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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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rdconigcA ot FA 0,921 in the stoceni oubat uhitremdao t,ratisirh ti si enivg ttha ihudomaetr euodlsn rae eud to ionirdbfi csorsne.i In teh ooylptagh hcptear ni AF, difbinori ricseosn is isda to eb an elaemxp fo etpy 3 etrystivipihneys .rncoetai nI sith eusnitqo e,tsm hte tapniet is iasd to aehv umrahtiode esdlnou and etyh sak th'e ucminlogoim csmanimhe fo isht sttpa'nie nlamtoimnaif is salimri oot?S' siabllayc ehty dakes btuao ahtw ypet fo ssthievyeyptirni raicteno is biiifdnor oenr hTs.scei wnars:e muRhe udlibrsnn-;idge&fooit nctg&-spstoi;reey 3 s&aeRgt-S;Hm sa msreu .kesisnsc toG it ngowr .bwt

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 +4  upvote downvote
submitted by sajaqua1(607)
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uSrem ecssksin is a pTey 3 rhiineysevystpit ieortn,ac ni chwhi eth odby resosdpn ot niiantegc malcedi scsasnbtue nad edcoursp sn.betodaii sTeeh tieasonibd ni coaciuritnl ehtn inbd to teh ngacieitn udsrg nad tes fof het tepcleonmm d.ascaec tudRimohae ratshrtii si oasl a yeTp 3 tyyvpristnieehis oterina.c

A) posiAotps of chepgmroaas- aosspotip si lgnleeyra otn a ypte fo iisenytrtvpeishy .eotrnaci B) atsM ecl ogndualntaeri- tish si prat of a yTep 1 vtsyehseiirpyitn oeisayiacphalxrt/,nan in ihwch tmas lcsle nbdi IEg on iterh ufacser, nad EgI ibnignd to eth rtatge itneang sedniuc a amfclnoranoiot ngache ni hte gIE htta tess off atms cell igdranutenlao. )C aulrtNa ieKlrl lCle lgnlkii- spayl a taervyi of lso,re cldgiunni ccraen oppssreinsu dan cidoenturst of ryalliv tincedef .elcls fI ethy play a elor ni s,ehyvieytiinprts it si tapr of ypTe 2 RHS in ihwch ehty lwodu srndope to Ig on het lelc .esacufr E) lWeeh adn rlefa tocsnra-ie hTsi is aols a ypeT 1 .RHS

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meningitis  I ndidt' cpki itsh eno scbeeau I uhgttho uSerm essksicn saw oto ysmiestc adn AR swa a moer dealzloci Type .3 g,inaA mi nihoiventgrk is.gthn +
youssefa  :Gljnao RA is a midxe tyep III and ytpe VI emuinm otricaen +9
dinagohe23  I tghouh NK ecll ikilngl asw siialmr ot T llce so nda RA is aols peyT IV +7
nephcard  bll,l dfusoo +3
usmile1  NK lecl llikngi dolwu eb a peyt of itnane nimtiu,ym otn rilsaim to mroemy T sell.c beasecu yeht ddi tno geiv an lemaexp of a ytep 4 ,HYS eht sawrne mtsu eb sermu csnek.ssi +

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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Mbeya ethy wnte ihtw serum kcisssne (a ptey III yeitnvrhsiyespti )nrx no this iqnoutse asdbe on eht lseyoorg udse to noeiadsg .RA Pts hwti AR aehv aetodnibis ot unmlnmilugoibo G )g,(IG dlealc iorhutedam fasotrc )FRs.( It esakm moes nsees htta nuop eehts radeuiothm rotcafs eagnictr iwth slef"" caniurigctl GIg, nieumm xlsocpeme olduw morf tath udowl aeltr oepsdit ni tsissue npeliaxng(i ni trap eth etrctrxlaraiau asmstnifieotna nsee htwi ,AR xe. rtumehidao ,nelsoud ,uriispetl disietprrica t.e).c

yt.-ety-wci-wpcdiinc/nt/ec:aiositieddsvyt-timshe.eiettyrnchpicpi/mdenorrwis/istensep/

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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 is a yept 3 itheysivytprenis trniceao cihwh sha tow .tponsnmcoe

  1. DC 4+ T lecls lilw fitirlntea usiste nad ertca ot stgeaotainun tensrep ni eht oialvnsy injot, sthi esscau N-FaaphTl dna -1IL to eb erselae.d Tehes raomyaftlinm etoykcsin liwl seacu eth itialni tnyilmmafrao ciaontr.e eTshe cotkisyen OALS aetvtaic B slecl.

  2. B lslce rpuodec uedaorhmti rfctoa as wlle sa iatn cyiclc drulilttnaeci dppetei tdbiyao.n They bidn eht gitoatsneuan adn frmo MMINUE esopmecxl htat pdeisot on eth vyisumo.n yThe seacu mpoencetml to eb ti.ctveada ceenH eth ascslci Tpey 3 ivieyieyttsrhpsn cao,itnre it si edmoscop fo 3 gshit:n .1 genanti 2. idabytno 3. mlnopmtcee

t,Nxe uyo ened ot owkn ttah mesru isesskcn (FA) is LOSA a ypet 3 hnpvyteeysiitris ri,eactno tihs meit ti is ude to lliinniepc ro a clnnolomoa ytoad,bin caslbylia osem ntaeigcin drug, cwihh sceusa iaonydbt to idbn nad ehtn stidoep e.oplmencmt

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submitted by namesthegame22(14)
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peTy III hnpyyiitetresisv si enidfed by eth pseecner fo ucgtlarcini nnypita-canbtelm-itnemgeood pcemxoles htta dostiep ni ssutise adn caues afntmimnaiol dan te.ocdritusn e(hs dha deraesdce 3C)

peyt III ievriytptiyhness or:ctasine S,EL rseum icksessn onr,iecta iratyspitloer s(doonNaPA,) dna crrahu(ctplS-oNnitecs-oPoplGsrot.iemogsetlp) AR is oasl a xmied ypeT 3 adn epTy 4 SH.R

ueSmr ssekcnsi sroucc henw a ,drgu cshu as -mhcoyntaittey nubgliol, ctas sa a hptean to teh mnmeiu ,esmyts iggtgenirr atnobydi .noitrfamo eruSm ksinsesc ncaeitro llsuayu uocsrc 1 ot 2 eskew taerf hte liitnia eeroxusp to eth gdur, tfrligecne eht eitm irudqeer to uonmt an ienumm .sreonpes heT itnbsieaod nhte ndib eht d,ugr iptdsoe ni u,istse nad actttar dna itacaevt cmteloep.mn Teh ulstre is ef,evr ,asrh adn sahigatrrl.a

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