American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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Which cytotoxic effect does not typically associate with Mycophenolate mofetil?

  1. Impaired thymocyte development

  2. Reduced platelet count

  3. Increased lymphocyte proliferation

  4. Decreased antibody production

The correct answer is: Increased lymphocyte proliferation

Mycophenolate mofetil (MMF) is an immunosuppressive medication primarily used in organ transplantation and autoimmune diseases. Its mechanism involves the inhibition of inosine monophosphate dehydrogenase (IMPDH), which plays a critical role in the de novo pathway of purine synthesis. This pathway is particularly important for lymphocytes, especially during proliferation. The correct answer highlights that increased lymphocyte proliferation does not typically associate with Mycophenolate mofetil. In fact, MMF is known to decrease lymphocyte proliferation by limiting the availability of purines necessary for DNA synthesis and cell division. As a result, it effectively suppresses the activation and proliferation of lymphocytes, particularly T and B cells, which is critical for its immunosuppressive effects. In contrast, the other listed effects are consistent with the pharmacological action of Mycophenolate mofetil. Impaired thymocyte development occurs because MMF's immunosuppressive properties hinder T cell maturation and function in the thymus. Reduced platelet count can result from the effects of MMF on bone marrow, where it may negatively influence hematopoiesis. Finally, the decreased antibody production is a direct consequence of the reduced activity and proliferation of B cells