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NBME 21 Answers

nbme21/Block 4/Question#24 (36.2 difficulty score)
A 56-year-old man undergoes a renal ...
IgG plus complementπŸ”
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 +11 
submitted by h0odtime(47),

Transplant Rejections (p.119)

  • Hyperacute - Minutes pre-existing Ab attack new organ Ag + activate complement T2
  • Acute - Weeks CD8 +/- CD4 bind organ MHC. T4
  • Chronic - Months/years CD4s can activate macrophages and mediate damage T4, or activate B cells --> Ab --> damage graft. T2 or T4
  • GVH - Time varies, organ with T-cells grow and reject foreign host. T4

Transplant Types

  • Autologous Self skin grafts
  • Allogenic Normal organ transplant
  • syngeneic graft (isograft) Monozygotic twins
  • xenograft animal to human heart valves

ABCD Hypersensitivity (p.112 FA2020)

  • T1 : Anaphylactic & Atopic
  • T2: (anti)Body-mediated
  • T3: Complex (Immune)
  • T4: Delayed Cell Mediated



 +4 
submitted by hayayah(1076),
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eetHracuyp atnartspln incjrteeo cuocsr inhwit tnuesim dt/ eipteisrgxn- epirneitc etndoasibi atth aetcr to nrood naiteng (etpy II yvyprtsiethsenii antroce)i, teatcavi emco.lmtpen

mcl  [Useful figures illustrating transplant rejection](https://www.stomponstep1.com/transplant-rejection-hyperacute-acute-chronic-graft-versus-host/) +  
drdoom  ^ via @mcl [Useful figures illustrating transplant rejection](https://www.stomponstep1.com/transplant-rejection-hyperacute-acute-chronic-graft-versus-host/ +1  



 +0 
submitted by priapism(6),
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Pre iFrst i:dA ensiobdtia agntias OBA oblod tpesy dnet to be IMg ro gIG, ihchw is hyw het nrseaw si GgI + eecopmmntl adn otn IgA + ltecpmmeon

yotsubato  IgA also has no role in any hypersensitivity reaction +2  
divya  hi. where is this given in first aid? +