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NBME 18 Answers

nbme18/Block 2/Question#18 (11.0 difficulty score)
Researcher testing new cancer drug
Neutrophil counts🔍
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 +0 
submitted by sunny(2),

why is this so //i know its basic but still...??

krewfoo99  I think its neutrophils because they mention myelosupression and rapidly dividing cells. +1  
wishmewell  Ya, Neutrophils, basophils, macrophages, eosinophils are considered Myeloid cells. While the rest of the T cells are from the Lymphoid lineage, The Immunoglobulins come from B cells ( lymphoid lineage). +3  
cuthbertallg0od  Myelosuppression refers to bone marrow suppression as a whole, including lymphocytes. I got it wrong too and no clue why its neutrophils, but I don't think that's why +  
cuthbertallg0od  Maybe they're looking for us to pick "losing innate immunity" (maybe worse than losing adaptive?), which wouldn't refer to complement here since the problem isn't in the liver +  
scrambledeggs  FA2020 p.424 Neutropenia: Absolute neutrophil count < 1500 cells/mm3. Severe infections typical when < 500 cells/mm3. Causes: Sepsis/postinfection, drugs (including chemotherapy), aplastic anemia, SLE, radiation +1  
kmichaels  Pretty sure the idea is that it's just the fact that you classical follow neutrophils. All cytotoxic T-cell activity is talking about ACTIVITY not counts. NK cells we just don't really measure those I think haha +  



 +0 
submitted by beastaran1(0),

From what I understand, chemo patients are at risk for floral sepsis (staph A/Gram negative enterics); these are regulated by neutrophil surveillance of blood (basically want to prevent sepsis/neutropenic fever). Might also be half life of neutrophil is the shortest (8 hours)