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Retired NBME 27 Answers

nbme27/Block 2/Question#16 (reveal difficulty score)
A 57-year-old man comes to the physician ...
Tyrosine kinase ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: chronic_myelogenous_leukemia

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submitted by โˆ—shak360(20)
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Some details about CML:

t(9;22)

Chronic myelogenous leukemia (CML) and less common in Acute myelogenous leukemia (AML)

Philadelphia chromosome, bcr-abl hybrid: the Philadelphia chromosome leads to a constitutively active tyrosine kinase oncoprotein in CML.

The translocation between the bcr gene on chromosome 22 and the abl gene on chromosome 9 produces a fusion protein, bcr-abl (encoded by the Philadelphia chromosome), and is the constitutively active nonreceptor tyrosine kinase targeted by imatinib, one of the mainstays of therapy in CML. The blood smear would show an overabundance of granulocytes in various stages of maturation. Proliferation of Myeloid stem cells Patients with CML typically present with an elevated leukocyte count, including increased numbers of mature and immature granulocytes, as well as basophilia and eosinophilia.

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