American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What should be monitored in patients receiving tacrolimus as an immunosuppressive agent?

1. Kidney function

2. Cardiac rhythm

3. Neurological status

4. Blood pressure

The correct answer is: Neurological status

Tacrolimus is an immunosuppressive medication commonly used to prevent organ rejection in transplant patients and to treat certain autoimmune diseases. One of the critical aspects of managing patients on tacrolimus is monitoring for potential side effects and complications that can arise from its use. In this context, monitoring neurological status is essential because tacrolimus can lead to neurotoxic effects, which may manifest as tremors, headaches, seizures, or other alterations in cognitive function. Patients may experience these symptoms due to the drug's effects on the central nervous system or secondary to renal toxicity, which can lead to electrolyte imbalances affecting neurological function. Regular assessment of the neurological status helps in early identification and management of any adverse effects. While kidney function, cardiac rhythm, and blood pressure can be significant in the context of tacrolimus therapy, they are more indirect measures. Kidney function is indeed important due to the potential for nephrotoxicity, and monitoring blood pressure is essential since tacrolimus can lead to hypertension. Cardiac rhythm concerns may arise more due to electrolyte imbalances, such as hyperkalemia, which is also an indirect complication that can be monitored through blood tests. However, the direct connection between tacrolimus and its potential neurological effects makes the monitoring