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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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submitted by curlycheesefriesguy(5)
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dorcnigcA to AF 1,209 ni eth tiecsno uabto idturaehom hiritsrta, ti is nevig taht hormdaiute ndoleus aer ude ot irofndiib crenso.is In het atoyolpgh hcptera in ,AF niioirdfb sonsreci is sdai to be na eeapxlm of teyp 3 vrypistiyenhstei .eaitocnr nI hist eitsuqon esmt, hte ttipnea si dsai to aehv ohreuamdit elsodnu adn eyth aks 'eht mcnugoloimi niammcehs of sthi tesia'npt aolmiinftanm si lamisri S'o?ot bclislaay yhte easdk uabto hawt eytp fo niipryhttveseiys ornteaci si rbiiinfod s.cnrehis oTe aswe:nr meuhR oiie-n&lnsfgbotddui;r osenytritpsge&;c- 3 &Regst;SmHa- sa ruems iesscsnk.toG it wognr .btw

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 +4  upvote downvote
submitted by sajaqua1(607)
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uermS ssecskni is a eypT 3 htvenprtiyseiyis oein,cart ni ichhw teh boyd serdpons to ignactein dceiaml etsncsabsu nad pducroes dnob.tesiai sThee tindasebio ni ccaliotrniu neht ndib to eht ncniteaig sugdr nda tes ffo het penmeoltmc caas.ced tudehoiamR hrrtiatis is losa a yTep 3 vrsyyhitepiinste ri.eotacn

)A otpAsspio of cmeaopas-rhg osioapspt si ngeyrella ont a type of ieestiitphynsvyr trani.coe )B sMta ecl -ndltiagonaure shti is ptra of a Tyep 1 tsinyprievesyiht aslriaoeycnht,/niaxpa in hwhci amst elslc dibn EgI no hiret ,rfceasu nad gEI dnngiib to teh rtgate neantig ceunsdi a irmoflnocantao ceghan in teh gEI atth sste fof tmsa clle .gnaoradtulien )C alaNurt lirKle Clle -glikinl yslpa a vatiyer of resl,o ulginndic acencr spsirponeus dna ensruotcidt of rlyliva efditecn el.scl fI yeht apyl a erol in esphtvin,riyystie it is part of Type 2 RHS in hcihw yeth doulw erpsnod ot gI no eht lcel uaecrs.f )E hleeW nad ralef arnciost-e hTis si loas a Tpye 1 .RHS

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meningitis  I n'didt cipk itsh oen euacesb I ogthhtu muSer cnseissk aws oot eismscty nda RA saw a omre llicdaezo yepT 3. ,aAign im vntoihgirnek s.htgni +
youssefa  Gaj:oln RA is a dimex eypt III nda ptye VI uenimm trcoenai +9
dinagohe23  I uohght KN lcel ilknigl aws msilria to T lelc so adn AR is aols eTpy VI +7
nephcard  lbl,l oosufd +3
usmile1  NK llce nikilgl lowdu be a yetp of anenti yimutin,m not alrmsii ot ymmore T cs.ell ceebaus yeth did otn vegi na axelmep fo a pyet 4 Y,SH the wnaers mtus be rmues cesi.knss +

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)


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 +2  upvote downvote
submitted by eli_medina9(22)
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bayMe yteh newt htiw erums scsskein a( ytep III rvpeiysehnisityt xnr) no siht uonqites sabde no hte rselgoyo sdeu to dnesgoai AR. Pst hwti RA ahev nbdioaitse to umuonmbgoillni G I)gG(, dlacel dirmuhaeto toscafr (RsF.) It smkae smoe ssene ttha nuop tehes iremotudha stfroac arneigct thwi "fsel" tcrgiuncali ,IgG niumem mespxcloe uowld from htat ulowd realt odtpsei in uestssi (liigaepnnx ni ptra eht exturcaaarlrit etomsatfinsina ense hwti ,RA .ex ruihmodtae usnod,le iipe,urlts ipicstrredai .e)c.t

sstthnmittvtteosdioewt/nicntirsdh/pdydinie/pe/wp/-r.emcecses--aiyiniiirc.et:wcypi-cye

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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).


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submitted by imgdoc(183)
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AR is a etpy 3 sithneipvyyrstie treocnia ihcwh sha wot onom.spectn

  1. CD 4+ T lslec wlil ttailernfi itessu dan eatcr to gateauitnnso estenrp ni het nivsloay ontji, tihs saescu aalFNpT-h adn -I1L ot be .lderasee ehseT taflminmorya ysicotnke will sueac het iianitl aymtlamrofin aeirn.cto shTee inoskcety OSLA tetaiavc B c.esll

  2. B elscl uerpcdo hmduortiae acroft as lewl as atni ylcicc ctilntiudrlae depitep dab.toyni eyTh dbni the nsueaiogttan and fomr EMMNUI meoplxcse atth tpidoes on hte yuon.ivms eyTh ceaus moemnlcpet ot be .ecdaattiv eceHn eth ssiccla pyeT 3 isepeyyvhitrstni coie,ntar ti is eocosmpd of 3 hs:gnit .1 gieantn 2. adnitboy 3. emempolntc

Ntxe, uoy eden to wonk ahtt userm eicknsss FA)( si LASO a eytp 3 ysesitrphiyntive ta,conrie sith miet it is due ot lilpnieinc or a olmooacnln aiyod,tbn ayialcsbl smoe eitigcnna r,ugd ihhcw sceaus onitbyad to bdni adn thne sotpeid ecmtpeom.ln

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submitted by namesthegame22(14)
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yTpe III sishyerttvypieni si einfded yb hte eserpenc of uitccairngl neen-ybgmtenptilmotcaia-ndo moespelxc that edpisto ni ustssie dna ceuas taifmninmalo nad scotiu.rdtne h(se ahd ceddseaer C)3

ptye III sviprtetniyhisey tnsieoca:r LSE, msreu sesicsnk at,orncie rtrloaeispity P,oAan(No)sd dan Pep-G.tiertslocc(-trlthoglepsumao)oiscroNpSn RA si sloa a mdixe Tyep 3 nad Type 4 RS.H

mruSe nsskiecs croucs when a g,rud scuh as hemtti-yyocnat olbn,lgiu ctas sa a nethpa ot hte mumeni ytms,se grneitiggr tdoibyna o.frmaniot uSrem enksssci aortcnei ullyasu ousrcc 1 ot 2 wekse afret teh tialiin oersupxe ot eth d,urg ftlienecrg the teim ureqdrei to moutn na eumnim oe.ssnerp ehT odbtaineis tnhe nbid hte g,rdu ptsodei ni sius,et and catratt dan vetaacti cempot.lmne heT srtelu is er,vef ,hras adn .gritlaaahsr

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