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Retired NBME 20 Answers

nbme20/Block 2/Question#29 (reveal difficulty score)
A 25-year-old woman has a flu-like illness ...
Picornavirus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: micro

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 +8  upvote downvote
submitted by โˆ—hayayah(1212)
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Most important cause of viral myocarditis is Coxsackie (picornavirus).

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 +3  upvote downvote
submitted by โˆ—hello_planet(43)
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I think one giveaway in this question for Adenovirus versus Coxsackie virus is the shortness of breath when lying down (orthopnea). That can be a sign of dilated cardiomyopathy, which is most common after viral myocarditis with Coxsackie B infection (as per Sketchy).

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 +0  upvote downvote
submitted by luke.10(4)
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picorna( coxsackie ) is more common than adenovirus but both can caause viral myocarditis

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dulxy071  Yeah Adeno is what I went for unfortunately +
divya  thank god for sketchy.. +3



 +0  upvote downvote
submitted by ilovemypuppies2295(0)
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What makes this coxsackie virus over Adenovirus? Both cause myocarditis which would be seen on autopsy? Is it just more common to get coxsackie?

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drdoom  the general consensus appears to be that Coxsackie is more common than Adenovirus, but i havenโ€™t come across any papers or textbooks that would agree (they only mention โ€œCoxsackieโ€ and โ€œAdenovirusโ€ as associations with myocarditis) +2
bharatpillai  there specifically is a question on uworld in which a young woman gets viral myocarditis with sore throat and the answer to that is adenovirus. i think thats why many people (including me) got it wrong :( +2



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