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to dr.aa Please help NBME 2 section 4 #38 - aksyonez
#1
An afebrile 8 year old girl is evaluated for mild edema and a pufy face. She recovered from an untreated sore throat and fever 3 weeks ago. Urine analysis shows moderate proteinuria and hematuria with occasional red cell cast. A photomicrograh of renal tissue obtained on biopsy is shown( can t post pic, but not necessary to answer)Which of the following is most likely responsible for the cellular infiltrate shown?
a) Bradykinin
b) C5 a
c) histamine
d)N-formylated peptide
e) Serotonin

I know the anwer just need the explanation..Thanks
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#2
C5 a - anaphylotoxin -- strong chemotactic factor for leucocytes

The diagnosis in above patient is AGN which is a type 3 hypersensitivity reaction - disease caused by antigen antibody complexes being deposited in the kidneys. The deposited antigen antibody complexes cause activation of classical complement activation pathway producing both C3 a and C5 a. Both these are strong anaphylotoxins causing chemo attraction and recruitment of leucocytes in the kidneys.
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#3
Thanks godfather, vey helpful explanation
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#4
u r w
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#5
hey aksyonez, i hope u got it.... godfather explained it really well
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