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Contributor score: 9
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
also neutrophils are only seen in acute inflammation. This pt has longstanding inflammation which is associated with monocytes, lymphocytes, macrophages, plasma cells.
Neutrophil come and goes quick like day or two , after that rest of immune cells take care
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.
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."
Depends who's dickier the doctor telling the patient she shouldn't live in smoke or some guy smoking in the house
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!
reactive lymphocytes are seen in EBV infection. you would see lymphocytes in the slide not neutrophils FA2018 pg 165
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!
They way I thought about it was:
Granulocytes: multi lobed nucleus
Lymphocytes: single lobe
@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.
how do i upvote multiple times
ty for the chuckle
is the AIDS to indicate that he can't get live vaccinations?
Yep, also his unimmunized cousin points you to the fact that he got it from someone else who was unimmunized.