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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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dioAcrngc ot FA 1,209 in teh ctoensi buaot aheutmirod rsari,itth ti si evgin taht miahroetud oulsend rea due to ofbiidirn onss.crei nI eth ooythgapl epahtrc in F,A ifniribod srneoisc is iads ot be an mlexeap fo ptey 3 vissitepynyireht re.ctniao nI thsi osnueitq se,mt het ieantpt si dsai to heav dhamrteuio eusndlo dan yeth aks et'h nmlmouigcio nmeshmaci of tish apt'tiesn nalftioimamn si lsmiari oS? t'o cslalbayi htey deask tbauo twah tpye of ysiiietpentvrysh irantoce si iibfdnoir seoc.s riehTn e:sarwn muhRe tgirl;iiuosf&no-ednbd o&eri;gycttnsps-e 3 &g;a-SHRstme sa remsu .cnsseiks Got ti gwrno twb.

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 +4  upvote downvote
submitted by sajaqua1(607)
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mreSu scnkssie is a ypeT 3 htreyiyspsviinet ire,tanco in hcihw hte byod sonspedr to ntaienicg amcdlie uatbsesscn nda uodcresp sin.otedbai esThe ibosnaitde in uiciacnlrto neth ibdn ot eht aciitngen urdsg adn tse off the oemplntmce ace.csad doRiuethma rasitriht is losa a yepT 3 tstnseheiiyiyrvp .trneocia

A) otopsipsA of corp-hesagam stpospoia is alnglryee otn a tyep of setyiitsihpyervn acenor.it )B aMst ecl -niuoaengtldar iths si part fo a pTey 1 eiityevshptyirns eaionlnyxia,ctrpasah/ ni hwcih samt clsel dibn IgE no erith faruec,s adn gEI iidngbn ot eth tgatre tgnneia sndueic a moconatrlfaion acgehn ni teh EIg that sets fof astm llec a.ulardtoegnni C) ltuaarN rielKl lleC -nklilig spyal a evytrai of r,leso gindiulcn ecanrc poesuprisns dna iotrdsucten of viralyl fcinteed lecs.l If yhte aply a role ni nypiee,vysttirhsi it si rpat fo Tepy 2 HRS ni wcihh hety uldwo dnersop to Ig on eth lelc eua.rfsc E) Wheel dna arlfe -nsoeatcri Tshi si aols a eTpy 1 SH.R

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meningitis  I tndd'i ikpc iths neo euacsbe I othught umSre snisksce asw oto ssicymet nda RA swa a roem loazdlcei eTpy .3 ignAa, mi vrghtoneinik nhgtis. +
youssefa  onla:Gj RA si a iexdm ytep III dna eypt VI menium acnoiret +9
dinagohe23  I ghtouh NK clle ililgkn wsa siramil ot T lelc so and AR is oals Tpey IV +7
nephcard  bll,l ufosod +3
usmile1  KN llce knligli woldu eb a etyp of tinena mnyumiit, otn isralmi ot reommy T lel.sc asbceue yteh did nto gevi an xemleap fo a pety 4 ,SYH eht easnwr ustm be smuer kc.sesnis +

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)



 +2  upvote downvote
submitted by eli_medina9(22)
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yaMbe eyth twne wthi mresu scesinsk a( pyet III yistntirheipevys x)nr no sthi iqesuont desab no the syogrelo udse to angsiode R.A Pst thiw AR evha snatibdeoi ot ugomilnnmboiul G ),IgG( ellacd huideamtor satfroc RF)s.( tI mksea eosm esnse that upno stehe timaedohur tsfoarc gitrecna itwh "fels" cnugilitcra GgI, memnui pxeocmesl olwud mrfo thta duwlo letra sitodep in suseist lnn(ixipega ni ptra eht uriceartaaxrtl oinafmitatsnes nees wiht ,AR xe. oheaimudrt ,olsdnue tluiprie,s prdeitasiirc ec)..t

whte/pcnpict-tdrehesosy:nipiei--ryw/.pei-tseisocidtiecmt/wdmtetrsyniiciynsen/vdca/.it

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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).



 +0  upvote downvote
submitted by imgdoc(183)
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AR si a tpye 3 stesiihyyietnrvp ntoeairc cihhw hsa wot m.netpncoso

  1. DC 4+ T lcsle wlli nfieiattlr isutse dan tarec to easatgounnit epstern in teh yisaonvl nitj,o stih sceaus TaN-aFphl dan I1L- to eb e.aerdesl ehTes tafimlmnraoy ctesoniyk lliw caesu hte tiliani amnmryaltfio ierontca. Tehse cnyiokets ASLO acvtieta B ec.sll

  2. B celsl rpceoud moidrhteau otfarc sa lelw as anti ciyclc iucalriteltdn edippet bd.yaonit eyhT bndi the oannusgaiett dan fomr MUNMIE eospxmecl atth odtiesp on eth iumnoy.vs yhTe ucsae lcmmptonee to be cadtti.vae enHec eht calscsi Tpey 3 pvyiyntitseiehsr iecor,tan ti is odocpmes of 3 si:gtnh 1. aiengnt .2 ainyobdt 3. meotlcempn

xt,Ne yuo edne ot onkw atht smeru eksisncs AF() si OSLA a yept 3 ieetvintyirhpsys rcna,teoi tsih imet it si eud to necilinpil or a olcoalnmno byidat,on bsiaclyal meso gneiacint g,rud hwhci ascues tadioynb to dnbi dna hnet tseiopd penem.mclot

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 +0  upvote downvote
submitted by namesthegame22(13)
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pTey III syyeiihivttperns is iedfend yb eth epnercse of tnlcaircgui tnelaeoitmtnpeagndconibmy-- esxlpocme that dtpiseo ni teuisss dna useca lnfnamtoamii dna eodtsint.cru hse( dha scderdeae 3C)

epyt III ithtnsrvepsyieiy rct:naioes LE,S sruem scssenki ,nareioct tirireatoypls Ao()os,aPdNn dna euictperoG.osmtoorSN-lapsp(-ecPlgritt)nhclso RA si laso a xdime ypeT 3 adn epTy 4 .RHS

meuSr iscssken rouccs nhew a gu,dr chsu sa nyimyt-oettahc lounlbgi, csta sa a hatepn to the euimmn tse,yms trrgieggni bindtoya amfnr.ioto urSme cksesnis ctreaion ulyauls scruoc 1 to 2 seekw faert the iitnial oepsuxre ot het rg,du ltgnerfcie teh ietm eqrriude to tomnu an iumemn respen.os ehT itsbnodiae htne dbin het g,rud edpsoit in e,istsu nad cattatr dan ctvaeati te.clnempom heT esrlut is erf,ve ,srha dan agli.asrtarh

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