Bruton agammawhat?

Discussion in 'Step I' started by Enzymes, 05.16.14.

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  1. Enzymes

    Enzymes 2+ Year Member

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    Ok guys, First AID is tripping.

    In my 2014 addition, it says Bruton's agammaglobulinemia has decreased pro-B cells and NORMAL CD19 counts.

    I thought that pre-B would be HIGH in this disorder (since the block prevents maturation at the pre-B stage). Also, CD19 should be LOW (as was so elegantly indicated to me in UWorld today). Do you guys make sense of First Aid's explanation of Bruton?
     
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  3. YANKEES88

    YANKEES88 2+ Year Member

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    Check the errata. saw it in there
     
  4. Enzymes

    Enzymes 2+ Year Member

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    Thanks! I actually checked, but I didn't think that would be in the MINOR errors...haha.
     
  5. dyspareunia

    dyspareunia

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    The enzyme deficiency actually occurs before pre-B cells (hence, low pre-bs and high pro-b). At least according to Abbas.
     
  6. Enzymes

    Enzymes 2+ Year Member

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    I'm not too sure why so many sources still say this. The defect is clearly at the Pre-B stage. Btk is a tyrosine kinase receptor that is part of the pre-B complex. This is all confirmed in Robbins and Wikipedia as well.
     
  7. dyspareunia

    dyspareunia

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    Idk, but now I have no idea why Pro-B would be low.
     
  8. Seph

    Seph 2+ Year Member

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    Does anyone know why pro-b cells would be low?
     
  9. Cyal

    Cyal 2+ Year Member

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    I think transition is from pro-B to pre-B. Issue is the transition from pre-B cell to immature B cell. So all cells move to pre-B cell stage and get stuck there.
     
  10. dyspareunia

    dyspareunia

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    FA13 says normal pro-B and it wasn't in the errata.
     
  11. notbobtrustme

    notbobtrustme Crux Terminatus Banned Account on Hold 2+ Year Member

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    okay, this is why people need to calm the **** down when they see something they've never seen before and freak out.

    I've had the path shelf, the CBSE, the micro/immuno shelf, 5 NBMEs, all of Uworld and all of Rx. That's something like 6000 questions.

    How many times was I asked what population of B cells was increased in BAG? 0. How many times was I asked to identify lab values, complications, defects, inheritance, presenting signs/symptoms, mechanism of defect? Probably >50.

    This is what people mean by knowing what is high yield and what is low yield.
     
  12. Cyal

    Cyal 2+ Year Member

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    pro-B's should be normal. But they move to pre-B and get stuck there, right in the bone marrow since no signal from BTK.

    I agree it is low-yield, and I only happen to randomly remember it.
     
  13. Enzymes

    Enzymes 2+ Year Member

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    Yeah, I realize this is low-yield. I was mostly shocked by the errata on the B cells.

    But I can't see how pro-B would every be LOW. The only thing low would be the mature B cells. Everything else backs up and would be normal/high.
     
  14. dyspareunia

    dyspareunia

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    I'm more worried about understanding the defect that I am memorizing the minutiae. If pro-B are supposed to be normal, then I understand the deficiency. If pro-B are supposed to be low, then I don't understand it and that is concerning to me. In my humble MS1 opinion, understanding is high yield for just about everything.

    Ok I thought you were saying that pro-B should be low. I agree they'll be normal.
     

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