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  #1  
Old 12-02-2011
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Question Weight loss, Anemia, Lung mass

A 65-year-old male is being evaluated for fatigue mild normocytic anemia and anorexia. He has lost 10 pounds over the last two months. Chest X-ray reveals an irregular perihilar mass in the right lung field. This patientís symptoms can be mimicked in experimental animals by administration of which of the following?

A. Interferon-α
B. IL-3
C. TGF-β
D. PTHrP
E. TNF-a
F. Vasopressin


Anwer will be given in 24 hrs.
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  #2  
Old 12-02-2011
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Is it TNF a
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  #3  
Old 12-02-2011
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Is it PTHrP...i think the Dx is Squamous cell CA...so just guessed it..
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Old 12-02-2011
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Default E?

I think its TNF alpha (cachexia)
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Think its TNf alpha but is the anemias of chronic diseases cos of tnf alpha?
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Old 12-03-2011
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I think it s Tnf a
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Old 12-03-2011
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Help please mention the reasons for the answers

Quote:
Originally Posted by dr.morphine View Post
I think its TNF alpha (cachexia)
plz mention the reason for choosing the option and basis for ruling out other options
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Old 12-03-2011
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i think the correct answer is TNFalpha since the question is reproducing the symptoms....the old guy may be suffering from lung carcinoma...as we know the primary cytokine responsible for cachexia in cancer patients is TNFalpha.....hope im clear
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TNF is definitely correct,,cachexia . .
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Default Answer is E

Explanation:
Cachexia is a syndrome that encompasses anorexia, malaise, anemia, weight loss and generalized wasting due to underlying systemic disease. Cachexia in the patient described above is a manifestation of the lung neoplasm revealed on his chest X-ray. Tumor necrosis factor-alpha is a cytokine that causes necrosis of some tumors in vitro. In experimental animals it also produces symptoms of cachexia. For this reason TNF-α is also called cachectin and is considered a main mediator of paraneoplastic cachexia.
TNF-α is produced by macrophages in response to infection as well as by some neoplastic cells. Its role in cachexia is explained by its influence on hypothalamus that leads to appetite suppression.
In bacterial infections, TNF-α produces fever along with IL-1 mediates many of the symptoms of septic shock and causes hepatic release of acute-phase reactants such as C-reactive protein and fibrinogen.
(Choice A) Interferon-α is synthesized by leukocytes and has antiviral as well as anti-tumor activity.
(Choice B) IL-3 is produced by activated CD4+ TH cells. It stimulates growth and differentiation of immature T cells in the bone marrow.
(Choice C) The main function of transforming growth factor-beta is inhibition of the inflammatory response. It decreases T cell proliferation and cytokine production
(Choice D) PTHrP (parathyroid hormone-related peptide) is produced by tumor cells and causes paraneoplastic hypercalcemia.
(Choice F) Production of vasopressin by some tumors results in SIADH (syndrome of inappropriate ADH secretion).

Educational Objective:
TNF-α was shown to induce a wasting syndrome (cachexia) in experimental animals. It is thought to mediate paraneoplastic cachexia in humans by suppressing appetite, inhibiting lipoprotein lipase and increasing insulin resistance of peripheral tissues.
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Quote:
Originally Posted by USMLE2011m View Post
Explanation:
Cachexia is a syndrome that encompasses anorexia, malaise, anemia, weight loss and generalized wasting due to underlying systemic disease. Cachexia in the patient described above is a manifestation of the lung neoplasm revealed on his chest X-ray. Tumor necrosis factor-alpha is a cytokine that causes necrosis of some tumors in vitro. In experimental animals it also produces symptoms of cachexia. For this reason TNF-α is also called cachectin and is considered a main mediator of paraneoplastic cachexia.
TNF-α is produced by macrophages in response to infection as well as by some neoplastic cells. Its role in cachexia is explained by its influence on hypothalamus that leads to appetite suppression.
In bacterial infections, TNF-α produces fever along with IL-1 mediates many of the symptoms of septic shock and causes hepatic release of acute-phase reactants such as C-reactive protein and fibrinogen.
(Choice A) Interferon-α is synthesized by leukocytes and has antiviral as well as anti-tumor activity.
(Choice B) IL-3 is produced by activated CD4+ TH cells. It stimulates growth and differentiation of immature T cells in the bone marrow.
(Choice C) The main function of transforming growth factor-beta is inhibition of the inflammatory response. It decreases T cell proliferation and cytokine production
(Choice D) PTHrP (parathyroid hormone-related peptide) is produced by tumor cells and causes paraneoplastic hypercalcemia.
(Choice F) Production of vasopressin by some tumors results in SIADH (syndrome of inappropriate ADH secretion).

Educational Objective:
TNF-α was shown to induce a wasting syndrome (cachexia) in experimental animals. It is thought to mediate paraneoplastic cachexia in humans by suppressing appetite, inhibiting lipoprotein lipase and increasing insulin resistance of peripheral tissues.
thanks for your explanation as i like the way you written this answer along with such long explanation!!!!!
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