A 45-Year-Old Man Comes to Clinic for Routine Follow-Up

question 41

Multiple Choice

A 45-year-old man comes to clinic for routine follow-up.  He has a history of end-stage renal disease due to autosomal dominant polycystic kidney disease, and he underwent a deceased-donor kidney transplant 4 years ago.  The patient has hypertension that initially resolved following the transplant but redeveloped 6 months ago.  Review of his recent laboratory studies reveals a progressive increase in serum creatinine levels over the last few months.  Urinalysis is within normal limits.  On ultrasonography, the transplanted kidney is reduced in size.  A biopsy of the graft is most likely to show which of the following?

• A)Dense mononuclear interstitial infiltration
• B)Glomerular crescent formation
• C)Obliterative vascular fibrosis
• D)Tubular hypertrophy and intratubular casts
• E)Vascular fibrinoid necrosis with thrombotic occlusion

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Definitions:

Neuropathy

A disorder or damage affecting the nerves, which can result in numbness, weakness, and pain, commonly in the hands and feet.

Plantar Warts

Hard, grainy growths that appear on the heels or balls of the feet, caused by the human papillomavirus (HPV), and often feel like a stone in the shoe.

Virus

A microscopic infectious agent that can only replicate inside the living cells of an organism, causing various diseases in humans, animals, and plants.

Corns

Hardened areas of skin that usually form on the toes due to friction and pressure.