NBME 21 Reactive granulocytosis (NBME Answers)

You must be logged in to vote!

Retired NBME 21 Answers

nbme21/Block 3/Question#20 (reveal difficulty score)
A 68-year-old woman has had a fever and ...
Reactive granulocytosis 🔍 / 📺 / 🌳 / 📖
tags:

+25 upvote downvote
submitted by ∗hungrybox(1277)

get full access to all content ⋅ pick a username

some wrong answers:

acute lymphoid leukemia (ALL): Look at these MONSTER lymphocytes. High N/C ratio.
acute myeloid leukemia (AML): Watch out for the faggot cells (a faggot is a bundle of sticks). The sticks are crystals made of MPO.*
chronic lymphocytic leukemia (CLL): Smudge cells are characteristic. Can transform into diffuse large B-cell lymphoma (Richter transformation)

*makes sense b/c myeloblasts are precursors to granulocytes, which use MPO to fight off infections

get full access to all content ⋅ pick a username

temmy Hungrybox aka life saver +1

hello Thank you!!! +1

bbr ....uh yeah im pretty sure we just call em "Auer Rods" now. Appreciate the answer tho! +17

You must be logged in to vote!

+4 upvote downvote
submitted by ∗seagull(1933)

get full access to all content ⋅ pick a username

The patient has a fever/infection. The picutre shows normal (1 immature) granulocytes (neutrophils). The immature might be part of the left-shift occuring in this patient. Therefore, this is simply a reactive immune process.

get full access to all content ⋅ pick a username

You must be logged in to vote!

+1 upvote downvote
submitted by dragon3(15)

get full access to all content ⋅ pick a username

What's the difference between reactive granulocytosis vs lymphocytosis?

get full access to all content ⋅ pick a username

whossayin Yes I’m at a loss for this one too. Still can’t figure out how we’re expected to differentiate those based on this slide shown. The only logical explanation that I can think of is that reactive lymphocytes may be seen in LYMPHOMAS as opposed to granulocytes which are seen in LEUKEMIAS Such a shitty way to trick us, hah! +

henoch280 reactive lymphocytes are seen in EBV infection. you would see lymphocytes in the slide not neutrophils FA2018 pg 165 +3

whossayin That makes sense.. but was the question talking about EBV infections or hematological malignancies? Just a vague question I wasn’t really sure what exactly was it trying to teach us, I guess the reactive lymphocytosis just threw me off! Anyways, thanks for the clarification buddy! +

ratadecalle They way I thought about it was: Granulocytes: multi lobed nucleus Lymphocytes: single lobe +9

hello @whossayin - it's not reactive lymphocytosis because there are no buzzword type symtoms of EBV in the Q stem. Also, reactive lymphocytes look way different. +

Granulocytes are neutrophils, eosinophils, basophils.

Lymphocytes are B, T, NK cells.

+9/- mafoo_xtreme(12)

You must be logged in to vote!

+1 upvote downvote
submitted by ∗step1soon(51)

get full access to all content ⋅ pick a username

We can rule out A B and C because its cancer and pt will present w/ weight loss. Here the pt likely has pneumonia w/ elevated leukocyte count indicating infection. On PBS, cells look like neutrophils (seen in acute inflammatory states) which are granulocytes therefore it is reactive granulocytosis.

get full access to all content ⋅ pick a username

You must be logged in to vote!

+0 upvote downvote
submitted by ∗apurva(101)

get full access to all content ⋅ pick a username

https://webpath.med.utah.edu/HEMEHTML/HEME069.html

get full access to all content ⋅ pick a username

You must be logged in to vote!

+0 upvote downvote
submitted by minhphuongpnt07(5)

get full access to all content ⋅ pick a username

There's a band cell in the middle=> left shift reactive granulocytosis

get full access to all content ⋅ pick a username

You must be logged in to vote!

Must-See Comments from nbme21

nosancuck on Absorption atelectasis
assoplasty on Free T4
seagull on GM2
lnsetick on Apocrine
niboonsh on NMDA receptors are blocked by Mg2+ at the ...
drdoom on Deletion of a hydrophobic amino acid ...
hayayah on HCO3− transported in the plasma
mcl on Aortic
notadoctor on Usual interstitial pneumonitis
madojo on Genital herpes
hungrybox on Obstruction of the bile duct
jambo2222 on Lung
hungrybox on Mismatch repair
hungrybox on Hydrochlorothiazide