One month after undergoing an uneventful renal transplant fo

Discussion in 'USMLE Step 2 CK' started by John., Feb 12, 2008.

  1. John.

    John. Guest

    . One month after undergoing an uneventful renal transplant for chronic renal failure secondary to glomerulonephritis, a 38-year-old woman is hospitalized because of increased serum urea nitrogen (BUN) and creatinine levels. Prior to transplantation, she had been receiving hemodialysis for 3 years. Current medications include cyclosporine and prednisone. Examination shows no abnormalities. Over the past 48 hours, urine output has remained stable. Both renal biopsy and a radionuclide scan confirm the diagnosis of acute rejection. Which of the following is the most effective treatment?

    A ) Immediate discontinuation of cyclosporine

    B ) Increased dosage of corticosteroids

    C ) Diuresis and alkalinization of the urine

    D ) Renal dialysis for 1•2 weeks

    E ) Transplant nephrectomy
  2. Diya.

    Diya. Guest

    b...acute rejection----->increase steroids
  3. Guest

    Guest Guest

    Acute rejectionappears within the first 6 post-transplant months and affects approximately 15% of transplanted kidneys. Roughly 20% of patients with transplants experience recurrent rejection episodes. Patients present with decreasing urine output, hypertension, and mild leukocytosis. Rising creatinine level may be delayed in acute rejection. Fever, graft swelling, pain, and tenderness may be observed with severe rejection episodes. Rejection is secondary to prior sensitization to donor alloantigens (occult T-cell crossmatch) or a positive B-cell crossmatch. The final diagnosis depends upon a graft biopsy. Acute rejection is treated with a 3- to 5-day course of high-dose intravenous steroids.

Share This Page