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nbme21/Block 2/Question#48 (reveal difficulty score)
A 75-year-old man has fever, back pain, and ...
Enterococcus faecalis๐Ÿ”,๐Ÿ“บ
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 +8 
submitted by felxordigitorum(10),
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onQsieut desak ofr gmra epvsitoi oiccc in SA.ICNH .S eausur fmros lceut,srs geintlmaiin t.i iThs slaeev cocrucsontEe alsiaefc dna uproG A psr.et .E saealfci is otcsidaesa thwi .sUTI

almondbreeze  get the clinicals but got thrown off by 'chain'. FA2019 pg.137 also says coccus = berry, strepto =twisted (chain), differentiating the two:( +2  



 +0 
submitted by sinforslide(54),
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tI emsse iekl ptSah ueursa TsU'I are otalms vxislucelye ,imlooancso e.sp /w aisettpn htiw rnyriua :eachsrett "We edtniefiid and dnreete onti hte utyds 102 ncecesiouvt ittapnse rof ohwm at alets 1 ieunr rltuuec was oitespvi rfo S. u8s2%r.ea.u. had a rnyauir thceatre of esom etpy ni eapc"l

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 +0 
submitted by aishu007(4),
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acn nanyoe iaxnple why ralscaoeneescuoicftc is teh rnwase e?rhe

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 +8  
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. +2  
santal  FA 2019 Page 639, too. +  
backwardsprogress  Enteroccocus is also a pretty common cause of chronic prostatitis, which was the give away in the prompt if you didnt know the characteristics of entero: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715713/ +  



 +0 
submitted by mangotango(20),

Seems like he has pyelonephritis because of the systemic symptoms (e.g. fever). The most common causes of that are E. coli (90%) followed by Enterococcus faecalis and Klebsiella. The only one that fits under "gram positive chains" is Enterococcus faecalis. // Pathoma pg. 132