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Retired NBME Free 120 Answers

free120/Block 1/Question#35 (reveal difficulty score)
A 10-month-old boy is brought to the ...
Mediation of cell entry via a fusion protein ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—bwdc(697)
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He has (presumably RSV) bronchiolitis. RSV is an RNA virus that enters the cell via a fusion protein (which is the target of the prophylactic monoclonal antibody drug Palivizumab).

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aakb  I thought the fusion protein produces multinucleated giant cells. I thought RSV enters using the epithelial G protein? First aid literally says "All contain surface F (fusion) protein, which causes respiratory epithelial cells to fuse and form multinucleated cells." +1
mariame  RSV F is a class I fusion protein that mediates fusion of the viral membrane with a host-cell membrane, a process that poses an otherwise insurmountable energetic barrier to viral entry. https://www.nature.com/articles/s41467-019-09807-5#:~:text=RSV%20F%20is%20a%20class,energetic%20barrier%20to%20viral%20entry. +1



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submitted by โˆ—azibird(279)
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How can we differentiate RSV from the common cold? Is it the bilateral, diffuse wheezes and expiratory rhonchi? Along with the intercostal retractions, signifying significant respiratory problems?

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nbmeanswersownersucks  I was initially thinking it was rhinovirus too but in retrospect I think the wheezes etc make RSV more likely +3
kevin  The key demographic for RSV is infants (<2yo), so based on age alone RSV is what they're going for imo. +6
lpp06  Signs of respiratory distress = bronchiolitis over rhinovirus +2



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