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Retired NBME 22 Answers

nbme22/Block 3/Question#5 (reveal difficulty score)
A 72-year-old man with multiple myeloma ...
Unrearranged immunoglobulin gene 🔍 / 📺 / 🌳 / 📖
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 +70  upvote downvote
submitted by sacredazn(101)
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hTe pntceoc si a ncvdleouto yaw fo nsikga fi ouy wnek woh JVD nnbomiicotear ,roskw wihch is hatt ti is cyaaullt na eelamxp of aretlign het ADN of hte /TB yhelm.cptoy

ohtrSnue ltbo qc:eiuethn oS ehnw yhte sue a robep tanisga eosm n,ogrie and itgutnuotp a eizs of .15 kb or 6 ,kb shti si lelingt yuo the izse of eth ADN angfemtr in haec llec nsed(o’t amrtet if tehy ysa J epobr ro tnnascto ngerio pe,bro ee’yrht jsut iaynsg e’ryeth tggtnriea esom ienectuodl nseuceeq ufond in teh gI usl/RocCT bate anihc lscou leysievpctre rfo TB/ ls)c.le

I nkiht eth suncnigof aprt ucdlo be dwnirnoge woh yuo onkw wehhetr yu’reo ayltpr othhrug nnrtaamgerree r(senwa oshecci B uhrt )D ro if ti hnats’ occreurd ta all tye e(cotrcr wsn)r.ea ,eerH eth tenoccp si htta B llsce dnguore )DJV( egranrrnmetae in eht beno ro,warm wehli T llesc od ti ni eth uhs,mty and ti lal pahspen ta e.noc So a aplsam lelc in eht odobl eikl in ltMuipel aeMoylm ldwuo vahe fluyl dgnrneeuo ibontroce,nami elwhi a T cell in the dloob doclu reheit be luylf cdtdueea (dan aehv fiehnisd VJD amrbeioto)cinn ro ummetiar ’asnh(t sdatetr .JV)D

ecinS teh T elcl nege wsa 6 bk nad ienidyetlf grgibe anth hte 5.1 bk egn,e eht T llec ’sntha erdoneugn atiboenrnimco .tey

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trichotillomaniac  rvye niec n!lxaniatepo +29
nwinkelmann  hsiT asw os!eeawm daeM os hmuc ssene adn eyolpuflh I lilw eb eabl ot nhitk atth ictryliacl uobat stoisnqeu in eht uuertf sucaeeb( I RNEEV duowl vhae meco pu tihw tihs no my wn,o ahh.) +5
eacv  M!OG HATNK UO.Y I DINTD WKNO IGNAYNTH atobu !hst!i Hpoe tihs si otn ttsdese no eral enaexm :p +5
ajss  o!ww iths niepnoatxla aws asm!oewe nts!kah +
mrglass  lAos hte llc-eT --VJD esgsmtne are otn hte asme as hte elc-Bl --JDV etseg.nms reefrheTo a Ble-cl J sneegmt suoternh lbot dwulo lkoo fro hewhtre the B-lcel esit VJD eentmsg in a T-,llce ihwhc ldowu lasawy oreae-arg.rnndn +6
mynamejeff  hkanT ou!y S o is this ecuabes tuelilmp elyaomm cesoudrp evxeeissc omonacolnl hilgt icnah ?Ig sI tihs teh .15 kb ?nege rse,aehW ell-csT ahtt evha nto engo rhohtug iointffdranteei eyt nad rihte J geroin ecsldiun tgeirhnevy VD)(J sv. utsj JV ni the itglh nih?ca (AF 2200 gp 14)0 +
peridot  iTsh aelpaxonnit si i!nagzam voHe,ewr to llfuy sddtnnarue aonerht pets fo ahwt eth nosqteiu is gtengti a,t eeaspl kaet a olok ta hgwsihoraddbas'l@isdyer adrno/ m'@sasgrl xnapieotnla sa lwel - a yrev ioamtnrpt niid!tdao! +1
skonys  My icgol swa grnow but ym wresna r.tecroc I am fsuginerf fmor sc.cesus +
fhegedus  w!ow sith si iama!ngz tkhna yuo! +



 +18  upvote downvote
submitted by highyieldboardswards(18)
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htroS s:arwen lAl esegn are neetprs ni bhto B dan T e,lcsl tub eyth ganeerrra adn eexpsrs etcsreorp that era iseifcpc to eitrh aeel.gni eiThr aer pnteednidne VJD igensor orf B ecll roctpeer egniaoenrt nda T llec ctopeerr ntanoi!geer Tsih wiik ecrtial hdess ltihg no ts:hi

pii/rinreT)p..D/ttileaktwgsJ_wcmh/eeV(neloo_#dnir/ocicpiekortab_s:

I oot lalgiayrtc desmis ..siht btu ti is atclualy os lspiem htat ew era mgssini eth orefts rhthoug het trsee W lhie-- hobt B and T clles ogdrneu VJD ernmergt,anrea eht ,V D, dan J eengs rae TEFRENFID GNESE espdtei nibge rdoiganez adn efhreotre fssialcide ni a rsiamil fohsian due to teirh ahsder ened ot rgneatee eeridvs utsurtscre. oT kame ttaerms remo u,gsnncofi tohb sset fo JVD ngese aer no osermocomh 41.

sThi si ywh het NBEM efieispdc taht ythe ear agggtin HTE SMAE J ORNEIG hcihw si taht fo het B elcl toecrper nege J nig,reo tno eth T lcle croretpe enge atJ-be ogenir see( iwki ile.ctr)a ehT B lcle rropceet egen si otn adegrenrra in a T ell,c fi ti w,as T sllec uodlw ahev iso!aedbnit

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redstrat  Ts.ih oS uhmc hs!ti +1



 +5  upvote downvote
submitted by david_bball(5)
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ehT wya I hotuthg tauob itsh suoenqit saw ttha in MM rtehe si a ONT fo iaeiotsbdn igneb med,a so the JVD etmensg si gbeni nebork edt/acreade/nrlsgreuep naym tmeis nda ahs bnee nrhesodte to .5.1bk sA orf hte T elCl,s thta riegno ’tins enibg sdue ncs(ie rethe si no cnaoll xpnoisean ro teinoec)ls so t’is ilstl gto eht full k6b nghetl t.udohuenc

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d_holles  T clsle istll ognerud VJD oroinbaicnetm to mrfo herit .RsCT +7



 +2  upvote downvote
submitted by sam1(22)
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Wilhe T cells od seu eht DVJ anoreibtnmoi,c the T lcle rtecpore snihac ear denirteff neseg omrf eth B el'slc vayeh nda ihglt iahnc.s eicSn hety sdeu a B ellc -orgJien obp,er eth T l'lecs ndba liwl eb cmhu larger as hsit reaa fo ist NDA e(th B ellc yaehv or iltgh acinh sene)g vhae not ebne geeaardrnr -- dsnaiet ist T lecl rtproeec senge avhe eneb adr.eragner

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 -5  upvote downvote
submitted by welpdedelp(270)
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l_.wrltwem//_2beer/xoasboei.a2tqoben1o/tunep_isu_ezsstes7edptmwi:qnd_h_pm/nr/ce/ohrlttcnm/npit4ps

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