ANSWERS GRADED A+
✔✔li-Fraumeni syndrome defect in gene___ get_____ - ✔✔P53 gene, childhood
sarcomas, breast Ca, brain tumors, leukemia, adrenal CA
✔✔susp axillary node - ✔✔lymphoma, breast, melanoma
✔✔bone mets - ✔✔breast, prostate
✔✔skin metastases - ✔✔breast, melanoma
✔✔small bowel mets - ✔✔melanoma
✔✔phase 1 - ✔✔is it safe and what dose
✔✔phase II - ✔✔is it effective
✔✔phase III - ✔✔is it better than existing
✔✔phase IV - ✔✔implementation/marketing
✔✔surable solid tumors with chemotherapy - ✔✔hodgkins and non hodgkins
✔✔prognostic indicators for survival after resection of hepatic colorectal mets -
✔✔disease free for >12mo, tumor number <3, CEA <200 size <5cm , negative nodes
✔✔cross match - ✔✔recipient serum with donor lymphocytes
✔✔# 1 malignancy following any transplant - ✔✔skin cancer
✔✔2nd most common malignancy following transplant - ✔✔post transplant lympho
proliferative disorder, EBV related.
✔✔mantenance therapy to prevent rejection, inhibit t cell growth, SE: myelosuppression
- ✔✔mycophenolate( Cell cept)
✔✔inhibits genes for cytokine synthesis, binds cyclophilin protein - ✔✔cyclosporin
✔✔tacrolimus - ✔✔binds to FK -binding protein
✔✔inhibits T and B cells response to IL2, inhibits mTOR - ✔✔sirolimus
,✔✔hyper acute rejection, time - ✔✔should have been picked up at cross match,
activation of complement and thrombosis of vessel occurs, min to hours
✔✔accelerated rejection, time - ✔✔sensitized T cellss to donor antigens, <1 wk
✔✔acute rejections , time - ✔✔caused by T cells , 1 week to 1month
✔✔chronic rejections, time - ✔✔type IV / sensitized t cells. Leads to graft fibrosis,
months to years
✔✔kidney transplantation : new protienuria - ✔✔renal vin thrombosis
✔✔5 years survival in kidney transplant, higher in - ✔✔70%,living donors
✔✔most common reason for liver transplant - ✔✔Hep c
✔✔MELD score - ✔✔BIC: bilib, INR, Cr
✔✔meld score > 15 - ✔✔will benefit form liver transplant
✔✔not a contraindication to transplant - ✔✔portal vein thrombosis, Hepatocellular CA( if
no vascular invasion)
✔✔acute rejection of liver transpl, time - ✔✔T cells against blood vessels, portal traid
lymphocytosis, endotheliitis, bile duct injury, 1-2 mo
✔✔pancreas transplant, no reversal of ___ - ✔✔vascular disease
✔✔associated with early mortality after heart transplant, treatment - ✔✔pulmonary
hypertension, give inhaled nitric oxide, ECMO if severe
✔✔acute heart rejection - ✔✔perivascular lymphocytic infiltrate with myocyte
inflammation and necrosis
✔✔chronic vasculopathy - ✔✔progressive coronary atherosclerosis , most common
cause of late death.
✔✔#1 cause of early mortality in lung transplantation - ✔✔reperfusion injury
✔✔acute rejection of lungs see____ - ✔✔perivascular lymphocytosis
✔✔chronic rejection of lung see____ - ✔✔bronchiolitis obliterans
, ✔✔PDGF function - ✔✔angiogenesis, epithelialization, accel. wound healing.
Chemotactatic and activates inflamm cells and fibroblasts
✔✔EGF function - ✔✔chemotactic and activates fibroblasts, angiogenesis and
epithelialization
✔✔FGF function - ✔✔chemotact and activates fibroblasts, angiogen, epithelial
✔✔platelet activating factor - ✔✔not stored, generated by phospholipase in endothelium
✔✔main source of histamine in blood - ✔✔basophils
✔✔main source of histamine in tissue - ✔✔mast cells.
✔✔bradykinin function - ✔✔peripheral vasodil, increased perm, pain, pulm vaso
✔✔inactivased bradykinin, located in the blood - ✔✔ACE
✔✔opposite effect of NO - ✔✔endothelin
✔✔NO activates__ increases ___causes____ - ✔✔guanylate cyclase, cGMP, vasc
smooth muscle dilation
✔✔largest producer of TNF alpha - ✔✔macrophages
✔✔first released by injury or infection - ✔✔TNF alpha
✔✔hepatic acute phase response proteins increased - ✔✔c reactive protein, amyloid A
✔✔hepatic acute phase response proteins decreased - ✔✔albumin, pre-alb, transferrin
✔✔classical pathway - ✔✔antigen-antibody complex
✔✔alternative pathway - ✔✔endotoxin, bacteria
✔✔pgI2, PGE2: vaso__, broncho__, ___permeability, ___ platelets - ✔✔dilation,
dilation, increase, inhibits
✔✔steroids inhibit - ✔✔phospholipids to arachidonic acid
✔✔wound healing mneumonic - ✔✔iNflammation, Proliferation, Remodeling
✔✔inflammation days - ✔✔1-10