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Contributor score: 9

Comments ...

 +0  (nbme24#43)

Can anyone explain why bacteria is neutrophils, viral/fungi are lymphocytes? I know this is a fundamental concept...

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
usmile1  also neutrophils are only seen in acute inflammation. This pt has longstanding inflammation which is associated with monocytes, lymphocytes, macrophages, plasma cells.
usmlecrasherss  Neutrophil come and goes quick like day or two , after that rest of immune cells take care

 +2  (nbme24#49)

I almost picked asking the roommate not to smoke in the apartment, but then I figured that's beyond the scope of the doctor... another person said taking steroids would be too much for now, and I suppose that's because the asthma is well-controlled with her inhaler rn? (that's what I had picked)

sherry  I would say the patient's asthma only got worse after her moving out. So its more allergen-related. Getting rid of the allergen is always better than upgrading medications.
et-tu-bromocriptine  Rippp the "don't be a dick" strategy definitely failed me on this one. For some reason, I thought requesting the patient to ask someone else to change their smoking habits would be a tad too much. I can just picture UWorld smacking me with a "Although it is likely that the roommate's cessation of smoking could alleviate the patient's asthma exacerbations, this request would be out of the physician's scope....etc."
peqmd  Depends who's dickier the doctor telling the patient she shouldn't live in smoke or some guy smoking in the house

 +1  (nbme21#20)

What's the difference between reactive granulocytosis vs lymphocytosis?

whossayin  Yes I’m at a loss for this one too. Still can’t figure out how we’re expected to differentiate those based on this slide shown. The only logical explanation that I can think of is that reactive lymphocytes may be seen in LYMPHOMAS as opposed to granulocytes which are seen in LEUKEMIAS Such a shitty way to trick us, hah!
henoch280  reactive lymphocytes are seen in EBV infection. you would see lymphocytes in the slide not neutrophils FA2018 pg 165
whossayin  That makes sense.. but was the question talking about EBV infections or hematological malignancies? Just a vague question I wasn’t really sure what exactly was it trying to teach us, I guess the reactive lymphocytosis just threw me off! Anyways, thanks for the clarification buddy!
ratadecalle  They way I thought about it was: Granulocytes: multi lobed nucleus Lymphocytes: single lobe
hello  @whossayin - it's not reactive lymphocytosis because there are no buzzword type symtoms of EBV in the Q stem. Also, reactive lymphocytes look way different.

Subcomments ...

submitted by seagull(840),

The semantics of this question made me vomit blood.

One day a patient will look me in the eyes and ask, "Where are tripetides broken down?" I will smile at them and say, "the intestinal mucosa and not the duodenum." They'll smile back and I'll walk away and think of this moment as I jump from the window.

sympathetikey  Too real. +2  
mcl  how do i upvote multiple times +10  
trichotillomaniac  I made an account solely so I could upvote this. +15  
dragon3  ty for the chuckle +4  
cinnapie  @trichotillomaniac Same +3  
thedeadly96  XD made my day! +  

submitted by step420(30),

Question pretty much is asking what type of virus is Measles, which is a Negative ssRNA virus.

dragon3  is the AIDS to indicate that he can't get live vaccinations? +1  
tinydoc  Yep, also his unimmunized cousin points you to the fact that he got it from someone else who was unimmunized. +  

submitted by usmleuser007(279),

Ifall else fails: note that other answer choices are COPD types

dragon3  (except sarcoidosis) +1  
leaf_house  I got hung up on why this couldn't be sarcoid, and I think no lymphadenopathy is one of the reasons you wouldn't pick it here. (Though it seems like it can cause alveolar septal thickening: https://pubs.rsna.org/doi/full/10.1148/rg.306105512) +  

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