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Repeated USMLE Questions Step 1- 282

A 29-year-old man underwent bone marrow transplantation two weeks ago. Yesterday he developed diarrhea with occult blood and rashes all over his face, hands and feet. Examination reveals jaundice and maculopapular rashes on his face, palms and soles.

What are the most likely cells activated in this case?

A-Donor B-lymphocytes

B-Donor T-lymphocytes

C-Host B-lymphocytes

D-Host T-lymphocytes

Answer



About half of the patients that undergo bone marrow transplantation develop graft-versus-host disease. It is caused when donor T-lymphocytes recognize host antigens causing acute reaction which leads to appearance of maculopapular rashes on the face, palms and soles. It also leads to abnormal liver function tests and diarrhea with occult blood.

The correct answer is B



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