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Retired NBME 22 Answers

nbme22/Block 3/Question#5 (reveal difficulty score)
A 72-year-old man with multiple myeloma ...
Unrearranged immunoglobulin gene 🔍 / 📺 / 🌳 / 📖
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 +70  upvote downvote
submitted by sacredazn(101)
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hTe tceconp si a euolvndtco awy of snkaig if uyo wken woh JVD inomoictbearn skrow, hhciw is tath ti is tlluacya an mpxeela fo atilengr hte AND fo hte /BT mlhyypoct.e

theuornS tlbo cqute:iehn So hnwe tyhe ues a ebpro gsatian osme ,oenigr and pitgttuuon a zeis fo 15. bk or 6 k,b siht si lgetlni uyo het szei fo eht NAD engfamrt ni cahe ecll tn’e(ods rmatet fi yhte ays J eoprb or csontatn ogiren roeb,p eyetrh’ ustj gaiyns e’rteyh etrnggtai msoe uldeinoetc eceseunq fnuod in the Ig CR/Touslc baet acihn clous ievlystrepec rfo BT/ lce)l.s

I inkht hte incfgunso ptra dcluo be nwodeigrn who oyu knwo wthrehe ’eyuor trlpya hthurgo targenmneerra wn(aers sechoci B hrtu )D ro fi it ah’nts dccreoru at all yte ccr(teor rae.ns)w ,eHre eht encctop si taht B csell erdugon (D)VJ gmetneraarenr ni het oben m,rroaw iwelh T leslc do it ni eht tu,hmsy and it lla phnasep ta ceo.n oS a palmas lcle in eth lodbo eilk in elltuiMp omyMlea dulwo ehav fluly rudoeegnn tnioaobenc,rmi liehw a T lcel in hte lbodo could rhteie eb lluyf edtdceau dan( vhae indeishf VJD mo)enaoibtcirn ro muaeirtm hn(t’sa tdeatrs DJ.V)

neiSc eht T elcl eegn swa 6 kb dna tyednieifl iegbgr hnta the .51 bk nge,e eth T lelc hsn’ta doneerung ninrcaobomite yt.e

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trichotillomaniac  vyre iecn tnpa!anoxiel +29
nwinkelmann  Tish saw ew!smoae eaMd so hmcu seesn and fuhpoleyl I liwl eb lbae ot inkht hatt itcllyrcai tuabo qsuseonit in the ueurft suceb(ea I RENVE udolw avhe ocem pu whti tish no my ,onw hha). +5
eacv  !GOM THKNA Y.UO I DIDNT WNOK YGNINAHT taoub !sh!ti Hepo shit si nto ettseds on aerl emexna :p +5
ajss  w!wo siht ianalotnexp saw wseo!mea nhtak!s +
mrglass  olsA teh -lTcel DJ--V msesgnte rae ont the meas sa eht ceB-ll -JD-V .ssetgmen rTefreeho a -cBlel J geesmnt tsrnuohe tbol uwlod oklo for whrtehe teh leB-cl iste JVD gsnteme ni a clleT,- chiwh uwodl wsalya nandgrro-.rneea +6
mynamejeff  aTnkh o!uy So is hsit aebuesc mlpeuilt yemmaol docsperu xseeesicv oconollman gihlt cnhia I?g sI isth het .51 kb e?nge seWh,rea e-sllcT thta aveh otn oeng ugtohhr eifteftadnironi yte nad tierh J rognie ludnices hretvnygei )V(DJ v.s sjtu JV in teh ligth cihn?a AF( 2200 gp )104 +
peridot  siTh taapolnenix is ia!gmnaz roveew,H ot lulfy snudeatnrd tnearho ptes fo whta eth tsuoeqin is etgtgni t,a paelse atek a oklo at rdobi'edhslyhsrwgadias@ anor/d asgsr@ml' nanxpiotael as lelw - a eyvr mpoarttni doa!ini!td +1
skonys  My locgi asw wognr tbu my earnws rcc.tore I am suneigrff ofrm .essscuc +
fhegedus  o!ww ihst si gain!mza thank !ouy +



 +18  upvote downvote
submitted by highyieldboardswards(18)
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rShto awes:rn lAl sngee rae tensrpe in othb B nad T s,lecl utb htey ergernaar and rsexpes ocepstrer that ear scficeip to treih lgi.anee Theri rea tdinpeneend DVJ ensroig orf B ecll ocpterre nntgieareo dan T clel torpreec rionen!tage This kwii rectlai ssehd lihtg no i:ths

b_tnto/t.redreio/(awnic)pDeew#imJ/lk.eTinpVokios/echrtcipgrs_l_:ia

I oot rligayalct edsmis htsi.. tub it si latucaly os pmseil atht we era nmiisgs the esrfto torhhgu teh rseet i Wl--eh hotb B nad T escll ngoedru DJV rgea,erenarnmt het V, ,D and J eegsn rae FINFDTERE EGSNE spiteed nebgi nagderzio and ehtrfeoer adeilisscf ni a lsmiair naosfih ued ot itehr aershd deen ot naeetegr evdsrei ctrstsreuu. oT kema tmtrase moer cio,nsgfnu thob sste fo VJD gsnee rae on coshmmooer 1.4

hisT si wyh eth BNME isfeecdpi ttha heyt era tanggig THE MESA J OIRNGE chhiw is ahtt of the B lecl trroecpe gene J ei,gnor nto teh T ecll eporcrte ngee tJeb-a ogiren e(se ikiw cal)rei.t Teh B lcel etroerpc egen si tno rreegnaard in a T l,lce if it ,asw T clsel dwlou aehv !sienaoibdt

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redstrat  Th.is So mhcu htsi! +1



 +5  upvote downvote
submitted by david_bball(5)
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hTe ayw I tuhgoht atubo siht utsoqine aws htta in MM erhet si a TON fo oisabtdein ngebi a,dme os eth JVD nestemg si nbieg bkorne cees/tedgrpeurlanear/d myan mseti nad has bnee esonhretd to 5kb.1. As rof hte T l,sCle atth rigoen stn’i negbi udes scne(i hteer is on olanlc pnnxioesa or sloeiecn)t os sti’ isllt tgo teh lufl bk6 genhlt nuthdoec.u

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d_holles  T lsecl itlls negdrou JDV rnaotoicminbe ot ofmr rihet .TsRC +7



 +2  upvote downvote
submitted by sam1(22)
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hWlie T lelcs od eus eht DJV boatnnocmeir,i het T ellc ecorerpt sacnhi aer rednftief eesgn mrfo het B cls'le ayhev nad light i.casnh enciS eyht edsu a B lecl roign-eJ b,roep het T cel'ls nabd liwl eb mchu lraegr sa htsi aera fo tis DAN e(ht B ecll ayhev or thgli nihca ge)esn vahe not nbee nargrdaeer -- eisndat sit T elcl reerctpo seeng evha eneb rer.adgenar

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 -5  upvote downvote
submitted by welpdedelp(270)
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_nrqrainp/s_osz2/xsp7.so_4rht1e/nitmicn/idbmweoepol/etb/_2pntetmleqa:tuuoc_nebss.h/prmtetd/eelww_

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