Immunology USMLE Step 1 Practice Question
A 54-year-old male with chronic renal failure receives a kidney transplant and begins cyclosporine immunosuppression. Six months later, he presents with progressive fatigue and dyspnea. Vital signs: BP 158/92, HR 98, RR 20, Temp 37.2°C, SpO2 94%. Serum creatinine has risen from 1.2 to 3.8 mg/dL. Urinalysis shows no proteinuria. A needle biopsy of the transplanted kidney is performed. What finding is most likely?
Answer choices
- ANeutrophils, immunoglobulin, and complement in vessel walls
- BThickening of the blood vessel intima due to cellular proliferation
- CIntimal fibrosis, interstitial fibrosis, and tubular atrophyCorrect answer
- DLinear deposition of immunoglobulin and complement in glomeruli
- ET-cell interstitial infiltrate and edema
- FDiffuse peritubular capillary C4d deposition with capillaritis
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