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NBME 21 Answers

nbme21/Block 3/Question#18

An 83-year-old man comes to the physician because ...

Bullous pemphigoid antigen

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Bullous pemphigoid antigen must be hemidesmosome. FA: bulla are "bullow" the dermis (subepidermal blister). BP also yield "tense" bulla.

seagull  I love how this cant be straight forward. All the other proteins are either subunits of desmosomes or cytoskeletal components. Because I know molecular biology that well on top of the majority of medicine....FML +1  
cienfuegos  @seagull: excellent comment, literally loling right now +  
cienfuegos  or sobbing and threatening to hold my breath if they don't make it stop +  

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submitted by drdre(5),

Bullous pemphigoid "Bull House" bulls are tough (BP do not rupture easily) and house reminds us of hemidesmosomes

Pemphigus vulgaris "Demphigus" for desmosomes

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submitted by nicnac20(6),

In bullous pemphigoid, autoantibodies are made against BPAg1 and BPAg2 found on hemidesmosomes.