CCTC - Certified Clinical Transplant Coordinator Transplant Immunology and Pharmacology Questions and Answers

Question 1

A kidney transplant recipient, 6 months post-transplant on a standard triple-drug regimen, presents with new-onset tremors, headache, and a random blood glucose of 215 mg/dL.
Which medication is the most likely cause of this constellation of symptoms?

Accepted Answer

Tacrolimus

Answer

Mycophenolate Mofetil

Answer

Prednisone

Answer

Azathioprine

Question 2

The presence of C4d deposits in the peritubular capillaries on a renal allograft biopsy is a key histopathological finding for which type of rejection?

Accepted Answer

Antibody-mediated rejection (AMR)

Answer

Hyperacute rejection

Answer

T-cell mediated rejection (TCMR)

Answer

Chronic allograft nephropathy

Question 3

A transplant candidate has a calculated Panel Reactive Antibody (cPRA) of 98%. What is the primary clinical implication of this value?

Accepted Answer

The candidate is immunologically sensitized to antigens present in 98% of the donor pool.

Answer

The candidate has a 98% chance of developing acute rejection.

Answer

The candidate's immune system is suppressed and will require less induction therapy.

Answer

The candidate has pre-existing antibodies against only two specific HLA antigens.

Question 4

Which of the following immunosuppressive agents is a monoclonal antibody that functions by blocking the CD25 subunit of the IL-2 receptor on activated T-lymphocytes, thereby preventing their proliferation?

Accepted Answer

Basiliximab

Answer

Antithymocyte Globulin

Answer

Rituximab

Answer

Alemtuzumab

Question 5

A liver transplant recipient who is stable on a sirolimus-based regimen is admitted for poor wound healing and a new-onset, significant leg edema. Laboratory results show 4+ proteinuria. These findings are most characteristic of the side-effect profile of which drug class?

Accepted Answer

mTOR inhibitors

Answer

Calcineurin inhibitors (CNIs)

Answer

Corticosteroids

Answer

Antimetabolites

Question 6

The primary mechanism of action for mycophenolate mofetil (MMF) involves the non-competitive and reversible inhibition of which enzyme, leading to impaired lymphocyte proliferation?

Accepted Answer

Inosine monophosphate dehydrogenase (IMPDH)

Answer

Calcineurin

Answer

Cyclooxygenase-2 (COX-2)

Answer

Dihydrofolate reductase

A kidney transplant recipient, 6 months post-transplant on a standard triple-drug regimen, presents with new-onset tremors, headache, and a random blood glucose of 215 mg/dL.Which medication is the most likely cause of this constellation of symptoms?

A kidney transplant recipient, 6 months post-transplant on a standard triple-drug regimen, presents with new-onset tremors, headache, and a random blood glucose of 215 mg/dL.
Which medication is the most likely cause of this constellation of symptoms?