition of the gene transcription of interleukins
B) Blockage of tissue responses to inflammatory mediators
C) Activation of NK cells
D) Increased catabolism of IgG antibodies

Answer 6

A

Question 7

Of the following which is most likely to be used for induction therapy?

A) Bortezomib
B) Belatacept
C) Basiliximab
D) Monomurab

Answer 7

C

Question 8

Which of the following is not a common adverse effect of calcineurin inhibitors?

A) Nephrotoxicity
B) Leukocytosis
C) Hypertension
D) Neurotoxicity

Answer 8

Leukocytosis

Question 9

Your patient today is a liver transplant recipient from 2017. He had an uneventful post-operative course and has had consistent therapeutic levels between 8-10 ug/mL of tacrolimus on his current dose of 5mg BID for the past month. His LFTs are within normal limits. JM is admitted to the hospital with a possible fungal infection and will need to be started on voriconazole today. What would you recommend in regards to his tacrolimus dosing?

A) Make no changes to his tacrolimus dose and check a trough in 2-3 days
B) Increase his tacrolimus dose and check a trough in 2-3 days
C) Make no changes to his tacrolimus dose and check a peak 2 hours after his next dose
D) Decrease his tacrolimus dose and check a trough in 2-3 days

Answer 9

D