need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)
NBME 23 Answers

nbme23/Block 2/Question#2 (reveal difficulty score)
Cyclophosphamide and some other ...
Granulocytes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: Immuno pathoma

 Login (or register) to see more

 +18  upvote downvote
submitted by โˆ—youssefa(162)

Pathoma: - Lymphocytes are the most sensitive cells to whole body radiation - Granulocytes (Mainly neutrophils) are particularly very sensitive to chemotherapeutic alkylating agents (requiring G-CSF shortly after)

 Login (or register) to see more
arcanumm  Always think of NEUTROPENIA when chemotherapy is treating rapidly dividing cells (a small fever is an ER visit for these patients). +10

 +12  upvote downvote
submitted by โˆ—seagull(1933)

Another way to approach this is asking yourself which of these cell types are likely undergoing the most mitotic activity. The granulocyte precursors are likely dividing more than nerves or lymphocytes (in absence of infection). This was my approach.

 Login (or register) to see more

 +3  upvote downvote
submitted by ninja3232(11)

This question is asking how much reserve capacity there is of each compartment, of which the granulocytes have the least.

Note that myelosuppression can refer to any lineage (including lymphocytes).

 Login (or register) to see more
ninja3232  This is similar to why sickle cell patients experience aplastic anemia during a parvovirus infection. +

 +1  upvote downvote
submitted by โˆ—blue4415(4)

This is the second time in NBME23 asking about the definition and of stable and labile cell~Just a another way to reach the answer It is IMP to ddx
1:lymphocyte (stable) vs Bone marrow(labile,maybe point to granulocyte here) 2.gut epithelium(labile) not endothelium Then rule out liver(stable) and neuron(permanent )

From FA๏ผš Stable (quiescent) ๏ผšEnter G1 from G0 when stimulated. Hepatocytes, lymphocytes, PCT, periosteal cells.

Labile ๏ผšNever go to G0, divide rapidly with a short G1. Most affected by chemotherapy. Bone marrow, gut epithelium, skin, hair follicles, germ cells.

 Login (or register) to see more

 +0  upvote downvote
submitted by โˆ—victor_abdullatif(10)

Another way to get this is to think about chemotherapy-induced neutropenia. Since we check absolute neutrophil count, it must be granulocytes that are the most impacted

 Login (or register) to see more

 -3  upvote downvote
submitted by โˆ—nwinkelmann(366)

Another way to look at: this question is essentially asking what is the MCC side effect of chemotherapeutic agents in general? Answer = bone marrow suppression thus affects granulocytes.

 Login (or register) to see more

 -5  upvote downvote
submitted by โˆ—sympathetikey(1599)

One of the side effects of Cyclophosphamide is myelosuppression.

See full list of side effects below:

Myelosuppression; SIADH; Fanconi syndrome (ifosfamide); hemorrhagic cystitis and bladder cancer, prevented with mesna (sulfhydryl group of mesna binds toxic metabolites) and adequate hydration.

 Login (or register) to see more
ninja3232  This is incorrect. Myelosuppression can also refer to the lymphocyte lineage. +7

Must-See Comments from nbme23

ferrero on Precapillary resistance
yotsubato on 99%
sne on Triglyceride
sajaqua1 on Area labeled โ€˜Dโ€™ (Spinothalamic tract, right)
hayayah on Iris
stinkysulfaeggs on Hypoglycemia
soph on Peak inspiratory pressure (alveolar): ...
seagull on Area labeled โ€˜Cโ€™ (Cranial nerve 8: ...
water on Dietary change
wired-in on 28.8
beeip on Binding of permeable ligand to nuclear ...
thomasalterman on Hypoglycemia
seagull on Decreased sodium bicarbonate reabsorption in ...
yotsubato on Inhibition of the cytochrome P450-dependent ...

search for anything NEW!