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NBME 23 Answers

nbme23/Block 1/Question#22 (reveal difficulty score)
An investigator is studying the adverse ...
Presentation of antigens to CD8+ T lymphocytes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ
tags: immuno 

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submitted by โˆ—aesalmon(95),
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oytecSnelmp = orme elisebustpc ot ctuaepdeasln gmsnoaisr

I tpu E. cilo as tis eesdunpatalc ubt ttha awnst' eht tsmo tihrg rnaesw I ue?gss

submitted by โˆ—sajaqua1(603),
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CMH I fuincton is laigtenr ot eccrna srnieo.pusps HCM I spiasdly yodlnogsueen tsdshneiyez isnpotre adn srnpetes meth to D+8C T clse.l eTh afiuler ot lpiayds MHC I, or CMH I dilapys fo lnfoens- (dan by ionxenest )rcecsnuao isroeptn grisegrt a clrlleau nemumi sneserop, legndai to dttosrcineu fo hte lel.c

ehT omtsaroeep si euds rof the raogtidaden fo rwon ,uto etc,nsnsee ro eodrmlafm rne.topsi As acencr dosel,pve oerm utstamnoi dlea to eecinrdsa nwrog nylO by snixsopree of eht apmeo,roets ro ist no-eireersspxo,v anc eehst tnmaut noitpsre eb dgdareed saft nugoeh ot not be edadylips by MHC I nad elda to the lelc giebn eill.kd bitezBmroo lobcks teh toaeospre,m os het ttamun iosnertp rea adsepyldi no teh fecua,rs wniolalg the mnemui esymts to inerceozg and lkli aallgthioocp lscl.e

catch-22  Aeotrhn way to aarpphoc ti si ot think atuob MHC sacls I grnps.secio aily,aBlcs fi uyo tniibhi eth ,srootempae ptesdpie lwil nto be trgadenee nda ihtgonn si livaaabel ot be daedol tnoo CMH I emebrm(re HMC I hsa ot be ddlaeo orefeb ts'i odrsepnratt ot hte lelc farc.e)us leCsl ttha odnt' xrspese HCM I gte lkedli by hte arlnaut co2evPl6nswt.Msi2wh:t/C7/.m1./nncmbg/tic.a3ih/pw4rlp/ +31  
kai  In" sinloocucn, we veha ersntedtdaom atth het oameorstpe htiinibro ibmebtrooz tea-oudrlgwsne clsas I nad ehasnenc the tysetsiiniv fo amymoel to NK ilaeldteecmโ€“d s"liys romf hte onluiccnos of het INH rappe +6  
maddy1994  honreat himnaecms si yb ngiclkbo remoostoep u enve aeecdser gadroinet of ciaproppoott pr.esstno.i.o ti hcescnnae ostppsoirom(af owl)rdu +6  
azibird  tuB C8D+ dan NK lcsel klli vai ipfrer!no hWy is sthi snrwea wngr?o Is it ebuceas 'its otn het iyrmarp tcef?ef +2  
testready  "heT opemtsorae si het ajrmo oesucr of tpcyloitoer iayctivt ivdvnoel in eth naigorente of sieptdep for pnattireeons by maojr otiiscypahitmibolt loepmxc csals I .eocuemlsl We rrteop the wne ainrobvetos ahtt ibtomeozrb -dwurlsotaenge HLA sacsl I on MM ,elcsl stnrlgeiu in scaeenrdi NK cdaeletimdโ€“le yssi"l. tbhmMwsape:h7on/icns/g.nmi4wi1lclp2w.3cr2Cv//P.t6//t. +  
fatboyslim  I khnit hwat PO said odcsttcainr wthi htwa cch22a@-t idcet in het bdeuPM .iareltc +  
an1  OP said Oy"nl yb nsoisprxee of the eposemrtao, ro sit -vseix,oerespnor nca etseh mtanut eopitrns be dddaeerg saft ounheg ot otn be ieayspddl yb HCM I". UW QDI 14176 yass htat a pernito nduosrege dtoiaargedn by teh biuutqnii ertseaomop atpaw,yh rteaf chiwh it esgo to teh ER adn hnet is eerseptnd to eth cell fucsera rof CMH 1 eospsern eaiglnd to isoapstpo iav mreospfr and mngseayz.r gvHina a atesmpeoro iinotbihr oudlw clatauyl neertpv eht CHM nosspeer eubaecs no ioertnps aer p.ydealids lAos etno atth het qnosieut yass hwchi pscoesr lilw be afcdetf,e eethr is on ienntom fo irecasne or oS ey,s het MCH /1 8DC pthsawya si te,facedf but 'its ctaalluy dwno lgeatdru.e An neabsec of MCH 1 dlaes ot KN cell iededatm detha. +  

"Studies have shown that proteasome inhibitors block the assembly of MHC class I molecules and this is almost certainly because they are stopping the production of presented peptides that are needed for this process (6)."

+3/- donttrustmyanswers(73),

submitted by โˆ—tinydoc(273),
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MOA fo oporetsmeo rbisthioni rfo .MM TDR:L is taht htye bcalslayi coblk the erpomotsoe ofrm iinfnugontc os ttah yemmola lclse cant' rcyeelc otrnspie t(yhe kema a otn of )hemt adn newh tyeh anc't be cydrclee htey budli pu and ahtst tcxio to hte cell dna ti ides.

bdeyon ttha eth oitusqne si ilacylasb iksnga if eth hinibtioin of eemstrspooo itsn cifipsce to hte oMlemya elscl dna ti ibneitdih treho llse'c romesstopoe whta oduwl be tdeecfe?f

MCH slcas I si tnprese no lla dtenlcaeu sellc l(la lescl ni eth odby cxteep )RCB dna uiotfncn to eptners odensungoe asgneitn ot DC+8 t llsec to eb edretyods o(rf meplxae Viral DAN in na eifcnetd e)c.ll hTe ayw htey do ihts si by gakint hte ieortnp it ensed to srpneet adn bigerakn ti nwod otni umch amelrls detpiep icnash o(s it anc itf on the H.MCI If isht spte swa dhitieibn in ohrte celsl then eht teh antPtereoisn of CMH I uldtown be leba ot tneespr heirt tnignase ot +D8C T cells dna aalNrut ikrlel es.cll sa eth ostnuiqe mlei.spi

heT enuisotq swa epsur ikrtyc csbeeau if you nd'ot oknw hwo smroeeootp itnihibsro okwr neht uoy satrt loigkon for an saenwr ttha ulwod xeanlpi ohw ythe lodwu lkil mrtou leslc as ell.w I tog ti nwrgo o.ot tI eqrdueri wkdgleeon of the wya HCM I pnesestr sip.edpte

submitted by โˆ—krewfoo99(115),
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yWh oulwd nesrriofp be hte rgown eawnsr? ontluWd lnauioaumtcc fo otcix irsetnpo sucea teh llec ot georndu ospaiptso ?

ergogenic22  oromBbezti sdeo nto rydiltce aeiatcvt r.onreifp tI ylceitrd bnihsiit the spmeeorato wichh โ†’ eelabsn +8DC T clels ot niaetiti oppaistso โ†’ vai rinfrope esaeelr (in scnesee a ornmeadwst ).teefcf +4  
drzed  Ea,tclxy it grersgti the lslec ot ruengdo itoapossp hcwih mneas hatt ti cna trieeh be elcl eedtidam oie(nfrpr nad ngezrmya via FF/SA)LSA OR it uocld olas eb rhotghu hte nricitins yataphw ge(.. aocidoitnlmh;r ocohrytmce c) +  
powerhouseofthecell  o:entsiuQ But hwo od CD8 llecs hvae a elor in htis rcoesps clyetax ni het ivnteget? sI it agisyn ttha nwhe teh pistreon ibuld ,pu yoln etnh do DC8 elcls moce adn asindet of HCM I snegetirnp ot osoe,paremts ethy petesnr it ot 8DC to iaiinett osiasto?pp +  
flexatronn  u@otepecoorlehhwlefs so ti all goes kacb to sbiac uonmim i( tog tihs rwgno and upt atoiospps as ll)ew tub tfear vinwgeire aevnretl iank csd,ra i won tge ito.S teroosmspea kaebr onwd edagtg isoprtne wiinth the ecll gsodnn.eeu()o Teh ednkwbaor dsourpct egt ketan pu yb rpatronst saosteaicd iwht nneiatg cpsseigrno TA)P( nda gouhrtb ot eht ohrug E.R eTh eranowdbk todupcrs rae ehnt dedlao toon CMH I olcselemu dan hbgourt to eht cfesrau fo eht lcel. ehWn ngnkitih atbou HCM ,I htkni abotu D+8C T lelcs F(A CHM 1 x 8 = w8oNDC. ot i,euzsmarm enhw nugsi a stramepeoo ri,onbithi r'euyo liknbcgo that gtngagi dan CMH I dlngiao rep.ossc sA ttades e,ebofr D8C ezcsnigeor HMC I hihcw( tn'wo apenph wehn sngiu eshet grsud) +3  
whosdaprincesss  ole@afxrntn nthak ouy !!!! +  

submitted by โˆ—abhishek021196(113),
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mzBbeor,oit iclmbazirof

csmiMhnae = oraeoetPsm rsobitnh,ii nucide aesrrt ta GM2- shepa adn opspas.oit

esU = etMlilpu amylemo, ntamel clel ympl.oahm

Avd fEfecst = ralprPieeh eanhurotyp, psheer eozrst ivceoraintta

tyrionwill  rndue imoozetBb,r eht aroestompe noatcn tgsied ilvar Ag dna etsrenps it to hte edrnmondemeba-b C-IMH. rrfheeoeT cDC8-T octnan oerziegnc eht host elscl tiocganinn asdeelrp ZVV. taTh is oalbbrpy wyh sighlnse is oen of hte ulparop desi tfceef fo zt.bremioBo +  
kcyanide101  The ugdr tiibsihn tespoor.oem ncHee ethre si no tngafmer laaivbeal hhturgo PAT ieinds C4D lcel ot ldoa utno CHM ...I. As shcu eht C8D neipeansrtto to Tlcel is pneedet.rv heT ligatuncmcua renostpi iindes the 8DC escll hchiw are ton einbg roekbn onwd yb eht oeeormtops uacse it ot nroeugd oopssatip +  

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