Inflammation and Immune Pathology USMLE Step 1 Practice Question
A 72-year-old woman presents with severe bilateral temporal headache and jaw claudication. Vital signs show BP 148/92 mmHg, HR 88/min, RR 16/min, temp 37.8°C. Laboratory studies reveal ESR 94 mm/hr and CRP 8.2 mg/dL. Temporal artery biopsy shows granulomatous inflammation. She denies vision changes. She takes aspirin and lisinopril. Which of the following changes in plasma proteins most directly accounts for her markedly elevated erythrocyte sedimentation rate?
Answer choices
- AExtravascular hemolysis in the spleen
- BComplement mediated lysis of erythrocytes
- COxidation of hemoglobin iron to ferric form
- DIncreased platelet adhesiveness due to vWF
- EReduced red cell surface charge due to increased fibrinogenCorrect answer
- FIncreased erythrocyte osmotic fragility due to elevated immunoglobulin M
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