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NBME 21 Answers

nbme21/Block 1/Question#45

An 18-year-old man comes to the physician because ...

Pyruvate kinase

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 +4  upvote downvote
submitted by est88(11),

Pyruvate Kinase defect leads to decreased ATP leading to rigid RBCs and extra vascular hydrolysis. Increased levels of 2,3-BPG decreases hemoglobin affinity for O2.





 +2  upvote downvote
submitted by cantaloupe5(29),

For this one you just had to know the glycolysis pathway. Stem told you 2,3-BPG is elevated, which is upstream of pyruvate kinase.

neonem  Right, and that glycolytic enzyme deficiencies lead to hemolytic anemias. +