Question 1

A patient diagnosed with grade IV of graft-versus-host disease would most probably exhibit _____.(Select all that apply.)

Accepted Answer

Grade IV GVHD is the most severe form and typically involves multiple organ systems. Jaundice, skin blistering and desquamation, and severe abdominal pain are all signs of systemic involvement and are commonly seen in grade IV GVHD. Serum bilirubin levels of 2-3mg/dl are not necessarily indicative of grade IV GVHD, and a maculopapular rash on less than 25% of body surface is too limited in severity to indicate grade IV GVHD.

Question 2

Residual leukemia cells persisting in a patient after they have received chemotherapy,irradiation,and a bone-marrow transplant are sometimes eliminated by a _____ effect which involves the action of _____.(Select all that apply.)

Accepted Answer

Graft-versus-leukemia effect involves the action of alloreactive T cells and/or NK cells which are capable of recognizing and killing residual leukemia cells while sparing normal cells. A haploidentical transplant (B) is a type of transplant where the donor and recipient are only partially matched in terms of their HLA antigens and requires extensive immunosuppression to prevent rejection. Acute minor histocompatibility (C) refers to minor antigen differences between the donor and recipient and can lead to graft-versus-host disease rather than graft-versus-leukemia effect. Myeloablation (D) refers to the destruction of the host's bone marrow to make space for donor cells and does not directly involve the immune system.

Question 3

Despite a slower engraftment,cord blood as a source of transplanted hematopoietic stem cells is better than bone marrow or than stem cells derived from peripheral blood in that _____.(Select all that apply.)

Accepted Answer

Cord blood transplants have a higher tolerance for HLA disparity and a lower incidence of graft-versus-host disease compared to bone marrow or peripheral blood stem cell transplants.

Question 4

_____ from a bone marrow transplant facilitate alloreactive responses,causing the condition defined as acute graft-versus-host disease.

Accepted Answer

Mature T cells are responsible for initiating alloreactive responses in acute graft-versus-host disease (GVHD) following a bone marrow transplant. They recognize the host's tissues as foreign and mount an immune response against them.

Question 5

Contrast acute rejection and chronic rejection.

Accepted Answer

The answer of Contrast acute rejection and chronic rejection....

Question 6

Males engrafted with HLA-identical bone marrow from their sisters develop graft-versus-host disease because _____.

Accepted Answer

HLA-identical bone marrow from a female sibling contains mature T cells that recognize male-specific minor histocompatibility antigens, leading to graft-versus-host disease in the male recipient.

Question 7

George Cunningham was diagnosed with Crohn's disease when 23 years old.He was experiencing acute abdominal pain,diarrhea,rectal bleeding,anemia and weight loss.He did not respond to conventional immunosuppressive therapies and was given a course of infliximab,an anti-TNF-α monoclonal antibody that suppresses inflammation by blocking TNF-α activity.On day 12 after receiving his first infusion,he developed a mild fever,generalized vasculitis,swollen lymph glands,swollen joints and joint pain.Traces of blood and protein were detected in his urine.Which of the following is the most likely cause of these recent symptoms?

Accepted Answer

This is an example of serum sickness, a type III hypersensitivity reaction. George has made antibodies against infliximab, which is a chimeric monoclonal antibody made of human and mouse (foreign) components. Because this is an adaptive immune response, it takes time before sufficient levels of anti-infliximab antibody are made and cause the formation of immune complexes. Deposition of the immune complexes in blood vessels, joints, and glomeruli are causing George’s symptoms. These symptoms are typically self-limiting, because as anti-infliximab antibody levels increase into the zone of antibody excess, the size of immune complexes will increase and they will then be cleared effectively by splenic macrophages, Kupffer cells of the liver, and mesangial cells of the kidney.

Question 8

A.Explain why an organ transplant made between a donor of blood group AB and a recipient of blood group O will always be rejected,even if it is perfectly HLA-matched and the recipient has been given immunosuppressant drugs.What is this type of rejection called?
B.Give another example of ABO incompatibility between donor and recipient that would lead to this type of rejection.
C.What other antigen incompatibilities,other than those of blood group,are most likely to provoke this type of rejection?
D.Which pre-surgical laboratory test should be performed to prevent this type of rejection?

Accepted Answer

The answer of A.Explain why an organ transplant made between...

Question 9

A.Identify three general classes of drug that are used to suppress acute transplant rejection,and provide examples of each class.
B.What side-effects and toxic effects are associated with each class of drug?

Accepted Answer

The answer of A.Identify three general classes of drug that...

Question 10

The term _____ is used to describe polymorphic antigens that vary between individuals of the same species.

Accepted Answer

Alloantigens are antigens that differ between members of the same species, typically due to genetic variation between individuals. This can lead to an immune response if an individual is transfused with blood or tissue that expresses alloantigens that they do not possess. Xenoantigens are antigens that are present on cells of other species, immunnoantigens are simply substances that can induce an immune response, histoantigens are antigens that are present on an individual's own tissues, and autoantigens are antigens that are recognized by the immune system as "self" and are not typically targeted for an immune response.

Question 11

What is the term used to describe the condition of an individual who possesses two sets of hematopoietic cells,one derived from the individual's own bone marrow and one derived from a different source,for example,an organ transplant or blood transfusion that has not been rejected?

Accepted Answer

The term used to describe this condition is chimeric, as the individual has two distinct populations of cells with different genetic origins. The other answer choices do not accurately describe this condition.

Question 12

Autologous bone marrow transplantation used to treat cancer patients involves reinfusing a(n)_____-depleted stem-cell population into the patient after their cancer treatment has been completed.

Accepted Answer

Autologous bone marrow transplantation involves reinfusing a tumor cell-depleted stem-cell population into the patient. This process ensures that the stem cells reintroduced into the patient's body are free from cancer cells, helping to prevent the recurrence of the disease.

Question 13

Donors treated with _____ can donate bone marrow-derived stem cells from a less invasive peripheral blood draw instead of the more invasive bone marrow aspiration.(Select all that apply.)

Accepted Answer

Donors treated with granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) can donate bone marrow-derived stem cells from a less invasive peripheral blood draw instead of the more invasive bone marrow aspiration. Anti-CD3 and anti-CD34 are not used for this purpose. Cyclophosphamide is used for conditioning treatment before bone marrow transplantation, but not for mobilizing stem cells from peripheral blood.

Question 14

Following a hematopoietic stem cell transplant,T-cell responses will be activated by dendritic cells of _____ origin.

Accepted Answer

After a hematopoietic stem cell transplant, the dendritic cells will be of the donor origin, as these are the cells that are transplanted and will engraft in the recipient. Therefore, the T-cell responses will be activated by dendritic cells of donor origin.

Question 15

We learned in Chapter 5 that the benefit of having and expressing multiple MHC class I and class II genes is that it increases the number and variety of pathogen-derived peptide antigens that can potentially be presented to T cells.If more is better,then why has natural selection not favored the evolution of more than three genes each for MHC class I and MHC class II?

Accepted Answer

The answer of We learned in Chapter 5 that the...

Question 16

Leukapheresis is used in hematopoietic stem-cell transplantation where stem cells from a suitable donor are fractionated on the basis of their expression of _____.

Accepted Answer

CD34 is a cell surface marker that is commonly used to identify hematopoietic stem cells. Therefore, leukapheresis is used to fractionate stem cells from a donor based on their expression of CD34.

Question 17

How do the clinical objectives of transplantation differ from those of vaccination?

Accepted Answer

The answer of How do the clinical objectives of transplantation...

Question 18

Explain why,in principle,an organ transplanted from any donor other than an identical twin is almost certain to be rejected in the absence of any other treatment.

Accepted Answer

The answer of Explain why,in principle,an organ transplanted from any...

Question 19

Forty-four-year old Danielle Bouvier is on the waiting list for a kidney transplant and is receiving weekly dialysis.Her HLA type is: HLA-A: 0101/0301; HLA-B: 0702/0801; HLA-DRB1: 0301/0701.Today,Danielle's physician informed her that several potential kidney donors are available.Which of the following would be the most suitable?

Accepted Answer

The answer of Forty-four-year old Danielle Bouvier is on the...

Question 20

(A)What is a cross-match test? (B)Why is it carried out? (C)How is it carried out?

Accepted Answer

The answer of (A)What is a cross-match test? (B)Why is...

Quiz 15: Transplantation of Tissues and Organs