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NBME 24 Answers

nbme24/Block 1/Question#28 (reveal difficulty score)
A 32-year-old woman comes to the physician ...
Eosinophils ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: immuno

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 +46  upvote downvote
submitted by โˆ—tea-cats-biscuits(273)
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Mast cells degranulate, producing histamine which attracts eosinophils. The early stage of an allergic reaction is mast cell mediated, but the late stage (including mucus production) is mediated by eosinophils.

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atstillisafraud  Thanks for a good answer. This question made me feel like I was taking T21 pills +18
medguru2295  Thank you- I was really thinking this question had 2 correct answers... of course my dumbass picked Mast cells. +7
ajss  where do i find this info?? +
paperbackwriter  @ajss pg 112 of first aid 2019, under type I hypersensitivity. Immediate --> mast cells releasing histamine and tryptase, late--> eosinophils and leukotrienes recruited via chemokines +3
graciewacie9  Wow, i missed the fact that the question is asking for the RESULT of the reaction, NOT the cause of the reaction. Mast cells cause the initial reaction, eosinophils would be the result of the eosinophils. *facepalm +9
greentea733  @graciewacie9 SAME UGH +
lba9587  Pathophys (as far as I understand it)...Mast cell degranulates, thus the phospholipid bilayer et. Al are left behind and needs to be degraded. Who comes in? Our good friend eosinophils, as they contain Major Basic Protein (responsible from breakdown of expired mast cell). Note, you can tie this in to the delayed Leukotriene effects of an allergic rxn, as the bilayer is also broken down by arach. Acid. (See this link to support my credibility +
mutteringly  who else looked up what T21 pills were +8
fatboyslim  Who else still doesn't know what T21 pills are and feels left out? +

 +7  upvote downvote
submitted by โˆ—andro(269)
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Recall : Findings on a sputum examination in asthma Curschmann spirals and Charcot Leyden Crystals

Charcot Leyden crystals: are made up of Eosinophils ( and their main active substance - major basic protein )

Curschmann spirals are just whorled mucus plugs formed by shed bronchial epithelium

Main chemoattractant for eosinophils :is not histamine but IL-5 ( which is produced by mast cells and T helper 2 cells)

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submitted by โˆ—unknown001(9)
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i never knew eosinophils play a role in mucus secretion

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submitted by โˆ—linnet23(0)
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also wanted to add that during late phase of mast cell degradation they release eosinophil chemotactic factor

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