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Assessment & Diagnosis Final > Transplant > Flashcards

Transplant Flashcards

1
Q

How is T cell mediated rejection diagnosed?

A

With biopsy

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2
Q

When does hyperacute rejection occur?

A

Within 24 hours after transplant

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3
Q

When does acute rejection occur?

A

Within first 6 months after transplant

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4
Q

When does chronic rejection occur?

A

Months to years after transplant

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5
Q

Glucocorticosteroids is used to treat what kind of rejection?

A

For acute rejection, and also for induction and maintenance of immunosuppression

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6
Q

What is the main class of immunosuppressive med?

A

Calcineurin inhibitor

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7
Q

What is a major side effect of antimetabolites?

A

Bone marrow suppression

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8
Q

Nosocomial infections occur in what time frame?

A

Within first month

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9
Q

Activation of latent infections occurs during what time frame?

A

1-6 months

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10
Q

What are two common viral infections after transplant?

A

Cytomegalovirus and Epstein-Barr virus

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11
Q

What is the most common fungal infection in transplant pts?

A

Aspergillus

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12
Q

What should you maintain hemodynamics at after transplant?

A

Normal

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13
Q

Chronic lung rejection has lasted for how long?

A

Greater than 3 weeks

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14
Q

Donors and recipients are matched based on what?

A

HLA

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15
Q

How is T-cell mediated rejection acute cellular diagnosed?

A

Biopsy

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16
Q

How is T-cell mediated rejection acute cellular treated?

A

Pulse dose steroids, change the immunosuppressant regimen

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17
Q

How is antibody mediated rejection diagnosed?

A

Biopsy

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18
Q

How quickly does hyperacute rejection occur?

A

Within first 24 hours after transplant

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19
Q

In what pts does hyperacute rejection occur?

A

Those with previous antibodies

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20
Q

Previous acute rejection makes what more likely?

A

Chronic rejection

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21
Q

Are glucocorticosteroids used for induction or maintenance of immune suppression?

A

Both

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22
Q

Cyclosporine and tacrolimus are what class of med?

A

Calcineurin inhibitors

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23
Q

What must you do when giving cyclosporine and tacrolimus?

A

Monitor levels

24
Q

What is the most significant side effect of cyclosporine and tacrolimus?

A

Nephrotoxicity

25
Q

What is the major side effect of antimetabolites?

A

Bone marrow suppression

26
Q

Are calcineurin inhibitors used for induction or maintenance of immunosuppression?

A

Maintenance only

27
Q

When are nosocomial infections most common?

A

First month after transplant

28
Q

What latent infection is common 1-6 months after transplant?

A

Cytomegalovirus

29
Q

Community acquired infections occur how long after transplant?

A

More than 6 months after

30
Q

What does cytomegalovirus do to platelets?

A

Causes thrombocytopenia

31
Q

How is cytomegalovirus diagnosed?

A

Biopsy, PCR or culture

32
Q

Bactrim is used for prophylaxis against what?

A

PCP PNA

33
Q

What two classes of meds interacts often with immunosuppressants?

A

The -azoles (antifungals) and calcineurin inhibitors

34
Q

Pts with a new transplant should get one drug from each of which 4 categories?

A

Antibacterial, antiviral, antifungal, PPI/H2 blocker

35
Q

How does primary graft failure in heart transplant present?

A

Ventricular dysfunction, hypotension and cardiogenic shock

36
Q

How is primary graft failure in heart transplant treated?

A

With inotropes and mechanical support (ie ECMO)

37
Q

Equilization of pressures after heart transplant indicates what?

A

Cardiac tamponade

38
Q

Elevated CVP after transplant indicates what?

A

R ventricular failure

39
Q

Bradycardia or asystole after heart transplant could indicate what?

A

De-innervation of the vagus nerve

40
Q

How to treat de-innervation of the vagus nerve?

A

Pacemaker

41
Q

Is atropine effective for de-innervation of the vagus nerve?

A

No

42
Q

How do you confirm heart transplant rejection?

A

Biopsy

43
Q

Suspected chronic lung allograft dysfunction must have lasted for how long?

A

3 or more weeks

44
Q

Suspected chronic lung allograft dysfunction must have FEV1 and/or FVC less than what percent of what it was at baseline?

A

90%

45
Q

Chronic lung allograft dysfunction must have FEV1 and/or FVC less than what percent of what it was at baseline?

A

80%

46
Q

FVC is equal to or less than 80% of baseline in which type of chronic lung allograft dysfunction?

A

Restrictive CLAD

47
Q

FEV1 is equal to or less than 80% of baseline in which type of chronic lung allograft dysfunction?

A

Obstructive CLAD

48
Q

Primary graft dysfunction occurs how quickly after lung transplant?

A

Within first 72 hours

49
Q

How is a vascular thrombus diagnosed after liver transplant?

A

Vascular US

50
Q

What two vessels can thrombose after liver transplant?

A

Hepatic artery and portal vein

51
Q

How is portal vein thrombus treated after liver transplant?

A

Thrombectomy and heparin infusion

52
Q

Allograft kidney rejection causes a Cr rise of what percent from baseline?

A

15%

53
Q

Transplant hydronephrosis could be caused by what?

A

Lymphocele

54
Q

Ipsilateral lower extremity edema after kidney transplant could be a sign of what?

A

Lymphocele

55
Q

How is lymphocele diagnosed?

A

US

56
Q

How is infarct after kidney tx diagnosed?

A

US or angiography

57
Q

How is infarct after kidney tx treated?

A

Thrombolysis or return to OR

Assessment & Diagnosis Final (6 decks)

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