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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 npetocc is a olvntdceuo awy fo sgkina fi uoy eknw how DJV iiroomntcabne ,srowk hwcih is ttha it si actlulay an lepaxme fo trlinaeg eht ADN of teh BT/ lmyyhp.eoct

Stnrhoue lobt huitenqe:c oS nehw they use a orepb asatgni emso ne,roig dna ogttupntiu a iesz fo .15 bk or 6 k,b hist is litelgn you eht szie of eht DAN germtanf ni ecah ellc tnd’(oes tremta fi hyte sya J rbpoe ro ntcatosn ngeior er,bop ereth’y ujts yiasgn y’heret inatgtger eosm enliueocdt sqeceeun dnufo in het gI ls/TuCcoR atbe ihcna coslu tceysrvielpe rof /BT selc.l)

I kthin the ogicufnsn rtap lcduo be negiordwn hwo you nkow hrtweeh ’oeury aplrty hgohtru marrrnetageen enraws( ehsccio B utrh D) ro fi it s’thna uroccred at lal yte e(rrccto .nwraes) Heer, eht ecctpon is taht B eclls rodengu )JVD( arenmegrteran ni the oenb mrrwao, elhwi T lclse do ti in the ,smyhtu nad ti all epnapsh ta .neco oS a lasapm ellc in the doobl klie ni ltMeiulp elyomaM odluw have ulyfl ngreoendu onrmecbt,iaoin eilhw a T ellc in teh ooldb udcol tehrie eb yfllu tdceudea ad(n aveh nidehsif JVD a)nrmobticonie ro miurtmae s’(nhta tdesrta .)VJD

cinSe teh T lcle gnee swa 6 kb dan edfntelyii gribeg athn eth .51 kb ,eegn eht T clle hs’nta rdgnunoee banoominritce tey.

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trichotillomaniac  rvye icne nxnat!opiale +29
nwinkelmann  sThi wsa emoswa!e aedM so much eness dan flelpuyho I wlli be bale ot inkth atht ylltcciair ubaot stnusoieq ni eht eurtfu uabecs(e I NEVRE lowud avhe ecmo pu twih thsi no ym o,wn .a)hh +5
eacv  M!OG ANKTH .UOY I IDTDN KNWO NAHYNIGT aobut !ht!si oepH shit is ton etesstd no elra eenaxm :p +5
ajss  w!ow sthi plnaxentaio was eaw!smoe !ktnhsa +
mrglass  oAls hte llec-T V--DJ mtsenseg rea tno eht easm sa teh eB-cll -V-JD mgn.ssete reeerTohf a l-lBce J eenmtsg eounrsth ltbo ludwo oklo orf thewher hte Bl-lec ties DVJ netsmeg in a lecT-l, ihhcw wodul slaawy raoerr.ndennag- +6
mynamejeff  knaTh ouy! o S is isht uecsbae itmlepul mmlayoe pduersoc sxsvcieee onlnoamloc gthli cniha g?I sI sith teh 5.1 bk e?egn ,esWerah cl-leTs atth ahev not ogne hghturo diintfeoeiatnfr tey adn hetri J noegri nusilced ytegnhriev )(DJV .vs stuj VJ ni teh hltgi ch?nai AF( 2020 gp 1)04 +
peridot  iTsh aloipatnenx is !agznmia eore,vwH ot lfyul dsnaendurt teahnro spte of wtha eth tqsineuo is ggitent at, paeels keat a look at elsodaiah'dy@bidsrghrws d/nora ms'gras@l onaleanxtpi sa lewl - a evry iporamtnt i!tno!dida +1
skonys  yM ocigl saw wgnro tbu my ernwas cc.troer I ma uiegfnrsf fmro .cecsssu +
fhegedus  !wow ihts si azamg!in tkahn yu!o +


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 +18  upvote downvote
submitted by highyieldboardswards(18)
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trhSo aensr:w All neegs rae neetrsp ni btoh B dna T ,lscle btu tehy eeangarrr nad psresxe peeostcrr ahtt aer ceisipfc to irhte eienga.l Trihe are dnnendetepi VJD iersgno ofr B lecl etopecrr enoganiret and T ellc eroterpc oeein!trang hTsi kiwi etlcair hessd lghti on i:sth

/etse:cr_T.ns/k_Jl.etiD/am/eikpegoooi_wrrlo)acdei#itiphnVtipnc(wrb

I too grataillyc dsmesi tih.s. btu ti is uclylaat so elsipm ttah ew rea misigns the oeftsr hugrtho eth stere -he liW- hobt B nda T clles ognreud JDV mraerrn,ategne hte V, D, nda J gnsee aer FRNETEIFD GENES dpsteei nebig iaozdergn dna heeefrtro lfcisaisde ni a imsalir isoanhf ued to treih esrhad ened to nageeetr dsevrie etr.cusrtsu To kame ttsaerm eomr nns,ugfcio btho stse fo DVJ egnse era no omshocmore .14

hsTi si hyw eth EBNM speicfied ahtt yhet era ngaitgg EHT SMAE J GRIONE ihwch is ttah of eth B ecll trerpcoe egen J neori,g nto teh T lecl rtpreeco gene tb-aJe oienrg (ese iwki .ticreal) hTe B clle etrocrpe eegn is tno argadrnere in a T e,llc if it aw,s T sellc udlow vahe !eaidsniotb

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redstrat  s.iTh So hmuc t!ihs +1


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 +5  upvote downvote
submitted by david_bball(5)
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Teh ywa I ughohtt aubto shti ienqotus was thta ni MM ehetr is a TNO of bidsnaoeit gnieb dem,a so hte JDV segentm si ngeib rbenok ecsrpr/duglane/deeater ymna miets and ahs nbee ondrseeht ot 1k.b5. sA fro hte T Cl,els that oienrg n’sti enbgi deus (isnec erthe is no lolcan isxeopnan ro lecenso)ti so t’is sltli otg eht flul bk6 tnhgel .eucnuhotd

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d_holles  T lscel ltils oeugdrn VJD inoebcrmnotia to form erhit RsT.C +7


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 +2  upvote downvote
submitted by sam1(22)
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heiWl T esllc od sue eth JVD noo,rceniibtma teh T llec tecropre inchas ear ffdienret gesen romf het B ll'sce havey nad iglht scia.hn eiScn hyte deus a B lelc Jo-regin pbo,re eht T 'lscel nadb iwll eb umch gralre as isht eara fo sit DNA hte( B lcle yvhea or ihtlg chani een)sg eavh ont neeb egdararern -- diaestn sit T llec eecrropt gsene vhea eben argnearrde.

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 -5  upvote downvote
submitted by welpdedelp(270)
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cpe7/aeetlusn___./e/no_cswemrstl/x/qepew//sn__ta:tilo41zbinor/nmmpwtdnbihted2shbu.irotestprqpeo2m

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