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Retired 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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ndgiocAcr to FA ,2019 ni eth toiecns botau ieoramutdh ttrhsiair, it is ngeiv ttha hotmiuaedr enuosdl are ude ot roniiifbd ioscrnse. nI teh lghypotoa tpahrce ni F,A irbndfioi srscneoi is sadi to be na mleaepx fo eypt 3 epyhiyetnvtirsis iercnot.a In hist utosniqe es,mt the tapiten is dsia to vaeh oiudermath lnudsoe adn ethy ska eth' muiiglnomoc necmasmhi of isht eptatsi'n mmiontnfiaal is ramlisi otS? o' aylcbials htye sdeak oubta htaw tpey of eyihrtnyieptvsis cnotraei is iidnborfi rinsoe.she cT w:ranse Rehum ol;ibdro&iutei-ndfnsg og-tisc&sptyener; 3 tmSagHe&R-;s sa seumr i.scnesks Gto it wgonr b.tw

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 +4  upvote downvote
submitted by sajaqua1(607)
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Smrue knescsis is a eTyp 3 rnyythpieiistsev raen,tico ni whhic the oybd oespsdrn ot ecgnniiat daecilm uaesscsbtn adn cupsoerd otansbe.iid Tsehe nadseioibt in ouancctliri nhte dbin to het iticnange gurds and est fof hte eenlmpotmc asde.cca tihRomedau iartrisht is aosl a pTey 3 rnteivsitsypyhei rncaetoi.

A) soippsoAt fo gomaecphas-r potoiassp is aryglleen nto a teyp fo snytiyvriethpsei aeico.ntr )B taMs ecl nag-tudielanro tihs is rtpa fo a eTyp 1 styevpniyirehtsi lynaxascoehaita/r,pni ni hhcwi smta cslle bdni IEg on rthie cr,asufe dan gIE gbindni ot the tgaert nteagin ecnsdiu a amictnlraofono cghnea in the EgI hatt etss fof tmas lelc tne.ruinodgala C) aluaNtr leirKl eCll n-ikglil salyp a tiyarve fo eros,l cnnuiigdl acnrec ssispnepuro nda rdtoecsunti of alryivl tecdenfi .sellc If hyte ypal a orle ni ttvrysyiiihpsn,ee it si rpta fo pTye 2 SRH ni wihhc eyth udolw pordesn ot Ig no eth lecl fscare.u E) elWhe and leraf terosna-ic ihsT si loas a Tyep 1 S.RH

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meningitis  I tiddn' kipc htsi one cubsaee I ugthoth Srmeu iscssnke saw too csimyest nad AR asw a eomr cadlzoeli eTyp .3 i,ngaA im hkvnintoireg gsn.thi +
youssefa  :ojlanG RA is a eixdm ptye III dna ypte IV immuen ciertnoa +9
dinagohe23  I hotghu NK lcle ilgklni saw lmiarsi ot T elcl os and AR si soal peyT VI +7
nephcard  ,llbl ufodso +3
usmile1  NK ellc nlkligi would eb a epyt fo etnian uiymtn,im ton iilasrm ot mymroe T .llcse eusaecb yeht did ton eivg na empelxa fo a pyet 4 HYS, eht earnsw muts be umrse skesnc.si +

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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yeMba yhet twen htwi esrmu sscnseki (a ytpe III svrhtniepeisyyit r)xn on sthi quteoins absde no hte esoogyrl sued to ignsedao AR. tPs ithw RA evha iabdtensoi ot nblmumnliiogou G ),G(gI eldacl moudiaerth rfatosc (F)s.R tI ksema esom neses htat opnu ehset oituedarmh ratfocs egnicart wtih f"ls"e gtlrncuicia IGg, uniemm eolexsmpc odlwu mofr that woldu altre destipo in iussste igxliapnen( in rtpa the racxuarlttarie atfnmontsiiesa sene iwht ,RA .ex ertioahdmu ,nsouled ,rpeilisut ctrisdipeari )c.e.t

thciedd/neirr/-eeticsi/mscetpnhsptw/nnoitcite:tpd/ivwtess.ctcsir-ey.a-o-ynieymyiipwdi

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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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RA si a epyt 3 sietstiyehnpryvi onrtceai hwcih hsa wot .ntnoopsmce

  1. DC +4 T lcesl wlli nrflietiat uestis nda tcear ot untsagotnaei etepnsr ni the ovinlays in,ojt ihst escusa apahTFNl- nda I-1L ot be ersel.dea ehTse lntmorfaimya scytoeink ilwl sucae teh liitnia afnrmytiolam ir.cetaon ehseT esknyotic SAOL acvieatt B ell.sc

  2. B eclsl cdeopru hoeiuadrmt frcato as well sa nita ccciyl latiedncltiur epptied itbonady. heTy ndbi the neusitngotaa dan romf MUENIM xemplseoc thta espdtoi no eht ns.mouyvi Thye sucae eenclpmtom ot eb iaed.avtct ecHen teh cscsial eTyp 3 teyivsestphyiirn i,aotrnec ti si opomdcse of 3 nihsg:t .1 gnniate 2. baoytndi 3. otpcmelnme

,eNtx uyo ende to nowk tath murse essnkcsi ()FA is ASLO a etpy 3 resntevhtypisiiy ,tcaernoi hsit tiem ti si ued to lnlecinpii ro a mnolonaclo oidb,ynat lalsabiyc mose nectaniig rgd,u whhci cssuae aiyodtnb ot idnb dna hnet tpodeis ptece.ommnl

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 +0  upvote downvote
submitted by namesthegame22(14)
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epTy III priesyytsivnteih si deeinfd by teh epresnce fo igutnirccla o-nanmcya-edelttnioetgnpmib ceospxlme taht dietspo ni ssusite nad aseuc aafoninltmim and ieudrnttsc.o (she adh cdesdeaer C)3

pyet III ithivyseytspnier c:rintoase SE,L userm nksicses raioc,nte rtiartlpoisye P,o)d(asNonA nad muatProS-l)ci-ls(p.oepoeNhoptgrtGoterilccnss AR is loas a mdexi eypT 3 nad eyTp 4 RS.H

Sumer ckesssni scuocr enhw a ,drgu cush as tatco-ehytiymn ngui,olbl acts sa a ntaphe to het niemmu ,tymess griiregtng niyaobtd ofma.torin umSre iseskcsn otrniace lausuly ucocrs 1 to 2 ekwse tearf eth ilaniit psexoreu ot teh udrg, fgrietecnl het etmi uqirered ot mutno an mnueim prsense.o The bisedaonit etnh dinb eht rdu,g teiopds in stis,ue and artactt nda tatvceai .omecntmepl The tueslr is e,rvef ,asrh and arsrtlgi.haa

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