A 72 year-old female came to your office complaining of fever, fatigue, lower abdominal pain, and decreased urine output. Her past medical history is significant for dialysis dependent end-stage renal disease for 12 years and a renal transplantation 9 months ago. Your physical examination is significant for pain on the right lower abdomen. In consultation with her nephrologist, you ordered some laboratory studies and a renal transplant biopsy. Laboratory tests came positive for circulating donor-specific antibodies. In biopsy, histological examination showed microvascular inflammation, intimal arteritis, acute thrombotic microangiopathy, acute tubular injury, linear C4d staining in peritubular capillaries, and de novo glomerulonephritis. What is the most common treatment for this transplant rejection?
A 72 year-old female came to your office complaining of fever, fatigue, lower abdominal pain, and decreased urine output. Her past medical history is significant for dialysis dependent end-stage renal disease for 12 years and a renal transplantation 9 months ago. Your physical examination is significant for pain on the right lower abdomen. In consultation with her nephrologist, you ordered some laboratory studies and a renal transplant biopsy. As you await the test results, she reports she is concerned about transplant rejection. Regarding transplant rejection, which of the following is a correct statement?
A 54-year old male developed end-stage renal disease secondary to diabetes. He received a kidney transplant from a living relative. The transplant functioned well with significant improvement in his well being. However, 4 months after transplantation, he noticed tenderness in his groin over the site of transplant, fever, malaise, oliguria, and decreased urine output. Which of the following is the most valuable prognostic indicator in this patient?
A 62 year-old male with end-stage renal disease expressed interest in receiving a renal transplant, and being taken to the operation theater for transplant surgery. The kidney is placed in the lower abdomen and blood supply is established with the iliac vessels. As the surgeons connect the donor kidney to the patient’s bladder, the patient’s temperature rose to 102 F, blood pressure dropped to 80/40 mmHg and heart rate has increased to 120 beats per minute. The transplanted kidney appears cyanotic, hemorrhagic, necrotic and mottled. You suspect hyperacute rejection in this patient. Of the following, what is the most likely mechanism in hyperacute rejection?
A 62 year-old male with end-stage renal disease expressed interest in receiving a renal transplant, and being taken to the operation theater for transplant surgery. The kidney is placed in the lower abdomen and blood supply is established with the iliac vessels. As the surgeons connect the donor kidney to the patient’s bladder, the patient’s temperature rose to 102 F, blood pressure dropped to 80/40 mmHg and heart rate has increased to 120 beats per minute. The transplanted kidney appears cyanotic, hemorrhagic, necrotic and mottled. You suspect hyperacute rejection in this patient. Of the following, which type of hypersensitivity is observed in hyperacute rejection?
A 62 year-old male with end-stage renal disease expressed interest in receiving a renal transplant, and being taken to the operation theater for transplant surgery. The kidney is placed in the lower abdomen and blood supply is established with the iliac vessels. As the surgeons connect the donor kidney to the patient’s bladder, the patient’s temperature rose to 102 F, blood pressure dropped to 80/40 mmHg and heart rate has increased to 120 beats per minute. The transplanted kidney appears cyanotic, hemorrhagic, necrotic and mottled. What is the most likely diagnosis?
A 40 year-old woman presented to the dermatology clinic with frank, fluid filled, pruritic blisters on her forearms, hands, wrists, and legs. She reports that last week while working in her garden, she was exposed to poison ivy plants. You noticed vesicles and flaccid bullae in a linear configuration on the involved areas. Which of the following immunopathogenic mechanisms is most likely to be the cause of this skin disease?
A 46 year-old male developed a hard, painful swelling with redness and discoloration on his right shoulder. He reports 10 hours ago he received a tetanus vaccine on the site where it is hurting now. He reports that if his memory is right, his last tetanus vaccine was 3 years ago in the same site after he accidentally stepped on a nail. But he is not sure because he does not keep a record of his vaccinations. As you consider this reaction to the tetanus vaccine, what would be the best advice to give to this patient?
In Graves’ disease, the autoantibodies bind to the thyrotropin receptor on thyroid follicular cells resulting in the overproduction of thyroid hormones. Which one of the following four types of hypersensitivity reactions occur in this disease?
Hemolytic disease of the fetus is a condition where fetal red blood cells are destroyed due to blood group incompatibility, primarily involving Rh or ABO blood types. Which one of the following four types of hypersensitivity reactions occur in this disease?
