NBME 6q - rtzmd

[ArchivalUser]

A 45 yo woman with Scleroderma with epidermal thinning, hyalinzation and bliteration or arterioles, and dermal thickening on skin biopsy. Dermatologic changes are caused primarily by the release of chemokines from w/c inflammatory cell types?

a. endothelial cells
b. eosinophils
c. lymphocytes
d. mast cells
e. patelets
f. segmented neutrophils


confused about A or C....
anyone please give me explanation.

[ArchivalUser]

It is CCC.

It is proposed that CD4 T cells respoding to a unidentified antigen in the skin & release cytokines that recruit inflam. cells like mast cell & macrophase. All these cells release variety of cytokines which cause transcriptional upregulation of gene encoded for collagen.

Granzyme A, released from CD8 T cell causes endothelial injury & fibrosis of microvaculature as seen in digital arteries of pt. with sleroderma.

[ArchivalUser]

thanks fab

[ArchivalUser]

cc

Hey rtzmd can u please send the nbme forms 5 and 6 at docnar. thanks in advance..