Urinary Disorders Q 6 - Gyan Darpan : Learning Portal
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Thursday 7 April 2022

Urinary Disorders Q 6

Mr. Roberto was readmitted to the hospital with acute graft rejection. Which of the following assessment findings would be expected?
    A. Hypotension
    B. Normal Body Temperature
    C. Decreased WBC
    D. Elevated BUN and Creatinine

Correct Answer: D. Elevated BUN and Creatinine.

After a few days or weeks of successful transplantation surgery, the patient complains about tenderness at the site of the graft, pyrexia, and abnormal function of the organ or tissue graft, for example, in renal transplantation appears anuria, an increasing serum creatinine levels, and metabolic problems including hyperkalemia.

Option A: Elevated BP levels post-transplant identify patients at high risk of AR independently of graft function. Treatment of BP and reduction of BP levels appears to be associated with a decreased risk of AR. It was hypothesized that high BP may be an indicator of a particular type of allograft damage, perhaps ischemic, that may predispose to AR.
Option B: In the past, fever has been considered to be an important sign of rejection in renal transplant patients but since the introduction and widespread use of cyclosporin this relationship has become less clear. Episodes of fever due to infection tended to occur after the 1st month, coincident with the peak incidence of cytomegalovirus (CMV) infection. However, with the exception of CMV disease, fever was not a reliable guide for the presence of infection, including septicemia.
Option C: Results of a study showed that (1) Contrary to what is commonly thought leukocytosis is the least common response to acute rejection and a decrease in leukocyte count is far more common, (2) A sudden decrease in leukocyte count in a previously stable patient can be an early sign of rejection, (3) There is a significantly greater incidence of graft loss in rejection episodes characterized by leukopenia and (4) The risk of infection following rejection is greatest in patients with rejection characterized by leukopenia.

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