NBME 21 Retrograde transport through nerves (NBME Answers)

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NBME 21 Answers

nbme21/Block 1/Question#20 (reveal difficulty score)
A 10-year-old girl develops fever, malaise, ...
Retrograde transport through nerves 🔍 / 📺 / 🌳 / 📖
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submitted by ∗haliburton(225)

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Rabies attacks the nicotinic Acetylcholine receptor, and travels retrograde via dynein motors after binding AChR, according to FA.

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+3 upvote downvote
submitted by ∗est88(19)

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Rabies Virus (rhabdoviridae)

Fever, encephalitis, drooling

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qball Make sure you can recognize a Negri Body. https://www.researchgate.net/figure/Section-of-cerebellum-showing-Negri-bodies-in-the-neurons-arrows-H-E-x100_fig1_327051230 +2

-14 upvote downvote
submitted by ∗uslme123(86)

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very stupid question. The virus was inhaled -- bats hang upside when they sleep and drool. So it spreads to the brain directly from the olfactory system via retrograde transport through nerves.

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niboonsh yea, aeresol transmission via bat poop in caves +

len49 How do you know the virus was inhaled? Doesn't mention it. Moreover, non-bite/scratch transmission is extremely rare. +

makinallkindzofgainz You get rabies by being bitten, not by inhaling it +

drzed She was probably bitten by a bat; many times the bite is not recognized ('unapparent bites'), and thus the CDC recommends that even if you think you have been bitten by a bat (or that you COULD have been bitten), you should go and get active/passive immunization immediately. +

mangotango Sketchy (and Zanki) says you can get rabies via animal bites OR aerosol transmission. In the U.S. it's most commonly through bats. It could also be through skunks (Western U.S.) or foxes/raccoons (Eastern U.S.). I remember this by thinking about how skunks smell so bad! +

shieldmaiden But the question is "how it got to the brain" not how she got it, so the best answer is through the nerves +

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