5 Written Questions

1. defend against intracellular bacteria, fungi
2. 1. pre-engraftment risks (days 0-30): neutropenia, mucositis, central line. S.aureus, strep, e.coli, klebsiella, pseudomonas, aspergillus, candida.
   2. early post-engraftment risks (days 31-100): lymphopenia, hypogammaglobulinemia, central line, idiopathic pneumonia, acute GVHD. CMV, HSV, VZV, RSV, adenovirus, listeria, mycobacteria, nocardia, candida, aspergillus, cryptococcus, histoplasma, pneumocystis
   3. late post-engraftment risk (days >100): chronic GVHD. residual splenic dysfunction leads to encapsulated bacterial infections. also VZV
   4. CMV infection: highest risk in donor-/recipient+, then donor+/recipient+ and donor-/recipient+ (CMV naive system exposed to CMV w/ severe immune dsyfunction)
   5. late aspergillus risks: mismatched donor, GVHD, CMV, steroids, neutropenia, T cell depleted
3. greatest risk of infection by intracellular bacteria, fungi, virus, protozoa
4. bacterial infection: N.meningitidis, Strep pneumo (encapsulated bacteria)
5. bacterial infection: S.aureus, grpB strep, H.influenzae, E.coli, Klebsiella, Pseudomonas, Bacteroides
   fungal infection: Aspergillus, Candida

5 Matching Questions

1. B cell defects
2. solid organ transplant
3. neutropenia
4. late period infection
   (solid organ transplant)
5. immunosuppressive period infection
   (solid organ transplant)

1. a 1-6mos, T cell defects. viruses, intracellular bacteria, all fungi, toxoplasmosis
2. b risk affected by specific organ, age, previous exposures/immunizations, # of blood products used during surgery, organisms in donor, immunosuppression, catheters, exposures
   highest risk in lung, then kidney
3. c greatest risk for extracellular bacteria, fungal infections
   risk of infection related to severity, acuity of onset, duration
4. d >6mos, small amount w/ significant rejection have persistent T cell defects
5. e viral infection: Enterovirus
   bacterial infection: Strep pneumo, H.influenzae, N.meningitidis, S.aureus
   parasitic infection: Giardia

5 Multiple Choice Questions

1. (days 0-30): neutropenia, mucositis, central line. S.aureus, strep, e.coli, klebsiella, pseudomonas, aspergillus, candida.
   1. early post-engraftment risks
      (bone marrow/stem cell transplant)
   2. late post-engraftment risks
      (bone marrow/stem cell transplant)
   3. late aspergillus risks
      (bone marrow/stem cell transplant)
   4. pre-engraftment risks
      (bone marrow/stem cell transplant)
2. defend against intracellular bacteria, viruses, fungi
   1. CD4/CD8 (cell mediated)
   2. B cell defects
   3. T cell defects
   4. NK cells
3. defects in both cell-mediated immunity + neutropenia,
   see defects in everything except complement system
   1. neutrophil defects
   2. CMV infection
      (bone marrow/stem cell transplant)
   3. solid organ transplant
   4. bone marrow/stem cell transplant
4. 1) Viruses: CMV, HSV, VZV, RSV, adenovirus
   2) Bacteria: Listeria, Mycobacteria, Nocardia
   3) Fungi: Candida, Aspergillus, Cryptococcus, 4) Histoplasma, Pneumocystis
   5) Protozoan: Toxoplasmosis!!
   
   All opportunistic due to T cell deficits.
   1. solid organ transplant
   2. solid organ transplant (early, 1 mo after)
   3. solid organ transplant (Middle 1-6 mo after)
   4. bone marrow/stem cell transplant
5. defend against viruses
   1. CMV
   2. NK cells
   3. antibodies
   4. neutrophils

5 True/False Questions

1. CMV → 1) is the most common infectious cause of morbidity and mortality in transplant recipients
   - highest risk in donor+/recipient- for solid organ transplants
   - highest risk in donor-/recipient+ for stem cell transplants

   True        False

2. CMV infection
   (solid organ transplant) → >6mos, small amount w/ significant rejection have persistent T cell defects

   True        False

3. physical/mechanical barrier defects → bacterial infection: S.aureus, Strep, Pseudomonas
   fungal infection: Aspergillus, Candida

   True        False

4. solid organ transplant → neutropenia is largest risk factor for this. Worred about Staph and Pseudo the most

   True        False

5. T cell defects → viral infection: Enterovirus
   bacterial infection: Strep pneumo, H.influenzae, N.meningitidis, S.aureus
   parasitic infection: Giardia

   True        False