nbme form 4 block 1 - oneexam

[ArchivalUser]

1. A 15-year-old girl is brought to the physician because of a 1-week history of vaginal discharge and a 2-day history of sore throat and white spots ih her mouth. She has had
recurrent candidal infections ofthe skin and mucous membranes since childhood. She has a 2-year history of type 1 diabetes mellitus and a 1-year history of autoimmune
thyroiditis. I»·˜Iedications include insulin and Ievothyroxine. Examination shows oral candidiasis. Pelvic examination shows a thick white vaginal discharge. Iylicroscopic
examination shows budding yeast. Which ofthe following is the most likely mechanism of her recurrent candidal infections?
O A) Autoimmune destruction ofthe thymus
O B) Blunting ofthe inflammatory response from complement deficiency
O C) Deficiency in anticandidal antibodies
O D) Impaired cell-mediated immunity
O E) Inability of macrophage to present candidal antigen

[ArchivalUser]

dd)

[ArchivalUser]

D

[ArchivalUser]

yes,, D

[ArchivalUser]

explanation pls

[ArchivalUser]

B, C and E can be excluded.
She has infections since childhood So looks like she has inherited disease more than autoimmune disease like Type 1 DM or Autoimmune thyroiditis. So A is excluded.
She is suffering from Chronic mucocutaneous candidiasis : T cell Dysfunction.

Hope this helps.

[ArchivalUser]

y not a?