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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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godirnAcc to FA 9120, in het tnecois aotbu oamhdietur sih,rirtat ti is ginve hatt ohdemtiaur solednu ear deu to nidiibfro ncsrs.oei nI teh ohotlapyg ctherap in AF, bionfridi ioescnrs si iads ot eb na pelmxae of yept 3 rysvnyehitspitei etcinaro. nI iths qustieno ,tmes teh eittnap si sida to eahv iroetuhadm dolnesu adn htey ask e'ht nomciigolum eimscnmha fo siht 'eatspnit aimfmitnnoal si milrsia t'?oS o cabliyals tyhe kadse atoub whta epty of ertnhpitiyysives toinacre si nifdiibor i .esnreshToc nare:sw hmeuR godbdls;rt-ennifii&uo ;tness&gyc-poteir 3 Rt;m&ea-SHsg as rmuse sci.knsseGt o it gwonr tb.w

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 +4  upvote downvote
submitted by sajaqua1(607)
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eurSm isenkscs si a yepT 3 yyienieptsvhsitr o,aiectrn in chihw the obyd sonseprd ot gictniena daleicm sacestusnb dan cespdoru ibdot.ensai heeTs isitboaden in rnticcuoila enht idnb to het nctieangi ursgd nad est ffo the ecmopmlnte .aceadcs oRethmdiau rrathisti is sloa a eypT 3 yitshirnesiyvetp tnorec.ia

A) ospAoistp fo aohgraps-emc tispspoao si lryglneea otn a tpey of nrthespyvysiieit nert.ocai )B satM lce ingt-deauonarl htsi si artp of a yeTp 1 nspeiryhvitieyst ilopnhtxa,eriya/anacs ni chihw tams cesll nbid EIg no iterh aef,sucr and IEg nnidigb to the trtgea enntiag iuncsed a traomfocainlno genhca ni het gEI ttha ests ffo tsma llec aa.eognidlrutn )C rNtaula ireKll Clle -kngllii lapsy a itrvaye fo selr,o igdilcnnu rnaecc nospsuprsei nda uestdrtcnoi fo rlyvlia denftcie lc.esl If ehty ylpa a lore in ,eryistsyvnipihte it si patr of epyT 2 RSH ni iwhhc ehty udlow eprosnd ot gI on hte clel ue.fsrca E) eWhle dan alfer ot-sreainc ihTs is salo a pyeT 1 SRH.

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meningitis  I 'intdd pcki tihs eon ebsauec I htohutg reSum ncksssei asw too sstycime nad RA asw a emor ealzlcido epyT .3 Aig,na mi tnihgenkvoir istg.nh +
youssefa  ol:njaG AR is a miedx tyep III adn ptey IV meiumn eniracot +9
dinagohe23  I guhoht NK lcel kgilinl swa imasirl ot T lelc so adn RA si soal yeTp VI +7
nephcard  ,lbll ofouds +3
usmile1  NK lcel igknill ulodw eb a tepy fo iatenn ,nymuitim tno smiirla ot memroy T el.cls eeuscab ethy idd otn vegi na mplaexe fo a ytep 4 S,YH eht eawnsr tmus be ersmu iesnssk.c +

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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ebMya htye went wiht msuer esiscnsk a( tyep III visttienyhsiryep x)nr on htsi usteoniq baesd no hte leysoorg dseu ot angideso R.A stP tihw AR eahv ienbdiaost to ionouuiblnmmlg G )g(G,I leadlc oitmhedaur tcsoarf Rs()F. It smeka mose eesns taht uonp ehets urdaimhote raoctsf angiectr hitw "slfe" gcariucntli gIG, enmmiu cxelmseop olwud mfor thta lwudo etrla itopsed ni estissu aeip(nnixlg in trap the tlurxtcaarreia afoniastnmtsie eesn thiw A,R xe. ieoaurhdtm ,usondel eiplstiu,r patdiresirci .e).ct

pwi-twsidt/writoscsdtc:/taseicn.semnic/iry-hevn.ei-ieetcirye/nipishyy/odedm-ptcpnitte

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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 tpey 3 eyenviisyphtrtis cantoeir cwhih sha wot .oontpcensm

  1. DC 4+ T sclle ilwl naeitrlitf eutiss nda certa to tesaoinnugta erpsent in the oalsvyni iton,j stih ecssau l-haNaTpF nad -1IL ot be aerseed.l heesT ftymmaaronli keoicysnt llwi cesau eht iltaini mtrflyianoam itcar.oen eThes yeinockst LASO veatiatc B ls.cle

  2. B lcsle pdreouc mhirdtaueo oatcrf as lewl sa nita liccyc udaclirleintt eiteppd ioda.ytnb Teyh nidb eth asantneugoti dan orfm MEUNMI xmopecles htat sptioed no the vynisum.o Tyeh uceas emcenmotpl ot be a.eaticvdt eHenc the siclacs yepT 3 pnetyiyteihrivss rcaeto,in ti si dpoomcse of 3 sig:htn 1. neginta .2 tdnybiao .3 nloeemmtcp

Next, yuo dnee to nwok htta mrsue eskscsin F)A( si AOLS a ytpe 3 tyirtpsnhveyseii noc,tirea htsi emit it is deu ot nliicnipel or a coonanlolm nai,tdbyo calylbsai some inteaincg gu,dr wihhc secusa itnoadyb ot ndbi and ehnt eisopdt om.mneetcpl

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submitted by namesthegame22(14)
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yepT III eivniityhespysrt si iefeddn yb the sperecen fo ruiagcncitl eb-nelnontatiycd-gonmmaetip pleemscxo hatt doteips ni tessisu dna uscea lomiifmtnaan nad cun.ttdrsoei (esh adh esrceaded C)3

etyp III shrtsiveytnyiipe :aiscteonr SE,L ruems nesskcsi reciato,n ileoiaptrytsr oNsAPad,()on and Nsaimtslpso-te.cprhlci(onP)grpt-olScreoetGuo AR si lsoa a eixmd pTey 3 dan peyT 4 H.SR

Semru sneckssi uorscc wehn a g,dru husc sa hetmit-tcyayon go,lulbni atcs sa a npteah to teh mueimn esyms,t nritegrggi nbioaydt ritaomfon. mueSr scinseks enarctio uyslalu urcsco 1 to 2 ewkes afetr het tiinlai xureespo to eht gr,du tfegicrlen het etmi rrdieueq ot omunt an immenu sener.ops heT otiibdnesa nhet ibnd eth rdg,u tdeopsi ni usti,se and rttaatc and tievcata ptlnemeo.cm hTe truels is evef,r r,ash nad .raariltghas

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