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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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ccAodinrg ot FA ,1029 ni eht sectoni about outriamhed hsiritar,t it si ignev ttha ieomrutadh dsueoln era deu to nbdifirio .isnresoc In hte hopytaogl apcerth in ,FA dbrniifio ossnriec is said ot eb na lapmeex fo type 3 eetiyptnvisyrshi aer.ction In isht untsioqe mt,se teh eintapt si asdi to aehv oehrmtdiua snueold nad hyte sak 'het gunolcioimm ihnmcaesm of hsti eta'istnp ammninifloat si mrsaiil 'oSo?t llasybcai thye ksdae oautb tawh ytpe of siytivpirsyhtene ntorciea si ndiiorbfi heToescrsn.i nswrae: hmRue giib-dntrinfo&ldse;uo -prttnsieo;gsy&ce 3 SsmHe;Rga-&t as uemsr .essncski Gto ti wrnog t.bw

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 +4  upvote downvote
submitted by sajaqua1(607)
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rSmue ksscnsei si a Tyep 3 irehssvinitetyyp ,ocreitna ni cihhw eth yobd pesronds ot ngictinae amlcide essctbunsa nad csoeurpd aidsnt.iboe eeshT dintseaiob in tiiulrccaon nthe bidn to eht eacingtni udsrg adn ets off eht mmcnetpoel sacedc.a htuoamdRei sairhtrit si olsa a Tyep 3 tyryptisiseeinvh c.ntiorae

A) iopsptAos of oahprmce-gas aopisotsp is arellegny not a tepy of tehyirnetiiyspsv tr.cinaeo )B tMsa lec -nladntoeuairg thsi si tarp of a pTey 1 ivssttyhiieneyrp carielaa/sxniatnhy,op in ihhwc tasm secll ndbi IEg on htire sfuarce, nda EIg gbdinin to the tagert einantg dinscue a nrfctanmoolioa gacenh ni the gEI ahtt sset ffo mtas ecll etaanrolnidg.u C) raNlaut Kirlel Cell nilil-gk lyaps a veaytir fo soerl, nunldigic caercn psnueosrsip nda scnitoeudrt fo riavyll intefedc .lcels If teyh ypla a relo in epehtiysitsnivr,y ti si atrp fo Tpey 2 HSR in ihhwc tyeh uodlw rdspeon to Ig on teh llce .sceruaf )E lhWee dna lfera orsneit-ac This si oals a peyT 1 S.RH

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meningitis  I ni'tdd ipck shti noe ubeeasc I gohttuh uemSr sesnscik aws too ysmiesct adn RA aws a oerm alzdoilce ypTe 3. Aa,ign mi gonvhnkiietr n.sghit +
youssefa  an:loGj RA si a ixedm epyt III and type IV nmemiu iernotca +9
dinagohe23  I tuohgh NK clle gkliiln asw mriaisl ot T lcle so nda AR is osal eTyp IV +7
nephcard  ll,lb dofuso +3
usmile1  NK cell ilkgnli dwuol be a tepy of innaet nu,tmiymi ont siriaml ot mromye T l.lesc esauceb hyte idd nto eigv an pmxleae fo a type 4 SYH, eth sanwre tums be smrue nski.scse +

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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byMae ythe ewtn itwh umers icessksn (a eypt III ihvinsryitypsete nxr) no siht uontqeis aedsb no teh oelgorys duse ot aeisgdno .AR stP twih AR eahv bsoeidtani to imobomlnuilgun G g),GI( llaced uaermtdhio rtfocas s(.)RF It meska semo sseen hatt ounp htees ruohiedmta rotfsca tencgair ithw l""efs ucrltniigac ,gIG unmemi leoecpsxm owlud mofr thta wdluo altre dietspo in isutses expignal(ni in trpa het raxlureicatrat tmenstosifnaia sene with RA, x.e umetidroha e,soldun ieul,itprs iacestrriipd ec.t).

n/eitteiticncicsihtetrs.ident/m-ywoeiespsae:vhtpyicnddyt/r-e//ditpcroi-yiespcswwi-nm.

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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 tepy 3 irtieenyhvpssyit otarcine chhwi sha owt psoctmn.one

  1. DC 4+ T llsec lliw flitraneti iusest and cetra to oaseagtintnu nrstepe in the lisoyavn nij,ot ihts esscau TFaaph-Nl and IL1- ot be reae.elds Thsee lanoitymrfam tkscnieyo lwil secua hte ailinti atilfomarynm etncriao. hTese itcneyosk SLAO taavctei B cse.ll

  2. B cesll erucdpo udmahetiro rctoaf as ellw sa iatn clcyic dinlaeucilrtt deieppt bdioant.y ehyT ndib eht ttaaniosgune adn omfr EMUMNI sclmepeox atht pesidto on eth onmyis.uv Tyeh ceasu encpteomml to be aittd.aevc ecHen teh csacsil pTey 3 etneyhsisyrvitpi iotnrac,e it is psmdoceo fo 3 in:ghts .1 ineangt .2 ontbyida 3. olmtecemnp

Ntx,e uoy dene ot nokw htta seurm cnkissse )A(F si LOSA a pyet 3 npiviyirtehystes ,rtnocaei this imte ti is ude to niciipllen or a annlloomco tyo,bdnia ilsycalba seom eiinacngt ,rugd hwhic susaec ytaidnbo ot bndi nda hnte isdeopt len.tcpmmoe

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 +0  upvote downvote
submitted by namesthegame22(13)
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eyTp III tnyveiphtsirisey si edindef yb eth erenepcs fo urcaglticni ayoinmntg-daetmelnboptin-ce lxeomcpes thta etsipdo in susiset adn cusae liaanntifmom adn ru.coednistt eh(s ahd ceeresadd )C3

type III eiityvisprteshyn os:aicrtne S,LE emsur sinsesck oanir,tce toliistareypr aPdnAo(o,)sN adn estgrGm(--lproNP.Sitathtpoicccusploneoreols) AR si alos a idemx pyTe 3 dan pyeT 4 .RHS

mSure sisscnke oscrcu newh a rdgu, uhcs as ceto-tiyhymtan uonlg,lbi stca as a tepahn ot eht iumnme y,estsm egggiinrrt boadynit tia.fnorom Sremu nsciessk tcenroai uslualy orcusc 1 ot 2 eeksw etfar eht aiinitl oserexpu to eth ug,rd rgtfcnleei hte mtie dqireure to tuonm an nemmui ree.pnoss The iistoanedb tehn dnib the dugr, pdteois in uetis,s nda ttacrta nad aaticvte .ommtclpene hTe stuelr is vrfee, hrsa, nda isrg.laathar

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