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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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submitted by curlycheesefriesguy(5)
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gcinAdcro to FA 2190, ni het neosict batou rodaeihtum isat,hitrr it si gvnie thta rheomutadi ldeuons rae deu ot ibioirdnf .iscrsoen In teh gloopahyt echrtap in AF, diinofrib eoricssn si adsi to eb na epxleam fo peyt 3 rhnseeitipivtysy oc.atrine nI ihst stneuqio setm, eht tanptei is isda to vahe roadmteiuh ldeonsu dna htye kas h'te olinumgmoic ienahcmms fo thsi etasnt'pi mniaimlafont si isiamrl Sot' ?o ayaclbsli heyt skade abtuo ahwt yetp of iitpiysevthernsy ntoairce is fioibinrd s.hnTreoesic wa:srne eumhR i;lienoodiudtbn&r-sfg eg&c-ssyrnop;teit 3 m&e;g-tRsHSa sa uerms .skissnceGto ti rognw .wbt

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submitted by sajaqua1(607)
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mSuer ckissesn si a peTy 3 iiesityyesrvtpnh rnit,oaec in hcwih eth oybd sosenrpd to cgnitniea edcalim nsacsstbeu dna dporeusc .sbodaitine hTese oatdiibnes in nircolicatu hetn ibdn to het anegincti srgud and ste fof het cmtlmneeop a.scaecd diRuhtamoe airtisrth is laos a yTpe 3 iteynsrsiheitpvy orniteac.

A) opssAoipt of recpa-ohmsga ospposati is ellrnegya nto a tepy of ehiittsynesprviy ecoratni. )B Msat ecl ugea-onrldnita iths si rtpa fo a eypT 1 tsyreiniytepvshi ianislcarhtpe/yxa,aon ni hwchi atms lecsl ibnd IgE no ihret rau,cfes dan gIE inngdbi to eht rgteat aitngen usneidc a ctonoaflomianr eagcnh ni eth EIg htta stse fof smta llce .enlintduaarog )C aNautrl ilrKel Clle g-kliiln pslya a ytivrea of eslro, niigndulc ecrcna surnsseoppi dna iotdutcsrne fo ryllvia iecefdnt .clels If ethy paly a orel ni eesynhipvsitt,riy ti is patr of eTpy 2 HRS in hichw tyhe dluow seoprdn to Ig no hte lecl uc.sfrea E) elWhe and earfl sn-trceoai hiTs is oasl a eTpy 1 H.SR

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meningitis  I dt'din kcpi iths noe usbeaec I htthguo Smeru kencsiss saw oto mseyitcs nad AR aws a eomr zdilcealo eTpy .3 gnA,ia im rknhoginivte tghsin. +
youssefa  la:nGjo RA is a xmdie ypet III dan tyep IV mimeun rontceia +9
dinagohe23  I hgouht NK elcl klnilig saw simirla ot T cell os nda AR is osal eTyp VI +7
nephcard  bll,l ooufds +3
usmile1  NK ecll iglikln oluwd be a epyt fo nntiae imy,tnumi ont misrail to eommyr T eslc.l saubcee ethy did tno vieg na aemeplx fo a eypt 4 HY,S the enwsra ustm eb rsmue cksns.ise +

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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submitted by eli_medina9(22)
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beyMa ythe ntew ihwt msrue ssicknse a( ytpe III ivtehinriyssetpy n)rx no hits niusetqo abeds on the oyrgsleo sdeu to nedsgioa AR. sPt hwit AR have iotedaibsn to mnlnlmobiogiuu G ,I)G(g adecll dteiuoarmh acfrots R()F.s tI kmaes emso ssnee tath nopu tshee omduteirha tsroafc rtiagcne wthi s"efl" cgtciaulrni gI,G mnemui oeecxmpls lwoud from ttha dlwou atrle ipotesd ni estsusi giixalep(nn ni rpat eht tirxtelruraaac matoaentinssfi ense iwth ,AR .ex ordmihtuae ledun,so irs,lpiuet apircrsidtei cet.).

:echai.-i/tmoynideyv-dwconnctst/dm/epieyiitp.pniicntyw/secristsh/t-wse-sietirtedrepci

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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 si a ypte 3 ttnyviseprsiyhie rciteaon ihchw ahs wto smecnt.opon

  1. CD +4 T leslc lliw afittilern tseuis nad ecatr to noenitsagaut repnste in eth vsoniyla tnio,j tihs causse lFaN-ahTp nad L1-I to be r.dlaeees eTehs oifnyrmmalat yiksnetco wlil eaucs het alniiti ialrfntyoamm r.naecoit heesT nostyecki LSOA iaceatvt B sel.cl

  2. B ellsc erdcpuo toidharuem focatr as lwel as tani clcyci eiutcitalnrld epdetip nobatiyd. yTeh dbni eht gtaesitnunoa nda mrof ENMMUI lecmopxes that pdiotse no het n.oismuvy heTy acseu nmceeltopm to eb tctaiedv.a cnHee eht cclassi pTye 3 tenthrisyeispyvi erctia,on ti si pdcmeoso fo 3 sgni:ht .1 natnieg .2 btyadoni .3 etmnpomcel

exN,t yuo deen to onwk htat seumr isescksn )(FA is AOSL a yept 3 hytirtievsiesnpy cront,aei tish itme ti is eud to incilnlpei or a ooncnlamlo oani,ytdb alisabcyl osem cangtinie ugrd, hwchi aesucs tyibadon to idnb adn enht siotepd oecmtmnple.

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submitted by namesthegame22(14)
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peyT III enrpitsvthsyiiey is edfiend yb eth snpecree of iungacticrl oteeaitgnobctlm-amnydnn-iep sxcoemepl taht iotpesd in istessu nad useac lantaifmimon dan etnrcoutids. seh( hda dreeadcse )3C

pyet III nhitssyvirteeipy ocntrs:eai ELS, suemr sknsiecs eirtanco, ptoltaiireysr oPod(a),snNA and tern)tpligropoNec(SGioao.ttsPpsc-eoclslum-hr RA is aols a diemx ypeT 3 adn eyTp 4 RHS.

eSurm icenksss ucorcs ehwn a g,dur schu as mecihny-tyttao lbgu,noli scat sa a htanep to teh unimem ,tyemss eigrngtrgi indyobat .oifmotnra Sreum cesnssik naoeictr lyualsu uscroc 1 to 2 keesw ftera the atilini ruoeespx ot eth u,rdg eilcgfrnte teh etmi urreqedi to unomt an muimen rone.sesp Teh ebtnisoiad nhte nbid eth rgu,d eopidst in isset,u nda rtcatta dan icveatat coelptem.mn The rslute is ,eefrv ,ashr nad aghastarli.r

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