BMTCN EXAM PAPER 2026 COMPLETE
QUESTIONS AND ANSWERS GRADED A+
◉What can CNI's cause?. Answer: TMA- thrombotic
microangiopathy
◉TMA- thrombotic microangiopathy. Answer: -inflammatory and
thrombotic diseases of the microvasculature
-thrombocytopenia, hemolytic anemia, and organ dysfunction
-treatment is to remove the CNI, ritux, steroids
◉cyclosporine. Answer: -prevents activation of T-lymphocytes
-begin at least 2 days prior to transplant
-side effects: hypomagnesemia, hirstuism
-grapefruit could increase level
-nephrotoxic
◉Tacrolimus. Answer: -begin 2 days prior to transplant
-hypomagnesemia
-nephrotoxic
,◉cellcept. Answer: -Q8-12
◉Methotexate. Answer: -side effects: myelosuppression, mucositis,
nephrotoxicity
-1st dose should be given at least 24hrs post transplant
◉gold standard of diagnosing GVHD. Answer: biopsy of involved
tissue
◉GVH skin. Answer: -usually 1st organ involved
-appearance similar to sunburn (could peel/desquamation)
-usually 2-3 weeks post transplant
◉Rules of Nines. Answer: -% of body surface with gvh skin
-head and hands: 4.5% each
-legs: 9%
-trunk: 18%
◉treatment gvh skin. Answer: -check CNI levels
-topical steroids
,◉GVH gut. Answer: -lower: diarrhea, could contain tissue or be
bloody
-upper: N/V, anorexia
-severity is determined by the volume of diarrhea
-r/o other causes first: c. diff, infection, adeno, etc.
-could develop a paralytic ileus (lack of muscles), narcotics could
contribute)
◉treatment for gvh gut. Answer: -bowel rest then slowly introducing
bland foods
-octreotide
-steroids
◉gvh liver. Answer: -hyperbilirubinemia levels
-diagnose with a biopsy
-actigall
◉best predictor of long-term survival for GVH. Answer: -how well
they respond to steroids
◉risk factors for chronic GVH. Answer: -acute GVH
-mismatched unrelated donor
-non-t-cell depleted transplant
, -PBSC more at risk chronic
-DLI
◉diagnosing chronic GVH. Answer: -requires the presence of at least
one diagnostic test (biopsy, PFT, etc).
◉GVH- nails. Answer: longitudiinal ridging, brittle, nail loss
◉GVH- mouth. Answer: -white lesions in mouth
-xerostomia
-both cute and chronic can present as mucositis, gingivitis
◉GVH eyes. Answer: -dry, painful eyes
-photophobia
◉pt presents with grade 2 GVHD of the skin- what are two first
steps?. Answer: -check tacro/cyclo level to confirm therapeutic
range
-topical steroids
◉one week after being on steroids, pt's volume of diarrhea has
increased to 3,000ml/day. What should be done?
a. increase steroids
QUESTIONS AND ANSWERS GRADED A+
◉What can CNI's cause?. Answer: TMA- thrombotic
microangiopathy
◉TMA- thrombotic microangiopathy. Answer: -inflammatory and
thrombotic diseases of the microvasculature
-thrombocytopenia, hemolytic anemia, and organ dysfunction
-treatment is to remove the CNI, ritux, steroids
◉cyclosporine. Answer: -prevents activation of T-lymphocytes
-begin at least 2 days prior to transplant
-side effects: hypomagnesemia, hirstuism
-grapefruit could increase level
-nephrotoxic
◉Tacrolimus. Answer: -begin 2 days prior to transplant
-hypomagnesemia
-nephrotoxic
,◉cellcept. Answer: -Q8-12
◉Methotexate. Answer: -side effects: myelosuppression, mucositis,
nephrotoxicity
-1st dose should be given at least 24hrs post transplant
◉gold standard of diagnosing GVHD. Answer: biopsy of involved
tissue
◉GVH skin. Answer: -usually 1st organ involved
-appearance similar to sunburn (could peel/desquamation)
-usually 2-3 weeks post transplant
◉Rules of Nines. Answer: -% of body surface with gvh skin
-head and hands: 4.5% each
-legs: 9%
-trunk: 18%
◉treatment gvh skin. Answer: -check CNI levels
-topical steroids
,◉GVH gut. Answer: -lower: diarrhea, could contain tissue or be
bloody
-upper: N/V, anorexia
-severity is determined by the volume of diarrhea
-r/o other causes first: c. diff, infection, adeno, etc.
-could develop a paralytic ileus (lack of muscles), narcotics could
contribute)
◉treatment for gvh gut. Answer: -bowel rest then slowly introducing
bland foods
-octreotide
-steroids
◉gvh liver. Answer: -hyperbilirubinemia levels
-diagnose with a biopsy
-actigall
◉best predictor of long-term survival for GVH. Answer: -how well
they respond to steroids
◉risk factors for chronic GVH. Answer: -acute GVH
-mismatched unrelated donor
-non-t-cell depleted transplant
, -PBSC more at risk chronic
-DLI
◉diagnosing chronic GVH. Answer: -requires the presence of at least
one diagnostic test (biopsy, PFT, etc).
◉GVH- nails. Answer: longitudiinal ridging, brittle, nail loss
◉GVH- mouth. Answer: -white lesions in mouth
-xerostomia
-both cute and chronic can present as mucositis, gingivitis
◉GVH eyes. Answer: -dry, painful eyes
-photophobia
◉pt presents with grade 2 GVHD of the skin- what are two first
steps?. Answer: -check tacro/cyclo level to confirm therapeutic
range
-topical steroids
◉one week after being on steroids, pt's volume of diarrhea has
increased to 3,000ml/day. What should be done?
a. increase steroids
