‘7 year-old an presons oa model loi wih complaints of ad nN ne ‘and lowers abdomial pin forthe past fw day, He sao concerned about inary ‘hequency and urgency He states that he recany completed a ye of chematerapy fo non Hodgrsymphama. The chemetorapy regen medication thot has most kay couse his symotom is? > A. cyarabine © BMeewerate © D.cycophesphamide © EPrerisone eae}‘A 7oyoa-old an presonis oa model loi wih complaints of ad nh ine ‘and lowers abdominal pin for to past fw days, He ao concerned about Umar equency ad urgency He state that he recent completed a yee of ‘omoterapy fs non Hodglar’symphoma. The chamehorapy regen mediation hat has most ely caused his stom i? © A.Orabine ox 2. Metotreate 8 . Cyclophosphamide om Preereons| * Resul @ neon Explanation: Related Videos: ‘comet answer D: Cyclophosphamide i n artcacer agent at stedExplanation: ‘corect answer D: Cyclophosphamide an ant-cancer agent thats sod san alafateg agent Cjlophosphamie ls used nthe westmant of number ‘ot matgnancis,ncudng nan Hogs mphoma. One othe mest caren ‘do ofect of cyclophosphamide s hemomhaai cits, which shou be in ‘the ferential lagnos of patents wth a istry of recent chemotherapy who resent with Herat, Adequate ation may event is sde eect osna and N-scabloene, Other ie effects of ophosptamide nce nausea, vomiting, lathea, ypersensty reactions, bone maton Seprostion, and ansiont try ‘Option A: cytarabine causes varius sido fects. sudonresawacoy sess, egalblastic anemia, conjunc, eal ces. ane neretocy. hae ot been asrocted with hemorhagi cyt. ‘OptonB: Methotrexate cases anaphyant,hepate necrosis oa and Gh Lucoretons. bono martow dopressen, pulmonary intrates an Exess, eel totes and teatogenoty, but not hamorrhagl eet, Option: taxinad may cause over chil, gar, Iypetonsion, ‘bronchospasm, bone martow depresion, angioedema recptaton of angina, and atotinis. Related Videos: Cancer Dge& Chematherapoutic Agent: Dactnemin Onsoubicn leomyen et. Wie Blood Cot Patobgy First Aid References: Fst Ad forthe USMLE Step 12019, 20h eh 433 Pst ad forthe USMLE Step 1 (208,280 ea 428 Fst Ad forthe USMLE Step 12017 270 dh 418‘Comet answer : Cyclophosphamide i an ant-cancet agent tat sie lean alofetng agent Cyclophosphamide is wed in the Woatment of arumber ‘of matgnancis, netucing nen Hodgkr'srnphom, One ofthe mest coro ‘ie eact of cyclophosphamide hemonogi cys wich should be (he ternal hghcas of patois wih airy of scent chemotherapy wf resent with hematuria, Adequate hyraton may event is side eect. Medication usa to eat chemethetapynduced hemaibagle cysts nclede ‘moana and N-scayleyseine,Otor ice eos of ophosphamid chads ausea, vomiting, lathes, hpersenstyreatons, bone marrow ‘depression, and wansint try ‘Option A: Ctarabine cause varius ede eters, oksng sudan respwatony clsvess, mogalotlastc anoma, cojunces eal ces, ana neuotly. hs ot been asrocinted wth hemortagi cyst pon B: Methotrxat causes anaphyans, hepa necrosis oa and Gt LUcereos, bone marow depression, pulmonary nates and fixes, renal ‘octes, and teatogeniny, but not hema ys, ‘Option: Ruxnad may cous eve chil, gars, hypotension, Lronsinpsbes bon amu dpi, egos, rapa fg and atoms. ‘Opton: Prednisone ia steot Prednisone cares retenon of water ac ‘3 leacng to hypertension, Precrigene dees net cause hemormage cysts. Leaming objective: Cyophosphamise may cause hemorrhage cysts in patents who recent andewentchemcthetaoy. Bsc ‘cance: Dugs& Chemotherapeut Agents: Dactnemyein, Daxoubich Bloomyan ate White Blood Cot Patalogy First Aid References: Fst Ad forthe USMLE Step 12018, 20h oa: 433 Fst A forthe USMLE Sep 12018, 2h oa: 428 Fst A forthe USMLE Stop 12017, 27h od 8a ‘4 85,yoa-og man presonts wi a smal patess cr with aod border on is . right forearm which hs persisted forthe lst 3 wooks His post history sgnfcant {for oenmencesofbaes cl eaenams on deren ran of hs body ing te los yous, which nav all een surgicayoxsod. Tho morphology oho presant lesions alo highly suggestive of bacl el carcinoma. Tho part says thao leson fa bal elleornoma, he doesnot want fo underg bepsy ana surgery can be avoided. The patents plescibeda clean, whch = FDRapproved fo he lucatment of smal zip baal ol arenomae low sk areas The team contains chemotieapeute age. which san antmetabelte and an Sphase- Specie antcancer aug. ich af he following bes expan the mechanism of | rtvoton of tbonicleoie reductase (© B.invbtion of ONA rept (© C inmtion ermymiayatesyehese .Inibiton of nsrotoate reductase © Inibton of de novo purine mucectide sts eae} i=a ‘4 85,yoa-og man presonts wi a smal patess cr with aod border on is . right forearm which hs persisted forthe lst 3 wooks His post history sgnfcant {for oenmencesofbaes cl eaenams on deren ran of hs body ing te los yous, which nav all een surgicayoxsod. Tho morphology oho presant lesions alo highly suggestive of bacl ell carcinoma. Tho pair says tha he leson fa bal elleornoma, he doesnot want fo undergo bepsy ana surgery Itean be avoided. The patients prescbedacrean, whichis Fapproved fhe ‘ucatment of small 2iparil baal ol arcnomae now sk aroas The team contains chemotieapeute age. which san antmetabelte and an Sphase- Specie antcancer aug. ich af he following bes expan the mechanism of © Aton of onvcletite recite ™ {.iehbtion of DNA rept we Cniton or ymiayat syenaso on .iibiton of nsrotoate reductase x nition fe novo purine nuccctie sybes we Result: @ conc B bsctto ttExplanation: Comet answer C53 5 suotcurac (FU) coansavatabie er tpi pptietion nd approved bythe FOR for tetmen of smal super ‘ess call canom lon sek arae. SFU fan antmetabolte and nS ‘phase spect ariancor aug. bon of ymidine sya sone of he ‘mochanisms of action of SFU se8 magebelow).5-FU a prodtug and is ‘onverednto ever mtabaltes whieh Mave antnsopati cone. FMP (Situer02°dearyerano.5-monophosphaa) ints hymaesyhase arc, thus ibs the de novo synthesis of tye which inure nthe Inbtion of ONA Syresis UTP (6uorourdine phosphate corporates ito RNA and, us, Imtreres win HNA processing FaUIP (> Motodeoxyutne > phosphate) | incerporatodinte NA and eat inthe noten ot ONA syns and funcion FU so valable for ieavenous use Ris wide ned the ‘ueatment of cleectal carcnema and slow growing sold tumors (29. cancers fer meread and neck, he esophagus, stomach Iva panceas, east and ovo ‘ts mportant adverse effets include severe gastitestn! symptoms such 3s nausea, vomiting, lores, nd mucostssleng wth bone marrow Suppression, neurotay and nan fot syaome. Also member that ee ee Related Videos: ° Cancer ugs& Chemoterapout Agons MK. SFU, 6, 616 & aC = Wste Blood Call Patiotay “Tyme Syrase and Recyeng of Fltes First Aid Reterences: Fst Ad forthe USMLE Step 12019, 20h oh: 432 Fst Afr the USMLE Step 12018, 2h oh: 427 Fst Afr the USMLE Step 1 2017, 27 47te mportont adverse elects inclade sovero gastitestnal symptoms such a: nausea, vomiting, lathes, and mucositis along with bone marrow Suppression, neuototy and Mand oct synoma, zo remember tat ‘nlereron lo. 2 imgsmod, and tazatctone are other apical agents ured the testment ofa cal crema, ‘Option A: 5-FU does notin bonucieotde reductase Cyarbine, Audarabine cladibino, and gemetabine are examples of antmetaboles that ‘Option B:5.FU doesnot nist DNA ropa Olapanb, cape and napa _sroraple of drugs that bit ONA ropa Open: 5.FU docs not inhib hyrooata reductace, Mothtotle and emmtraxed are cxceplor of armetabolte hat nb ycofoate ‘Option 5-FU does nt ib de nove purine nucootide snthest 6 motcapopurine and 6 Pioquanne are examples of antneanctes at nha de novo pune nuceeide sess Looming objective: 5 Fs an rtmotabote sed» prods, whic sod ‘niravanouy inthe teste of sleretl erenams anlow- gringo ‘umers. 5% SFU coams als avalabifr to topical ueatvent of basal ct ‘orcnoma. ts mechanisms of act inde nhbiton of ya sys, Innbsion fONA srthei nafineton, ang interference wah BNA processing. Fst A forthe USMLE Step 12017, 27th ed 47a ‘872. yea-o8 ma nas boon recnty dagnasod with stage 3 squamous cll . arcinoma ofthe ora avy. Aor the nocoesay oboatry workup. concurent ‘hemoracaton therapy has boon planed. Radstion therapy plored take ace vor 7 wooks anche wi recelve radiation doses da monday, 20 Gy factions For concurrent chemotherapy. wl ocsive ravenous ipa ot 3 dosage of 50 mpi“ weekly fr 7 weeks. Which of te fotowng bet explns the mechanism of acton ote antineoplast dug that e patent wl cele? © A ttt of poymenzaton of oun Bitton of tpotsomerase 2 (© € Formation of rrsvand ONA cross‘ris © D.imtionertepasomarase1 £ Free recs modtd i perxiation Bsc h e‘872. yea-o8 ma nas boon recnty dagnasod with stage 3 squamous cll arcinoma ofthe ora avy. Aor the nocoesay oboatry workup. concurent ‘hemoracaton therapy has boon planed. Radstion therapy plored take ace vor 7 wooks anche wi recelve radiation doses da monday, 20 Gy factions For concurrent chemotherapy. wl ocsive ravenous ipa ot 3 dosage of 50 mpi“ weekly fr 7 weeks. Which of te fotowng bet explns the mechanism of acton ote antineoplast dug that e patent wl cele? {A ntapion of poymerzation of uo os B.iition of tpotsomerase 2 x Fmt of errand DNA cro nk 4 ‘0. niten oftopetsomeraso 1 ax £ Free recs modtd i perxiation ™ eal}Explanation: Ccorect answer C: Cpa acts by forming nerd and nasrand oss tras whic ind DNA an thereby nt DNA syne and uncon The serine and 08 postion of een are the oe bing sts. so bin to ‘joplsnic and nucea proteins, which contbtes os atineoplesc actuty S20 mage below. Cepia ea pathum andi wech as ume s Init pheses ofthe cet cycle, wth cline Glad § phases bang most ‘ued o the atone of these chugs lela sed inthe wostmento ls tumor uch 98 cholanglocarcnmas, ‘ma col,and non smal clung ctenoma, cancers of a esopNa95, [tects of canine nave, vavtng, aephrotoesy, eatoey, a ether sensory peucpathy. Th dose mustbe reduced in patos wth ‘onal dysfunction. a ts extensively cared bythe Kidneys. Carboplatin and ‘xaipstn ae othe platinum analog. Related Videos: cancer Drugs & Chemotherapeit: Agents MTX 5, VF, 616 8 Bem = Winte Blod Cal Patoogy Cancer Bugs & Chemotherapout Agots:Dactremyein, Dasa ‘loomyein ok. White Blood Col Pathology First Aid References: Fst Afr the USMLE Step 1 2019, 20h 0: 433 Fst Afr the USMLE Step 1 2018, 28h: 429, Fst A forthe USMLE Step 12017, 27 ed 419[Spat are oe Pam analogs rst Ad forthe USMLE Stop 1 2018, 28h od: 429, Fst A forthe USMLE Stop 12017, 27th ed 19 ‘Option A nso of olymerzaton of ubuin te mechanism of action of microtubule intr sch a Wnertine, nt cepa, ‘Option Binns of topotzomerase 2s the mechanism of acon of ‘topoede not eat, ‘Option: anton ertoplsomeraso isthe mechanism ef action ot camptothecin not pit,‘Option A Inti of polymerzaton of tubuin the mechan of action cf ‘mcrotubuoinbtors such a ners, ot cepa, ‘Option B:intsion of toposemerase 71s he mochansm of action of ‘topos, not latin, (OpbonD: ahbiton af topizomerase tis the mechanism of acon a camptothecin, not pit, ‘Option: Free adcabmedaed ld perondaton sone of te mechanisms of acton of antvacysings ater than f spat. Leaming objective: Cieplan is a platinum analog, wich ats by forming lnrstrend and rastand cross nk, wich bind DNA and torah nds [DNA synthesis and ctor azo bids to ytplesmic and neler potas ‘The mpotant advereo efi of cepatimincude nausea, voting, ephectocy, cote, and penphetl sensory neuopaty. Bsc‘A 32 year-old woman is lagrotod wit astago Ia eAating ctl carcnams Involving tho lft beac. Tho tumors ERPR postive HER2 negate. pooiy ‘itscentetd loom Richardeon gre 3.4720 regona noe te pve, The Patent undergoes 2 lumpectomy Wh asltary mph nodo dissect flowed by ‘chemotherapy and anton therapy othe fet boas and avila, Her chemotherapy regimen involves doxorubicin, cycaphesphianide, and pacitare Foowing completion oft tensive phase, she's started on tamotten as an adja parorysma nocturnal dyspnea, Physical examination reveal the presence of an $3 {gaop jug venous dstension JVD), pe edema, and asctes. Se s lagnesed echocardogram conf the cagnoss of ilated carlomyopsty with severe fast dtuncton and an ejection acon of 1% Her medical story pit othe ‘dass ot reas cancer i negate fr any cate conor. Tho soln echocarlogram prior to staring chemotherapy anda T24ead eecrocrdegram ‘ete noma. Which of he allowing seat hay response for hor curert © B.Raaaton ner © D.cyctophosphemide © Myocoets ea Valo}‘A 32 year-old woman is lagrotod wit astago Ia eAating ctl carcnams . Involving tho lft beac. Tho tumors ERPR postive HER2 negate. pooiy ‘itscentetd loom Richardeon gre 3.4720 regona noe te pve, The Patent undergoes 2 lumpectomy Wh asltary mph nodo dissect flowed by ‘chemotherapy and anton therapy othe fet boas and avila, Her chemotherapy regimen involves doxorubicin, cycaphesphianide, and pacitare Foowing completion oft tensive phase, she's started on tamotten as an adja parorysma nocturnal dyspnea, Physical examination reveal the presence of an $3 {gaop jug venous dstension JVD), pe edema, and asctes. Se s lagnesed echocardogram conf the cagnoss of ilated carlomyopsty with severe fast dtuncton and an ejection acon of 1% Her medical story pit othe ‘dass ot reas cancer i negate fr any cate conor. Tho soln echocarlogram prior to staring chemotherapy anda T24ead eecrocrdegram ‘ete noma. Which of he allowing seat hay response for hor curert 8 Raamton nerapy 1. Cyclophosphamide aagaz E MyocerisExplanation: ‘Comect answer A: Doxorubicin an antvacyline deuave anda potent chomatnorapoute agert Doxouscnis used a tho eatmert of various lis tumors, leukemias, multiple mylora, Hodgkin berohama, 2nd non-Hodgkin ymphoma.Artracycines er edminstered Wa the intaveneus route and ‘motabeizea many nthe Wet. Tho mechanism of ation of anvacyetnes follows “Uinhibiton of tpoisomorase 2 Beokage of DNARNA yrs by binding to DNA 3 Bring anyoen and semiquinone re adcals anspor ‘Among these, the re aril mechanism beloved tobe responsible forthe carte of anvacycines. Alopecia stoma and newropenia ate thet {ie lde oats of domi. Cardo may be acto or one ‘Te acuto form occurs wit days of adminstaton ofthe drug and yplcaty presents wth rythm and eonducton problems, Prcrdts aed nyoearie moy lobe seen, “Te crore form presents 36 dated cardomyopaty wth hea lire. Related Videos: © Cancer Drge& Chemtherapai Agate MK. 50, 69, 616 8 en = Winke Sod Cal Pancogy {Cancer bugs & Cremotnrapoi Agont:Dactremyein, Daxouban ‘leomycn et. White Blood Cet Patobgy First Aid References: Fst Ad forthe USMLE Step 12019, 29h ed 431 Fst Ad forthe USMLE Step 12018, 2th oh: 428 Fst Afr the USMLE Step 1 2017, 27 418,yoearae mey lobe seen ‘The crore form presents 36 tes cardomyopaty wth hea fire, Ri se dependent and iteversible. Ts patent preserés win ted Cardiomyopathy and her alure. Her negetve pat hitary of are inosres Indicates thatthe current feng maybe a est of her chemotherapy. Avena the opens lted, donorubicns meet commonly aaeocated wih of cordetoncty, ‘Options: Ratan ny syleaty causes oscars in he acuta Seting. ‘Carcomyopathy anton effects on the coronary res heart ales ofthe «aria conduction systom may present as conic elects of the veatrent But ‘acaton causes ress of the myocardium which Qves seo rescve cardlomyopaty as opposed tthe lated cardiomyopathy ths cas, ‘Option ¢: Tamoxifen ia slecive esttogen receptor modultor (ERM) Pat fet 2 an eetrogen receptor antagonst in manny te bu ean agen h ene and endometrium estogan ecopts. The sie eects oftanaston Ince hot foes, vaginal charge, mental abnormalities, nawsoe ad an ‘neraasd sk of endometacanese ‘Option D: The tac efecto cylophosphanide include hemor cysts along win myelosuppression, alopeda, andousea. Adequate yaaten S| ‘sso t preva cys ‘Option E: myocar totes oto lanmaton eth myecardum, Russaly presets in an here heathy person wr heat alu. an cari dysfunction. There maybe asocated chat pan wth concarent Detcarats, sometimes preceding wth tke symetoms, wou cis, and ‘epree, This patents history and presentation are, however, ot pial of myocar bt rather of doxonsbien toe Loaming objective: Darcrbn is an anthacyine dotative used tho B bsctcto tt‘cation causes ren of he myocardium nhih ghee aot restive Carlomyopaty as opposed tthe ated cardiomyopathy ths cas, ‘Option: Temoxten 2 selective estonen receptor modltor (ERM! Pat ‘22s 35 an estiogen receptrartagonit in mammary sue but aban agonist ene and endometrium astogan ecopts. Te ss eects eftanauton Include hot foshes, vaginal dscharge, mental abnormal, nausea and an Incrensed ek of endometiaeanest, ‘OptonD: The esc aes of cyclophosphamide incide hemornage cyst along wi myelosuppression, alopeda andnausoa Adoqusto yaveten S| sre fo prevent psi Option E: Myocari refers othe flammaton of the myocarium, Russa resents ina there heathy person wh heat fale, aytnas, an carlo dysfunction, There maybe asocated chest pln wth concent petcarats, sometimes preceding wth she symtoms, wou cil, and ‘yspoen, Tis patents history ane presentation are, however, nota of myocar but rater of doxonbi tox Leaming objective: Dovorlen i an anthracyne denvative ures inte ‘teetmontt verte so tumors lutea pe mytoms odgkin ymphoma, and non Hodgkin hmphoms. Cater alepecistcratt and neuropenia ae the most important ove side eects of daxonbien. Doserubicnnuced carcotataty maybe acto ox cone. The cut orm ‘may presents with athyhias and conduction problems, Prcrcs and ‘yocatate may aloe ren, The chen frm present elt ‘Cardonyopay with heer tue. Ris dose-cependent and revere, Bsc‘A 7.yeao lt reson witha owe. over tay an ttiqu othe past \wook- The patir’s mother ays she als complains fog pan forthe post couple of ‘weeks. No sgncantpast medica coy The patent was bom at tem va Spontaneous transvaginal ovary wh no complatons, On psc examination, tho patent shows generalized paler, Conical hmphadcnopathys present Abone rmatow bopey ie perormed which conime the lagna of axa raphobastc leukem JL). Te patents stated ona chemoterapy veimen consisting of tiecsinn,daunonticn,L-eaperagnese aed prcialane tor induction, towel by Inisthecal methotrexate for mintenance Following he sth cy of chemotherapy, she develop lstralposs Phystal examination shows anormal pully efox nd eye movement: She stated on priaxine and pyrartigmine on 7 day ‘she has complete ecouion ofthe poss Which ofthe folowing drugs mos ely associated ith his patent's averse reaction? Pyidocine‘A 7.yeao lt reson witha owe. over tay an ttiqu othe past ‘ook. The pair's mother ays she als complains of eg pan forthe post couple ‘tweaks No sgticatpartmedenl neon The patente orn aterm in Seortaneous ansveginal ivory fh no complications. On physical examination, tho patent shows generalized paler, Conical hmphadcnopathys present Abone rmatow bopey ie perormed which conime the lagna of axa raphobastc leukem JL). Te patents stated ona chemoterapy veimen consisting of byintathecsl methotorate for maintenance, Florin the ath ce of chematerapy she develops bietal poss Physica examination shows 2am estan, ann das, she has complete resciion of tho ptosis Wich of ‘the folowing cvs is mos kay associated wit this patents averse reactor? Result: B bscteto ttResult: Explanation: Correct newer D: Vintisine vine ake, an one of the chit nducton agents used fo the veatment of ALL Rworksby binding to tubull and Blocks ‘he formation of micoubules. The dystunctona spindle appari thas ‘oti peditecaners sch as rhabdomyosarcoma, neuebastona, EWR ‘zcoma, and Wins tun In adut, kis aed for te eaten of Hodgn Iympama, non Hod fpoma, and maltplomyeloma The main dose. Sming factor the ure of crn le neurtodcy whch ean averse fect ofthe up tmost commonly resents as peipheral neuropathy. bt ‘uonomic detubances and cranial nave pases may alo aca Virrsine so category D ug and is conalncated mn pregnancy de to ‘evidence of hunan fet! kc nth cniesl gna, a rei nen pay ‘caus dung the couse of chomotherapyinapatnt wth ALL. Arion ho ‘hug sted above, ners is known to caus such an aero roction. The Derphers nevepaty en be teat th pyre (Option anrecovey 'Scomplote inmost cases. ‘Option A: Daunomuticin is an antvacytne hat works by nhng tepocomerasolL typical causes carotodtly as an adverse react, Related Video: Cancer Drge& Chematherapeuic Agent: Dactnemin, Onsoubicn ‘leomyci et. — Whe Blood Cot Patobgy First Aid References: rst Ad forthe USMLE Step 12019, 20h e433 Fat Ad forthe USMLE Step 1 2018, 28 oh 491,420 Frat Ad forthe USMLE Stop 1 (2017, 270 ch 9,422Vinci is eatogoryD ug and is contindated in pregnancy do to ‘evidence of haan fetal isk. nts cnial wane, 2 rarial neve palsy ‘occu dung the couse of chemotherapyina patient wth ALL. Arong the ‘rugs ited above, vnc is known to causa such an ars faction. The erpheralneucpaty ean be treated wth prtcxre (Option E) anc recovery ‘5 complote in moat cses. ‘Option A: Daunorticin is an antracyin that works by nhiing tposomerasoiL typically causes cardotodty as an advose reac, ‘nichts dove dependent and meverBle,Otor averae effects eke ‘Sopecia ane myelosuppression ‘Option B:Predncolone fs used wh vbcrisine to achieve remission in ALL ‘The ie eects of predisloneicude suppeesion of te puny arena! 2 isvogon Cushing syndrome, and ostesnecross Noes net cauze pextonaty ‘Option: Methotrexate folate atagonst. The adverse elects seen wth #5 ‘se ate myelosuppression, megelbla anemia, alopecia, and mucectis. Motetrxate doo: not cauze nowopathy. {eaming objective: vincrstne wis prciisotone ae the most common tat tie agents wed for induction ALL Vitti azo ure n Wirs tumor, vena sacoms, mabdomjoesreoma, Hodgkin phoma, and non Hedge !ympnoma, The mochanismef acton inten of ubun maton and ret of car potferation inthe Mghaca of rts, Tho most conn ‘severe fect the ues prpherl neuropaty, but rail news py ah ‘autonomic neuepathy may alse occur Bsc Fst Ad forthe USMLE Stop 1 (2018, 28 421,479 Fst Afr the USMLE Step 12017, 27H dh 49,422‘32 year-old woman prosons tothe clinic x folowup of he AIDS teste wth hight actweantsoroWral therapy HAART) Sos in good spits and hasbeen tury complant wih her meccatins and cine vss, Other melcaens nce prophylactic cotimorarole Recon blond studies show to fling Hemacobin 2) Moat Moan corpuscular volume ACV) 8011 Retculoot count 058 Enatooje count 2 108i Leucocyte count oomm? eutophis 40% Pool count 20.0000? ‘Assays also show 2 decroasea Wal DNA and mRNA bude, as wollas 2 slonslcanycnnished val loa. To avoid modifying the eecve an ctowra ‘therapy shes stared ona blo improving medication, Tar minios afro 1st dog, mo patient develops city breathing, severe musco pan and ‘vomiting. Hor pulse rte 120/ni andthe blod presse fs 8050 msm Ho, Which bfthefotoning mecestone wae mort ely aernstreato the patent? © Aerytropoietn © Bruges © Cimcon 3 © 0 Petlet derved grow factor © E Saoramestm ea Valo}Moon corparcular volume CV) 8011 etcuyt count 05% Enatocye count 2x 04mm? eveoeyo count {oamm? ‘eutophis 40% Paelet count 2000040? ‘Assays als show a decroasea Wal DNA and mRNA bute, as wollas 3 slanfcany cmnished val oa. To avoid moving the eecive anita ‘therapy she is stared ona bod improving’ medicaton,Thry minutos afer te 1st dose, mo patient develops city beating, severe musco pa and ‘vomiting. Her ule rte 120fni andthe blod presse fs 8050 msm Ho, Which bfthefotoning mecestne wae mot ely erinstredto the patent? © A eytropoietn > C itceun 3 © D.Platlet dered growth factor © E Sagramestm > F.Thrombopoietn reMoon corparcular volume CV) 8011 etcuyt count 05% Enatocye count 2x 04mm? eveoeyo count {oamm? ‘eutophis 40% Paelet count 2000040? ‘Assays als show a decroasea Wal DNA and mRNA bute, as wollas 3 slanfcany cmnished val oa. To avoid moving the eecive anita ‘therapy she is stared ona bod improving’ medicaton,Thry minutos afer te 1st dose, mo patient develops city beating, severe musco pa and ‘vomiting. Her ule rte 120fni andthe blod presse fs 8050 msm Ho, Which bfthefotoning mecestne wae mot ely erinstredto the patent? | eytreopoietn ites 3 Plt derived grow actor Sargramosti F.Thrombopolets Bbsctcto ttExplanation: Covet answer Segtamostin GMLCSF Is nametoplete growth ar or cslon siting taco usd to improve the mysosipprssion wich ‘tars dang HN testers chemotherapy eee ane oe aces, {otouing bere nanow ga. and ara om colonel. ‘Suganestnneases Do cet plodicton and matuaon te bone First Aid References: Fst Afr the USMLE Step 12018, 2h e121 Fst A forthe USMLE Step 1 (2018, 2h e121 Fst Ald forthe USMLE Step 1 2017 27h e117‘Srgamostim has 3 pronounced fst ose elect which posers 3s + Hypotension + Tachycardia + Fushi + Ugineadednesstetng fant + Dieesvvontingnaveeo + Maknesstaiguo + Musou pain + Breating dcuty + Pan ate ste otinjocton ‘Toso side eects canis in ntonsty wth subsequent deses and often lsappearaogeter. The so eects of sargrametim resemble those of _anaphylan, which should als be ruled out ‘Option A: Erthopoien potent tnsstor ore! od! cal producto, ‘maturation ond elenes hom he bone maow,Eytvopetetn sued for patnts wan pared orytvopoitnproduion, such ss even kenoy ‘lseose This pants slfty anemic and should be managed wih cal kon and mentored regulary but dogs net caren ‘Show any inaeaton fr enytopoatn tera. ‘Option B: Tho wcscatons or tgastin (G.SF) ao soar 0 Sargramestn or the westmertofreutopena. The mochanion tated below of con fx ‘gratin increase neuvophtsctation, sural and mobizaten eo the ‘od. Figrastindoos nthave a ist dose oot Iho sarees but con ‘esutinanaphyct eacons wth similar presentations eal}‘ewimemioy crown eon, == oo ety ‘Option: Inereukn 3 isan endogenous blood protein which acs as 9 ‘akin ora meceengerfor te mine syetom tran 3s knot | Incloas me production of varus blood cls, incuding grarsocjes, ‘macrophages mac cll, stm col, eri cal osiophis and rmegokanecytes. This colin not used as @ dug. ‘Option D: Recombinant attt derived grow factors smetines used 0 ap heat cere ces and folowing athopadic surgery to state Dene ‘egenerton.Entogenniy reconbieant pleted growth factor loys 3 signfcare role promoting angogenests anc sue reat but does rot improve mylosupptesson. ‘Option F Thrombopotn i aprten produced bythe body to crease -mogatayocytefermaten and ron, osutng in incoasedpltlt courts, ‘Trrombopotetn is used to ncease te platelet count ter myeosuppression ‘orn propartn or latlet donation. Thmbopelctin wll nt inprove ‘utcomes oth patent and does ot havea nscoabo st. dose eect ‘Loaming objec: Sagramestin and grastn ef usd 0 oat he ‘petopen of myelosuppressve condor cating HAART for HV. “Secrmosi hie sgntian et. soee eect which pecans oon ater Injection of est dose BscTest Results © Comect: 16 (17%) © Omitted: 0/5 (0%) fou Marie Sbjct Spine atom 8 4 Frama Heratiogy8 Oncly = e 150 Pramacloy Heri & Onclogy a e 462 Framacloay Heratioa/§ Only ae ° 464 Pamala Hertlog§ Onelogy en e | hemes eatiogy8 Onecloy a ° 240 Pramacclogy Heratiogy& Oredosy en