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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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eTh tnocecp si a octdonuelv yaw of sgkina fi uyo nkew who VJD roomantciinbe ,wksor hihwc si ahtt ti si ycltaual na elmpxea fo ilgrtaen eht NAD fo hte /TB cylt.pmeyho

eSuorthn lbot :itnceuheq So hwen they eus a ebpro iasnagt msoe ongi,re dna tpitgtunou a iesz fo 51. bk ro 6 kb, siht si nlgltie uyo teh isze of the ADN fentgmra ni ceha clel ’dst(noe eatrmt fi yeth sya J ebrpo or stontanc gnieor pe,bro ’heetry tsuj sniagy reeht’y irgtganet oems ieedlntcuo nuqseeec dufon ni teh Ig Ruc/olCTs tabe hiacn losuc reityseevclp rfo T/B c.s)lle

I kihtn teh couinnsfg prta uclod eb oinnwgred hwo uyo owkn hthwree reouy’ aprlty rhthgou nageermrtaenr wns(aer ischeco B utrh )D or fi ti sthn’a urredcoc at lla yet r(rtecoc .)aenrws ee,rH the cotnepc is atth B lcsel runedgo V(J)D rereaennmgtar ni teh ebno ,owamrr eliwh T esllc do ti ni het sh,ymut and it all ensppah at enoc. oS a aalpsm cell ni the doblo lkei ni tieluMpl Mloemya woldu have fluly noedrgenu rtoimicnane,ob hliew a T clel ni hte olobd odlcu ihreet be ullfy utcdeead (nad eavh ifdeihsn VDJ e)oiarbcniontm ro ruieamtm a(snth’ sdttera J).VD

icSen eht T cell enge wsa 6 kb dna teifyelind ibergg nath eth 51. kb ,eegn the T cell tnsa’h eneornudg naiboonrticme .tey

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trichotillomaniac  eryv einc eaonpnx!tila +29
nwinkelmann  Thsi swa esme!oaw edaM os cmuh neses adn ueflyolph I liwl be aelb ot htkin ttha ciltclriya botua sntsqueoi in the ufuret (uebceas I EENVR lwduo heav mceo up ihwt shit no ym ,nwo )hh.a +5
eacv  GOM! KHTNA .OYU I DDNIT NWKO IYHNNTAG oubat hi!!ts pHoe stih si nto ssetdet on erla emnaxe :p +5
ajss  w!ow ihst aixtlepnoan swa m!sweeao k!htasn +
mrglass  lsoA eht -Tcell -J-VD tsmgenes aer not het msea sa teh ce-Bll V--DJ se.tengsm Treeroefh a lclB-e J tesgenm thesrnuo lbot wodul lkoo fro rehtewh eht B-cell seti DJV engetsm ni a ,ec-lTl wchhi odulw aswlay agen-rennrdroa. +6
mynamejeff  khTan o!uy So si tihs sbceaue utillpem oaymmel rupceods secvxiese nlcalnoomo hltgi naich Ig? Is shit eht .15 bk eeng? Whs,eear lcT-lse that eahv tno gnoe hthruog nainfiteeordtif yte adn rehit J grnoei nudlcies ervhyitgen )DVJ( v.s jsut VJ ni eth igtlh n?hiac FA( 0202 pg )140 +
peridot  hiTs pineltxaano is na!agizm vwee,Hro to flyul nednutadsr hteoanr pest of thwa het uiqnsoet si gnegtit ,at lesaep eatk a lkoo at diyeisha'sb@orawhdlsdrg drona/ amslr@s'g alaontpxine sa llew - a revy oatrinmtp !idio!atnd +1
skonys  yM ilogc aws nwrog ubt my wreasn erocc.rt I am nugieffrs rofm eusss.cc +
fhegedus  wow! this si iagznma! nhkat o!uy +



 +18  upvote downvote
submitted by highyieldboardswards(18)
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rhotS sw:nrae llA ngese aer restpen ni tboh B nad T l,escl btu hety eargraenr adn ssxreep etrroscep tath rea ipsccife ot hirte eni.gela reTih ear tnddeneipen JDV iernosg rfo B lelc roecpert aonenriteg dan T ecll tceorerp gioantnee!r Tihs kiwi aclitre hdess tiglh on isht:

edet_/rlre#ciwtVop_/i/koagoeoamrpbsiiep:ecJ)kn/(_tnitl.nTD.scirhiw

I too aatrllcyig msdeis .it.hs tbu ti si utcaalyl so liemsp htta ew rae smigins teh trofes htorguh the trese lW- h-ei btoh B nad T elcls engrdou VDJ ,emrreangrtean hte ,V D, adn J nseeg rae FRINDTFEE SNGEE eidtsep nibeg znareidog adn oeefrther csesaildfi in a islmari fonhais eud ot hrtie haesrd need to reatngee dsviere rcts.teusur To emak setrmta oerm ficunogs,n htbo etss fo DVJ ngese ear on mehcooroms 4.1

shiT si hyw teh MEBN sepifdiec ttha htye aer nitggag HET MEAS J OIRNEG iwhhc si ahtt fo teh B elcl rorepetc eegn J rigen,o tno het T lcel oerctrep nege ba-teJ orgnei ees( iwik rlcae)t.i Teh B ellc tporeerc egne is ont eraeandgrr in a T lce,l if it a,sw T cslel uwold aevh iatdsoin!eb

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redstrat  T.sih oS uhmc ht!is +1



 +5  upvote downvote
submitted by david_bball(5)
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heT yaw I tuohhtg aubot ihts iuteqnso was hatt in MM ehert si a NOT of bnodiseiat genbi maed, os eht VDJ egtsmen si gbeni orbken tad/se/rerpulgedercean mayn mties dna ahs eben seohtredn to b1.5.k As fro the T ,sCell htat gieron s’tni benig edsu (insce eetrh is no clnloa xoisenanp or ecte)oisnl os tis’ tlisl tgo the flul bk6 ntlheg utdocu.hne

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d_holles  T elcsl llsti rnuodeg DVJ aoentnbimocri to mrfo eirth sCTR. +7



 +2  upvote downvote
submitted by sam1(22)
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Wlihe T lelsc do use eth JVD e,oibntomaincr the T clel peeorrtc shanci are rfetfdien esnge frmo the B lc'lse vyhea dna lihgt ahnics. cieSn they eusd a B clle reJ-goni ,poreb eht T sle'lc andb lilw eb much egrarl sa htsi raae fo sti NDA teh( B lcel ehavy or lhitg acihn een)sg haev ont eenb agdaerrnre -- saentdi tis T lcle eocptrer ngees haev bene .reradrnega

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 -5  upvote downvote
submitted by welpdedelp(270)
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m_./xotus4prbcize_ndtae/itmpbre2ophteeeel/rmtswnpn/lqbsinoneseldewwt2tc:_qs/_/1/osrp_7hu.ni/o_mat

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