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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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rdAingcoc ot FA 0912, ni het nicteso botua treiumahod isithr,tra ti si ngeiv ttah hameiudtor snlduoe rae ued ot nfiibirod sinscore. nI eth poltohgya aprtehc in FA, bidfinoir soeiscrn si idsa to be na xelempa of ptey 3 esttriinispyveyh erotn.ica In sith qetsionu semt, hte ntapeti si sdai to evah rdmutheaio sendlou and teyh kas ht'e unmgmioiclo maischnme of tshi etiaps'tn nnfmaaiiltmo si rsimial So ot?' slacbyial hety eskad otabu hwat teyp of phttvsesrniyeyii otiecanr is ordbfinii eorhss.nieTc nws:rae uemRh &od-nnb;iluidgfiresot oeyseg&;-rstcnpti 3 a-mgHte&SRs; as msure isekssc.nGo t it gonrw wb.t

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 +4  upvote downvote
submitted by sajaqua1(607)
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mrueS icnsesks si a pTye 3 eyshinterpiisvty ,eoraticn in which eht ydob redopsns to enniiagct amlcdei cnaesstbus nda cusredpo bdestioa.in sTeeh biotneaisd ni urocnaiiclt tenh dbni ot eht negiciatn rguds dna set off hte oetcmelnmp eccaad.s itRmdaoeuh tirhraist si saol a Tpye 3 tihirvtepeynsiys rotiane.c

)A Aptipsoos fo acms-hropega aoptspsio is nrglaylee tno a pyet fo yvspieiteistnryh a.tocinre )B tsMa lce regaa-odutnnil siht is patr of a Tpey 1 teiipseniystvryh la,rtnacpna/yieoahsxi ni iwhhc samt llsec ndbi IgE on hetir fucresa, dan IgE igdninb to eth rattge anenigt siedunc a loorcmfatonain cgneha ni teh gEI taht sets ffo msta llec git.nenualaord C) rNtlaau lelKir Clel iiglnk-l saylp a eaitvry of olsr,e iduinglnc rnecca ssipensrpou adn tiudncrseot fo llyaivr efcnietd e.lscl fI eyth aypl a roel ni ,yptirtieyvehsnis it si tapr fo Type 2 HRS in chhwi tehy owdlu esopndr ot Ig on the ecll cufa.res E) eleWh nad earlf cs-reianto siTh is soal a yTep 1 S.HR

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meningitis  I 'ntdid kicp iths one ecebaus I gohuhtt eSmru sekscsin aws too tsmescyi dan AR aws a reom eozldcila Tyep .3 ,iAagn mi ethnngvokrii t.hgsni +
youssefa  lojGa:n RA is a dmiex etyp III dna eytp IV einumm eicanotr +9
dinagohe23  I hhotgu NK clel inliklg saw iarlsmi ot T lcel so and RA is oasl pTye IV +7
nephcard  lll,b osfuod +3
usmile1  NK ellc lniiklg duwol eb a epyt fo eannti yutminim, ton mlriias ot rmoyem T cl.sel eeubcas tehy ddi nto vige na pealmex fo a etpy 4 YHS, het saewnr smtu eb umrse ecisnsk.s +

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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byeMa ehty tnew itwh umres sscsniek a( tyep III itstreihisvepyny xr)n on hits isunteoq abeds on het oroeylsg deus ot oadnsgie .AR tsP thwi RA aehv sibndeaoit to oloimmnlniubgu G )G(g,I elcdla othieraumd trcoafs (FRs.) It samek osme esens ttah pnou these toiahrmude aortfcs tgeircna wthi e"fl"s guclitirnac gIG, mmeniu epsclmoex dulow fmro tath dwluo alter sdtoipe in suseist i(inangepxl ni rapt hte uteiracxarltra iestasmoaftinn esen wtih ,RA e.x ruehaitmod d,nusole i,tislupre ictrpdrisaie .et)c.

ip/iyry/yittyd-/oecidrip-dendinottcwmttet-hwcsep:anisis.ic/estetps.imnvicnhe/riwc-see

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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 si a type 3 iespihsientyyrvt canioert hwhci sha wot msencnot.op

  1. DC +4 T llsec illw ltaireifnt etsisu dan aetrc ot noatntueigas spneetr ni eth vsaoilny jnt,oi shit casues lpN-TahaF adn L1I- to eb ealres.ed seTeh mitfoamryaln osiekncty lwli aecsu hte iintila lnmamyiraotf ecatonri. Tehse necktysoi SOLA tacteiav B ellcs.

  2. B slecl deucrop ohameturid rfcoat sa elwl sa anti ycccli lritctadunlie peedpti bdaoit.ny eyhT idnb hte attninaeougs dan rofm UMNEMI eoxpmlesc taht spdoiet on het umysvnoi. Thye ceaus mtnceompel ot be dit.caveat cHnee teh sslcica eypT 3 syehvtrsniieipyt i,aeonctr ti is opcodmse of 3 it:nsgh .1 aeitnng .2 tndyaboi 3. oememtlpnc

xe,tN uyo dnee to kwon tath eumrs cinsssek )F(A si SOAL a ptey 3 ptyihiryesvetins tanoeir,c ihts tmie ti is ude ot pnlciniile ro a amlcnoonlo dioy,natb lsabiacly esom ennaigcit grdu, ichhw eascsu oiytabnd ot dbin dna nhet oedtpis cmentplom.e

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submitted by namesthegame22(13)
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pTey III sprehsventiyityi si ieddenf yb hte percnese of iuartcginlc -enotbi-gpyamceaotdntlnemni ecmlspxeo htat isdepot ni tisusse and casue liitmfnoamna and .uosrttneicd (esh had rceaddese 3C)

eypt III sytiyihiensverpt io:anrestc ESL, srmue inescssk rani,ecto rayetpiisrtol (oPNdas,on)A dan hPcstueipt(lmoopesilNrtcgptSlG)-rco-oesrao.n RA si salo a edxim Tepy 3 dan Type 4 HRS.

emruS seissckn ccruos henw a ,udrg husc as hcyetytanmot-i lbg,lioun atcs sa a apnhte to eht imnume e,yssmt rrgigietng dyinotba iafto.nrom uSrme ncssieks cotriena yausull ucsrco 1 to 2 wkese rafte hte lnaiiti rxpseoue ot teh rdgu, tgnflrceei eth time rieeqrdu ot notum na imuenm pre.onsse The sdeatboiin etnh dbin het ,ugrd eiodtps in siet,us nda cttaart dna vtctiaea tme.monpelc eTh rulest si efrve, ,sarh nda aglrarhsi.at

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