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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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gAcniocdr to FA 91,20 in eth iscteno tbuao eouhtimdra rriatsh,it ti si vineg thta ohdimauetr euoldsn rea due to rifinoibd no.scesir nI teh hygtooapl retcaph in A,F nfdioibri recisosn si dsia to eb na lxeeapm of tpey 3 insyrtihesyteivp inrecta.o In shit nqsiteuo sme,t eth iatetpn is isad to hvea mteaurdhio snoedlu nda tyhe sak 'the giiumomoncl hnmieacsm fo isht titapen's miltomafnnia is lisarmi ' oo?tS cabillays tyhe dakse ubtao wtha tpye fo siyvpehrteyisnti cniaroet is fdirbioin seTh oscrn.ei rw:nsae ehmRu dtifireo&bsdoug;inl-n ;rs-ctpeetsiyo&ng 3 gRs-;S&Haemt as mresu kssc.esinotG it nrwog t.bw

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 +4  upvote downvote
submitted by sajaqua1(607)
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Sumre nsiecssk is a Tepy 3 iistpneisthvryye roa,icetn ni ihchw het obyd norsesdp to nigeianct dcimlea scbsseautn dan ueosdrcp dsbnati.oei hesTe idtnisbeoa ni nioracuiclt etnh nibd ot teh tnnacgeii gsdru nda tse ffo eht cmeeoptlmn dcc.aase odaitmehRu iaihrttsr si lsao a Tpye 3 iyprttiehenviyss tnirc.eao

A) toApispos fo -gesmhapacor opposisat is erlgeylan nto a yept of sviistnhypeirtye iaceto.nr B) asMt ecl nge-noiratuadl htsi si ptra of a ypTe 1 hirvitnisetepsyy hroaa/ienplnyaxi,stac in iwhhc smta lclse inbd EIg on itrhe ,racusfe and gEI nnibgdi ot the atregt igatnen unciesd a nfnooarmtoalic ghenac in the IgE thta sets fof tams lcel tidunaogea.rnl C) rlNatau Kleirl lleC iilg-lnk plsya a riayvte of rs,loe ilnuidcng nrcace spsnsuepoir adn tcuronsdtie fo vylrali nedfciet clesl. fI eyht aypl a leor ni ih,iseptsetyryinv ti si patr of Tepy 2 HRS ni hihcw yeth lwoud nrpsode to Ig on the elcl .usarefc E) ehWel dna freal -noesciatr ihTs si oasl a eyTp 1 .HRS

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meningitis  I idt'nd ipck hits neo cubeesa I otthuhg umreS ncisesks swa oot sietycms dan AR swa a orem laicdezol eyTp 3. ,agAni mi konhregnvtii s.gihnt +
youssefa  lGnja:o AR is a ixmed ytpe III dan eytp IV nmuemi tneiarco +9
dinagohe23  I htuohg NK ellc ilglkni asw msaliir ot T lecl so and AR si sloa yeTp VI +7
nephcard  lbl,l doufos +3
usmile1  NK llce lgikiln wodul be a pyet fo ntanie ymiuitn,m ton rlimasi ot eoymmr T .lcels subecea hyet ddi ont veig na pxemeal of a ptye 4 YSH, het waners stmu eb musre ecks.nsis +

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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eaMby yeth etwn iwht suemr sescsnki a( pyte III hynyestsiriteipv rxn) on isht otieunqs adbse no eht yloosegr euds to genosadi .AR tPs iwth RA aehv obndiaeist ot lbnmiomniouugl G g(G)I, dlcale mrahtoeidu cstafro Fs).R( It smaek omes snees that opnu ehtes tiuomhrade acrfsto itrcenga thwi lf"se" nultagircci ,IGg mniume eolxecsmp uoldw rofm ttha uwdlo rlate tepodsi in sesutsi aexgi(nlinp in rtap eht crxrttaiuaaerl ntintisasfmaoe esen tihw ,RA xe. mdhietuaro osen,lud pstiilru,e ectiipisadrr .)t.ce

:/ietw/i-nyicrsi/sye-cehwtptcprevnhci/isttye/wdte.dmidpnoyemictii.tocneedtapiis-srn-s

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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 ypet 3 riyttiesnvpisehy iotnerca cwhhi hsa otw ntpooensm.c

  1. CD 4+ T secll wlil tinteialfr tseuis dna etcar to gsaeautonint senetrp ni the yaolnsiv iontj, this ssauce lNpTF-haa and LI1- to eb r.ledasee eheTs iolaaymnmrft esintyock ilwl uceas teh itilain aotfarymlnim itn.acore seehT teyisonck ALSO cvatatei B l.clse

  2. B lslec oreudpc oedirahmtu ftoarc as lelw as anti liccyc lcrndateiiutl ditpeep ybtiod.an yThe ibnd eht otstiauagnen adn mfro IUMMNE melpcxose htta idspote no eht iy.mvnous heyT saecu emctoemlpn ot be ta.vadicte ceHne het iclcass ypeT 3 ieehvirynypttsis aeit,rnoc it si odeopscm fo 3 stgh:ni .1 engtain .2 dbanotiy .3 otemmeplcn

xteN, ouy nede to know ttah eusrm secnisks (A)F is SAOL a type 3 preesvysiitytihn ociet,nra tsih mtie it si ued ot llnieinicp or a mlcnlaoono ianby,dot lscialyba semo agtieincn r,gud cwihh ssacue ydaonibt to dbin dna nthe epidost .emelpconmt

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submitted by namesthegame22(13)
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epyT III yenhrieypsvtitis is edndife by teh cepnsere of ricialnguct i-noemtbcntp-eodayamtlnineg eeomlspxc ttha esodpti ni etsssiu nad aceus manimftnoail nad enoisttcur.d s(eh dha deeecrsad )3C

etyp III enpriytiithsysve :ensrticoa ,ELS esmru nkisescs ericta,no rylioaepsirtt sNa(d,P)Aono nad )pP.suNrGsooto-ao-leecis(hcSgppttnimerrloltc AR is laso a iexdm yTpe 3 and Tepy 4 R.SH

emSur ssekcisn sucorc wehn a rug,d csuh sa -eomnhcyyatitt lloni,bgu asct sa a pathne to hte mnumie ts,emsy iggitrrgen bdyoanit nofoimtar. ermuS nsicseks irntaceo slaluyu rosucc 1 ot 2 keesw etfar eth niltaii erseuxop to hte ,drgu gntirelecf eth tiem rdieerqu to unomt an emnumi peosrn.es ehT dtaeiionsb enht inbd teh u,drg spodtei in ssiute, nad taarttc and ievtaatc cpmlnm.eoet eTh rtelus si erev,f ha,sr dan a.ailrsrgaht

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