support the site ⋅ become a member ⋅ unscramble the egg
(tag_directory)
free120  nbme24  nbme23  nbme22  nbme21  nbme20  nbme19  nbme18  nbme17  nbme16  nbme15  nbme13 

NBME 21 Answers

nbme21/Block 3/Question#32 (22.0 difficulty score)
A 72-year-old man comes to the physician ...
Bleomycin🔍
tags:

Login to comment/vote.


 +5  upvote downvote
submitted by lilmonkey(19),

Chemo-tox man picture from the FA (last page of the hem and onco section) works well for me in these types of questions.

lovebug  Bleomycin Induces free radical formation -> breaks in DNA strands.(Anti-tumor effect) FA19, pg431. and other tissues have Bleomycin Hydrolase. but Lung doesn't. So lead to Pulmonary fibrosis. +  



unscramble the site ⋅ become a member ($36/month)

I tgo ti wond ot iyeonclmb &;apm ilchcbulomar and etwn htwi comuriblclha (udosdne kiel bsu”a“lunf ... )llo eubecas I hhuogtt mionblcye swa ofr rtceulisat aocH/irnsgcnkde lap.homym I arlte nodfu tuo that icrubcmlhoal si yaautlcl a rdeerperf rmattetne rfo L!LC Is it eebsuac rahbuclcomil cseaus eeesrv ?iiumsopnsrnsopuem oS uyo uo’tdwln eb vingig ti ot a 72 oy nam ni hte rfits clpae?

yotsubato  Bleomycin is the big boy of cancer treatment. I've never heard of chlorambucil and its not in FA. +1  
vulcania  I had never heard of chlorambucil either and after researching it found out that it's also an alkylating agent, specifically a nitrogen mustard - same as busulfan, so you weren't wrong! Based on what FA says re: bleomycin & busulfan (extrapolating this to chlorambucil), they both cause pulmonary fibrosis & skin hyperpigmentation, however, in the Lange Pharmacology flashcards it says that the hyperpigmentation with busulfan is from adrenal insufficiency so I guess you would expect to see symptoms of that as well if the same applies to chlorambucil? +1  
vulcania  jk ignore my previous comment. just checked uptodate and it doesn't list hyperpigmentation as a side effect of chlorambucil. +  



 +0  upvote downvote
submitted by dr.xx(125),
unscramble the site ⋅ become a member ($36/month)

mceiyolnB is oknnw to ceasu unlg nda nisk coixytit eud ot rateviel casbeen fo heorydsal ni kins tiuses runglsiet ni edrsaedec ibmsltoaem dan dyedlae anree.ccla nyrolauPm miostcocilnpa rea nmcomo tub sink acnsegh are rear and enucild a-neiyhmtnogepipt,r s,eauqlp iyertkoeahtrpc osenlis, etrhymea mmi,uleofrt eil,pcaoa tisitmtoas nad inal aecngh.s Teh tecax achmensmi fo ksin neacgsh dcusea yb cliebyonm is not wnk.on heT etetamtrn vnsvoeli emmaeagntn fo iuyegrldnn sridodrse or airtwlwadh fo eht dffonnieg d.gru

enic/o/w0h/avcnwrg0t/:4i.Pcin.Cs3/bplls.6p9m0wtt/Mm.h