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Retired NBME 24 Answers

nbme24/Block 3/Question#43 (reveal difficulty score)
A 35-year-old woman with a long-standing ...
Infiltration of lymphocytes and monocytes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—neonem(629)
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Histoplasma can act like TB and cause cavitary lesions and calcified nodules with fibrotic scarring. In general, fungi are combatted by lymphocytes and macrophages, not eosinophils or neutrophils.

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baja_blast  Asthma history got me and I put Eosinophils.... but in hindsight I should have noticed that the biopsy is specifically of the nodules. RIP. +2



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submitted by โˆ—yex(128)
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This also refers to chronic inflammation & granuloma formation.

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submitted by dragon3(15)
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Can anyone explain why bacteria is neutrophils, viral/fungi are lymphocytes? I know this is a fundamental concept...

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lolmedlol  i think neutrophils (in addition to lacking granzymes and perforins which are used to kill viruses and fungi) dont recognize intracellular things; viral antigens needs to be processed and presented on an MHC for the lymphocytes to recognize +7
usmile1  also neutrophils are only seen in acute inflammation. This pt has longstanding inflammation which is associated with monocytes, lymphocytes, macrophages, plasma cells. +4
usmlecrasherss  Neutrophil come and goes quick like day or two , after that rest of immune cells take care +



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submitted by โˆ—sexymexican888(46)
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HONESTLY WTF IS THIS QUESTION WHY TF DO THEY SAY ON CORTICOSTEROIDS that shit fucking confused me... ugh frustrating

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suey  Steroids would cause increased neutrophils but not necessarily an infiltrate, and they would not be attached to lung tissue +



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