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Old 04-18-2012
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Default Pathology doubts

So i have been reading Goljan these days and coming up with all sorts of weird doubts! :-/

Why do methotrexate and 5-flourouracil decrease folate levels, when they are actually inhibiting enzymes that use folate? I can understand why phenytoin,alcohol,OCPs cause defeciency of folate-they decrease its absorption.

Why does CML have warm and cold hemolytic antibodies, when the B-cells cant produce Igs at all?

Does MI have neutrophilia or neutropenia?
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Old 04-18-2012
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Methotrexate and 5FU don't decrease folate levels; they just create the same sort of symptoms as folate deficiency (megaloblastic anemia) because they prevent folate from being used in thymidine biosynthesis. I'm not sure what Goljan said, but he might have just been trying to oversimplify it.



Are lymphocytes affected in CML? I thought it was generally a disease of the myeloid cell line (i.e. granulocytes). If I'm not mistaken, B-cells would only really be affected if the person was in a blast crisis or something.



MIs cause neutrophil recruitment around days ~2 to ~4-5. After that macrophages take over. I've never heard of neutrophilia after an MI, but I could be wrong about that.
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Old 04-19-2012
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got it.
and that was CLL i was talking about.
Umm yeah its mentioned in goljan tht MI does cause neutrophilia.
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Old 04-19-2012
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*sorry, I meant "neutropenia". I've never heard of an MI causing neutropenia.

Lymphocytes aren't fully dysfunctional in early stages of CLL. Actually, CLL isn't necessarily even a fully fatal disease. A person can still have some normally-functioning B-cells in addition to the proliferating lymphoblasts.
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