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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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dcingcAro ot FA 29,01 ni het ontecsi obuat eohtdiaurm irrh,istta ti is ignev that itaodrhuem usednlo aer edu to noirifbdi .ircsnoes In teh tlhgooapy acthpre ni ,FA doifibnir oienrscs is idsa to eb an lapeexm fo pyte 3 enpivstyesthiiry in.oetarc nI shit nestquoi mt,se hte entapti si adis ot evah rmdeoathiu ueldnos and tyhe aks 'eth giicomoumln enmchsaim of ihst spaet'tin nnaotlfimima is msiilra '? ootS llbyaacis hyet ksade tbuao twah ptey fo ihsvpetinirstyey oiternac si ibdoifinr eecis.onsTrh wra:sne huRme iudnignsi-rb;&deoloft cse&n-ttipero;sgy 3 smtg;Ha-Se&R sa ruems cks.nsseiG to it wongr wt.b

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 +4  upvote downvote
submitted by sajaqua1(607)
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eurmS ncskiess is a peyT 3 rheyesiiisptnvyt crionta,e in hhwic teh oydb ropssdne to iacngeitn ilcadem nucbatssse nad cpsrdoeu neioadbit.s eTshe tnbseidoai ni antclucoiri tnhe bind ot hte ntnacgeii rgsud dan est ffo hte cemepotlnm sdecaac. edaimuthoR aitistrhr si sloa a eypT 3 syvtnrihsitiepey erc.tonai

A) sipsAotpo fo m-arecahsgop aitosppso si nallygree tno a ptye of itsevpehsnyytiir cn.raieto )B tMas elc auogt-rindlaen htsi si ratp fo a Tpey 1 ttnyhpriesiseviy ne,lh/iarapcoiansaxyt ni whihc stam elcls dibn IEg no tehir fu,casre nad gEI ndniigb ot eth raetgt antigen duecsin a noialotnfocarm gaench ni teh EIg tath etss off tmas elcl tr.olnguanaedi )C altaNur rlKlei ellC lkln-gii yspal a avrytei of ore,ls digunnicl rnacce nsoeusprpsi nad cstreontudi fo ylarvli ftinedec llec.s fI etyh alpy a eolr ni senshtetiiypiyvr, it is ptra fo Tpye 2 SRH ni ichhw yeth ouwdl nrosdep to gI no eht lecl .recusaf )E hleeW nad lfear s-oarcenti iThs is oasl a Tepy 1 .RHS

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meningitis  I dtdni' kicp tshi eno uceseab I ugthhto Surem eissncsk aws oot msistcye dan AR asw a eomr zocledali peyT 3. iAn,ag im knvtiihnroge gi.hnst +
youssefa  nGal:oj AR si a iemdx etyp III and ptey VI umenim iteanroc +9
dinagohe23  I tohguh NK cell ikgnlli wsa riimasl ot T lcle so and AR is laos Tpey IV +7
nephcard  llbl, oofdus +3
usmile1  KN llce kigllin lwodu be a pyet of tneian ,mtymuiin not rmsalii ot rymome T lecsl. eubsace yhte idd ont evgi an xepmale of a ytep 4 H,YS the wernsa stum be eurms snc.sikse +

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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Meyba thye tnew hitw mresu sikcsnes a( ytpe III vthpyiseerynisti x)rn no sith esoitqnu desba no eht rylosgoe esdu ot siegnado AR. tPs htwi RA ahve abetsiondi ot noulilmouibmgn G (,g)GI deallc iduarhtmeo caofstr (R)Fs. tI smkae seom neses ahtt puon htese emhtouaidr ocfarst ateignrc wthi esl""f rnuclcagtii IGg, emmniu ecsxopmel oluwd morf htat doulw raelt diptoes ni usessti aiiepn(nlgx in rpta the aiaaturcxtrelr matiitonssanfe esen hiwt RA, ex. urodemtaih euolds,n pirtuse,li recdiraipist .t.)ce

tssecrc-.incs-yecepeosth/i/tn.dye/eprvtyiiwspmt/niwtni:ntwidtioceapie/-tse-iimyhiddrc

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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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AR is a eytp 3 tiyteseviipynrhs ioertacn hhiwc has tow mopsncn.oet

  1. CD 4+ T lclse lliw ltaeinfitr eituss nad crtae to eotsatnaungi eersptn in eth lainovys tj,oni isth sueacs hFal-NpaT and I1-L ot be elarse.de Tehse ymolfmtairna noyesikct lwli eacsu het tiliani mniayflmtoar icnorat.e heTse knytoscei LOAS ctetviaa B cl.lse

  2. B llsec rueocdp drmuhetioa rfoact as lwle sa atin yccilc dlirtluecanti eptpdei i.ynabdto ehyT dibn the naeaitontgus nda mrof MUNEIM xlemscpeo taht tpodsie no eht iunsmvyo. ehTy usace cetolmmnep ot be dtvate.ica eecnH eth icalcss eTyp 3 etyitssirypievnh ,arteinco it is cpoodsem fo 3 tg:sinh 1. neagnti 2. yintoadb 3. pecnetlomm

,Nxet oyu ened to wokn taht rmuse cisesnsk (FA) si OASL a etyp 3 ityesieypntvshir rcnai,eot hsit emit it si edu ot nicelnpili ro a oollnamocn yatbi,ndo aclybiasl smoe neiingatc ,gudr hihcw eusasc tdbyinao ot inbd and enht tdoipes ncot.lpmeme

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 +0  upvote downvote
submitted by namesthegame22(13)
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peyT III ihetyrveypstiins si feddein by eth nesecerp fo cligictunar nytabnod-oclmnegpia-tinmeet cesxmoelp tath ditesop ni iseusts nad scaeu mmanflatiino and odict.retuns seh( hda eredaceds 3C)

ytpe III nertevhistspiiyy t:aoernisc EL,S urems nescsksi nai,troce trlpayseirtio aoN,)s(AnoPd nad po-amser-olrS(GcNth)pcireeositgtsconoplt.ulP AR si olsa a mdixe peTy 3 adn yeTp 4 HS.R

ureSm scekinss occsru nhwe a rdug, cush as ie-mtotnacyyht ,bnlulgio astc as a hantpe to the mnmiue s,mtyes ntregiggir abidtyon .mrfnooiat emuSr ikscssen cnrietoa ulylaus suorcc 1 ot 2 seekw ftare eht aliniti euerxspo ot het rg,ud clrinefgte the ietm irequedr to tmoun an ummine r.eespons eTh atibeoidns tenh ibnd the grd,u siepdto in is,suet dna taacrtt dna aivettac pemlo.ectnm The lseutr is vre,ef ha,rs dna laatirhagrs.

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