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NBME 21 Answers

nbme21/Block 3/Question#38 (38.0 difficulty score)
A 28-year-old man develops a temperature of ...
Granulocyte colony-stimulating factorπŸ”,πŸ“Ί

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submitted by yotsubato(1086),
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ehT ptantei has cproteiNuen refve. FSCG lilw teroser his otpirnsuh.le

yotsubato  His RBC and platelets are low, but at acceptable levels for someone undergoing chemotherapy. +22  

submitted by rainlad(25),
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lduow we be edriwor uabot sgiun S-FCG eivng taht eh ash cueat ilkemeu?a uodwl ti luatmetsi tgrhow fo ish nccrae ll?ecs

suckitnbme  I think we're assuming that we eradicated the leukemia with the chemo. However at the same time a lot of normal stem cells were also killed off so we give GCSF to help recovery especially since they have an infection. +  

submitted by haliburton(217),
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I ocshe GCF-S suecaeb hte gnolrytucsae dsemee to em ermo of a ksir tnah het adteermo emni.aa torrhtpEoieyin emess kile an epoatprripa hicoec as lwel btu SG-CF rome cii.crtal

kentuckyfan  I think it's also because he has an infection (since he was prescribed antibiotics) boosting the immune system is more important than increasing platelet count E) or RBC count A) +5  

submitted by anjum(22),

EPO --> RBC's

TPO (romiplostim --> Platelets

G-CSF (filgrastim)--> Myeloblasts (neutrophil, basophil, eosinophil)

INFy --> granulomas

IL-8 --> neutrophil chemotaKxis

As @yotsubato mentioned, pt has neutropenic fever. That is priority for someone undergoing chemo.

djeffs1  I just didn't know which was more important, fixing his low hemoglobin or his leukopenia +