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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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Adgcnoicr ot FA 901,2 ni het einscot oubat amuetordih srhia,ttri it is ingev that emhditoaur lnesodu ear edu to bdnoiriif .snicoesr nI teh gotpayohl phaetcr ni F,A ifobnriid riocnsse si dsia to be an elxaemp fo pyet 3 itipyseysrhvteni tnaoeirc. In tsih eoqisntu mset, eht tpentia si sida to haev dhmuratieo oulndse adn tyeh aks et'h lmigicounmo nhmisemca of hits istetnap' nmialmnotifa si amiisrl S'o t?o aysbaicll yhte sdkea tuboa thaw etpy fo eyyvptihntisiers racnitoe si oibdirinf eiThn.orecss rnaswe: Rhmeu io&diunines-tr;ldofbg tson-try;epe&icsg 3 StHRe;-s&mag as eumsr sckie.ssn Gto ti worgn bt.w

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submitted by sajaqua1(607)
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umSre sinsecks is a pyeT 3 niitptsseeiyvyrh oi,rtecan in hcihw het bdyo sneprsod to ngtnceaii dclamie uescnsatsb nad osprdeuc s.btnodiaie eTehs tiibadseon ni tcuracnioli nteh nbid ot hte gitieacnn udsrg nad tes fof het mmetelpnco edccs.aa tihadRomeu hatsrtrii is aosl a yTpe 3 rpeitvssiyythnie neaoi.tcr

A) sptipsooA fo rhgcpo-msaae tpassipoo is agyelnlre nto a tyep of niryvstehisyipte neicrt.ao B) taMs lce ligunra-enoadt shti is atpr fo a Type 1 yytntsesrvehpiii na/si,ohptxacraieylan ni iwhhc asmt lelcs dnib EgI no hreit u,seafrc nad gIE igindnb to hte egttra itengna suiendc a naoomtlroacfin neaghc in het gEI tath sets ffo stma lecl auln.oartdneig C) altuNar Krlile lCel ikiln-lg lypas a taerviy fo o,lrse ilgnncudi cracne sroseinsupp dna toreuidsctn fo yvlirla cdefntei c.lesl If tyeh aylp a leor ni siihpvtetsyrny,ie ti si rtap fo pyeT 2 RSH ni wihch yhte odwlu pdosren to gI no teh ellc asefr.uc )E heeWl dna afler tcio-rnsae shTi si also a Teyp 1 .SRH

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meningitis  I 'tindd ckip shti one esaubec I hthugot mreuS cnsiskes aws oto isyestmc dan AR swa a mero cealiozld Type .3 n,Aiga im hrneikgvtoni nshgi.t +
youssefa  Glo:anj RA is a xmide ytpe III nad peyt VI eminmu etnircoa +9
dinagohe23  I ohught NK lelc lniiglk was imliasr to T lcel so dna RA si laos yTpe IV +7
nephcard  ,lllb oudsof +3
usmile1  NK lecl inkigll luowd be a ypte of antnei iyutnm,im not lmsriia ot mmyeor T clsle. sucaeeb ethy ddi otn veig na aplexme fo a etpy 4 H,YS eht wasner tsmu eb meurs sse.ciksn +

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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yeMab eyth wtne thwi eusmr snssekci (a tpey III tvysiershitipeny x)nr on hsti qsneuoit asdbe on the yoeogsrl udse ot igodaesn .AR tsP twih RA ehav oasibdneit ot bummginnololiu G I,)g(G laelcd raieduthom ftocsra F(.R)s tI maske some snese htat opun ehste dahmeriout oarsctf ernigact whit elf""s ncliugctira IGg, eumnim omlexcsep dwolu orfm htta luowd arlet dietosp ni iseusst ialin(pngex ni prta the atxrucaarlreti nfanetstiasomi seen iwht A,R .xe torhaumdie edo,luns siitupr,le tiepdasrrcii .tce).

i.iee/stttsinsioyivped/.tdyietecrrpc:wrmenepitc/mdciiya/-w-o-hh/yticisteecntnssp-indw

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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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RA is a tepy 3 isviyyhteprnties itoaernc hhwic ahs two pnot.scemno

  1. CD +4 T llsce liwl eitrnfalti iteuss nda trace to agneiosantut trpeesn in eht ysnaolvi jio,nt sith uscsae N-FahlpTa dna I1L- ot eb esdrele.a Tseeh myianlarftom neyitocsk lwli ucsea teh naitiil nyiommtlfraa cin.ortea sehTe yncoesikt LAOS eatcivat B scell.

  2. B sclel depruoc tduerhmoai frtcao as lwel as anit cccliy eulltndiitacr tdpiepe doyi.natb heyT inbd het nuoaeatintgs nad mrof MNUMEI pelomxecs htat spietod no hte y.uimsvon yehT caeus cpmletnemo to be tdaav.itce ecenH the isaccsl peyT 3 vyrieipsyhtniets trinca,oe it si oocspedm fo 3 :shtngi .1 ietagnn .2 iandotby .3 mtpcnmeole

Nte,x oyu dene ot know thta remsu snsekcsi AF() si AOSL a tpye 3 vrisnyptihtesyie ciero,ant sith iemt ti is edu to peliinilnc or a omcllnanoo t,ydnobia ycalsblia esom inciateng grdu, ciwhh auescs yitbdoan to bidn and tnhe siopetd pmcmten.ole

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 +0  upvote downvote
submitted by namesthegame22(13)
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pyTe III nvttyipsheyerisi si eedfdin yb teh pecneers fo cgraniictul imiegeodtonennmybaactt-ln-p sopxmecel thta etpsiod ni tsiuess and uasce oalniammifnt dan .eucsntiortd hes( adh serceddae 3C)

ypet III eitstihyiypersvn onarsteci: ,ESL emsru skssenic ni,etoacr stapitiyorlre as(oPd)nN,Ao nad sgloilsmpceriNeprnoPt(cosco.eu)loStat--phtGr RA is also a mdexi yepT 3 adn epTy 4 S.HR

Srmeu ceskssin csuroc nehw a dugr, chus sa a-htitotyecnym unlo,ligb tsca sa a apnhet ot hte eunmmi tsyme,s igtrgirgne tdynaboi fironma.to rueSm isksnesc inceaotr lylusua corusc 1 to 2 wesek retfa hte iitnail rseouxep to hte udgr, cilrfeetgn teh mtie druqreie to otmnu na nimemu .sporsnee Teh ositdeaibn neht nbid hte gur,d dptoeis ni eitsus, nad attarct and itcavate lmompnecte. hTe suerlt is re,evf r,ahs dna ahgtalisa.rr

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