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Retired NBME 15 Answers

nbme15/Block 4/Question#20 (reveal difficulty score)
A 53-year-old man develops a fever and ...
Clostridium perfringens ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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Clostridium perfringins is a common cause of myonecrosis and would be described as a large gram(+) rod (FA2020p138).

  • Bacillis subtilis is a motile gram + rod known as hay bacillis found in soil and the intestines of humans. It is almost never pathogenic and used in probiotic supplements.
  • Bacteroides fragilis is an anaerobe like clostridia but it is a gram negative rod. It is found in lung abscesses from aspiration.
  • Listeria monocytogenes is a gram positive rod but it is more associated with consumption of unpasturized dairy or deli meats and it causes listeriosis which can present from mild gastroenteritis to meningitis. It can be associated with sepsis but more commonly in the elderly, immunocompromised, or newborns and would not be associated with myonecrosis.
  • StaphyloCOCCUS aureus is a gram positive cocci.
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whk123  Side note (UW): Clostridium septicum (causes spontaneous gas gangrene, non traumatic and is triggered by underlying colonic malignancy) and Vibrio vulnificus (gram -ve curved rod, u get it from raw oysters, increased risk with Fe-loaded patients or liver disease) also causes myonecrosis/ necrotizing fascitis. +1
fatboyslim  ^UW# 15027 +



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