CCTN Exam Study Guide with Correct Solutions
Rituximab - ANSWER Monoclonal antibody against CD20, which is found on most B
cell neoplasms.
Used in induction and in PTLD
Azathroprine (Imuran) - ANSWER purine analog, incorporates into DNA and RNA to create
nonsense mutations, and decrease cell proliferation. Hepatotoxic, bone marrow
suppression, THROMBOCYTOPENIA, hepatoxicity
Alemtuzumab - ANSWER Monoclonal antibody against CD 52. (b and t) Given once at time of
transplant, prevent cellular rejection for 6 months. must premed with methylpred. Also used
in B cell lymphocytic leukemia
Basiliximab (simulect) - ANSWER monoclonal antibody against IL2 (receptor antagonist). IL2
only on activated t cells, inhibits proliferation without destroying lymphocyte.. Day 0 and 4
of transplant.
Corticosteroids - ANSWER A group of hormones, including cortisol, released by the adrenal
glands at times of stress. htn, bone loss, DM, infection. bind to glucocorticoid receptor alter
DNA and RNA synthesis. Inhibit IL1 and IL 2. inhibit cytotoxic t cell generation
Everlimus - ANSWER inhibit mTOR, inhibit t cell proliferation in response to il2. freeze cells into
G1. ppneumonitis, proteinuria, delayed wound healing
proliferation signal inhibitor prohibited in heart tx - ANSWER everlimus - increased mortality
, Cyclosporine - ANSWER sandimmmune and emulsin neoral or gengraf. calcineurin inhibitor by
binding to cyclophilin. Inhibits il2. Interact w macrolide abx, diltiazem, grapefruit juice, mag.
tremor, htn, nephrotoxic. rabdo, hyperlipidemia. Cyp pathway
Belatacept - ANSWER used for pt who don't tolerate CNI immunosupression. Contraindicated in
livers due to PTLD. Less nephropathy. Blocks binding of cd86 and cd28 , blocks t cell activation.
lower cv profile. monthly infusion or day 1, 5 2, 4, 8 and 12 for induction. must be eb positive.
metronidazole - ANSWER plus vanco for cdiff. May decrease mmf and increase tac. N/v. against
anaerobic gram neg and gram pos.
bactrim - ANSWER prevent pjp and listeria. propylaxis. hyperkalemia, gi
disturbances, photosensitivity, thrombocytopenia. May decrease mmf.
Antithymocyte globulin - ANSWER polyclonal antibodies, induction and rejection. anti t and
b cell. premed tyl and benadryl, give over 6 hrs then 4 hrs.
plasmapheresis - ANSWER removal of plasma, replace leukocyte reduced. used for rejection.
desensitization therapy - ANSWER used for negative crossmatch tx. plasmapheresis, ivig,
alemtuzum, rituximab, eculizumab, basiliximab.
maintenance immunosuppression - ANSWER cni, antiproliferative, corticosteroids,
proliferation signal inhibitors, costimulation inhibitors.
induction or acute rejection. - ANSWER polyclonal antibodies, monoclonal antibodies, il2
antibodies, glucocorticosteroids.
voriconazole - ANSWER aspergillus. increases cyclosporine and tac levels. don't use
with sirolimus
Rituximab - ANSWER Monoclonal antibody against CD20, which is found on most B
cell neoplasms.
Used in induction and in PTLD
Azathroprine (Imuran) - ANSWER purine analog, incorporates into DNA and RNA to create
nonsense mutations, and decrease cell proliferation. Hepatotoxic, bone marrow
suppression, THROMBOCYTOPENIA, hepatoxicity
Alemtuzumab - ANSWER Monoclonal antibody against CD 52. (b and t) Given once at time of
transplant, prevent cellular rejection for 6 months. must premed with methylpred. Also used
in B cell lymphocytic leukemia
Basiliximab (simulect) - ANSWER monoclonal antibody against IL2 (receptor antagonist). IL2
only on activated t cells, inhibits proliferation without destroying lymphocyte.. Day 0 and 4
of transplant.
Corticosteroids - ANSWER A group of hormones, including cortisol, released by the adrenal
glands at times of stress. htn, bone loss, DM, infection. bind to glucocorticoid receptor alter
DNA and RNA synthesis. Inhibit IL1 and IL 2. inhibit cytotoxic t cell generation
Everlimus - ANSWER inhibit mTOR, inhibit t cell proliferation in response to il2. freeze cells into
G1. ppneumonitis, proteinuria, delayed wound healing
proliferation signal inhibitor prohibited in heart tx - ANSWER everlimus - increased mortality
, Cyclosporine - ANSWER sandimmmune and emulsin neoral or gengraf. calcineurin inhibitor by
binding to cyclophilin. Inhibits il2. Interact w macrolide abx, diltiazem, grapefruit juice, mag.
tremor, htn, nephrotoxic. rabdo, hyperlipidemia. Cyp pathway
Belatacept - ANSWER used for pt who don't tolerate CNI immunosupression. Contraindicated in
livers due to PTLD. Less nephropathy. Blocks binding of cd86 and cd28 , blocks t cell activation.
lower cv profile. monthly infusion or day 1, 5 2, 4, 8 and 12 for induction. must be eb positive.
metronidazole - ANSWER plus vanco for cdiff. May decrease mmf and increase tac. N/v. against
anaerobic gram neg and gram pos.
bactrim - ANSWER prevent pjp and listeria. propylaxis. hyperkalemia, gi
disturbances, photosensitivity, thrombocytopenia. May decrease mmf.
Antithymocyte globulin - ANSWER polyclonal antibodies, induction and rejection. anti t and
b cell. premed tyl and benadryl, give over 6 hrs then 4 hrs.
plasmapheresis - ANSWER removal of plasma, replace leukocyte reduced. used for rejection.
desensitization therapy - ANSWER used for negative crossmatch tx. plasmapheresis, ivig,
alemtuzum, rituximab, eculizumab, basiliximab.
maintenance immunosuppression - ANSWER cni, antiproliferative, corticosteroids,
proliferation signal inhibitors, costimulation inhibitors.
induction or acute rejection. - ANSWER polyclonal antibodies, monoclonal antibodies, il2
antibodies, glucocorticosteroids.
voriconazole - ANSWER aspergillus. increases cyclosporine and tac levels. don't use
with sirolimus
