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Retired NBME 24 Answers

nbme24/Block 3/Question#1 (reveal difficulty score)
A 3-year-old girl has a history of recurrent ...
NADPH oxidase ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—m-ice(370)
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This girl has chronic granulomatous disease, in which the immune system cannot properly form reactive oxygen species needed to kill phagocytosed organisms. This is especially bad when dealing with catalase positive organisms (like Staph), because these organisms already use catalase to break down reactive oxygen species. The most common cause of this condition is a mutation in NADPH oxidase, responsible for the generation of the superoxide radical.

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et-tu-bromocriptine  To add on: If neutrophils don't have access to NADPH oxidase, they can still use the bacteria's own hydrogen peroxidase to create ROS and kill the bacteria; however, catalase + organisms will not have this hydrogen peroxidase available (because catalase converts hydrogen peroxidase to O2 and water). So then the neutrophils are screwed and have no way of creating ROS. +9
yousif7000  the fact that I chose catalase I'm laughing so hard right now +2
clear  you are not alone +

How do you rule out myeloperoxidase? Lactobacillus are gram+, cat- vs Staph aureus are gram+, cat+

Someone with MPO def would be susceptible to staph but not lacto. What am i missing here?

+3/- thotcandy(131)

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submitted by โˆ—faus305(39)
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You know why I don't get chronic granulomas? Because I've got NADPH Oxidase. It makes OXYGEN FREE RADICALS THAT WIPE AWAY STAINS.

AND THAT'S THE POWER OF OXY-CLEAN.

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submitted by โˆ—an1(114)
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NADPH def: CGD --> infections with catalase + (SNAPS - staph species, nocardia (NOT actinomyces), aspergillus, pseudomonas (esp cepacia), serrate marcescens) ~ Dihydrorhodamine or nitroblue tetrazolium testing MPO def: candida infections, responsible fro green colour of sputum

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