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NBME 23 Answers

nbme23/Block 3/Question#36 (reveal difficulty score)
A 70-year-old woman comes to the physician ...
Serum sickness 🔍 / 📺 / 🌳 / 📖
tags: Immuno repeat rheum

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 +5  upvote downvote
submitted by curlycheesefriesguy(5)
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dginccoAr to FA ,2901 in hte ntoices utaob utohmradie ,itathrsir it is gvnie ttah tmrohdiaue ulndseo are edu to indribfio ernscsio. nI het gthlyaoop rhteacp ni A,F iidorfinb reisocns is asdi ot eb na elemxap of ypet 3 tseetnpyviisriyh oern.iatc nI htsi sotuqein me,st teh ptentia is isad ot ahve haieoumdtr doulsne nad ehyt ksa 'eht ciilooummgn icnemsahm fo ihst s'etanitp mifnoitamaln si iimrlsa Sot?' o ylcbisala heyt sdkea taobu hwat yetp of syeernihyptistvi arcinote is fdibrnoii e .iToscesnrh swnear: meRhu idneri;&gutoo-fbsindl -opsent&;rtsygcie 3 meas;SH&Rg-t as mures icsskes.noGt ti wnogr b.wt

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 +4  upvote downvote
submitted by sajaqua1(607)
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reumS cseisnsk is a Tpey 3 syieheyitnpritsv o,tianerc ni wchih teh ybod dsrsnepo to tiangnice eildcma becsssunta dan urcpdseo ndtiabsei.o eesTh osniditeba ni oinructialc ehnt nibd to eth gticianne urgds dna ets fof het cmpeotneml dcaes.ca haeuitmRod irishtatr is lsoa a eyTp 3 iheniyevrsyisttp er.cnatio

)A poAssptio fo shpoam-agerc tpaispoos si gnlrlyeae ton a ypte fo ryenishteypivtsi ocr.tneai B) astM lec ralntnaog-duie itsh is prta fo a Tpye 1 eiyeitstrpvnihsy xealropihaansicn,tay/ in cihhw tasm elcls dbni gEI no trieh rs,acfue dna gEI binndgi ot teh raegtt neganit dineusc a aiotfnmnocarlo cengah in eht EgI ttha tess ffo tams ellc laurtendao.gni C) laautNr lelrKi Cell lknig-li yplas a itayerv of oerl,s uinilcgnd craecn eopusrnissp nad rtceidosunt of vilyalr dctfeine les.lc If teyh alpy a leor ni si,nityeviresythp it si prat of epTy 2 HSR in ihchw htye udowl spdoenr ot Ig on hte llce .esfcaru E) eelWh nda lfear roceti-nsa Thsi si asol a eTyp 1 RS.H

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meningitis  I i'tddn ipck isth neo usbeaec I hhgoutt ruSem niskssce swa oto essmcyti nda AR swa a emor ldozaliec pyeT 3. n,iAga im tenkhnviogri ig.ntsh +
youssefa  joGlna: AR is a miexd tepy III adn etpy VI iemnmu oraneict +9
dinagohe23  I thgohu KN clel likling aws sriimal to T clel os adn RA si aosl eTyp VI +7
nephcard  llb,l sfoodu +3
usmile1  NK lcel ikgilnl owuld be a ytep of nineta t,nmiyimu not lasrimi ot oemmry T .eclsl aubecse htye ddi not give na lepxaem fo a yept 4 HYS, eht swanre mtus be usmre esssc.nik +

bumping the OP; extraarticular manifestations are common in RA (i.e. rheumatoid nodules in subcutaneous tissue and lung (+ pneumoconiosis --> Caplan syndrome), interstitial lung disease, pleuritis, pericarditis, anemia of chronic disease, neutropenia+splenomegaly (Felty syndrome), AA amyloidosis, Sjogren syndrome, scleritis, carpal tennel syndrome. (btw I thought RA was local and HSR II)



 +2  upvote downvote
submitted by eli_medina9(22)
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Maeby hyet ntwe itwh esmru skncsesi (a ytep III ihysiepiseryvntt x)rn no iths tonsuqei abdes no teh yegorlos sdeu ot doaniges RA. sPt thwi RA veah sdbiniaoet to nlobinguuomilm G ,g(G)I llecad raheimduot atsfocr R(F.)s It mskae eoms enses that unop eshte tohdriemua astrcof creiatgn hwit e""slf lgurccinati ,gIG mnuemi moslcexpe uoldw fomr atth ulwdo trlae ieostdp in sstiues (xnaeliinpg ni atrp het ttaarilxuracre eimastotnisnaf snee whit A,R ex. udaihreotm ,nodesul rei,lpitus tisiecrirapd .e.)ct

:rcniwincsyptch/i.ssdicsewwtntitdvh--eioertpsntd//ie.yoreae/pt-citn-ismt/ecipimdyeeiy

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Serum sickness—the prototypic immune complex disease. Antibodies to foreign proteins are produced and 1–2 weeks later, antibody- antigen complexes form and deposit in tissues = complement activation = inflammation and tissue damage. Fever, urticaria, arthralgia, proteinuria, lymphadenopathy occur 1–2 weeks after antigen exposure. Serum sickness-like reactions are associated with some drugs (may act as haptens, eg, penicillin) and infections (eg, hepatitis B).



 +0  upvote downvote
submitted by imgdoc(183)
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AR is a ypet 3 pvistenrstyiyhie taneirco wchih sah wot t.nsencompo

  1. DC +4 T clles illw liiftrnaet itseus dna ceart ot aetsonatuign tepesnr ni the nvosalyi iont,j isth sauesc FNalpahT- dna LI1- ot eb e.earlsde eeshT oaitlfamrynm kenitcsoy will seuca hte iitailn nmifmylarato .eoticran shTee sincetoyk OALS vacaitte B lecs.l

  2. B llces cpdouer doetrmiahu rfocta sa ellw as anit ylcicc crtuanitlield petpdie ano.byitd yThe ndbi eth ainsanoutetg nad orfm MUEIMN lxsempoce hatt tespdio on teh sviyn.oum heTy uceas oetpmlmnec ot eb aec.dttiva eenHc teh slccisa Tpye 3 isneitevyrhistyp ornitace, it si coosdmep of 3 inth:sg .1 itagenn .2 botidyan .3 pneomcmelt

tN,ex you eend ot wkon atht sreum inscseks A)F( si LASO a pety 3 isteyiinhpyrvtes o,cnitrea sith itme ti si edu to lnipieicnl ro a nlmloaocon oaidtb,yn slblaiyac meos aiigctnne ,gdru hhicw caesus diboyant ot nbid nad hetn siotepd .ncepmemlto

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 +0  upvote downvote
submitted by namesthegame22(13)
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peyT III ptsyyrthviisniee is edidfne by het nerpsece fo tcialirnugc mytnai-geidonnlm-ecoaebttpn plmsxceoe thta siteodp ni stusise dan useca manlinotifma dna tn.dsrctouei ehs( adh dearseecd 3)C

eypt III iiyevypehtisnrts :citreaons SEL, musre sskncesi cetrn,iao pteytoslrraii oNn(APso,)ad dan -ls-oltNPGpSearipromelnooce)csopugttr(thcis. AR is sola a ixedm yTpe 3 nad ypeT 4 .SRH

mrueS nicsksse ccsrou hwen a dr,gu cshu sa yteaoth-miytnc ,olibnulg atcs as a npahet ot the inmmue ,meysst ignggirtre dnoyaibt oo.nframti Srume eincssks rcatoine uaysull rccsuo 1 to 2 ekwes tfrae hte iitnali reuoepxs ot hte d,rgu leetcnigrf het miet erduerqi to muton na eiunmm pess.oern The beitanidos enth bind eht r,ugd topised ni su,site nda tcatart nad ataitevc mnpleocetm. ehT tlseru si v,free ,hsra adn taa.rslagirh

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