NBME 21

nbme21/Block 3/Question#32

A 72-year-old man comes to the physician because of ...

Bleomycin

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submitted by danger_rave(1),

@infundibidum6 So, I got to bleomycin due to SketchyMicro. Bleomycin can cause hyperpigmentation and pulmonary fibrosis, and I didn’t have any connections to chlorambucil. Anthracyclines can be used for all sorts of malignancies (free radicals kill lots of stuff), so the exact indications did less for me to get to the answer than it might have with another category. n=1, but it’s not a magic memorization answer at least.


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submitted by infundibidum6(0),

I got it down to bleomycin & chlorambucil and went with chlorambucil (sounded like “bu”sulfan ... lol) because I thought bleomycin was for testicular cancer/Hodgkins lymphoma. I later found out that chlorambucil is actually a preferred treatment for CLL! Is it because chlorambucil causes severe immunosuppression? So you wouldn’t be giving it to a 72 yo man in the first place?