NBME Answers : kash1f's page

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submitted by atstillisafraud(217), visit this page

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Alkylating agents (merchlorethamine) (the other drugs listed are microtubule inhibitors) increase the risk of AML.

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keycompany Additionally, AML is the only answer choice that has multiple blast forms (myeloblasts, promyelocytes, etc.). ALL is characterized by a single blast form (lymphoblasts). +31

seagull CML has blasts too but they tend to favor mature forms. +5

kash1f You see numerous blast forms == AML, which is characterized by >20% blasts +11

keycompany The answer choices are all of lymphoid origin except for AML and Hodgkin Disease. We know Hodgkin Disease is a lymphoma (not leukemia) and would present with lymphadenoapthy. So the answer must be AML #testtakingstrategies +13

impostersyndromel1000 @atstillisafraud thanks for mentioning the merchlorethamine increasing risk for AML, i was trying to make a connection with the drugs but couldnt. Had to lean on the test taking skills just like key company +2

sweetmed Procarbazine is alkylating as well. +1

pg32 @keycompany how did you know the phrase "multiple blast forms" meant literally different types of blasts and not just many blast cells were seen? +4

castlblack this link says CLL has 'large lymphocytic variety' under the picture of the peripheral smear. I am not arguing against you, just researching here https://emedicine.medscape.com/article/199313-workup +1

jurrutia @keycompany, how did you know it had to be of myeloid origin? +1

submitted by goldenwakosu(7), visit this page

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Why is the answer adenylyl cyclase? I looked in FA and I saw that GH uses the JAK2/STAT pathway and that IGF-1 uses the MAP Kinase pathway. Not sure how adenylyl cyclase plays into this.

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pug_sheen I think they are talking about the GHRH receptor on somatotrophs, which works through the cAMP pathway. +

staygoodpupper I don’t know how it relates to GH/IGF-1 in particular, but the question said there was a mutation in the alpha subunit of Gs, which activates adenylyl cyclase. +3

kash1f I agree the patient does have Acromegaly, but in the question it talked about how the patient had a mutation that prevented the GTPase activity of Gas. So Gs would be overactive --> excess adenylyl cyclase +31

hyperfukus ugh i was so excited too bc i thought i remembered jak stat epicfail +3

skonys Doesn't GHRH act through an IP3 seconary messanger? +

xmen the tumor secretes GH. GH act via a JAK/STAT Pathway. But the GH secretion is stimulated via a GHRH through a Gs. This Gs in this tumor's cells is mutated and is permanently actif. so cAMP will increase. +1

weirdmed51 @skonys GHRH works via cAMP +

kcyanide101 GnRH is IP3 --- Remember GOAT HAG? GHRH is CAMP remember FLAT ChAMP +