Deck 54: Laboratory Evaluation of the Transplant Recipient

Question 1

Laboratory assessments are conducted to monitor bacterial, viral, and fungal complications posttransplant for recipients of what type of organ?

A)heart
B)liver
C)kidney
D)all of the above

Answer 1

all of the above

Question 2

Which of the following is not involved in the transport of cyclosporine in the blood stream?

A)white blood cells
B)red blood cells
C)albumin
D)lipoproteins

Answer 2

albumin

Question 3

Cyclosporine toxicity manifests as which of the following?

A)increased renal blood flow
B)decreased GFR
C)increased urine output
D)decreased sodium retention

Answer 3

decreased GFR

Question 4

A recipient's preformed antibodies against what HLA class are responsible for immunological destruction of the allograft once implanted and can signal the cellular immune system to induce additional tissue destruction?

A)I
B)II
C)both a and b
D)neither a or b

Question 5

Kidney donors who have been monitored for up to 20 years after donation exhibit a slight ______ in glomerular filtration rate and a mild ______ in urine protein excretion, without an increase in hypertension.

A)decrease, increase
B)decrease, decrease
C)increase, increase
D)increase, decrease

Question 6

Which group of drugs has the longest half-life and therefore has a lower monitoring frequency?

A)cyclosporine
B)tacrolimus
C)sirolimus
D)everolimus

Question 7

The binding of glucocorticoids to their receptors blocks the synthesis or release of lymphokines and cytokines.This results in which of the following?
1)an inhibition of T-cell response to stimulation
2)a redistribution of lymphocytes from the vascular to the lymphatic system
3)an increase in the number of circulating T-cells
4)a decrease in the number of circulating B-cells

A)1, 2, 3
B)1, 2, 4
C)1, 3, 4
D)2, 3, 4

Question 8

The detection of antibodies specific to the donor are most commonly tested at what intervals following transplant?
1)7 days
2)14 days
3)1 month
4)6 months

A)1, 2, 3, 4
B)1, 2, 3
C)1, 3, 4
D)2, 3, 4

Question 9

Once a patient progresses to brain death, frequent monitoring of which of the following is/are essential for the successful maintenance of healthy organs?

A)serum electrolytes
B)blood gas
C)blood pH
D)all of the above

Question 10

Which of the following statements are true of kidney donation and transplants?
1)Kidney allograft survival rates are greater when the graft is obtained from a living donor.
2)There is improved potential for increased immunological match if the recipient is genetically related.
3)A live donor transplant spares the recipient the long waiting period on dialysis that frequently occurs when one is waiting for a suitable deceased donor transplant.
4)Deceased donor allografts are associated with an improved long-term graft survival.

A)1, 2, 3, 4
B)1, 2, 3
C)1, 3, 4
D)2, 3, 4

Question 11

Elevations in ______ are suggestive of hepatocellular necrosis, and elevations in ______ are suggestive of cholestasis.

A)ALP and bilirubin, AST and ALT
B)AST and ALT, ALP and bilirubin
C)ALP and AST, ALT and bilirubin
D)ALT and bilirubin, ALP and AST

Question 12

A patient with severe head trauma is a potential organ donor.He has no history of diabetes but is now hyperglycemic.Does this exclude him from being a pancreas donor? Why?

A)Yes, the patient's history is irrelevant now that he is hyperglycemic.
B)Yes, even though the head trauma could have caused the hyperglycemia, there is no way to know for sure.
C)No, the head trauma could have caused the hyperglycemia, but a glycated hemoglobin should be measured for confirmation.
D)No, hyperglycemia is not related to the pancreas.

Question 13

What test ensures that a potential transplant recipient has no preformed antibodies against a donor's proteins?

A)ABO blood type
B)cytotoxic T-cell crossmatch
C)protein electrophoresis
D)immunofixation electrophoresis

Question 14

Which of the following is a standard test for posttransplantation cardiac allograft monitoring?

A)myoglobin
B)creatine kinase
C)endomyocardial biopsy
D)troponin T

Question 15

A patient who received a liver transplant 2 days ago has started rejecting the organ.This is which type of rejection?

A)hyperacute
B)acute accelerated
C)acute
D)chronic

Question 16

When is the risk of allograft rejection and infection the most intense?

A)7-14 days
B)1-3 months
C)3-6 months
D)6-12 months

Question 17

Which of the following is a bacterial agent commonly seen in transplant recipients?
1)Nocardia species
2)Aspergillus fumigatus
3)Serratia marcescens
4)Proteus rettgeri

A)1, 2, 3
B)1, 2, 4
C)1, 3, 4
D)2, 3, 4

Question 18

Serial measurements of __________ are the standard method for indirectly detecting changes in the glomerular filtration rate.

A)serum creatinine
B)serum BUN
C)specific gravity
D)24-hour urine output