welcome redditors!to snoo-finity ... and beyond!

NBME 21 Answers

nbme21/Block 2/Question#48

A 75-year-old man has fever, back pain, and pain on ...

Enterococcus faecalis

Login to comment/vote.

Question asked for gram positive cocci in CHAINS. S. aureus forms clusters, eliminating it. This leaves Enterococcus faecalis and Group A strep. E. faecalis is associated with UTIs.

almondbreeze  get the clinicals but got thrown off by 'chain'. FA2019 pg.137 also says coccus = berry, strepto =twisted (chain), differentiating the two:( +1  

It seems like Staph aureus UTI's are almost exclusively nosocomial, esp. w/ patients with urinary catheters: "We identified and entered into the study 102 consecutive patients for whom at least 1 urine culture was positive for S. aureus...82% had a urinary catheter of some type in place"

Here's the link to the study

 +0  upvote downvote
submitted by aishu007(3),

can anyone explain why enterococcusfaecalis is the answer here?

priapism  Best I can guess is that both S. aureus and E. faecalis can cause UTI, but S. aureus is described as having clusters where as the other Gm+ cocci are in chains +3  
nala_ula  My doubt here in this question is the fact that Enterococcus faecalis is a normal gut microorganism that causes these different symptoms of sickness after genitoruinary or gastrointestinal procedures... but in this question there is no mention of any procedures. +  
fez_karim  its says chains, so not staph. only other is entero +  
temmy  according to first aid, staph aureus is not one of the high yield bugs for UTIs +1  
temmy  uti bugs are E.Coli Staph saprophyticus Klebsiella pneumonia Serratia Marcescens Enterococcus Proteus mirabilis Pseudomonad aeruginosa +  
privatejoker  Where in FA 2019 does it list that C.coccus is specifically in chains? +  
privatejoker  E.Coccus* i mean +  
divya  @privatejoker FA 2018 Pg 134 table +  
jennybones  @privatejoker Enterococcus is Group-D STREP. Streps are arranged in chains. +1  
santal  FA 2019 Page 639, too. +