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Retired NBME Free 120 Answers

free120/Block 1/Question#29 (reveal difficulty score)
A 63-year-old homeless man is brought to the ...
C5a ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +7  upvote downvote
submitted by โˆ—bwdc(697)
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The arrow is pointing to a neutrophil (multilobed nucleus): main fighter of the immune system in acute inflammation and bacterial infection (such as aspiration pneumonia). C5a is a chemotactic factor for PMNs.

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ibestalkinyo  Other chemotactic factors include IL-8 and LTB4 +6
j123  Note: C5a is a chemotactic factor for many immune cells in addition to neutrophils. Also, C3a is a chemotactic factor for just eosinophils and basophils (not neutrophils) +2
cheesetouch  Q. What's so sexy about C5a? A. It's like Chanel No. 5 for neutrophils: they smell it and come running. +11
igurl11  I guess I kind of overthought this and went back and forth between C5a (initial choice right off the bat) and Histamine (until I saw this... aaaand went into internal battle mode). Since it asked what cause the Neutrophil to be at that location, I thought margination and rolling would be the 1st reason that neutrophils move from center to the periphery via Histamine (VD -> center to margin) and then it would start to slow down via P- (WP bodies bc of Histamine) and E- (IL-1 and TNF)) selectin speed bumps. I did wonder if they wanted us to go with the adhesion portion which would be the C5a, LTB4 etc but was there anything that specifically pointed towards Adhesion vs Margination/rolling? I need to stop overthinking things xD +



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submitted by โˆ—an_improved_me(91)
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So mad.. these don't even look like neutrophils! They all have what look like are 2 lobes.

I couldn't make heads or tails of what they were. I ended up thinking they were eosinophils (bilobed), even if they weren't exactly fileld with granules lol.

So much pain.

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jbrito718  SAME! +1
an1  Even if the image was lame (which it was), he has an acute injury of some sorts. That helped tip me off for neutrophils (Pathoma: Fluid phase --> neutrophils --> macrophages) +



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