Deck 19: Transplantation

Question 1

For each of the descriptions in questions ,choose the immunosuppressive or tolerance induction therapy for allograft rejection (A-I)that best matches it.
Can induce anergy in T cells through inhibition of costimulatory signaling

A)Azathioprine
B)Cyclosporine
C)Mycophenolate mofetil
D)Rapamycin
E)Anti-CD40L antibody
F)Anti-IL-2R antibody
G)CTLA4-Ig
H)OKT3
I)Corticosteroids

Answer 1

CTLA4-Ig

Question 2

For each of the descriptions in questions ,choose the immunosuppressive or tolerance induction therapy for allograft rejection (A-I)that best matches it.
Blocks calcineurin-dependent activation of NFAT

A)Azathioprine
B)Cyclosporine
C)Mycophenolate mofetil
D)Rapamycin
E)Anti-CD40L antibody
F)Anti-IL-2R antibody
G)CTLA4-Ig
H)OKT3
I)Corticosteroids

Answer 2

Cyclosporine

Question 3

For each of the descriptions in questions ,choose the blood group antigen (A-E)that best matches it.
Nonglycosylated red cell membrane protein missing or mutated in 15% of humans

A)A
B)B
C)O
D)RhD
E)AB

Answer 3

RhD

Question 4

For each of the descriptions in questions ,choose the immunosuppressive or tolerance induction therapy for allograft rejection (A-I)that best matches it.
Inhibits a lymphocyte-specific isoform of inosine monophosphate dehydrogenase,an enzyme that is required for the synthesis of guanine nucleotides

A)Azathioprine
B)Cyclosporine
C)Mycophenolate mofetil
D)Rapamycin
E)Anti-CD40L antibody
F)Anti-IL-2R antibody
G)CTLA4-Ig
H)OKT3
I)Corticosteroids

Question 5

For each of the descriptions in questions ,choose the blood group antigen (A-E)that best matches it.
Blood group of a person whose red blood cells can only transfused to a person with the same blood group

A)A
B)B
C)O
D)RhD
E)AB

Question 6

For each of the descriptions in questions ,choose the immunosuppressive or tolerance induction therapy for allograft rejection (A-I)that best matches it.
Inhibits mTOR,and thereby inhibits IL-2 driven cell cycle progression in T cells

A)Azathioprine
B)Cyclosporine
C)Mycophenolate mofetil
D)Rapamycin
E)Anti-CD40L antibody
F)Anti-IL-2R antibody
G)CTLA4-Ig
H)OKT3
I)Corticosteroids

Question 7

Which type of molecules are the most frequent target of allogeneic immune responses against transplanted organs and why?

A)Endothelial adhesion molecules,because they are present in the blood vessels of grafted organs,where donor lymphocytes can interact with them
B)Human leukocyte antigens (HLA),because they are the most polymorphic proteins in the organs.
C)Lipids,because they easily cross through the membranes of lymphocytes
D)Polymorphic cytosolic proteins,because they are readily processed into peptides that can bind class I MHC molecules
E)Blood group antigens,because they are expressed on all red blood cells and endothelial cells

Question 8

Allogeneic immune responses lead to graft rejection.Which of the following best defines an allogeneic immune response in human-to-human transplantation?

A)An innate immune response mounted by an individual against transplanted cells or tissues derived from an unrelated individual.
B)An adaptive immune response mounted by an individual against transplanted cells or tissues derived only from an unrelated individual.
C)An adaptive immune response mounted by an individual against transplanted cells or tissues derived from a genetically non-identical individual.
D)An innate or adaptive immune response mounted by an individual against transplanted cells or tissues derived from a genetically non-identical individual.
E)An adaptive immune response mounted by an individual against transplanted cells or tissues derived from a genetically identical individual.

Question 9

For each of the descriptions in questions ,choose the blood group antigen (A-E)that best matches it.
Antibodies specific for this blood group found in a person with type A blood.

A)A
B)B
C)O
D)RhD
E)AB

Question 10

For each of the descriptions in questions ,choose the blood group antigen (A-E)that best matches it.
The blood group of a red blood cell blood donor than can be transfused to any recipient.

A)A
B)B
C)O
D)RhD
E)AB

Question 11

Which of the following is a correct description of direct T cell recognition of allogeneic MHC molecules by graft recipients?

A)Recipient T cells recognize soluble donor MHC molecules shed from the graft cells.
B)Recipient T cells recognize peptides derived from allogeneic MHC molecules that are bound to the recipient's own MHC molecules on recipient antigen presenting cells.
C)Recipient T cells recognize intact allogeneic MHC molecules on graft cells,without the need to processing those MHC proteins into peptides and presenting them on self-MHC molecules.
D)Donor T cells in the graft recognize recipient peptides bound to recipient MHC molecules.
E)Recipient T cells act as antigen presenting cells to donor T cells.

Question 12

A kidney is transplanted into a patient with renal failure to diabetes,and within 15 minutes after the recipient blood supply to the graft is established,the graft becomes pale,and stops functioning.Microscopic analysis of the failed graft shows death of cells due to lack of blood flow ("ischemic necrosis").What is the most likely cause of this graft failure?

A)Acute rejection due to stimulation of the recipients B and T cells specific for graft alloantigens
B)Chronic rejection,with narrowing of the graft blood vessels by vascular smooth muscle cells and fibrous tissue
C)A leaky surgical connection between the recipient and graft blood vessels
D)Hyperacute rejection,with thrombosis (clotting)of graft blood vessels due to previously formed antibodies in the recipient specific for recipient HLA molecules
E)Damage to the graft by because of the patient's diabetes

Question 13

For each of the descriptions in questions ,choose the immunosuppressive or tolerance induction therapy for allograft rejection (A-I)that best matches it.
Inhibits macrophage cytokine secretion

A)Azathioprine
B)Cyclosporine
C)Mycophenolate mofetil
D)Rapamycin
E)Anti-CD40L antibody
F)Anti-IL-2R antibody
G)CTLA4-Ig
H)OKT3
I)Corticosteroids