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NBME 20 Answers

nbme20/Block 2/Question#39 (26.0 difficulty score)
A 29-year-old man comes to the physician ...
Absence of peptidoglycan🔍

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submitted by sinforslide(49),
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ehT qonsetiu mtes si asgnik awht tureesfa eld ot het csteniifenefesv of hrahpatyoacerpm. tPenait's teiponerntas is tesnosctin with palcsoMmya innemaupeo t,inocfein chihw 'osnetd hvea a clle awll nda fheotrere tgi,lopedcnypa ichwh is eht tesi of antoci orf .isienlnlcpi tI sode eruiqer ostrsel orf th,wrog ubt atth d'wtloun inpaxel hwy xnlcomiiali si etiie.fcfvne

submitted by neovanilla(35),

Reason why it's not E: While it's true that mycoplasma pneumoniae uses sterols for its cell membrane, it's the lack of a target for amoxicillin (peptidoglycan) that renders it ineffective. Classic test technique where they include a right answer but isn't the correct answer

submitted by haliburton(208),
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olapaMcmsy dmuenpalo icone gg,inlsnaiut on rnpeseos to ix.icillnmao

AF 7102: saclisC aesuc fo taalipyc “wngkil”a aennmipou ssuidnii(o ,ntoes a,eahedhc vconuierdtopn guco,h tacphy ro fsdufei tetinsiliart n.)eflrtaiti ry-aX slkoo orswe htan iatepnt. High teitr of lcod niustnailgg g,M)(I hchwi can igltatgeanu or ysel RC.sB ornGw no oEnat .atrtrema:Tange lsedam,cori iconx,yedlcy ro eunlonrouofoqli leilin(pcni vtiffeience ncies Msypaocmla eahv on clel a.B Al)wCl = rafiA,c esnnBld,si rocihnC noii.entfc –DK = eytrnveihg Na.esnletolae deissea nca be arecqudi dingur spseaag ghtoruh cenidfet bihtr anl.a cNo lelc aw.ll toN nese no Grma iant.s ePphoicolrm tcleBAraa. i abemrmen ionnscat soeslrt ofr is.ailyttb lyMlaospcam puninaemo is oemr oocnmm nntisit aep ;&tl 30 raesy Fue.oteql nrd rbokuaset ni rilitmay tcseruir drsnmiaopsl op nac.aMsy gtes ocdl ituowth a tcoa lecl( l)a.wl

johnthurtjr  Have you mixed Chlamydia in with Mycoplasma? +2  
smc213  I mean the Q stem is not about Chlamydiae, but Chlamydiae does lack the classic PTG cell wall d/t decreased muramic acid = beta-lactam abx ineffective. FA 2018 p.148 +