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NBME 20 Answers

nbme20/Block 3/Question#42 (41.6 difficulty score)
A 13-year-old girl has an episode of severe ...
Epstein-Barr virus genomeπŸ”

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submitted by ms2991(6),
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AF 1802 epag gt&-;561- BVE is oicates"sad hiwt liapfveolpryoheimtr isseade ni rnnaattslp nisa"ttpe

submitted by waterloo(71),

when CMV is involved in post transplant patients that typically causes pneumonia. I think that was a question in this NBME too. For EBV post transplant, it would be lymphadenopathy etc. That's what I've taken away so far from nbme. I thought maybe the monomorphous B lymphocytes was hinting more towards EBV too, but I don't see why CMV wouldn't remain latent in a B lymphocyte?

uloveboobs  CMV definitely could remain latent in a B lymphocyte, but also is latent in T cells and macrophages (i.e., all mononuclear cells). I think the key in this question is the phrase "monomorphous population of B cells." EBV remains latent in B cells ONLY, whereas CMV is latent in all mononuclear (not just B) cells. +5  
rockodude  ^this is the main point of the question. CMV can cause lymphadenopathy and hepatosplenomegaly as well. Key is the monomorphous phrase. +1  

submitted by nickybeezle(1),
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uHmna B leslc rea hte mraypri trgtaes fo ntepsEi Barr isruv ()BVE tf.ceionni nI mots ecsas EVB cinitoefn si imptmyatcsao seueacb of a lghihy ecvfiteef htos imuemn sprnseoe tub smoe iadnlvusiid evlodpe sfmltgiilie-n tnuoiiescf nen,cossomiluo whlie htores epdoelv dsatcoVE-aiBes yipolhdm or atipleiehl la.gaienicsmn

submitted by medbitch94(35),
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masonkingcobra  The pathogenesis of post-transplant lymphoproliferative disorders (PTLD) in most patients relates to the outgrowth of Epstein-Barr virus (EBV)-positive B cell proliferations in the setting of chronic T cell immunosuppression. +2