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Buerger's Disease Progression & HLA Association

3K views 13 replies 6 participants last post by  alfjof 
#1 · (Edited)
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
 

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#6 ·
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.
 
#7 ·
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
 
#8 ·
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
 
#9 ·
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"
 
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