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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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gociAcrdn ot FA ,0912 ni hte sctieon aotbu uhairtmdeo tsrrti,iah it si envgi ttah udhmitorae udleons rea due ot ndirifibo essic.rno nI hte oltyhgapo caretph in AF, rdibiifon oersnsci is sdai ot be an apeemlx fo etyp 3 ynvrhstepitieisy e.tacroni In htis niuqteos e,mst teh eitptan is siad ot hvea huditoamer udsloen nad yhte aks h'et cminlogmiou ihamncems of stih tpsn'etia fmioianmaltn is srialmi ' So?to asilbalcy yteh adesk about wtah tpye fo eitnsheiypsyvrti nteicaor is nbiifrdoi sohTic.ernse n:swrae muRhe ou;siinl&bgdordnfei-t ts&t-opricn;esegy 3 sR;m&H-eSatg as esumr ssinke.sc toG it nrwgo t.wb

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 +4  upvote downvote
submitted by sajaqua1(607)
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uSrem ksisscen is a pyeT 3 ripstsviyniteeyh ocenrait, ni hhciw eth ydbo eospnsrd ot inagnetci melcdia bcnstssuea nad usrcodep aoisei.tbdn Teseh saedtioibn ni taccnruiiol hnet indb to eht ietcinnga udgsr nad tse fof hte mctenompel cedaa.cs idtmeRahuo itirhrtsa is aols a pTey 3 stpivyetesriynih tenr.ioca

A) otAosipsp fo rahopacgsm-e astopoisp is ngelalrey not a yept fo pyiisteiynhetrvs nreci.ota )B tsMa lce ntruoiaa-nlged hist is atpr of a ypTe 1 nyhysiteeivripts alrasxtcnhinipoay/,ea in wcihh stam lelcs dnbi IEg on ireht f,earusc nda EIg ngdibni ot het rgttae enigant csndieu a lootmnfirconaa ehgacn ni eht IgE tath esst fof smat lcel rdial.uteganon )C rNutlaa rKeill Clel kg-linil aylps a yvrtaei fo r,oesl icidnlugn rnacec rpnuepsosis dan utiednrscto fo ilalryv inedftce ls.ecl fI ehty paly a orel ni tvyiriehsypsine,t ti si aprt fo pTye 2 RSH ni hhwci heyt would erdonps ot Ig on hte clel ucrfs.ea E) leheW adn rlfea stn-aercoi Tsih si sola a eyTp 1 SR.H

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meningitis  I 'dtnid kcpi siht neo abcuese I tugothh meSur iessnsck asw too cimsteys nad RA swa a meor llaezdoic ypeT 3. nia,gA im ktiivgehnonr .igstnh +
youssefa  ajln:Go RA is a imxed epyt III dan pyet IV enmmiu taeinroc +9
dinagohe23  I gothhu KN llec nikllgi saw srlimia to T lelc os dan RA si soal pyTe VI +7
nephcard  ,lbll ouosfd +3
usmile1  NK cell ingklli ldwuo eb a etpy fo eiatnn nimt,umiy not isamrli ot emrmyo T lel.cs beecuas yteh idd ont vgie an eeamlxp of a pety 4 ,SYH het wnsrea smtu eb rsuem nekic.sss +

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)


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 +2  upvote downvote
submitted by eli_medina9(22)
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bMeay yhet tewn htwi remus inssskec a( pyte III svpyetiinrsytehi )nxr on hsti etiuqnos esbda no teh yglrosoe sued to ioadnges .RA sPt wiht RA ehav oeiabistnd ot lommiunoglnbui G )(gG,I lclead eoidhuatrm caosftr .F)sR( It kesam moes nsees atth noup teseh raotidhume faosrtc icertang whti ""lfes cniluragcti GI,g euimnm elmscpoex lwdou rfmo taht uwold aretl epsodti ni ussesit aen(lnigixp ni rtpa teh rrttacuiexrala mafiasstneonti eens iwht RA, e.x rdetuamoih snulde,o lei,turisp rasiidprtcie t.e).c

n-soieiew/-t..vtsiotisetsyipy/:dimmdttaydsiyitti/cstinncneire--w/cinececcpehwhrepr/dp

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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).


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submitted by imgdoc(183)
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RA is a ytpe 3 ieitsyeihyprsnvt tracinoe whchi ash two tocs.npnmoe

  1. DC 4+ T lselc will eaitnlftri usesti dan react to atesangounti spertne in het vlniasoy inojt, shit eucsas -ThaNlaFp nad LI1- to be l.erdasee hsTee ayifomlamtnr oestkciny will ceasu eth aiinilt ylmmnofaarti rtn.aeoic hsTee tnociekys ASOL caativte B cl.sel

  2. B slecl peroucd hdroiuatme cftroa sa lelw as tina cccily tlatlidcriune ieepdtp obnt.aidy yeTh bidn eth tsnagoiuenta dna ofmr EINMUM peeoxmslc hatt otpsied no eth .uyomnsvi Tyhe cuaes peolenmmct to be ac.devitat cHene hte asslcic eyTp 3 sethrvnyyseiptii aeoint,cr ti is soecmpod of 3 :itsgnh .1 aenigtn .2 tbodaniy 3. meolemptnc

Net,x ouy dnee to onwk htat eusrm siksnsce A()F is OASL a ypte 3 yrnttsesypivehii tcoaenir, siht temi ti is ued to eilincilpn ro a aocnomnoll adinyo,bt ialabylcs emso eacniigtn rdug, hhwci seaucs iadytnob ot idnb dan etnh esptoid tcnmmepole.

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 +0  upvote downvote
submitted by namesthegame22(13)
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Tepy III iisyhipentteyrvs si endiedf by eht rpsencee fo ulnigcrtcai tmbm-nl-itneoanedyngecpotia oplcesmex that otespdi ni tiessus nda useac aifnnalotimm nda .edotucstrin seh( ahd asdceedre )3C

type III itvipsstinyrheey ia:rcntose ES,L smuer knsssiec narc,toie relisrioytapt oa(,n)NAodPs adn .oleols(Gheslco)siSarcgNrpteoimncpr-uoptttP- RA si oasl a emdix eypT 3 adn peTy 4 HR.S

emrSu sicksesn rucosc newh a du,rg ushc sa t-enmhctoiytay blniul,og ctsa sa a neahtp to eth umenim sem,yst rggrgiiten ayidbtno romani.tfo eurSm eicsssnk oanrteci usayull ccsrou 1 to 2 weske afret eht lianiti pexreous ot the gr,du gfienerctl het mtei eudrqeri to muton an uimnme rno.epess The ioisebtdna htne ndib eht dr,ug etipdso ni ieus,st adn aratctt nda aiatvect ptcnm.oeeml heT tseulr si fve,er ,hrsa adn ght.larraais

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