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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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gdAoncric to FA 21,90 in teh tecsino aoubt tdamirhoeu htit,sarir ti is geinv ttha mtdirheuoa udelons ear deu to foinbdiir snre.cios In the topolahyg ethparc ni ,AF oidrinifb iesnosrc is isad to eb na eeampxl of pety 3 ripshneietivytys coearni.t nI siht ioenqsut est,m hte nietpta si dasi to heav imhraouetd nosedul adn ethy ask teh' mmoionlugci mescinahm fo isht spaneit't latfnaimnoim si iarslim 'S oo?t cliysalab htey eadks oabtu hwta tpey fo pytisniysevtrieh etranico si idrofiinb cnie osTrhse. ear:swn mueRh fibdin-l;osgudte&iron tpgysit;ceer-os&n 3 -eR&S;tmagHs sa surme sn.ksisecGo t it grnow wtb.

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 +4  upvote downvote
submitted by sajaqua1(607)
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uemrS sksncies is a ypTe 3 yvyitetiprensish naroeitc, in chhwi hte dybo prdnsseo ot nneciigat lcmedia setasuncsb dan coerdups sbda.ntioie hseTe isnoidbeat ni lactuiconri nthe ndbi ot eth nangietic surdg dna tse off hte teeolmcpnm dccseaa. thmoidueaR irrsttiah is also a eypT 3 hitvenyryeiispts a.ierncto

A) psispooAt fo aohear-spcmg apsospito is reelganly not a ptye of eetpthyinrsisivy otre.ncia B) sMta elc tduaegnl-aoirn thsi si rtpa fo a eTpy 1 iipintyhreetsvys ,ya/norpanacalhixiste ni hhiwc amts llsec idnb IEg on ithre csraufe, dan IEg nnbiigd ot the argtet teangni cdnsuie a armonitfncoloa agenhc in hte gIE atht tsse off stam lelc raitlan.gneduo C) Nuatlar irelKl llCe gii-lnkl saply a raevyti fo sl,oer lcidginnu rcaecn pssopesnriu dna dincretstuo fo yvilral dfenteci ells.c If yhet play a lroe in spihie,nyttryveis it is ptar of Teyp 2 SHR in wchih hyte ulwod dpnores to gI no hte elcl ur.esacf E) elehW and ealrf roc-aesnti hiTs si aosl a Tepy 1 RSH.

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meningitis  I 'tindd ipkc tshi eon buesaec I tohguht Srume eiskcsns saw oot cymstsie dna AR aws a roem eacizodll yeTp .3 gia,An im ngeiovknthir gtnihs. +
youssefa  anj:oGl AR si a diemx pety III adn tyep IV emmiun inorceat +9
dinagohe23  I huhotg KN clel gllikin aws lsiairm to T lecl os and RA is osal ypTe IV +7
nephcard  b,lll sdoouf +3
usmile1  NK clle illknig would be a ptey fo tnniae ynmi,muit tno limiras to royemm T scel.l sbuecea tehy ddi tno ievg an xealemp of a teyp 4 ,HSY eth raensw tsum be reusm ssise.nck +

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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bMaey they tenw with emsru snciseks a( yetp III tneeyphyitrivssi n)xr no iths isqotuen dbsea no hte elogsyor udes to ndigseoa AR. sPt whit RA heva saoindbeti to limuoogbnmluni G IG)g(, deacll uhdmotiera craofts R()s.F tI amkes eoms seens htta unop eetsh oruthmadie sfrtoca ercingta itwh "lfes" ctgauncilir ,GIg imneum xsmpleoec owdul orfm thta oldwu terla otdepis in sseiust iniexan(plg ni rtpa eht xaletaartirurc tfstemnoniiasa eesn twih A,R ex. otuidharem nod,eusl isitelu,rp iiaesrrtcdpi t)..ce

-c/-idty:ppyiise/ecctdsmotiatvsrri.wph/tensdcswi-weymienr.iineih/nsycieptte-ndoteitc/

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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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AR is a eypt 3 sisviihrnyettpye aieocnrt cihhw hsa tow ocn.mentosp

  1. CD 4+ T lcesl liwl frtniteial ueists adn crtae to nognitasuaet ptrnees ni hte ylvoisan ,ijnto ihts uscsae -hFapaNTl dna L1-I to eb eaed.resl ehTes afiaolmmtryn yoekscint will ucase the ilainti notyirlmafam icron.tae ehseT kcteioyns LASO ateaticv B elcs.l

  2. B sclel orcdupe udhrmeatio corfat as lelw as nait ycccil trutiecndilal dpieetp tnyad.oib Teyh idnb eth annouetistga nda rfom UIEMNM pmeoeclsx htta ipstoed on eht ioyum.nvs yTeh ueacs elnectopmm ot be tcdva.etia cenHe eth cacisls pTey 3 vypietrhynietssi oteric,an ti is decoopms of 3 :gnitsh 1. tgneina 2. abondtyi .3 loeecmmntp

Ne,xt uyo nede ot onkw ahtt usmer neksssci (A)F si ALOS a ptye 3 intysevseihrpyit nieta,orc thsi eimt it is ude to cnlenipili ro a oallnnomoc yn,obaidt aisalcylb omse tiageninc gu,rd chiwh sauces bodytain to ndib dan hnet dtsiope .mtonemcple

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submitted by namesthegame22(13)
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yepT III itstsipryevnehiy is einfedd by eth epcenrse of gaulcriitcn tbtincpeaeni-m-dnlmngaoeyot omxelepsc atht idoepst in tsussei nad saceu ammtnofailni and deouc.intsrt (hes dha secedared )C3

etpy III eyvysstihpiirent :soinertca ES,L eumrs kcssiens cnoetrai, trasrytiloiep oNd),AaPos(n nda tostomt-ela(oeoShisn-loprcc)sgrtPlrNeGicpup. RA si lsao a xmeid epyT 3 dan peyT 4 HSR.

rueSm ikesnssc cocurs when a ,rdug husc sa hmatiy-tcytneo ,ugliobnl csta as a hteapn ot eht mmuein t,smesy gieggtrnri ibdtayon aoftnimr.o erSmu icssskne neaorcit aslluyu rcusco 1 ot 2 kesew faret hte tnlaiii usxrpeoe ot het ug,rd flncretige het miet erdqreiu to tmoun na nmimeu eerp.snos Teh atidbnsoie etnh indb hte ugrd, tpedosi in ,sesiut dna trcatat dna caietavt lmpncmotee. The srulte is e,efvr ,ahrs nda alathr.sragi

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