A 28-year-old woman with AML - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 12-21-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 387
Threads: 82
Thanked 613 Times in 234 Posts
Reputation: 623
Arrow A 28-year-old woman with AML

A 28-year-old woman is diagnosed with acute promyelocytic leukemia after experiencing severe fatigue and malaise for several weeks. She and her parents have done extensive reading on the Internet and expect that she will be treated with intensive multiagent chemotherapy. To their surprise, her physician suggests an oral agent that is not used to treat other forms of acute leukemia. Why might the physician be concerned about using standard intensive multiagent chemotherapy in this patient?

(A) A desire to allow the patient to preserve her fertility
(B) A higher incidence of chemotherapyrelated death in patients with acute promyelocytic leukemia as compared to other leukemias
(C) An observation that acute promyelocytic leukemia does not respond to conventional chemotherapeutics
(D) A personal preference to treat acute promyelocytic leukemia with homeopathic agents
(E) An understanding that acute promyelocytic leukemia is so sensitive to oral agents that intravenous chemotherapy is simply not required in its treatment
Reply With Quote Quick reply to this message
The above post was thanked by:
aknz (12-21-2012), rupesh (12-25-2012), ts1234 (12-21-2012)



  #2  
Old 12-21-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,867
Threads: 149
Thanked 2,089 Times in 1,047 Posts
Reputation: 2109
Default

(E) An understanding that acute promyelocytic leukemia is so sensitive to oral agents that intravenous chemotherapy is simply not required in its treatment
__________________
A man doesn't know what he knows until he knows what he doesn't know.
“What is man? He's just a collection of chemicals with delusions of grandeur.”
Reply With Quote Quick reply to this message
The above post was thanked by:
heartbeat (12-25-2012), ts1234 (12-21-2012)
  #3  
Old 12-21-2012
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 623
Threads: 111
Thanked 424 Times in 264 Posts
Reputation: 434
Default

(E) An understanding that acute promyelocytic leukemia is so sensitive to oral agents that intravenous chemotherapy is simply not required in its treatment
Reply With Quote Quick reply to this message
The above post was thanked by:
heartbeat (12-25-2012)
  #4  
Old 12-21-2012
USMLE Forums Scout
 
Steps History: ---
Posts: 84
Threads: 2
Thanked 38 Times in 36 Posts
Default

Quote:
Originally Posted by heartbeat View Post
A 28-year-old woman is diagnosed with acute promyelocytic leukemia after experiencing severe fatigue and malaise for several weeks. She and her parents have done extensive reading on the Internet and expect that she will be treated with intensive multiagent chemotherapy. To their surprise, her physician suggests an oral agent that is not used to treat other forms of acute leukemia. Why might the physician be concerned about using standard intensive multiagent chemotherapy in this patient?

(A) A desire to allow the patient to preserve her fertility
(B) A higher incidence of chemotherapyrelated death in patients with acute promyelocytic leukemia as compared to other leukemias
(C) An observation that acute promyelocytic leukemia does not respond to conventional chemotherapeutics
(D) A personal preference to treat acute promyelocytic leukemia with homeopathic agents
(E) An understanding that acute promyelocytic leukemia is so sensitive to oral agents that intravenous chemotherapy is simply not required in its treatment
E it is very sensitive to oral agents . so i ve chemo is not required.
Reply With Quote Quick reply to this message
The above post was thanked by:
heartbeat (12-25-2012)
  #5  
Old 12-25-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 387
Threads: 82
Thanked 613 Times in 234 Posts
Reputation: 623
Default

The correct answer is B. Although acute promyelocytic leukemia (APL) is generally responsive to the chemotherapeutics used to treat acute myelogenous leukemia, cytarabine and daunorubicin, approximately 10% of APL patients treated on this regimen die from disseminated intravascular coagulation. This phenomenon occurs when dying leukemic promyelocytes release their granule components. Modern protocols use tretinoin, an oral drug that promotes maturation of leukemic.

Answer E is incorrect. In fact, clinical trials have shown that tretinoin is not sufficient as a single agent to treat acute promyelocytic leukemia (APL). For this reason current protocols involve the use of tretinoin in combination with intravenous anthracycline chemotherapy (daunorubicin or doxorubicin). Although the understanding of the sensitivity of cells with t(15;17) to tretinoin has allowed major treatment advances and increased the therapeutic: toxicity ratio in APL, tretinoin has not proven to produce durable remission when used alone.
Reply With Quote Quick reply to this message
The above post was thanked by:
anomali (12-25-2012), eriqaly (07-24-2015), slamdunk (12-25-2012)



Reply

Tags
Hematology-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
A 69-year-old woman with DVT heartbeat USMLE Step 2 CK Forum 6 12-25-2012 03:24 AM
A 20-year-old woman with SOB heartbeat USMLE Step 2 CK Forum 4 12-17-2012 11:45 PM
18-year-old woman with NIDDM heartbeat USMLE Step 2 CK Forum 3 12-07-2012 05:30 AM
A 75-year-old woman with COPD Novobiocin USMLE Step 2 CK Forum 10 09-07-2012 12:36 PM
Tx of DVT in 31-year-old woman? USMLE-Syndrome USMLE Step 2 CK Forum 0 06-21-2011 02:39 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)