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Retired NBME 27 Answers

nbme27/Block 4/Question#20 (reveal difficulty score)
A 23-year-old woman with type 1 diabetes ...
Inability to produce hydroxy-halide radicals ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—shak360(20)
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Comparing and contrasting CGD and MPO deficiency

CGD - deficiency in NADPH oxidase

Lack of superoxide formation in leukocytes leads to decreased respiratory burst in neutrophils. Results in increased susceptibility to catalase-positive organisms, namely S. aureus, and Aspergillus.

Decreased oxygen consumption after phagocytosis and inability to produce hydrogen peroxide occurs in CGD as a result of impaired function of NADPH oxidase.

In CGD, the PMNLs will NOT turn blue in the Nitro Blue-Tetrazolium Test (NBT).


MPO deficiency - deficiency in MPO

An inability to produce hydroxy-halide free radicals within phagolysosomes. MPO on chromosome 17 encodes the protein MPO which is contained in neutrophil granules where it catalyzes the final step in the neutrophil oxidative burst. This results in IMPAIRED but not absent bacterial killing.

In MPO deficiency, the PMNLs WILL turn blue in the Nitro Blue-Tetrazolium Test (NBT).

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