Immunology: graft-versus-host disease: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · Immunology: graft-versus-host disease

Sample item

Three weeks after allogeneic bone marrow transplantation for leukaemia, a patient develops a maculopapular rash, jaundice and watery diarrhoea. Which cells are the principal effectors of this complication?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Mature T lymphocytes in the donor graft

Graft-versus-host disease occurs when immunocompetent donor T cells recognise recipient tissue as foreign and attack skin, liver bile ducts and gut. Risk factors are HLA mismatch and a profoundly immunosuppressed recipient. Irradiating cellular blood products prevents transfusion-associated disease in at-risk patients.

Option by option

  • A. Recipient natural killer cells

    Recipient NK cells can reject marrow grafts but do not cause this triad.

  • B. Donor neutrophils

    Neutrophils are innate cells and do not mount this alloreactive attack.

  • C. Mature T lymphocytes in the donor graft (correct)

    Correct. Donor T cells attacking recipient tissue cause the skin, liver and gut involvement.

  • D. Recipient plasma cells making anti-donor antibody

    Anti-donor antibodies mediate hyperacute or antibody-mediated rejection, not this syndrome.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Microbiology questions

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is C, Mature T lymphocytes in the donor graft. Graft-versus-host disease occurs when immunocompetent donor T cells recognise recipient tissue as foreign and attack skin, liver bile ducts and gut.

Why is "Recipient natural killer cells" not the answer?

Recipient NK cells can reject marrow grafts but do not cause this triad.

Why is "Donor neutrophils" not the answer?

Neutrophils are innate cells and do not mount this alloreactive attack.

Why is "Recipient plasma cells making anti-donor antibody" not the answer?

Anti-donor antibodies mediate hyperacute or antibody-mediated rejection, not this syndrome.

What concept does this question test?

It tests Immunology: graft-versus-host disease in Microbiology. Risk factors are HLA mismatch and a profoundly immunosuppressed recipient. Irradiating cellular blood products prevents transfusion-associated disease in at-risk patients.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Immunology: graft-versus-host disease?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.