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Absite Topic Review General Surgery

Absite Topic Review General Surgery. Nir Hus, MD, PhD. Mount Sinai Medical Center Miami Beach. Transplantation.

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Absite Topic Review General Surgery

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  1. Absite Topic ReviewGeneral Surgery Nir Hus, MD, PhD. Mount Sinai Medical Center Miami Beach

  2. Transplantation

  3. Q1 – Two weeks s/p renal transplant, a pt. developes res. Insufficiency requiring adm. To ICU. CXR shows diffuse infiltrates & BAL show cells w/ inclusion bodies. The most appropriate therapy is: • Gangcyclvir • Acyclovir • Bactrim • PCN

  4. Q2 – Hyperacute rejection following organ trans. Is most often due: • ABO incompatibility • Rh incompatibility • Previously sensitized T cells • Macrophages

  5. Q3 – Hyperacute rejection is an example of hypersensitivity reaction type: • Type I • Type II • Type III • Type IV

  6. Q4 – Successful Tx of hyperacute rejection usually involves • Steroids • Removal of the organ & re-trans. • OKT3 • Rapamycin

  7. Q5 – The machanism of cyclosporin is: • Binds FK binding protein • Binds cyclophilin protein • Inhibits purine synthesis by way of 6-mercaptopurine intermidiate. • Binds antigen on T cells

  8. Q6 - The mechanism of azathioprine is: • Binds FK binding protein • Binds cyclophilin protein • Inhibits purine synthesis by way of 6-mercaptopurine intermidiate. • Binds antigen on T cells

  9. Q7 – The most common malignancy following transplantation is: • Lung CA • Prostate CA • Breast CA • Skin CA

  10. Q8 – A positive cross-match means: • There are no immunologic problems so one may proceed w/ the trans. • Will likely result in only mild rejection sometimes after the 1st week. • The recipient has preformed AB to donor Ag. • Both the donor and recipient are CMV positive.

  11. Q9 – A cross-match is performed by: • Mixing donor lymphocytes w/ recipient serum • Mixing recipient lymphocytes w/ donor serum • Mixing donor plasma w/ recipient serum • Mixing recipient plasma w/ donor serum.

  12. Q10 – Post-transplant lymphoproliferative disorder has been most commonly linked to: • HSV • RSV • EBV • Influenza viruses

  13. Q11 - A 35 yo man POD#6 from a cadaveric renal trans. Developes a rise in Cr. The most appropriate next step is: • Emergent reop • Angiography • OKT3 • US

  14. Q12 – in the previous pt. the US shows flow acceleration of the renal artery. The next appropriate step is: • Emergent reop • Angiography • OKT3 • US

  15. Q13 – in the previous pt. the US is normal. The next appropriate step is: • Emergent reop • Angiography • OKT3 • Biopsy

  16. Q14 - in the previous pt. the Bx. shows acute tubulitis. This is consistent w/: • Acute rejection • UTI • Chronic rejection • Renal vein thrombosis.

  17. Q15 – New proteinnuria in a pt. following renal trans. Is most consistent w/: • Acute rejection • UTI • Chronic rejection • Renal vein thrombosis.

  18. Q16 – Most common cause of acute death in a living related renal trans. Is: • PE • Hemorrhage • MI • Infection

  19. Q17 – Most common cause of acute death following renal trans. In a recipient is: • PE • Hemorrhage • MI • Infection

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