NBME 15 Excess lymphoblasts (NBME Answers)

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Retired NBME 15 Answers

nbme15/Block 4/Question#42 (reveal difficulty score)
A 4-year-old boy with a karyotype of 47,XY+21 ...
Excess lymphoblasts 🔍 / 📺 / 🌳 / 📖
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submitted by ∗brise(86)

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I thought that a child with down syndrome under the age of 5, had a chance of getting acute megakaryoblastic leukemia? and over 5, acute lymphoblastic leukemia?

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mittelschmerz I was stuck between those as well. My thought process was that megakaryocytosis would be mature megakaryocytes though, which would not happen in a megakaryoblastic leukemia since they are stuck in the blast stage. That left only lymphoblasts, and I presume while one may be MORE likely age 5, a patient with Down Syndrome is still at higher risk for both. +4

cassdawg "Megaloblastosis" as in the answer choices refers to megaloblastic anemia in B12 and folate deficiency, so it is not associated with megakaryocytes or megakaryoblastic anemia! Hope this helps! +14

"We ALL fall Down" to remember Down syndrome is associated with ALL

+2/- fatboyslim(118)

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submitted by ∗cheesetouch(250)

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Acute lymphoblastic leukemia/lymphoma (ALL) is associated with Down Syndrome and most often occurs in children [FA2018 p420]. AML and ALL are increased in those with Down syndrome [p63] but median age of onset of AML is 65 years old (p420). megaloblastosis refers to megaloblastic anemia.

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