BMTCN - CHAPTER 6 WITH COMPLETE
SOLUTIONS ALREADY GRADED A+
What are the types of cardiac diseases common post HSCT? What conditioning medications can
cause these diseases? - answer Cardiomyopathy, arrhythmias, congestive heart failure - high
dose cytoxan and radiation causes this
HTN/Dislipidemia: Immunosuppression meds
HTN/Hyperkalemia: Cyclosporine
HTN/Hyperlididemia and edema: Sirolimus
How would you management cardiac disease in post-HSCT patients? - answer Assess risk
factors, follow up testing (EKG, ECHO, labs such as BNP, A1c, thyroid function), medications,
weight loss, stress reduction
What is the major cause of transplant-related mortality and morbidity? - answer Infection-
related complication. Depends on hx of infections, chemo regimen intensity, and type of
transplant.
What are the risk factors of the development of an infection post-transplant? - answer -Hx of
infection (CMV status, blood stream infection)
-Type of transplant: Auto (regimen related) Allo (slow count recovery, GVHD)
-Myeloablative regimen and immunosuppression drugs
-HLA mismtached and CMV status
What are the prevention and management of infection? - answer -Vaccination (pneumococcus,
Tdap, Influenza, meningococcus, Hep B, MMR (1 year post)
, -Surveillance (T cell counts, CMV screening)
-Antibiotics Bactrim post transplant (6mo)
-Avoid pets
-Avoid sick people
-Practice good hygeine
-Safe sex practices
-Follow travel guidelines
What are other common post transplant complications? - answer -Occular
-Muscoskeletal
-Psychological
-Graft failure and rejection
What is the major cause of occular damage post transplant? What are the clinical
manifestations? - answer Cause: GVHD
Manifestations: Photophobia, conjuncitivits, ulceration, dryness, pain
What is the treatment for GVHD of the eyes? - answer -Cyclosporine eye drops
-Eye shielding during TBI
-Systemic immune suppression
-Lubricate the eyes
-Wearing eye protection
What is avascular necrosis (AVN)? - answer Painful condition that develops when blood supply
to the bone is disrupted
What are the risk factors of developing AVN? - answer -GVHD
-Old age
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