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Retired NBME 23 Answers

nbme23/Block 1/Question#22 (reveal difficulty score)
An investigator is studying the adverse ...
Presentation of antigens to CD8+ T lymphocytes 🔍 / 📺 / 🌳 / 📖
tags: immuno repeat

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 +11  upvote downvote
submitted by sajaqua1(607)
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HCM I tuficonn is glieatrn to ccearn iprssupnse.o MCH I adilsspy gdeonsunoeyl ietsnyezdhs oestpnir and espenrts hmte to D+8C T llcs.e eTh fuailer ot pldaisy MCH I, or MHC I ladsiyp fo nles-ofn n(ad yb ntnsoexei c)esounrca isnerpto stgiregr a rlulclae imnmue onsr,epse eldaign ot edotrsiutcn of het lce.l

The rpmoeosaet is usde ofr hte idetoardagn of norw o,tu ntsnsee,ce ro dmmelrafo tprinso.e sA ccraen elo,edpvs roem oitmsuatn lead to srinedaec rowng ipo.enstr ylnO yb reisxnsoep fo hte ,sreaptoome or sti xrnio-esso,eerpv can thees tumtan nirpstoe be geedrdad fast ougenh to otn be sdlyiaped yb CMH I dan lead ot eth cell begni .ldiekl rozbeimBto koblcs hte eepoor,tsma so the mattun orsepnti ear sdleiydpa no the r,cefsau glnowlai eht mimeun tsseym to nicegzero nda ilkl allhoigcptoa .lelsc

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catch-22  Arnthoe ayw to aarpochp it is to ikhtn aoubt CMH alcss I einsso.rcpg clla,Basiy fi ouy ihinbit the orpstoam,ee dpseietp lliw otn eb tgeerndea dna gihotnn si ibaeaallv ot eb edldao toon CHM I emee(bmrr CMH I has ot be doadel rfbeoe ti's tdosetranpr ot hte clle e)rfscu.a lelCs atth tdno' pseexrs CHM I get eikdll by het tnaural irl.ks leh3gncvCwm/4il2h2sc:7eont.6./wtrppMscn.lim.//t/ibwa1P/ +32
kai  nI" ionnclco,su we ahev stoeemtraddn taht teh mrasopeoet iiobrhnti robboztmie owu-nrsadeletg lsasc I dan hneensac teh sievitnyits fo melaoym ot NK adl–deiecmlte lssiy" mfro the noiuccolsn of eth NIH rappe +6
maddy1994  nohaetr nisemhacm si yb lbogckni oeotosmepr u enve seeraced ntareodgi of pipatocptoor on.rsoitsep.. ti hncancsee parmtssooifop( uld)wor +6
azibird  tBu D+8C nad NK sclle ilkl avi ir!renpfo yWh si hsit wrneas ?nwgro Is it bcuaees 'ist not het amyrpri ?fctefe +2
testready  he"T restemooap is teh ramjo rcusoe fo iyepocltotr iayivctt envvldoi ni the eoiatgennr fo pitsdepe ofr ierotntpsnae by jmora oyipmoctitlithasib ecoxpml lsacs I .ollcuesme eW rotrpe hte wen arbnteiosov atth mirzoeotbb tnera-lusegdwo AHL calss I no MM sl,elc rsnutlegi in ardincees NK aleetdideclm– . ys"ilsa1s7.Mcem/vo.m2r/swnpii:3//ilw6/tghC/p.lbthtc.wPncn24 +
fatboyslim  I ihktn twah OP disa asccondtrti ihwt tawh c2@2cat-h cedit ni het buPedM ela.tric +
an1  PO dsia ny"Ol by nsroxiesep of eth moteeop,sra ro tis ise,pnvoxe-erosr acn eshte nmtuta tpesinor eb rgeddaed tasf uhonge ot nto be dlyipaeds by MCH ".I WU IQD 76411 ysas thta a niroept eruoengsd igrotdenada by eht uintiuibq eopotramse apayhw,t efrat icwhh ti soeg to teh RE nda hnte si sdreetnep ot het lcel sreaufc for HCM 1 peenssor niadgle to pstoiaosp iav orprfmse adn .mygzresan Hinagv a reoatmoeps hrniibiot wdlou tullyaca vrpetne the HMC eospsern esuaebc on sprotnie aer esd.pdaiyl solA toen ttah eth tqsunoei sasy hiwch cospsre iwll be fftdc,aee theer si no ometnni fo encresia or resecdea. So ,yse het MCH /1 C8D tsypawha is cfta,defe utb its' talalcyu odwn lr.egutade nA scbneea fo HCM 1 easdl ot NK lecl demteiad ht.dae +

"Studies have shown that proteasome inhibitors block the assembly of MHC class I molecules and this is almost certainly because they are stopping the production of presented peptides that are needed for this process (6)." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094101/



 +5  upvote downvote
submitted by tinydoc(276)
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/:Ih.R5b3ehsmotUuHyp/ftuztJ/

MOA of smooerotep nhtibroisi rof .MM RLD:T is atth htey licaybsla obckl teh otoreospem frmo otnucinnifg os thta lyammoe csell cn'at ceyelrc torpeins ye(ht keam a ton fo h)etm nad hewn tyhe tnca' be cdrcleey ythe ldiub pu nad thast tocxi ot eht lecl dan it ide.s

ndboey that the nseoiutq si asaicybll inaksg if hte ihonitnbii of seootorsmpe istn ccispeif ot eth emlaMyo clles nad ti eniiihbdt etroh lc'sle roetsmsepoo wtha udowl eb eteff?edc

MHC scsal I si ptneres on all autdeecnl sclel a(ll llcse ni het odyb cpteex RC)B adn tifunonc to pesrten ngnduseoeo ntneagsi to 8D+C t slcle ot eb trdoeysde ro(f laexepm alriV AND in an efidcetn el)lc. The way heyt od thsi si yb itngka het tpinoer it nsdee ot eretnsp dan nagebkri it nwod iont uhcm slalmre edeitpp hsacin os( it nac tfi on the H.MCI If htsi pets swa deihibnti ni ehtor lescl hetn hte teh arPnneseiott of MCH I ondltwu eb able to ntesper rihte nistgaen to DC8+ T llces nda lurtaNa likler lclse. as the nqsoieut m.eislip

The qitesoun saw usper itrykc cebusea if oyu 'ndto ownk who ooermepots rsbinotihi kwor hten ouy tarst ilknoog rof an ranews ttah wldou epalxni hwo yteh dwolu ilkl tmuor lscle as le.lw I tog ti nowrg o.to It erdreqiu nwoegekld fo teh awy CMH I pssreent epesi.dpt

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 +4  upvote downvote
submitted by krewfoo99(116)
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yWh uodwl poesirrfn eb het rwgon res?naw utolnWd ocumtniaaluc of oxcit tpnsireo saecu hte lelc ot renugdo pisotpoas ?

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ergogenic22  tBeormzbio odse not lidrceyt ceatvati pf.roenri It cyltdier hsiinibt hte teerposaom hcwih → ablsene D8C+ T llecs to nitietia atposspoi → avi npofreri sreelea ni( eceessn a sremowdant f)tf.eec +4
drzed  tal,xyEc ti geirtrgs the lclse to eondrgu soaitposp whhci mneas tath it nca rehtie be clle eetmaidd ierf(ropn nad yagnzmer iav /AS)LSFFA RO ti cudol asol eb hrhoutg teh iciitsrnn apyahwt .eg(. armliocindhot; tcrmceoohy c) +
powerhouseofthecell  Qi:noteus tuB how do 8DC elcsl evha a orel in siht espcros clxeayt in eht tvnte?ige Is ti gyains ttha ewnh hte notepris iubld u,p oyln etnh do DC8 lelsc cmeo nda esdatin of CHM I stnripegen ot ot,mreapsose htye rnstepe it to D8C ot itatieni soisop?pat +
flexatronn  slechlho@terefupwooe so it all oges akcb ot ibasc minmuo (i tgo stih ornwg dna put poisotpsa sa e)lwl btu tefra weeigvrin nrelvtea niak rdsc,a i now egt to. iS eremstsopao ebrak wdno dgtage rpointes wnthii hte lcle eoe)udnn.(sog hTe kbwoerdan dpsurtoc get etank pu yb attoprrns asceodstai iwht giaennt rsinpscoge (AP)T adn bhortgu ot eth ghuor E.R hTe nowbkrdae drotcups era tneh odedal tnoo CMH I lsleeomcu nad uborthg ot teh ufersac fo teh .lcle nehW nhtgkiin utboa MHC ,I knhti utboa DC8+ T lslce F(A CHM 1 x 8 = N8.wo CD to mzaimues,r newh inugs a tpsmaroeoe rhtiboini, oruey' lngoibkc atht gnitgag and CMH I gladnoi sepcs.ro As tdsaet efbe,ro 8DC zocernseig MCH I wci(hh 'owtn aehpnp enwh iguns tehes srudg) +3
whosdaprincesss  nofa@enlrtx nhatk uyo !!!! +



 +0  upvote downvote
submitted by abhishek021196(120)
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ioBb,merozt rzifmiblaoc

scinaeMmh = Pemtorosae soi,hbrntii edinuc etarsr at -2GM ahspe adn posptoai.s

seU = Mteulpil lomyeam, aeltmn clle hlomymp.a

dvA fEsctef = aPlperheir het,urnaoyp hrpese eozstr vnicteiorata

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tyrionwill  udenr btzrio,meBo the eeoparomts tncnao tgdsie lvira Ag nad srepntse it to the momb-rnadedbnee MH.IC- hrfTeeoer -DTCc8 tonacn neoizrcge eht hsot llecs goinictnan epsladre ZV.V htTa si yrbplbao why liesnhgs is neo fo hte oualppr sdie efcfet of emtborz.ioB +
kcyanide101  eTh ugrd iinitshb m.soreetoop eHnec htere si on emrfntga ielaaavlb thuogrh TAP ensiid DC4 ellc to dloa nuto MCH ..I.. sA usch eht D8C nsrttnieeoap ot lcelT is dprnee.tve ehT uncaliuatgcm trpenosi esdnii eht DC8 lsecl hiwhc aer ont iengb eobnrk nwod by teh oeomosretp eucsa it to urdeong isaostopp +



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