Haematology and oncology: acute graft-versus-host disease: 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 · Haematology and oncology: acute graft-versus-host disease

Sample item

Three weeks after allogeneic stem cell transplantation, a patient develops a maculopapular rash, cholestatic jaundice and profuse watery diarrhoea. What is the most likely cause?

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

The answer and the reasoning

C. Acute graft-versus-host disease

Acute graft-versus-host disease occurs when donor T cells attack the recipient's skin, liver and gut, typically within the first 100 days. Prophylaxis uses calcineurin inhibitors with methotrexate, and treatment is with corticosteroids.

Option by option

  • A. Cytomegalovirus colitis alone

    CMV colitis can cause diarrhoea but would not explain the rash and cholestasis together.

  • B. Primary graft failure

    Graft failure presents with persistent pancytopenia and not a rash with organ involvement.

  • C. Acute graft-versus-host disease (correct)

    Correct. The triad of rash, cholestasis and diarrhoea after allogeneic transplantation is acute GVHD.

  • D. Hepatic veno-occlusive disease

    Veno-occlusive disease causes tender hepatomegaly, weight gain and jaundice, without rash or diarrhoea.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Acute graft-versus-host disease. Acute graft-versus-host disease occurs when donor T cells attack the recipient's skin, liver and gut, typically within the first 100 days.

Why is "Cytomegalovirus colitis alone" not the answer?

CMV colitis can cause diarrhoea but would not explain the rash and cholestasis together.

Why is "Primary graft failure" not the answer?

Graft failure presents with persistent pancytopenia and not a rash with organ involvement.

Why is "Hepatic veno-occlusive disease" not the answer?

Veno-occlusive disease causes tender hepatomegaly, weight gain and jaundice, without rash or diarrhoea.

What concept does this question test?

It tests Haematology and oncology: acute graft-versus-host disease in General Medicine. Prophylaxis uses calcineurin inhibitors with methotrexate, and treatment is with corticosteroids.

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 Haematology and oncology: acute graft-versus-host disease?

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.