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nbme - usmleicandoit
#1
a 42 yr old man comes to the physician b/c of malaise muscle ,joint pain ,and temperatures up to 38.4 C(101.1 F) for 3 days. Three months ago, he underwent cadaveric renal transplantation resulting in immediate kidney function. at the time of discharge, his serum creatinine level was .8 mg/dl. he is receiving cyclosporine and corticosteroids. examination shows no abnormalities. his leukocyte count is 2700/mm3 and serumn creatinine level is 1.6 mg/dl. serum cyclosporine level is in the therapeutic range. a biopsy of transplanted kidney shows intracellular inclusion bodies. which of the followign is the most appropriate next step in management?
a) increase the dosage of corticosteroids

b) increase the dosage of cyclosporine


c) begin amphotericin therapy

d) begin ganciclovir therapy

e) begin heparin therapy
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#2
d.
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#3
agree d
CMV infection
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#4
Agree D.
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