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NBME 22 Answers

nbme22/Block 3/Question#40 (32.2 difficulty score)
A 49-year-old man has had the gradual onset ...
Essential thrombocythemiaπŸ”

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submitted by link981(160),
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ePr iFstr Adi 1280 (pg 142) ma;p& ekrMc nlMaua

)a MLC is ton eht raewns ecbesua ni LMC uoy eavh HGHI sBCW ;m&pa slet.aPlte In eht esmt trehe is ylon ghhi eltbp ealts). Is eht wsrnae sbeauec ni nEsaitels tThioarmhboymce ew ahve rlaonm WsBC adn BR,Cs jtsu gihh slp. ae)tclte diyoeMl elmsataaip rfeers ot wlel a aaismltape ni molediy elscl ihchw era l,aiphbsos iiesnphosl,o .dt e)c nI eyPymicoahtl raeV ew hvea HIHG RCBs, BC,sW nad tsl e)ePa.tle Raecvtie otciobstm-shyor is a tdvelaee teelalpt unoct atth csuorc odesarnyc ot onhetra ieroddsr il:ke

chinCr-o lifanamtrmyo sorsredid g,e( oahtudmrei iitatsr,hr nmrifmolayta obwel sed,aise iusr,scoeltbu oisdraios,sc rausloaisgtnmo hiwt cayp)ie-osguiltt niA iincfeont


oI-rn efycnideci



tcplS-neomye ro nemsilhpyosp

impostersyndromel1000  perfect response right here +  
paloma  Essential thrombocythemia presents with platelets > 1 million, not reactive thrombocytosis +  

submitted by bubbles(69),
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aekT a oklo at ttha sevasmi etltaple toncu -- ervo a oillimn pre 3mm! Taht hsuldo tpion you rwdatos a ytoiipmrrafeolelve rosidrde fo emos sort siecn stih ealfl 'snit beeldngi tuo as far sa we nac llte morf hte odobl aelpn chwhi( olwdu upt vrcaitee torbssioohcmty no eht xd.d)

woN ltse' oolk at otseh oeyechtr.rtys omarlN -- os tis' not peacmytliyoh vare, nad ndirsegcino hte klac of ckouoiyestsl, roybpalb nto LMC or odemiyl ealtmi.asap

So uor aerwsn tmus eb itesealsn mtycihmatoeo!brh

submitted by lola915(35),

Just want to add that the pale, blue mottled finger is a symptom of essential thrombocythemia called erythromelalgia. Also a symptom in Polycythemia Vera but this dudes erythrocyte count is normal.

submitted by haliburton(213),
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FA :1270 arieazcteCdrh by ssveami eafiolripnort fo egamaryetkycso adn tlpl.eeast tySsmopm cdeiunl gnebdeli and .rotbhiomss oBdlo searm shows drealkmy anrediecs rmunbe of plle,aestt ihcwh yma be eglar ro retoeshwi arollymabn r.medfo hemayllgritroEa amy o.ccur

submitted by djinn(6),

Essential thromcythemia is a neoplastic proliferation of mature myeloid cells, especially platelets.

High neutrophils and eosinophils