Transplant Surgery – Test Type 1

1. The term „allograft“ defines

a. A graft from the same patient
b. A graft from same species donor
c. An animal graft
d. All of the above
e. None of the above
2. A “Xenograft”defines
a. A graft from the same patient
b. A graft from same species donor
c. An animal graft
d. All of the above
e. None of the above
3. Oldest historical registering refer to:
a. Kidney transplantation
b. Liver transplantation
c. Cornea transplantation
d. Skin Transplantation
e. Bone transplantation
4. First kidney transplantation between twins was made in Boston in
a. 1954
b. 1967
c. 1933
d. 1902
e. 1997
5. Which of the following substances was NOT used in immunosuppression
a. 6-mercaptopurine
b. Methotrexate
c. Cyclosporine
d. Azathioprine
e. Tryptophane
6. First kidney transplantation from cadaver donor was in Romania in Timisoara by Prof Dragan’s team
in the year
a. 1981
b. 1980
c. 1976
d. 1990
e. 2001
7. The “father” of liver transplantation is
a. Starzi
b. Ulmann
c. Hutne
d. Shumway
e. Barnard
8. First lung transplantation was made by
a. Starzi
b. Ulmann
c. Hardy
d. Shumway
e. Barnard
9. First medullary transplant was made in Romania in
a. Timisoara
b. Bukarest
c. Cluj
 d. Targu Mures
e. Iasi
10. First heart transplantation was accomplishe in Cape Town by Prof C. Barnard in the year
a. 1933
b. 1954
c. 1957
d. 1970
e. 1980
11. Ideally the evaluation of patiens in the hemodialysis programme as candidates for kidney
transplantation must begin:
a. 1-2 days before transplantation
b. Before entering in hemodialysis progamme
c. 24h before transplantation
d. 12h before transplantation
e. 3h before transplantation
12. Annual mortality of patients in hemodialysis waiting for kidney transplantation is:
a. 6%
b. 25%
c. 40%
d. 1%
e. 33%
13. “Preemptive transplantation” means
a. Partially compatible graft transplantation
b. Xenograft
c. Transplantation before hemodialysis
d. Preventive transplantation in first degree relative of pat with Chronic kidney failure by
autosomal dominant transmitted diseases
e. None of the above
14. The major advantage of preemptive transplantation is
a. Longer surviving of the graft
b. No immunosuppression needed
c. Minimum hemorrhagic complications
d. Minimum rejection risk
e. All of the above
15. Major kidney transplantation contraindication include:
a. Hypertension
b. Diabetes mellitus type 1
c. Uremia
d. Metastatic Cancer
e. Diabetes mellitus type 2
16. Intermittent claudication in a patient evaluated for renal transplantation warns of
a. Rejection risk
b. Immunosuppressant intolerance risk
c. Ischemic cardiac disease or acute MI risk
d. Cerebro-vascular disease risk
e. All of the above
17. The major post-transplantation death cause is represented by:
a. CV complications
b. Pulmonary complications
c. Metabolic complications
d. Rejection
e. Infectious complications
18. Risk factors for post transplantation cerebrovascular diseases are the following, EXCEPT:
a. Age
b. Pretransplant cerebrovascular disease
c. Hypertension
d. Hypoglycemia
e. Age
19. The most frequent colonic perforation cause in transplanted patients is
a. Diverticulitis
b. Accidental injury of colon during transplant procedure
c. JJ catheters that can perforate the bowel wall
d. Colic wall ischemia during intervention
e. All of the above
20. Pretransplant nephrectomy at graft receiver patient is recommended for those patients with
a. Infected renal lithiasis
b. Mild essential hypertension
c. Chronic glomerulonephritis
d. Minimal proteinuria
e. Microscopic hematuria
21. Recurrence risk of renal diseases after kidney transplant is most frequently increased in patients
with:
a. Focal and segmental glomerulonephritis
b. IgA Glomerulonephritis
c. Type III membrane proliferative glomerulonephritis
d. Lupus
e. Membranous Nephropathy
22. Which of these affirmations regarding the kidney transplantation at obese patients is true
a. Obesity is not a risk factor for transplant
b. The graft resume activity slower after transplant
c. A BMI 30-35 is ideal for transplant
d. All of the above are correct
e. None of the above is correct
23. Which of the following information regarding diabetes and kidney transplant is true
a. Approx 40% of patient with decompensated CKD waiting for renal transplant are diabetics
b. Approx 10% of patient with decompensated CKD waiting for renal transplant are diabetics
c. Diabetic nephropathy is a common cause of transplant failure
d. All of the above
e. None of the above
24. Graft storing temperature for renal transplant after washing is usually
a. 0-4°C
b. -10
c. -5
d. -15
e. 20
25. In the reperfusion state of renal transplantation
a. There are no secondary effects
b. Large quantities of free oxygen radicals are produced
c. There is a stable equilibrium between inner and outer cell ionic concentrations
d. All of the above
e. None of the above
26. Graft preservation solutions for kidney transplantation
a. Have the role in counterbalance the changes of graft by ischemia
b. Most used is glucose 5%
c. Most used is glucose 10%
d. Most used is saline solution
e. None of the above is correct
27. By preservation of renal graft basic kidney metabolism decreases at
a. 20-30%
b. 50%
c. 4-8%
d. 40%
e. 70%
28. An undesirable effect of cold preservation of kidney transplant is
a. Apoptosis
b. Alkalosis
 c. Acidosis
d. Hematuria
e. None of the above
29. The responsible mechanism for structural renal cell changes in the preservation state is represented
by
a. Na+/K+ATPase alteration
b. Na-ClATPase alteration
c. Inner cell alkalosis
d. All of the above
e. None of the above
30. Most efficient impermeabilising agents in graft preservation solutions are
a. Monosaccharides
b. Oligosaccharides
c. Non-saccharidic anions
d. Large molecule saccharides
e. None of the above
31. Renal graft preservation solution must
a. Limit the damage caused by free oxygen radicals
b. Ensure maintenance of cellular pH
c. Rebalance transmembranous ionic balance
d. Prevent the inflow of water into the cell
e. All of the above
32. Proteases releases under conditions of hypoxia are responsible for:
a. Detachment of renal epithelial cells from the basal membrane
b. Intracellular alkalosis
c. Cell swelling
d. All of the above
e. None of the above
33. Donor nephrectomy can be performed
a. Transperitoneally
b. Lumbar approach
c. Laproscopically
d. All of the above
e. None of the above
34. Principles of nephrectomy in donor are
a. Proper exposure
b. Preservation of peripheral and periureteral fat
c. Maintain the intraoperative active dieresis
d. All of the above
e. None of the above
35. The accessory vessels are encountered in kidney transplantation in
a. 1% cases
b. 12-15%
c. 50%
d. Under 1%
e. 25%
36. In the case of multiorgan removal, organ harvesting sequence is
a. Heart-lungs-liver-kidney-pancreas
b. Heart-liver-kidney-pancreas-lung
c. Liver-kidney-pancreas-lungs-heart
d. Heart-lungs-liver-kidney-pancreas
e. No variant is correct
37. Maximum acceptable age for multiorgan donors in brain dead is
a. 60 years
b. 70
c. 55
d. 65
e. None of the above
38. The maximum duration of warm ischemia during the harvest of the transplant kidney is
a. 10min
b. 20min
c. 30min
d. 40min
e. 1h
39. Stimulation of diuresis during the harvest of the graft is done with:
a. Mannitol
b. Diuretics
c. Vasopressors
d. All of the above
e. None of the above
40. Dialysis before transplantation
a. Is mandatory
b. Is optional
c. Is prohibited
d. Is only necessary in younger patients
e. Is done only in patients over 60 years
41. Immunosuppression for kidney transplant is initiated
a. Prior to transplantation
b. During transplantation (on the table)
c. Immediately post transplant
d. 1-2 days post transplant
e. To 7 days post transplant
42. Prophylactic antibiotic therapy in renal transplantation with brain dead donor
a. Is not needed
b. Is recommended
c. Is prohibited
d. Does not benefit the patient
e. Increases the risk of rejection
43. Typically a left renal graft is implanted to the receiver in the:
a. Left iliac fossa
b. Right iliac fossa
c. Right lumbar area
d. Left lumbar area
e. Hypogastrium
44. Usually the artery used for graft anastomosis is the
a. Internal iliac artery
b. External iliac artery
c. Superior bladder artery
d. Superior gluteal artery
e. Aorta
45. If for the renal graft arterial anastomosis is used the external iliac artery than the anastomosis
beween external iliac artery and graft artery will be
a. Terminolateral
b. Terminoterminal
c. Lateroterminal
d. Any of them
e. None of them
46. Anastomosis between graft vein an receiver vein regardless of the vein used will be
a. Terminolateral
b. Terminoterminal
c. Lateroterminal
d. Any of them
e. None of them
47. If for the renal graft arterial anastomosis is used the internal iliac artery than the anastomosis
beween internal iliac artery and graft artery will be
a. Terminolateral
 b. Terminoterminal
c. Lateroterminal
d. Any of them
e. None of them
48. Post transplant urinary fistula due to ureteral necrosis occurs
a. In the first week
b. In the first 24h
c. After 3-4 days
d. After 2-3 days
e. In the first 14 days
49. Post transplant urinary fistula caused by surgical technique related to error occurs
a. In the first week
b. In the first 24h
c. After 3-4 days
d. After 2-3 days
e. In the first 10 days
50. Posttransplant ureteral obstruction may occur through
a. Extraluminal mechanism
b. ureteral mechanism
c. intraluminal
d. all of the above
e. none of the above