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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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grocinAcd ot FA 12,09 ni eth onestci utoba odiahtrmeu tthis,arri ti si ivegn ttah toiurdaehm udseoln rea ued ot ifdiroinb eirso.ncs nI eth gyhoatopl ctephar in FA, ionirdbif osercnsi si dias ot be na xleeapm fo epty 3 tysensthyviiepir roenact.i nI ihts quostnei s,met teh ttpneia is sdia to aveh haeudtroim sdenoul and ythe aks h'et iolonigcmum ehsnmcmai of siht staet'nip mfainolminat is ariisml oSo '?t lbaylacis htye kesda uatob wtha yetp of tissveiprthnyiye otaciner is ifdniirob r. seTnschieo ewn:rsa eRhum ;i-beunroidgflotn&sdi g&yrtpeisce;tosn- 3 eHst;amSg&R- sa ursme .nikecsssoGt it owrgn bwt.

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 +4  upvote downvote
submitted by sajaqua1(607)
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uermS icskessn is a eyTp 3 yeviisihrpttysne ntacier,o ni ichwh eth boyd sepsnord ot eiatigncn calidme bnsacsutes nad srpcedou s.tdboaniie heTes isebniodta in riioantlucc hent dnib to eth gininteca sudgr dan tse off teh ecelmtmpno .sadccea Rdtoihumea ttiirahsr is aols a pyTe 3 ieyhiiseystnrptv iort.acne

)A soiptopAs of m-acgposaehr otippssoa is lngayreel otn a ytep fo iitsynyehtevirsp caeir.otn )B Mast lec aiuodenr-tngal htsi is rapt of a yepT 1 itiyyrhetissvnpe nxynh,aatsaociiera/lp ni hwhci tasm slcle bdni gIE no hreit ,rcsuefa adn gEI ngiidnb to het atetgr gtennia deuncis a acotmoanrinlfo eanghc in het gIE htta stse ffo asmt lcel ngatrinudoea.l )C aNtlaru rlKiel Cell ng-illik alyps a veritya of erl,so gicudlinn ncrcae pnsssruiope and sterucoidtn of lavylri cfidnete llesc. fI eyht lpay a lroe in tyeysiti,svpirehn ti si aptr fo peTy 2 HSR ni hwihc teyh wodlu pdrsneo ot gI on eth lecl ae.fscur E) eeWlh nad lfrae s-aericnot ihTs si olas a eyTp 1 SHR.

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meningitis  I tin'dd pkci ihts one esbeuca I hogutht uSemr nsiskces swa oot smtcsyei dna AR aws a reom cadlzeoli epyT 3. gn,iAa im ehonrvingitk hisngt. +
youssefa  :lnojaG RA si a dmiex etyp III nad yetp VI mmueni tecniroa +9
dinagohe23  I otughh NK lecl nkiglli aws mliiars ot T elcl os dan RA is saol Teyp IV +7
nephcard  bl,ll uofdso +3
usmile1  KN llec lkligin oduwl eb a eypt fo iaetnn uin,imtmy tno lasmiri ot rymoem T celsl. eesuabc ehyt did nto gevi an aexpeml fo a epyt 4 ,YSH het rweasn sutm be semru ni.sskesc +

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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yaebM heyt ewtn tihw murse cisksesn a( tepy III ihypeniietssyvrt )nxr on htis iunteoqs edbsa no eth grsoleoy sdue ot oniaedgs A.R Pts whit RA vahe obsntadiie ot onoubngilmuiml G ()gI,G lacdel oeaidthrmu cotfsar .RsF() It amesk moes sesen atht poun sthee ohatdrumie cftoras agcinter hwit sf""el glnictriuac IG,g meinmu plcmxeeos olwud mfro ttha udlwo larte tdsoepi ni stssieu xnepga(inli ni tapr hte arcaltrteiruxa tfineastsmnoai eens tihw R,A x.e aohtuierdm esnd,uol is,utriple precsiairitd t..ec)

tp-ntasiveisii.ecewetyohsyictine/iiho/m.mte-swidntrwyce-td:/prpiynci/estdet/n-cisrdcp

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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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RA is a yept 3 iyvishisretepynt oritance iwchh ahs wto opoemn.sntc

  1. CD 4+ T eclsl lwli tfaliinert suetis dan arcet ot snaunaoigtet teesrpn in het oviynals ijton, isth acesus aNFal-Thp adn 1LI- to be rse.ealde Teesh rmmontliayaf ykotcnise wlil easuc teh inltiia olfmtiaaynmr r.ietoanc Thsee iyscknoet OSAL taavicte B ells.c

  2. B llsec cropdue reuhidotam crfato sa elwl as iatn icccyl inlcltarteidu dipepte iod.yabnt Teyh bndi eth itesaungaont dna rmfo INMEMU pxleomsce hatt ipsoetd no het mn.ivosuy yTeh cseua leemmncpto ot be va.tdaceti cneeH teh scsailc peTy 3 setivyysneiiphtr r,neiatco it is eodpscmo fo 3 tisn:hg .1 engnati .2 odbatniy 3. leompnetmc

t,exN oyu eden to onkw htta mesur nesickss F(A) is ASLO a etyp 3 ivnseehstpitryyi ,eriotcan sthi eimt ti is ude to eciilnnilp ro a oomanollcn tnd,iboya asailbcyl moes aigtennci dg,ur ihchw esscua ytobnadi to bnid dan nteh pidteos lcmo.tneemp

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 +0  upvote downvote
submitted by namesthegame22(14)
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yepT III einhsipyiytvrset is deneidf yb the scrnpeee fo giccauitnrl -nnioemegdapmctty-naoelitnb pmscoexel hatt tdoipse ni suestis dan uscea tnoamnilmfai nad odnsttucer.i he(s ahd ercadeeds )3C

type III sitiheieyypsvntr oeiarnc:ts EL,S esurm cienksss a,nroicet tryltpoesiira ason)PodN,(A nad aor-goesh.msStulPcepnt)cprcootrNlpil(tiose-G AR is saol a dxemi eTpy 3 dna Tepy 4 .SHR

uSemr keiscssn cocsru nwhe a g,rud hucs as h-intcoaytmeyt nlugol,bi atsc as a aethpn to eth emnuim tmsey,s tggerngiir boiayndt fio.tnrmoa Sermu issnekcs cornteia lluuyas ourscc 1 to 2 ekesw ftaer hte ltianii xoersepu ot teh dur,g negrcfleti eht mtie idequrer ot ntmuo na uemnmi snspoe.er ehT bisaideotn nhte inbd het gdur, isedtpo in u,tssie nda ctatrta dan tteaavic mtecnml.ope heT lurste is vr,fee hsra, dna hr.aailragst

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