need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)

NBME 18 Answers

nbme18/Block 1/Question#40 (reveal difficulty score)
A 3 yo boy is brought to the physician for a ...
Complement activation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags:

 Login (or register) to see more


 +9  upvote downvote
submitted by โˆ—motherhen(69)
get full access to all contentpick a username

This is describing Hyper IgM syndrome; without CD40 ligand, T cells are unable to provide the secondary signal to activate B cell class switching. This prevents IgM from switching into IgD, G, E and A, and thus an accumulation of IgM - hence the name "hyper IgM" - and deficiency in the rest (causing infections like S.pyogenes early in life, PCP, cryptosporidium and CMV).

Note in this question the cause of Giardia infection from lack of IgA (lack of mucosa/GI protection) must be distinguished from Selective IgA Deficiency. Lack of CD40L ligand defines it as Hyper IgM syndrome.

Answer choices:

  • Complement activation= IgM and IgG

  • Cross placenta= IgG

  • Attach eosinophil Fc receptor= IgE

  • Attach mast cells= IgE

  • Easy secretion across mucosa= IgA

get full access to all contentpick a username
jer040512  To further add: IgG opsonizes +3



Must-See Comments from nbme18

feliperamirez on He is medically qualified to drive
anechakfspb on Tubular atrophy
aneurysmclip on Endothelial nitric oxide synthase production
azibird on 24,25-Dihydroxycholecalciferol
famylife on Increased transcription of HMG-CoA reductase
match95 on Plasmid loss
apurva on Antineoplastic
cbreland on Basement Membranes
match95 on Proximal tubule: isotonic; Macula densa: ...
sugaplum on Abnormal migration of endoderm from the ...
amirmullick3 on Myelofibrosis
merpaperple on Primary spermatocyte
wishmewell on Alpha-synuclein
namira on Greening reaction on blood agar

search for anything NEW!