(F) IS Lec L1

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D

What is the term for tissue transferred from one position to another within the same individual?

• a) Allograft

• b) Xenograft

• c) Syngraft

• d) Autograft

• e) Homograft

A

Which classification refers to tissue transplanted between genetically identical individuals, such as monozygotic twins?

• a) Isograft

• b) Autograft

• c) Allograft

• d) Heterograft

• e) Xenograft

B

What is the most common clinical transplant scenario, involving tissue grafted between genetically different individuals of the same species?

• a) Autograft

• b) Allograft

• c) Syngraft

• d) Xenograft

• e) Isograft

C

What is the classification for tissue transferred between individuals of different species, such as a porcine heart valve into a human?

• a) Autograft

• b) Homograft

• c) Xenograft

• d) Isograft

• e) Allograft

D

Which blood type is considered the universal donor in solid organ transplantation?

• a) A

• b) B

• c) AB

• d) O

• e) Rh-positive

D

Which organ is considered the most common solid organ transplant?

• a) Liver

• b) Heart

• c) Pancreas

• d) Kidney

• e) Lung

B

Which unique organ has a robust ability to regenerate or grow within 4 to 12 weeks after transplantation?

• a) Kidney

• b) Liver

• c) Heart

• d) Pancreas

• e) Bone Marrow

E

Which highly time-sensitive organ must be transplanted within 4 hours?

• a) Kidney

• b) Liver

• c) Pancreas

• d) Cornea

• e) Heart

C

Which of the following is considered the most immunogenic tissue?

• a) Cornea

• b) Heart

• c) Bone Marrow

• d) Liver

• e) Kidney

A

Which MHC class directly presents endogenous/intracellular peptides to CD8+ Cytotoxic T-cells?

• a) MHC Class I

• b) MHC Class II

• c) MHC Class III

• d) Minor Antigens

• e) MICA

B

Which MHC class presents exogenous/extracellular peptides to CD4+ Helper T-cells?

• a) MHC Class I

• b) MHC Class II

• c) MHC Class III

• d) Minor Antigens

• e) MICA

C

Which proteins are expressed on endothelial cells, keratinocytes, and fibroblasts, but notably NOT expressed on T or B cells?

• a) HLA-A

• b) HLA-DR

• c) MICA

• d) Minor Antigens

• e) MHC Class II

D

Which tissue is considered the least immunogenic due to being avascular?

• a) Bone marrow

• b) Skin

• c) Heart

• d) Cornea

• e) Kidney

D

What type of transplant rejection occurs within minutes to hours after vascular supply is established?

• a) Chronic Rejection

• b) Acute Cellular Rejection

• c) Accelerated Rejection

• d) Hyperacute Rejection

• e) Graft vs. Host Disease

C

What type of rejection spikes 3 to 5 days post-transplant and involves preformed non-complement binding antibodies?

• a) Chronic Rejection

• b) Acute Cellular Rejection

• c) Accelerated Rejection

• d) Hyperacute Rejection

• e) Graft vs. Host Disease

B

Which rejection primarily occurs days to weeks post-transplant and involves CD8+ cells mediating direct cytotoxic reactions?

• a) Chronic Rejection

• b) Acute Cellular Rejection

• c) Accelerated Rejection

• d) Hyperacute Rejection

• e) Graft vs. Host Disease

A

Which rejection is hallmarked by graft arteriosclerosis causing progressive fibrosis and scarring?

• a) Chronic Rejection

• b) Acute Cellular Rejection

• c) Accelerated Rejection

• d) Hyperacute Rejection

• e) Graft vs. Host Disease

B

What complication arises when immunocompetent donor T-lymphocytes transfused alongside the graft mount an attack on the host's native cells?

• a) Chronic Rejection

• b) Graft vs. Host Disease (GVHD)

• c) Accelerated Rejection

• d) Hyperacute Rejection

• e) Acute Cellular Rejection

E

What specific gamma irradiation dose is used to regulate and kill donor lymphocytes to prevent GVHD?

• a) 500 cGy

• b) 1000 cGy

• c) 1500 cGy

• d) 2000 cGy

• e) 2500 cGy

A

What powerful signaling molecules are released by activated Helper T-cells to hyper-activate macrophages?

• a) Lymphokines

• b) Antibodies

• c) Histamines

• d) Trypan blue

• e) Tritiated thymidine

B

What vital dye is used in the Lymphocytotoxicity Test to indicate if a cell has been damaged by the complement system?

• a) Methylene blue

• b) Trypan blue dye

• c) Tritiated thymidine

• d) Ficoll-Hypaque

• e) Gram stain

A

In the Lymphocytotoxicity Test, what does a positive result (dead cells taking up dye) signify?

• a) Incompatibility (chance of GVHD/rejection)

• b) Perfect match

• c) Successful engraftment

• d) Negative crossmatch

• e) The transplantation can take place

B

What in vitro assay measures the cellular immune stimulation of a recipient's T lymphocytes when exposed to donor cells?

• a) Lymphocytotoxicity Test

• b) Mixed Leukocyte Reaction (MLR)

• c) Crossmatching

• d) Serology

• e) Cardiopulmonary bypass

C

What radioactive isotope tracer is added during an MLR test to measure lymphocyte proliferation?

• a) Carbon-14

• b) Trypan blue dye

• c) Tritiated thymidine

• d) Ficoll-Hypaque

• e) Technetium-99

E

Which immunosuppressive drug is an antimetabolite with multiple systemic immunosuppressive activities?

• a) Corticosteroids

• b) OKT3

• c) Cyclosporin

• d) Sirolimus

• e) Azathioprine

A

Which immunosuppressive drugs specifically inhibit the induction and maturation of cytotoxic T-cells?

• a) Cyclosporin and Tacrolimus

• b) Corticosteroids

• c) Sirolimus and Azathioprine

• d) OKT3

• e) Gamma irradiation

D

Which immunosuppressive drug functions by inhibiting BOTH the activation and the subsequent proliferation of T-lymphocytes?

• a) Corticosteroids

• b) Azathioprine

• c) Cyclosporin

• d) Sirolimus

• e) Tacrolimus

C

Monoclonal antibodies like OKT3 specifically bind to which surface membrane markers on T-cells to neutralize them?

• a) CD4

• b) CD8

• c) CD3

• d) HLA-DR

• e) MICA

B

Hyperacute Rejection is entirely driven by which type of hypersensitivity mechanism?

• a) Type I (Immediate)

• b) Type II (Cytotoxic / Antibody-Mediated)

• c) Type III (Immune Complex-Mediated)

• d) Type IV (Delayed / Cell-Mediated)

• e) Type V

D

Graft vs. Host Disease (GVHD) and Acute Cellular Rejection are primarily driven by which type of hypersensitivity mechanism?

• a) Type I (Immediate)

• b) Type II (Cytotoxic / Antibody-Mediated)

• c) Type III (Immune Complex-Mediated)

• d) Type IV (Delayed / Cell-Mediated)

• e) Type V

Autograft

What specific term refers to a graft transferred from one position to another within the same individual, also known as a Rescue Transplant?

Allograft / Homograft

What specific term refers to a graft between genetically different individuals of the same species?

AB

Which blood type is known as the universal recipient in solid organ transplantation?

Rh factor

Which matching factor, fundamental in blood transfusions, is surprisingly irrelevant in solid organ transplantation?

Human Leukocyte Antigen

What does the acronym "HLA" stand for in compatibility testing?

Cardiopulmonary bypass machine

What specialized equipment utilizes a pump, oxygenator, and reservoir to circulate oxygenated blood while the heart is removed and replaced during surgery?

Pancreas

Which solid organ is heavily dependent on tissue crossmatching and the specific matching of HLA-DR antigens?

HLA-A, HLA-B, HLA-C

What specific sub-types make up the MHC Class I genes?

HLA-DR, HLA-DQ, HLA-DP

What specific sub-types make up the MHC Class II genes?

MHC-class I related Chain A

What does the acronym "MICA" stand for in tissue immunogenicity?

Islets of Langerhans

Along with bone marrow and skin, what specific pancreatic cells are classified under the "Most Immunogenic" category?

It is avascular

What primary anatomical characteristic gives the cornea the lowest rejection rate?

Graft vs. Host Disease (GVHD)

What severe complication presents with exfoliative dermatitis, marrow aplasia, severe diarrhea, and extreme weight loss when a graft attacks a host?

Hyperacute Rejection

What catastrophic pathology involves massive intravascular thrombus formation leading to immediate ischemia and necrosis, typically with a 0% success rate for therapy?

Acute Cellular Rejection

Which type of rejection is treated heavily with steroids or OKT3 (monoclonal antibodies), boasting an 80-90% success rate?

Graft arteriosclerosis

What progressive pathology is the hallmark of Chronic Rejection, leading to the narrowing of the vessel lumen due to vascular smooth muscle cell proliferation?

CD8+ Cytotoxic T-cells (Tc cells)

What class of T-cells mediate direct cytotoxic reactions during an acute cellular rejection?

CD4+ Helper T-cells (Th cells)

What class of T-cells drives a delayed-type hypersensitivity (DTH) reaction during acute cellular rejection?

Macrophages

In cellular mechanisms of rejection, what hyper-activated cells are stimulated by lymphokines to attack and kill foreign graft cells?

Complement proteins

What specific proteins are added to the mixture in step 2 of the Lymphocytotoxicity Test alongside Trypan blue dye?

(-) Result / Live Cells Take Up NO Dye

In a Lymphocytotoxicity Test crossmatch, what visual result indicates the patient and donor are compatible (meaning transplantation can take place)?

Ficoll-Hypaque centrifugation

What specific centrifugation method is used to isolate lymphocytes from whole blood during the Mixed Leukocyte Reaction (MLR) procedure?

5 days

During a Mixed Leukocyte Reaction (MLR), how many days are the lymphocytes incubated together?

37C

At what precise temperature (in Celsius) are the lymphocytes incubated during the Mixed Leukocyte Reaction (MLR)?

Corticosteroids

What class of immunosuppressive drugs acts as potent anti-inflammatory agents by inhibiting antigen-driven T-cell proliferation?

Type I (Immediate / IgE-Mediated)

Which hypersensitivity mechanism is triggered when IgE antibodies bind to allergens, causing mast cells to release histamine?

Type III (Immune Complex-Mediated)

Which hypersensitivity mechanism involves free-floating antigen-antibody complexes forming in the blood and getting stuck in tissues?

Type II (Cytotoxic / Antibody-Mediated)

Preformed antibodies (ABO or HLA mismatch) reacting with the donor's vascular endothelium represent which specific mechanism of hypersensitivity?

Type II and Type III

Chronic rejection is heavily driven by humoral mechanisms that share characteristics of which TWO specific types of hypersensitivity?

High doses of chemotherapy or radiation

Before a bone marrow transplant, patients undergo what specific conditioning to destroy residual cancer cells, suppress the immune system, and provide physical space in the cavity?

1954

In what year was the first successful organ transplant, which involved a kidney between identical twins, performed in Boston?

CMV (Cytomegalovirus)

During patient screening, what specific infectious viral disease often associated with immunocompromised patients is screened for alongside HIV, Hepatitis, and syphilis?

48 hours

Crossmatching is performed multiple times up to how many hours prior to the transplant to ensure the recipient lacks preformed antibodies against donor tissue?

8 weeks

What specific timeframe is required for newly transplanted bone marrow to engraft and regenerate within the bone marrow cavity?

Minor Histocompatibility Antigens

What class of antigens are non-HLA proteins that demonstrate polymorphism in their amino acid sequences and mediate a slower rejection pace compared to major mismatches?

Physiologic reserve

During patient screening, cardiopulmonary and cancer screenings are performed to ensure the patient possesses what specific capacity to survive massive surgical stress?

Polyclonal antilymphocyte globulin

What specific therapy is used alongside plasmapheresis and cyclophosphamide to treat Accelerated Rejection, yielding an approximate 60% success rate?

Chronic Rejection

Prolonged cold ischemia, reperfusion injury, and toxicity from immunosuppressive drugs are major predisposing factors for which specific type of transplant rejection?

Class II antigens

In the pharmacological prevention of graft rejection, administered antibodies can block host T-cell receptors, or they can bind directly to which specific antigens on the graft cell to prevent the host's Helper T-cells from docking?

Lacks autonomic nerve connections

Why will a newly implanted heart post-surgery not respond to physiologic stimuli (like stress or exercise) as promptly as a native heart?