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NBME 23 Answers

nbme23/Block 3/Question#30 (46.2 difficulty score)
A 20-year-old woman comes to the physician ...

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submitted by notadoctor(165),
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LES is oaedsctasi wthi yiccndeief of leyar toelnecmmp npogre.te(is 1,qC ,C4 .)2C AF( ,91 gp. 6)24

tinydoc  Am I the only one who has never heard of C1Q? +28  
llamastep1  I knew SLE is related to low complement but when it talked about a "mutation" it threw me off. +1  
xmen  Yessssssssss FA 2019 P462. Assoc iated with de fi ciency of ea rly complement protei ns (eg, Clq, C4, CZ) - I clearance of immune complexes. +  

submitted by axsa19(9),
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1,qC 1,rC and sC1 fmro the C1 .xmepolc nyA mite uyo ees C1 with nay fo esthe ethre etrlets "s"rq knhti of C1 chiwh si hte tirsf copmnento of het ssaiaccll otnemcmlep thwpaya

submitted by thomasalterman(161),
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nompletmeC is rpaomtnti ofr rvniomeg emmniu lomxpese,c so siettpna hiwt lcommentpe icfinscieeed -c)1(4c* aer moer ellyik ot develpo .LSE q1C is a tbeert srnwae tahn hatn BLM ()D c/b eth BML taywpah si retigedrg by bcaetira.

myoclonictonicbionic  Thats the reason I put MBL, because the question mentioned that it got worse when she went to the beach so I was thinking some sort of contact with bacteria may have exacerbated her immune system. +  
thotcandy  @myoclonictonicbionic i think that's just the typical SLE photosensitive malar/butterfly rash +1  
dna_at  FYI it is less to do with immune complex clearance than it is to do with clearance of apoptotic debris. The overload of apoptotic autoantigens contributes to loss of tolerance -> SLE. +2