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NBME 22 Answers

nbme22/Block 1/Question#15 (54.0 difficulty score)
A 35-year-old woman has weakness and fever. ...
Acute myelocytic leukemiaπŸ”,πŸ“Ί
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 +14 
submitted by d_holles(187),
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nGolja eersssst the dsoBra iviggn the laiemuke niotqsesu waya adbes no hte age inveg in het qunotise .smets

ALL = 041-

ALM = ;1593- -4590

LLC = +60

MLC = 9-540

tmttojol3u.doa/n/dsnsaootplu.mr.eentssfnh-dge:khst-urr3/it0e5/0/6eca

impostersyndromel1000  thanks for the reminder, often overlooked are the simple demographic hints. helps you make an educated guess +  
hyperfukus  also a key thing to remember in general is a person who undergoes chemo is a big demographic hint to later developing AML regardless of the clues :) and yes the AGE!!! +3  



 +11 
submitted by atstillisafraud(201),
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gilantlAyk natsge oemehtha)ne(crirml eh(t ertho srugd elsdit ear mcueiuobtlr iioisrb)htn acnreise hte rski fo M.AL

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). +27  
seagull  CML has blasts too but they tend to favor mature forms. +4  
kash1f  You see numerous blast forms == AML, which is characterized by >20% blasts +9  
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 +12  
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 +1  
sweetmed  Procarbazine is alkylating as well. +  
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? +3  
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 +  
jurrutia  @keycompany, how did you know it had to be of myeloid origin? +  



 +3 
submitted by sweetmed(144),
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arcbnrozaePi dsie ffceet si km.eluiae FA 1082 paeg 248

bdaines8  Perfect, that narrows it down to three answers +5