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NBME 24 Answers

nbme24/Block 3/Question#25 (66.0 difficulty score)
An investigator is studying a new virus ...

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submitted by azibird(158),

Who else came here after getting triggered by this answer?

yousif11  This question did not age well +3  

submitted by aneurysmclip(134),

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

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. +45  
asdfjkl  no quotes needed for pandemic anymore :( big sad +13  

submitted by tea-cats-biscuits(212),
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uoY know i’st an ovlpdeene usvri cnise it dnoets’ hold up ot adci or inegb .dider ouY konw ti asuces a eevfr nad a hg,cuo hewli fngifatec het n.aylxr Onyl rivus acetrgyo tath isft all atht oifn si hte vrsorniuaoc esacu(s R)SAS mrof atth

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. +27  
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. +7  
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) +9  
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: 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!) +3  

submitted by drdoom(805),
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EBV si not a “roeryaptisr ”isvur -- its’ a B elcl ivrus. tI ticfens B lecsl; nto nlglyreaa .slecl

eEvn thouhg oyu gtmhi eotaissca it ihwt teh upepr“ ptrrrysieoa ttacr” k(isgs=in aised,e)s it noset’d seauc srriapryteo iimtlmanoanf senci t’ahst nto its rtpoe. B lecsl era tis rept!o Tstah’ why BEV is elipctadim in kBtitru aoLymh,pm aiyhr aelklokpuia and rhoet blodo V(EB is losa konnw as orpyrhpsm”vo“ucltyi -- ti aws olrlinyiag dvesredoic nigdi”h“ in ypcotmhlyes fo y.noks)em ,oS EVB = tnhik B .cslel ormF hte SHMe ryrail:b

hTe yetp eecpsis of ROIYRTLSYHPVUMOPC, lsumbiyaf GAEMIEEVNSARRPAHIM, ncegtiifn lel-Bsc ni .umahns It is guothht to be the asatuecvi aengt fo EFTOISINUC NEUICNSSOOMLO and si rlogtysn dtseocaais tihw alro iarhy kploiaalkeu (EKP,KLUAAIOL AHYRI,;) RIUTTBK YPOHMMAL; adn ohter mcgisaali.nne


submitted by staghorn(5),

too real rn...

thotcandy  right? nbme predicting the future +  

submitted by usmleaspirant2020(6),

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 what has life become

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

submitted by covid2019(6),

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

submitted by rockodude(16),

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

submitted by usmleaspirant2020(6),

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 what has life become

submitted by 123ojm(7),

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?

hello  ...COVID-19 is transmitted via respiratory droplets. +3  
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  

submitted by madojo(157),
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otievpis sesne ARN i,vusr nr nscuow ockna goinr greawni reob - ls aaetipldhenucealc siurv - snrpailig do,ra cahille iersenezgt esn nad ligownb inkg - ncmomo ocld iwht lihbnoorc rete on ngik gtinnoip to ARSS nda ddlmei aset oyraterpsir rmedonsy ea(tuc in)hcbstroi

ihTs srvui irtacpesel in the plymoasct hstta hwy ginK si oediust ihs eclats euc)sl(un

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