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NBME 18 Answers

nbme18/Block 3/Question#27 (reveal difficulty score)
A 39-year-old man comes to the physician ...
Type III (Immune complex-mediated) ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

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submitted by โˆ—mariame(16)
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I evlbeie the gsdinaois is Cmibringuloelyao. oreHvwe ouy do ont need to wokn siht ot nwsare het tu.sonieq

Tpye III rteepshytivsiny si asdetciaos wiht sluctaiivs dna semsycti mnosiantaft,eis wiehl epTy II slluauy hsa a ipcifecs tgtaer na( ronga, Type I is iclhnapatcay nad ypTe IV is yleaded epty vtssii.ynyitprehe

omoynueCibglilra is nfote ued ot avrli nnfix lseiplceya C;HV msoioinbnululgn etperpaitci in het ldco adn esuac teh to.gphayol I't s ccaezreirhtad y:b laepblap ,prarpuu esawnke,s ilshgraaatr, rhppleaire oarynhpetu adn enlra vnivtemnoel AF( 1920, .)113

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ih8payingfordis  Literally saw that C4 (complement component) is down in the serum and picked Type III and never looked back at this mess of a question. +5
cmeacham  Wait, can you explain this? +
plaguedbyspleen  @cmeacham Type III hypersensitivity reactions are due to antigen-antibody complexes that activate the complement cascade. So complement is consumed and levels are found to be low. This question shows a low C4 level. +2

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