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Full Version: nbme 3 block 4 q 19....xplain - adrenaline4u
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40 yr woman comes to physician because of too much stress in life.. she is depressed and tense because of recent marital separation, job change , the need to relocate to another city, worsening of 8yr old boy asthma. Physical examination is normal.. lab studies most likely to show wat abnormalities??
1 decreased lymplhocyte reactivity to antigens
2 decreased serum prolactin concentration
3 increased serum calcium concentration
4 increased TSH conc...
5 mild normocytic normochromic anemia
--THE 40 year old woman HYPOTHALAMUS -PITUITARY -ADRENAL CORTEX axis is activated like THE BP LEAK in reponse to the stress(LATE STRESS RESPONSE)......

--THEN she will produce excess glucocorticoids (cortisol)....TO THE BLOOD STREAM

--the excess glucocorticoids have the side effect of decreasing lymphocyte reactivity to antigens(which is why glucocorticoids are immunosuppresants)....

aaa
I think ans shd be mild NCNC anemia....! Chronic cond asso with NCNC anaemia...
thanq yeabiruh & usmle19 for ur reply...
hi yeabiruh...i have seen ur replies for many questions,those were helping me a lot ...thanq a lot.Have u done with ur xam?ALL THE BEST....WISHING U 9999999.....
just addition

1.steroids,lithium,catecholamines-- decrease in marginating pool of neutrophils and increase in circulating pool,so neutrophilic leukocytosis and also lymphopenia,eosinopenia.

2. endotoxins,african american race--increase in marginating pool and decrease in circulating pool of neutrophils,so absolute neutropenia.
thanq sodium.......