Buerger's Disease Progression & HLA Association - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 05-18-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 104 Times in 62 Posts
Reputation: 114
Send a message via Yahoo to alfjof
Question Buerger's Disease Progression & HLA Association

A 27-year-old man presents to the emergency department with a history of cold intolerance in his distal upper extremities and superficial nodular phlebitis. The patient has known as heavy smoker his hands are shown in the slide below. which of the following should be a predisposition of progression and protection on the slide?


A) DRB1, DQA1, DQB1, and DPB1 TYPING
B) HLA-A9, HLA-B5, HLA-B54, and HLA-B 12
C) HLA-A, HLA-B, HLA-C, HLA-DQW1, and HLA-DR2
D) HLA-B8, HLA-Cw7, HLA-A, HLA-B, and HLA-C
E) Positive HLA-B39, HLA-DR , and negative HLA-B27
Attached Thumbnails
Buerger's Disease Progression & HLA Association-image.jpg  
__________________
Happy to Learn New Concept and Mechanism each Day

Last edited by alfjof; 05-18-2012 at 06:22 PM.
Reply With Quote Quick reply to this message



  #2  
Old 05-19-2012
Dr. Mexito's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 662
Threads: 72
Thanked 370 Times in 204 Posts
Reputation: 380
Default

I have no idea but my "gut-feeling" is pointing to B...
__________________
"Disease is very old, and nothing about it has changed. It is we who change as we learn to recognize what was formerly imperceptible." JMC
Reply With Quote Quick reply to this message
  #3  
Old 05-19-2012
imgchuchu's Avatar
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 218
Threads: 4
Thanked 74 Times in 55 Posts
Reputation: 84
Default

same here bro;no idea atall but in the exam i will go for

Cc
Reply With Quote Quick reply to this message
 
  #4  
Old 05-19-2012
USMLE Forums Addict
 
Steps History: 1 + CS
Posts: 160
Threads: 6
Thanked 47 Times in 38 Posts
Reputation: 57
Default

I would go with E...
Reply With Quote Quick reply to this message
  #5  
Old 05-19-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 104 Times in 62 Posts
Reputation: 114
Send a message via Yahoo to alfjof
Default

Mycoplasma asks for a harder question, I posted one and I am waitin' for him to answer it before.
It's not a simple question and I found it yesterday in USMLERX qbank
__________________
Happy to Learn New Concept and Mechanism each Day
Reply With Quote Quick reply to this message
  #6  
Old 05-19-2012
USMLE Forums Addict
 
Steps History: Not yet
Posts: 125
Threads: 17
Thanked 67 Times in 38 Posts
Reputation: 77
Default

i think correct answer is B
Currently, the initiating factor in BD is not known. The hypothesis is that a tobacco-related antigen initiates the pathology. BD is seen in pipe, cigarette, and cannabis smokers, and rarely in subjects chewing tobacco. There is a strong association between smoking and disease progression. Improvement in symptoms is dependent on cessation of smoking. In BD, there is an association with HLA- A9, HLA-B5, and the combination HLA-B54 and MICA 1.4. HLA-B 12 is considered protective. Cell mediated and antibody responses to collagen type I and III, major constituents of the arteries have been demonstrated along with antibodies to elastin. There is consumption of CH50 and reduced levels of C3. To date, studies exploring the causes of BD have included few patients and remain inconclusive. The etiologic factors in BD remain elusive.
Reply With Quote Quick reply to this message
  #7  
Old 05-19-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 104 Times in 62 Posts
Reputation: 114
Send a message via Yahoo to alfjof
Default

Quote:
Originally Posted by irakly View Post
i think correct answer is B
Currently, the initiating factor in BD is not known. The hypothesis is that a tobacco-related antigen initiates the pathology. BD is seen in pipe, cigarette, and cannabis smokers, and rarely in subjects chewing tobacco. There is a strong association between smoking and disease progression. Improvement in symptoms is dependent on cessation of smoking. In BD, there is an association with HLA- A9, HLA-B5, and the combination HLA-B54 and MICA 1.4. HLA-B 12 is considered protective. Cell mediated and antibody responses to collagen type I and III, major constituents of the arteries have been demonstrated along with antibodies to elastin. There is consumption of CH50 and reduced levels of C3. To date, studies exploring the causes of BD have included few patients and remain inconclusive. The etiologic factors in BD remain elusive.
Why you not posted your source, below is where all you explained and B is correct
http://www.mdl-labs.com/about/buerger_study.html
__________________
Happy to Learn New Concept and Mechanism each Day
Reply With Quote Quick reply to this message
The above post was thanked by:
curiousmind (06-26-2012)
  #8  
Old 05-19-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 104 Times in 62 Posts
Reputation: 114
Send a message via Yahoo to alfjof
Default Explanation

A) DRB1, DQA1, DQB1, and DPB1 TYPING: Scleroderma
B) HLA-A9, HLA-B5, HLA-B54, and HLA-B 12: Buerger's disease reference USMLERx, and the only 2 HLA you have to know for the board in this case are: HLA-A9 and HLA-B5(correct answer)
C) HLA-A, HLA-B, HLA-C, HLA-DQW1, and HLA-DR2: Paget's disease
D) HLA-B8, HLA-Cw7, HLA-A, HLA-B, and HLA-C: Sarcoidosis
E) Positive HLA-B39, HLA-DR , and negative HLA-B27: Polyarteritis nodosa
__________________
Happy to Learn New Concept and Mechanism each Day
Reply With Quote Quick reply to this message
The above post was thanked by:
Dr. Mexito (05-19-2012), koolkiller88 (05-20-2012), mycoplasma (05-20-2012), Pachys (08-14-2013), thelostsoul (07-11-2016)
  #9  
Old 05-19-2012
Dr. Mexito's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 662
Threads: 72
Thanked 370 Times in 204 Posts
Reputation: 380
Default

Quote:
Originally Posted by alfjof View Post
A) DRB1, DQA1, DQB1, and DPB1 TYPING: Scleroderma
B) HLA-A9, HLA-B5, HLA-B54, and HLA-B 12: Buerger's disease reference USMLERx, and the only 2 HLA you have to know for the board in this case are: HLA-A9 and HLA-B5(correct answer)
C) HLA-A, HLA-B, HLA-C, HLA-DQW1, and HLA-DR2: Paget's disease
D) HLA-B8, HLA-Cw7, HLA-A, HLA-B, and HLA-C: Sarcoidosis
E) Positive HLA-B39, HLA-DR , and negative HLA-B27: Polyarteritis nodosa

“You have to master not only the art of listening to your head, you must also master listening to your heart and listening to your gut”
__________________
"Disease is very old, and nothing about it has changed. It is we who change as we learn to recognize what was formerly imperceptible." JMC
Reply With Quote Quick reply to this message
  #10  
Old 05-19-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 104 Times in 62 Posts
Reputation: 114
Send a message via Yahoo to alfjof
Default

Quote:
Originally Posted by Dr. Mexito View Post
“You have to master not only the art of listening to your head, you must also master listening to your heart and listening to your gut”
What do you mean with that?
__________________
Happy to Learn New Concept and Mechanism each Day
Reply With Quote Quick reply to this message
  #11  
Old 05-19-2012
Dr. Mexito's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 662
Threads: 72
Thanked 370 Times in 204 Posts
Reputation: 380
Default

Quote:
Originally Posted by alfjof View Post
What do you mean with that?
Nothing man... Just that I answered this Q using my "gut-feeling"

Well, part was gut-feeling and part was using my head... This is how I reached to the answer.

First, I've never heard about this correlation with Buerger's disease, so I tried to eliminate options.

I looked at the options and realized that some of them sounded like cell-mediated immunity and I remembered that Buerger's disease has something to do with an allergic reaction to tobacco, so I eliminated all the options that had DR, DQ and DP (MHC II)... That left me with options B and D. Now, at this point... I couldn't remember that D was sarcoidosis, but D looked so extremely familiar and B seemed so out of place... That's when my "gut-feeling" kicked in

“Never ignore a gut feeling, but never believe that it's enough.”
__________________
"Disease is very old, and nothing about it has changed. It is we who change as we learn to recognize what was formerly imperceptible." JMC
Reply With Quote Quick reply to this message
  #12  
Old 05-20-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 104 Times in 62 Posts
Reputation: 114
Send a message via Yahoo to alfjof
Default

Quote:
Originally Posted by Dr. Mexito View Post
Nothing man... Just that I answered this Q using my "gut-feeling"

Well, part was gut-feeling and part was using my head... This is how I reached to the answer.

First, I've never heard about this correlation with Buerger's disease, so I tried to eliminate options.

I looked at the options and realized that some of them sounded like cell-mediated immunity and I remembered that Buerger's disease has something to do with an allergic reaction to tobacco, so I eliminated all the options that had DR, DQ and DP (MHC II)... That left me with options B and D. Now, at this point... I couldn't remember that D was sarcoidosis, but D looked so extremely familiar and B seemed so out of place... That's when my "gut-feeling" kicked in

“Never ignore a gut feeling, but never believe that it's enough.”
Ok I agree with you, it was not an easy question
__________________
Happy to Learn New Concept and Mechanism each Day
Reply With Quote Quick reply to this message
  #13  
Old 05-20-2012
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 205
Threads: 58
Thanked 19 Times in 16 Posts
Reputation: 29
Default

wow thanks for the question I asked for the hard but not soo much
actually I HAD NO IDEA ABOUT IT
and thanks for posting the answer as well
Reply With Quote Quick reply to this message
  #14  
Old 05-21-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 104 Times in 62 Posts
Reputation: 114
Send a message via Yahoo to alfjof
Default

Quote:
Originally Posted by mycoplasma View Post
wow thanks for the question I asked for the hard but not soo much
actually I HAD NO IDEA ABOUT IT
and thanks for posting the answer as well
You're welcome. I will post another one soon
__________________
Happy to Learn New Concept and Mechanism each Day
Reply With Quote Quick reply to this message
The above post was thanked by:
Dr. Mexito (05-21-2012)



Reply

Tags
Cardiovascular-, Figures-, Pathology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
N-Myc Oncogene Association scopusmount USMLE Step 1 Forum 14 11-26-2015 07:36 AM
My score progression winner21 USMLE Step 2 CK Forum 7 05-07-2012 04:47 PM
Psoriasis HLA Association shafaliMD USMLE Step 1 Forum 18 03-30-2012 11:12 AM
Limiting the progression of renal failure! achistikbenny USMLE Step 2 CK Forum 17 02-28-2012 12:52 PM
Buerger's disease Mnemonic Dr.B.SHRAVYA USMLE Step 1 Mnemonics 1 12-31-2010 12:34 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)