Nephrology: calcineurin inhibitors: 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: calcineurin inhibitors

Sample item

A renal transplant recipient on immunosuppression develops new-onset diabetes mellitus and tremor. Which adverse effect is more characteristic of tacrolimus than of cyclosporine?

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

The answer and the reasoning

D. Post-transplant diabetes mellitus

Tacrolimus and cyclosporine both inhibit calcineurin and cause nephrotoxicity, hypertension and hyperkalaemia. Tacrolimus more often causes diabetes and neurotoxicity, while cyclosporine more often causes gingival hyperplasia, hirsutism and hyperlipidaemia. Drug levels are monitored closely.

Option by option

  • A. Gingival hyperplasia

    Gingival hyperplasia is more typical of cyclosporine.

  • B. Hyperlipidaemia

    Hyperlipidaemia is more marked with cyclosporine.

  • C. Hirsutism

    Hirsutism is characteristic of cyclosporine.

  • D. Post-transplant diabetes mellitus (correct)

    Correct. Diabetes is more frequent with tacrolimus.

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 D, Post-transplant diabetes mellitus. Tacrolimus and cyclosporine both inhibit calcineurin and cause nephrotoxicity, hypertension and hyperkalaemia.

Why is "Gingival hyperplasia" not the answer?

Gingival hyperplasia is more typical of cyclosporine.

Why is "Hyperlipidaemia" not the answer?

Hyperlipidaemia is more marked with cyclosporine.

Why is "Hirsutism" not the answer?

Hirsutism is characteristic of cyclosporine.

What concept does this question test?

It tests Nephrology: calcineurin inhibitors in General Medicine. Tacrolimus more often causes diabetes and neurotoxicity, while cyclosporine more often causes gingival hyperplasia, hirsutism and hyperlipidaemia. Drug levels are monitored closely.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: calcineurin inhibitors?

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.