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NBME 23 Answers

nbme23/Block 2/Question#2

Cyclophosphamide and some other chemotherapeutic ...

Granulocytes

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 +3  upvote downvote
submitted by sympathetikey(259),

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.





 +3  upvote downvote
submitted by seagull(354),

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.





 +1  upvote downvote
submitted by nwinkelmann(59),

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.





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submitted by youssefa(6),

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)