NBME 21 Streptococcus pneumoniae (NBME Answers)

NBME 21 Answers

nbme21/Block 1/Question#14 (reveal difficulty score)
A 21-year-old man is brought to the emergency ...
Streptococcus pneumoniae 🔍 / 📺 / 🌳 / 📖
tags:

+2 upvote downvote
submitted by ∗powerfulgarbage(17)

get full access to all content ⋅ pick a username

FA 2020, page 127:

Encapsulated bacteria are opsonized and then cleared by spleen. Asplenic patients have decreased opsonizing ability and an increased risk for severe infections.

They need vaccines to protect against Neisseria meningitidis, Streptococcus Pneumoniae, Haemophilus influenza

mnemonic: "No Spleen Here"

regardless I got this one wrong because of a 50/50 guess between strep and e. coli. I guess they wanted you to recognize that he was at risk for S. pneumonia sepsis and therefore needed to be vaccinated, whereas there's not much you can do to protect him from E. coli other than wash your hands lol

get full access to all content ⋅ pick a username

drdoom ^ voted best username +1

mambaforstep ^^what he/she said. FA 2019 pg 127 +1

meryen13 its not e coli not because you couldn't vaccinate the pt but because he was in an accident and the chances of infection with s. pneumo is higher. page 186 FA 2020: splenic pt: s.pneumo >> H. influenza b> N meningitidis +1

+1 upvote downvote
submitted by ∗aesalmon(95)

get full access to all content ⋅ pick a username

Splenectomy = more susceptible to encapsulated organisms

I put E. coli as its encapsulated but that wasn't the most right answer I guess?

get full access to all content ⋅ pick a username

pippylongstock This question is asking about the ‘S’ of FA Mnemonic for S. Pneumonia “MOPS”. Strep pneumo is the most common cause of sepsis in adults. +3

emmy2k21 MOPS stands for meningitis, otitis, pneumonia, and SINUSITIS. It doesn't stand for sepsis. My guess as well is which is "more correct". It's about being able to identify encapsulated organisms and the spleen's role in immunity. Ha I chose E coli as well. +7

et-tu-bromocriptine emmy2k21 is correct, the S is for sinusitis. I was between E.coli & Strep Pneumo, but then recalled Sketchy putting the sickle on the 'encapsulated' knight in the Strep Pneumo video; Strep Pneumo is more associated with infecting sickle cell "functionally asplenic" patients. +4

aneurysmclip You could also recall that before splenectomy(ik this is a emergency splenectomy) we would want to give an encapsulated vaccine like the pneumococcal vaccine. this pushed me towards strep over ecoli +2

+0 upvote downvote
submitted by ∗drzed(332)

get full access to all content ⋅ pick a username

Perhaps this is an incorrect way of thinking about this, but I always associate the virulence of Strep pneumo to its capsule, but I only associate the K capsular antigen of E. coli to meningitis (recall that E. coli has other specific virulence factors like fimbriae for UTI).

So basically, I figured that the capsule of Strep pneumo is involved in more disease processes (MOPS) than the capsule of E. coli (mostly meningitis), and thus I chose Strep.

get full access to all content ⋅ pick a username

b1ackcoffee You are right, this is INCORRECT way. Capsule helps in hematogenous spread by protecting from phagocytosis causing sepsis, meningitis, pneumonia, i.e. more systemic infections. +1

+0 upvote downvote
submitted by ∗kevin(52)

get full access to all content ⋅ pick a username

Asplenic, think SHiN (Strep pneumo, Haemophilus, Neisseria). Do not bother with any other encapsulated organisms

get full access to all content ⋅ pick a username

Must-See Comments from nbme21

nosancuck on Absorption atelectasis
assoplasty on Free T4
seagull on GM2
lnsetick on Apocrine
niboonsh on NMDA receptors are blocked by Mg2+ at the ...
drdoom on Deletion of a hydrophobic amino acid ...
hayayah on HCO3− transported in the plasma
mcl on Aortic
notadoctor on Usual interstitial pneumonitis
madojo on Genital herpes
hungrybox on Obstruction of the bile duct
jambo2222 on Lung
hungrybox on Mismatch repair
hungrybox on Hydrochlorothiazide