NBME Answers : drjmrt26's page

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In the Kaplan's behavioral science lecture note, they stablish that as a physician, we should foster patient adherence by: - Attend to the amount of imformation; explain its complexity. - Note the patient's affective state. - Explain why a particular treatment is being recommended. - Stress the threat of non-adherence to health. - Stress the effectiveness of the prescribed regimen; give instructions both orally and in writing. - Arrange periodic follow-up visits. - Ask the patient to do less; a long list of instruction is detrimental to adherence.

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drjmrt26 It's actually confusing because one could say that "Stress the threat of non-adherence to health" = inform the patient of the health consequenses of not treating her condition. +1

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This patient has Raynaud phenomenon.

Those patients should avoid medications that cause vasoconstriction (narrowing of the blood vessels) – Such medications include decongestants containing phenylephrine or pseudoephedrine, other amphetamines, diet pills, some migraine remedies containing ergotamine, herbs containing ephedra, and medications used to treat attention deficit disorder (ADD) such as methylphenidate, dextroamphetamine-amphetamine, and atomoxetine.

UpToDate: Raynaud phenomenon (Beyond the Basics) https://www.uptodate.com/contents/raynaud-phenomenon-beyond-the-basics

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kcyanide101 worth adding is that phenylephrine is an adrenergic agonist (a1>a2).... so it will basically result in vasoc further worsening the pts symptoms +

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submitted by sunny(9), visit this page

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why is this so //i know its basic but still...??

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krewfoo99 I think its neutrophils because they mention myelosupression and rapidly dividing cells. +2

wishmewell Ya, Neutrophils, basophils, macrophages, eosinophils are considered Myeloid cells. While the rest of the T cells are from the Lymphoid lineage, The Immunoglobulins come from B cells ( lymphoid lineage). +10

cuthbertallg0od Myelosuppression refers to bone marrow suppression as a whole, including lymphocytes. I got it wrong too and no clue why its neutrophils, but I don't think that's why +1

cuthbertallg0od Maybe they're looking for us to pick "losing innate immunity" (maybe worse than losing adaptive?), which wouldn't refer to complement here since the problem isn't in the liver +

scrambledeggs FA2020 p.424 Neutropenia: Absolute neutrophil count < 1500 cells/mm3. Severe infections typical when < 500 cells/mm3. Causes: Sepsis/postinfection, drugs (including chemotherapy), aplastic anemia, SLE, radiation +1

kmichaels Pretty sure the idea is that it's just the fact that you classical follow neutrophils. All cytotoxic T-cell activity is talking about ACTIVITY not counts. NK cells we just don't really measure those I think haha +2

drjmrt26 Remember that Lymphocytes are quiescent cells. The stem says that it shows little effect on quiescent cells. +1

plaguedbyspleen Maybe another helpful tidbit. For preface, I worked on clinical trials at a children's hospital. In the pediatric oncology world, immunosuppressed kids are automatically admitted to the hospital for febrile neutropenia and don't get considered for discharge until their ANC (absolute neutrophil count) is greater than 200. Neutrophils are usually the first to show up to the party and in high numbers (important primary defense against infection). +1

submitted by drjmrt26(6), visit this page

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drjmrt26 It's actually confusing because one could say that "Stress the threat of non-adherence to health" = inform the patient of the health consequenses of not treating her condition. +1