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NBME 24 Answers

nbme24/Block 3/Question#25 (reveal difficulty score)
An investigator is studying a new virus ...
Coronavirus 🔍 / 📺 / 🌳 / 📖
tags:

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 +47  upvote downvote
submitted by azibird(279)

Who else came here after getting triggered by this answer?

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yousif11  This question did not age well +23
helppls  I'm going to be taking Step with this song stuck in my head lol +



 +28  upvote downvote
submitted by aneurysmclip(209)

anyone else get this wrong while the current coronavirus "pandemic" (acc to some sources) is happening? feeling reaaallll dumb rn

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targetmle  yes because i thought they wont give ques on current coronavirus situation so early!! +
adamventure  I thought to myself "damn it sure would be fuckin hilarious if Coronavirus was the answer".. turns out it was and it wasn't hilarious since I got it wrong. +67
asdfjkl  no quotes needed for pandemic anymore :( big sad +14
yesa  Yes! but also, coronaviruses often cause the common cold, not all of them are really bad! So this 4yo girl could literally just have the common cold, and the coronavirus isolated from her likely doesn't have pandemic potential. So this question has nothing to do with the ongoing pandemic--it's just coincidence! +2
jaramaiha  Was I the only one that thought it was cause it is enveloped and easily destroyed? lol I didn't even bother with descriptors. +1
madamestep  "acc to some sources" oh so young... so naive +
fatboyslim  @jaramaiha good one there +



 +14  upvote downvote
submitted by tea-cats-biscuits(273)

You know it’s an enveloped virus since it doesn’t hold up to acid or being dried. You know it causes a fever and a cough, while affecting the larynx. Only virus category that fits all that info is the coronavirus (causes SARS) from that list.

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zelderonmorningstar  EBV doesn’t cause fever and cough? +1
zelderonmorningstar  Wow, just checked First Aid and it doesn’t list “cough” as a symptom of EBV. +4
drdoom  EBV is not a “respiratory virus”; it’s a *B cell virus*. Even though you might associate it with the “upper respiratory tract” (=kissing disease), it doesn’t cause respiratory inflammation since that’s not its trope. B cells are its trope! That’s why EBV is implicated in Burkitt Lymphoma, hairy leukoplakia and other blood cancers. (EBV is also known as “lymphocryptovirus” -- it was originally discovered “hiding” in *lymphocytes* of monkeys.) So, EBV = think B cells. +30
fulminant_life  EBV does cause pharyngeal and laryngeal inflammation along with fever, malaise, and cough and LAD. The only thing that pointed me away from mono and towards coronavirus was the patients age. +8
nbmehelp  Can someone explain what not holding up to acid or being dried has to do with being enveloped? +
yb_26  @nbmehelp, the envelope consists of phospholipids and glycoproteins => heat, acid, detergents, drying - all of that can dissolve the lipid bilayer membranes => viruses will loss their infectivity (because they need an envelope for two reasons - to protect them against host immune system, and to attach to host cells surface in order to infect them) +12
lowyield  @yb_26 does that mean that non-enveloped viruses hold up better to acid/dryness? +2
rina  yes enveloped viruses are easier to kill (see post from drsquarepants: https://www.nbmeanswers.com/exam/nbme23/1161). also i think the "when dried" might refer to the fact that coronavirus is spread by respiratory droplets (don't even need to read first aid can just read the news at this point!) +4



 +7  upvote downvote
submitted by drdoom(1203)

EBV is not a “respiratory virus” -- it’s a B cell virus. It infects B cells; not laryngeal cells.

Even though you might associate it with the “upper respiratory tract” (=kissing disease), it doesn’t cause respiratory inflammation since that’s not its trope. B cells are its trope! That’s why EBV is implicated in Burkitt Lymphoma, hairy leukoplakia and other blood cancers. (EBV is also known as “lymphocryptovirus” -- it was originally discovered “hiding” in lymphocytes of monkeys.) So, EBV = think B cells. From the MeSH library:

The type species of LYMPHOCRYPTOVIRUS, subfamily GAMMAHERPESVIRINAE, infecting B-cells in humans. It is thought to be the causative agent of INFECTIOUS MONONUCLEOSIS and is strongly associated with oral hairy leukoplakia (LEUKOPLAKIA, HAIRY;), BURKITT LYMPHOMA; and other malignancies.

https://meshb-prev.nlm.nih.gov/record/ui?name=HERPESVIRUS%204,%20HUMAN

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 +5  upvote downvote
submitted by staghorn(6)

too real rn...

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thotcandy  right? nbme predicting the future +



 +3  upvote downvote
submitted by usmleaspirant2020(9)

quarantined at home during the coronavirus pandemic and selecting the right answer as CoRona without thinking twice as i use the sanitizer to kill those little bastards knowing they are enveloped..wow what has life become

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procrastinator  Lol, I couldn't really figure this question out so I was like F it. Coronavirus it is. +



 +1  upvote downvote
submitted by covid2019(8)

Hi there! Predicting some questions on pandemics in STEP1s in the near future. Stay tuned!

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 +1  upvote downvote
submitted by 07chess(3)

I picked Rotavirus, sitting in the library with a mask on due to COVID19.

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 +0  upvote downvote
submitted by 123ojm(11)

Specifically didn't choose coronavirus due to the evidence that COVID-19 is spread fecal-orally. How does it get through the GI tract if it's inactivated by pH < 6? Can someone explain why my thinking is wrong?

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hello  ...COVID-19 is transmitted via respiratory droplets. +4
123ojm  Right but some research has come out saying it's also spread fecal-orally. So I'm wondering what I'm missing in this question. +
tyrionwill  Don't trust US CDC in this pandemic. They always downplayed the truth. Cronavirus does spread mainly by droplets, when they drop, they contaminate the surface, then fecal-oral could be a second pathway. Wearing mask, social distancing are both to prevent a droplet. +
boostcap23  I thought covid used to be low yield when this test was made and they didn't mention helical so I didn't pick it smh I'm an idiot. +1



 +0  upvote downvote
submitted by rockodude(39)

eliminate fecal oral viruses then you're down to EBV and corona. corona is a respiratory virus, second most common cause of common cold, and EBV causes mono, not really associated with a cough. thats how I looked at it

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 +0  upvote downvote
submitted by usmleaspirant2020(9)

quarantined at home during the coronavirus pandemic and selecting the right answer as CoRona without thinking twice as i use the sanitizer to kill those little bastards knowing they are enveloped..wow what has life become

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 -1  upvote downvote
submitted by theunscrambler(4)

Amboss:

Envelope: Lipid bilayer around the capsid that contains viral glycoproteins and host cell proteins. The presence of the lipid bilayer makes nearly all enveloped viruses vulnerable to rapid inactivation by organic solvents (e.g., alcohol), detergents, and dry heat.

Where as non-enveloped viruses are generally resistant to the environment.

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 -3  upvote downvote
submitted by madojo(212)

https://www.sketchymedical.com/products/catalog

CORONAVIRUS SKETCHY

positive sense RNA virus, sun crown corona king wearing robe - encapsulated helical virus - spiraling road, helical trees sneezing and blowing king - common cold with bronchiol tree on king pointing to SARS and middle east respiratory syndrome (acute bronchitis)

This virus replicates in the cytoplasm thats why King is outside his castle (nucleus)

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j44n  I'm so glad i dont have to take step one once they discover all this shit about the new corona strain. +



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