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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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goidccArn ot AF 2190, in the ctsonei ubtoa etuaromdhi srrtiaiht, it is venig htat utaeohrmid eodsnul are due to biodrinfi sosice.rn nI teh pgyhotola ahtcrep ni F,A ibiironfd soecsrin si asdi ot be an xeapelm fo etyp 3 tstyniesipyiehrv nireo.tca nI ihts teosuinq ms,et eht ttipnea is dias to heav eumaiorthd ldenuos and yhte kas 'the mgiuomicnol ehsicnmam of tish tta'einps altimnoafinm si liamris to' ?So cbsayilal yteh aedsk touba wath tpey of vyiiyrstetpisneh eiortnca is ifrbdinio no.sesicrehT e:nwsar Rmheu ng&sidbnduo-oie;irlft systct&pnoie;rg-e 3 ;RSsa-mH>e as eumrs .sskeisnctoG ti owrgn wb.t

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 +4  upvote downvote
submitted by sajaqua1(607)
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urmSe isknscse is a pTey 3 irtivspsyhteneyi onac,iert ni cwhhi teh odyb sdepnrso to nacngiite lmdicae bensctsasu dna oduspecr iaenbt.idos eshTe dneiboiast in torcliunica neht inbd to eth naienitcg rdugs and ets ffo the enltoemmcp .aesacdc ouatihRemd asitrrith is slao a Tpey 3 eiivrsttpysiyhne encri.ota

A) toispsAop fo cahoaemrp-gs osstppoia is lyeelgran nto a tepy of yeittenyviihrsps ni.aeotcr )B asMt cle nruli-nodgaaet hsti is rpat fo a yepT 1 tiisehvyeipsnytr aplaso,yenhnrx/ticaia ni ihcwh satm lcels idnb IEg no tiher fuecs,ar nda IEg bdninig ot teh gertat aenntgi dsiunce a almotnncarofio hecgan in eht IgE htat ests ffo tmsa llce n.relnodutiaga C) tralauN rKliel elCl nkil-lgi lpsya a iayertv fo s,erol gliucnidn ccnera espoursnsip nda usncetdtiro of lryalvi fencdtei escll. If hyet ypal a eolr in tiesenityrisyphv, it is part fo yepT 2 SHR in hwich yteh lduow rpeodsn to Ig on het llec a.ecufsr )E eeWlh dan elafr ts-aneciro Thsi si sola a peyT 1 R.SH

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meningitis  I ddnt'i pkic stih oen scbauee I hoghutt euSrm neskcsis swa too ytscsmei nad AR saw a roem oelalzidc eTyp 3. i,Anga mi gokvnnerihit htg.sin +
youssefa  nojGl:a RA si a eximd ytep III nad epyt VI iunmem aonciter +9
dinagohe23  I tuohgh KN lelc lnligki saw sarilim ot T lcle so adn AR is olas eyTp IV +7
nephcard  lbll, dsoofu +3
usmile1  KN elcl inkgill ulodw be a etpy fo netnai mtnyimu,i not mrilasi ot omerym T l.lesc suecbae yeth did ton vgei an pamelxe fo a epty 4 ,SYH eth awerns tsmu be uesmr nsis.scek +

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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yeaMb tyeh wten tihw mresu sissenck (a etpy III pivynstisihereyt r)xn no hits unetisqo saedb on het gyeorsol seud to densagio .RA Pst whti AR vaeh nstieibaod ot uolnnioblmiugm G g,(IG) edllca emhdoiruat octfars (.RFs) It skema eosm nsese htat opun esteh heodiaturm ofsctar tracengi hiwt "elfs" icrnlgautic gI,G mmenui xesoeclmp wolud rofm htat ouwdl elrta sotpeid in stssuei (nxagpeliin ni tarp hte aerttaraxcrliu asentamiifnost eesn ihwt A,R .ex tomdheirau uodesn,l isuilpter, isrerdpiitac .t)e.c

iyemiww.nrtdroeedsi.s/t/ihmen/-patt:cvnn-dtn-ertitetysocccit/hey-wiipidiiseccpsespy/i

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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 is a type 3 hyipesnveisitryt rtneoaic hwhci hsa owt nstm.oopecn

  1. DC 4+ T lselc lwil linrtafiet usetsi dan atcre ot nagusaentito tpesern in teh ynslviao iojnt, sith aescus F-NaaTlhp dan 1L-I ot eb eerdsl.ea Teshe nytaamlimrof nostkciye iwll sueca teh litinai fyramalitmon en.aotcir sThee ksnycotei AOSL eicttaav B ll.cse

  2. B lelsc erpodcu hdierutaom artfoc as lelw as tani cycilc tralntdecuili edeptip dyo.tnabi ehyT dnbi eth tasogteniaun dna omrf MNIUME sopecxmel ttha oistdep no het y.mvsuion hyeT uaecs eelcotmpnm to eb .aetdtcvai neecH eth sacclis pTey 3 hnteivstsiyeypri teorcna,i it si edoomspc of 3 isghtn: 1. nntgeia 2. obnaidty .3 eonlctempm

xt,Ne oyu dnee ot owkn taht eurms snsecksi (FA) si LAOS a ptey 3 pysehtviyireints eortnic,a isht time ti is deu to nicelinlpi or a oamnlnoclo tdbaion,y iybscalla mseo nciegnati ,rgdu hhiwc ceassu ainyotbd ot idbn nad tenh detosip me.lomnepct

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 +0  upvote downvote
submitted by namesthegame22(13)
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peTy III ptevryiieshniyst is dnifdee yb hte cpsrenee fo rtlciuigcna tlpencegtni-ad-mmneoaotybin elsmxecpo htat edopsit ni itesssu dna ceuas limmtaoinfan nda os.tuitndcre se(h adh caereedds 3)C

yept III iittpseirvysyhen oan:rsitec S,LE ruesm sesicnks nocret,ia pstrratyiieol n,NA(d)oosaP and lue(Po-etloi-nistGrotpcNcl.mtrohpSgac)spores AR is sloa a imxed ypeT 3 dna eTyp 4 .SHR

ruSme sesnksic rouscc wehn a ,gdru scuh sa item-ctotyyanh nogblui,l tsac sa a etpnah to eth inumem symest, regtrinigg inyodatb rm.iaootnf eurmS esksncis oacntire ylluusa crcsuo 1 ot 2 seewk erfta eth tiilain peusorxe to hte ,rdgu rftecligne het imet eireuqrd to mtuon na eiummn erpsen.so heT tedsinioab neht bdin hte rug,d pisdoet in t,eusis and ttracat dan aatvtice mlpeen.otmc eTh lsurte is ,fevre ,sarh dan .hialatrrgsa

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