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Retired NBME 16 Answers

nbme16/Block 4/Question#22 (reveal difficulty score)
The chemotherapy regimen prescribed for a ...
Ventricular cardiac muscle fibers ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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Vinblastine works by binding tubulin and inhibiting microtubule formation. This inhibits cell division.

Basically, this question is asking which of the following cell types is nondividing/would not need functioning microtubules.

Enterocytes in crypts (which divide to replace intestinal epithelium(, keratinocytes of the stratum basale (which divide to to replace skin), and erythroblasts (blasts are stem cells) are all dividing cells and thus could be affected by vinblastine. Cortical thymocytes are also dividing cells, as they will divide to create progeny T-cells through the process of T-cell maturation.

Thus, the only non-affected cell is ventricular cardiomyocytes.

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the_enigma28  Cortical thymic epithelial cells (cTECs) [aka cortical thymocytes] form unique parenchymal cell [& therefore proliferating] population of the thymus which critically contribute to the development of T cells +4
cheesetouch  Pathoma Ch 1.1 mentions permanent tissues include: cardiac muscle, skeletal muscle & nerve - only can grow by hypertrophy. +3



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