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NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 1/Question#23 (reveal difficulty score)
Twelve days after undergoing an orthotopic ...
Allograft rejection ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: GI inc

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  • Patient with recent liver transplant presents weeks later with fever, eosinophilia (in a patient taking prednisone where we would otherwise expect low eosinophils), elevated LFTs and a biopsy showing a mononuclear infiltrate with eosinophils in the hepatic triads, consistent with allograft rejection
  • Key idea: Graft eosinophilia is a sensitive and specific marker of acute rejection in liver allografts (https://www.ncbi.nlm.nih.gov/pubmed/9724472)

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jmorga75  Also applies to renal rejection https://pubmed.ncbi.nlm.nih.gov/8081790/ +1
namesthegame22  Hours - 2 days = Hyperacute rejection < 6 months = acute rejection 6 months = chronic rejection +



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