new_n_lost
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An elderly woman with a history of multiple oral ulcers presents with flaccid bullae on her scalp, face, and trunk. Manual pressure on the skin produces separation of the upper layer of the epidermis, followed by eventual sloughing of the skin. The patient has been in relatively good health until recently, and denies taking any medications. A biopsy of one of the skin lesions reveals separation of epithelial cells above the basal layer.
Autoantibodies to which of the following components would most likely be found in this patient?
A. Epidermal basement membrane proteins
B. Glycoprotein IIb/IIIa
C. Intercellular junctions of epidermal cells
D. Intrinsic factor
E. Type IV collagen
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| Aashi
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Flaccid bullae+ oral involvement + nikolsky sign positive-------->Dx---->Pemphigus Vulgaris----->only epidermis involved and autoabs against the adhesion molecules of epidermis are found, chk for IgG in epidermis------->C
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| keepgoing
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cool ashi..
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| mytime
Kick my butt!
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C.
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| mytime
Kick my butt!
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Check my journal has a big list of autoimmune markers!
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| new_n_lost
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Aashi wrote:
Flaccid bullae+ oral involvement + nikolsky sign positive-------->Dx---->Pemphigus Vulgaris----->only epidermis involved and autoabs against the adhesion molecules of epidermis are found, chk for IgG in epidermis------->C
See I never made this correlation like i didnt derive the answer as u have done, Which further proves my point the nick fits u, u r the "Genius Girl"  
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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The correct answer is C.
Bullae with the cleavage plane above the basal layer of the epidermis suggests pemphigus vulgaris, which is caused by autoantibodies to intercellular junctions of epidermal cells. The autoantibodies decrease the ability of the keratinocytes to adhere to one another, permitting formation of vesicles and bullae. Oral involvement is common, and often precedes the characteristic skin lesions. Separation of the epidermis upon manual stroking of the skin is known as Nikolsky's sign. This sign is present in other disorders such as Stevens-Johnson syndrome, but we are told the woman is not taking any medications, a typical cause of Stevens-Johnson syndrome in the adult population.
Antibodies to epidermal basement membrane proteins (choice A) are seen in bullous pemphigoid, which is a bullous disease characterized by blisters with a cleavage line between the epidermis and dermis.
Antibodies to glycoprotein IIb/IIIa (choice B) are seen in autoimmune thrombocytopenic purpura.
Antibodies to intrinsic factor (choice D) are seen in pernicious anemia.
Antibodies to Type IV collagen (choice E) are seen in Goodpasture's syndrome.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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Aashi wrote:
Flaccid bullae+ oral involvement + nikolsky sign positive-------->Dx---->Pemphigus Vulgaris----->only epidermis involved and autoabs against the adhesion molecules of epidermis are found, chk for IgG in epidermis------->C
Guys this is a Very Excellent Way to Approach Questions Take Huge Hint from this Approach this will really help.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| amritt786
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hey ,its usually confuses me what goes with what? how to remeber thanks
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