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Old 05-11-2012
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Skin Differentiating Pemphigus Vulgaris from Bullous Pemphigoid

A 65-year-old arrives to the clinic for a consultation about flaccid bullae on(her scalp, face, and trunk), the doctor cannot make a differentiation between Pemphigus vulgaris & bullous pemphigoid. Autoantibodies to which of the following most likely present in this man to make the of bullous pemphigoid?

A- Mutation of the fas protein is oreventing by apoptosis
b) Overexpression of MHC class I protein on the sarcolemma
C) Presence of alpha-6 integrin and lamin 5 in the subepidermal
D) Breakdown of epithelial cell-to-cell junctions with IgG against epidermal
E) Destruction of desmoglein-1 and desmoglein-3
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hmmm tough one

D and E are for phemphigus vulgaris
C doesnt mean u have bullous pemphigoid, that ish is supposed to be there
i dont see how B and A play a role.

im stumped.
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Originally Posted by Dr.NickRiviera View Post
hmmm tough one

D and E are for phemphigus vulgaris
C doesnt mean u have bullous pemphigoid, that ish is supposed to be there
i dont see how B and A play a role.

im stumped.
Come on you can answer that one
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ooo it asks antibodies against which of the following

ummm C? although im not sure if that right. antibodies are against the hemidesmosomes, not integrin or laminins.
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Man... I get troubles reading your Qs and answer options... but I think is C: anti subepidermal antibodies
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man, what is wrong with these questions?
can you please check the next one you post for spelling and presence of all the words!!!

Its D

autoantibodies to hemidesmosomes in Bullous Pemphigoid...
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Quote:
Originally Posted by DocSikorski View Post
man, what is wrong with these questions?
can you please check the next one you post for spelling and presence of all the words!!!

Its D

autoantibodies to hemidesmosomes in Bullous Pemphigoid...
hemidesmosome are not cell-to-cell junctions but cell-to-ECM junctions
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Originally Posted by DocSikorski View Post
man, what is wrong with these questions?
can you please check the next one you post for spelling and presence of all the words!!!

Its D

autoantibodies to hemidesmosomes in Bullous Pemphigoid...

There is nothing wrong in the question, only in time to write PREVENTING I put oreventing. If you tell me man I don't anderstand or I don't know. I'll be able to explain each point of the key papa!
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Originally Posted by Dr. Mexito View Post
Man... I get troubles reading your Qs and answer options... but I think is C: anti subepidermal antibodies
Is the same question you got in Kaplan Qbanq, so, I just changed the diagnosis in put them in the explanation form, you will see ANSWERS AND QUESTIONS like that in your real test, that is the reason always I asked you to read carefully all of the explanation you have in a Qbank
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Quote:
Originally Posted by Dr.NickRiviera View Post
hmmm tough one

D and E are for phemphigus vulgaris
C doesnt mean u have bullous pemphigoid, that ish is supposed to be there
i dont see how B and A play a role.

im stumped.

A- Mutation of the fas protein is preventing by apoptosis: LUPUS
b) Overexpression of MHC class I protein on the sarcolemma: POLYMYOSITIS
C) Presence of alpha-6 integrin and lamin 5 in the subepidermal: BULLOUS PEMPHIGOID
D) Breakdown of epithelial cell-to-cell junctions with IgG against epidermal: PEMPHIGUS VULGARIS
E) Destruction of desmoglein-1 and desmoglein-3: PEMPHIGUS VULGARIS
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Quote:
Originally Posted by alfjof View Post
A 65-year-old arrives to the clinic for a consultation about flaccid bullae on(her scalp, face, and trunk), the doctor cannot make a differenciation between P vulgaris & bullous pemphigoid. Autoantibodies to which of the following most likely present in this man to make the of bullous pemphigoid?

A- Mutation of the fas protein is oreventing by apoptosis
b) Overexpression of MHC class I protein on the sarcolemma
C) Presence of alpha-6 integrin and lamin 5 in the subepidermal
D) Breakdown of epithelial cell-to-cell junctions with IgG against epidermal
E) Destruction of desmoglein-1 and desmoglein-3
Not that I was unable to read it, but u know... In a q on the exam every word counts...
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Quote:
Originally Posted by alfjof View Post
Is the same question you got in Kaplan Qbanq, so, I just changed the diagnosis in put them in the explanation form, you will see ANSWERS AND QUESTIONS like that in your real test, that is the reason always I asked you to read carefully all of the explanation you have in a Qbank
Nothing personal man... I like your Qs... I just stumble with the stem (You know... I'm not a native English speaker)

No hard feelings right???
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Quote:
Originally Posted by alfjof View Post
A 65-year-old arrives to the clinic for a consultation about flaccid bullae on(her scalp, face, and trunk), the doctor cannot make a differentiation between Pemphigus vulgaris & bullous pemphigoid. Autoantibodies to which of the following most likely present in this man to make the of bullous pemphigoid?

A- Mutation of the fas protein is oreventing by apoptosis
b) Overexpression of MHC class I protein on the sarcolemma
C) Presence of alpha-6 integrin and lamin 5 in the subepidermal
D) Breakdown of epithelial cell-to-cell junctions with IgG against epidermal
E) Destruction of desmoglein-1 and desmoglein-3
A: Autoimmune lymphoproliferative syndrome
B: Myositis
C: Junctional epidermolysis bullosa
D: Bullous Pemphigoid

E: Pemphigus Vulgaris

Autoantibodies of the IgG class attack antigens in the hemidesmosome of keritinocytes. these are found in the EPIDERMIS. This suggests D to be the correct answer!

Newbie to the forums here... just joined. Currently on medical leave from school after a 30 ft. fall on my bicycle in the mountains.

Last edited by CircaRigel; 05-12-2012 at 06:04 AM.
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So answer is C eh?
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Please explain C. I was differentiating epithelial junctions from the basement membrane when I put D as my answer, and I was pretty sure I was correct.
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Quote:
Originally Posted by alfjof View Post
C) Presence of alpha-6 integrin and lamin 5 in the subepidermal: BULLOUS PEMPHIGOID
D) Breakdown of epithelial cell-to-cell junctions with IgG against epidermal: PEMPHIGUS VULGARIS

This is correct. The answer has to be C. I think a lot of you (including myself) started looking for a "hemidesmosome" answer. Remember that most questions are two-steps.

First step: Knowing that Ig's would be against hemidesmosomes
Second step: Knowing what makes up a hemidesmososme

Therefore the answer has to be C due to the integrin and lamin.
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Quote:
Originally Posted by CircaRigel View Post
Please explain C. I was differentiating epithelial junctions from the basement membrane when I put D as my answer, and I was pretty sure I was correct.
D is cell-to-cell interaction... that is more like desmosome.

Bullous Pemphigoid is about hemidesmosome cell-to-ECM
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The correct answer is:

C) Presence of alpha-6 integrin and lamin 5 in the subepidermal: BULLOUS PEMPHIGOID
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