Nephrology: renal transplant rejection: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Nephrology: renal transplant rejection

Sample item

Within minutes of reperfusion of a transplanted kidney, the graft becomes mottled and cyanotic. What is the mechanism?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Hyperacute rejection from preformed antibodies

Hyperacute rejection occurs within minutes to hours from preformed anti-donor antibodies, such as ABO or HLA antibodies, causing complement-mediated vascular thrombosis. It is prevented by cross-matching. Acute cellular rejection occurs weeks to months later and responds to steroids.

Option by option

  • A. Calcineurin inhibitor toxicity

    Drug toxicity does not cause immediate mottling at reperfusion.

  • B. Hyperacute rejection from preformed antibodies (correct)

    Correct. Preformed antibodies cause immediate graft loss.

  • C. Acute cellular rejection from T cells

    Acute cellular rejection takes days to months.

  • D. Chronic allograft nephropathy

    Chronic nephropathy takes years.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Hyperacute rejection from preformed antibodies. Hyperacute rejection occurs within minutes to hours from preformed anti-donor antibodies, such as ABO or HLA antibodies, causing complement-mediated vascular thrombosis.

Why is "Calcineurin inhibitor toxicity" not the answer?

Drug toxicity does not cause immediate mottling at reperfusion.

Why is "Acute cellular rejection from T cells" not the answer?

Acute cellular rejection takes days to months.

Why is "Chronic allograft nephropathy" not the answer?

Chronic nephropathy takes years.

What concept does this question test?

It tests Nephrology: renal transplant rejection in General Medicine. It is prevented by cross-matching. Acute cellular rejection occurs weeks to months later and responds to steroids.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nephrology: renal transplant rejection?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.