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NBME 20 Answers

nbme20/Block 1/Question#41 (35.6 difficulty score)
A 45-year-old man has fever, chills, dysuria, ...
Escherichia coli🔍,📺
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 +5 
submitted by hayayah(1101),
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itoatstsPir is dzeartrahicec yb sr,idayu eneucqfyr, ue,ncryg low cabk i.anp am,rW e,erndt eregnlad sopet.rat

tucAe blratiace tnotp—tiiasisr delro mne mtso cmomon micbutrea si E. ci.ol

ergogenic22  In young men it could be chlamydia but the question stem makes no mention of sexual activity, so it is e. coli +20  
charcot_bouchard  First this guy isnt older! He may incite Daddy issue but not older. At this age people tend to be more monogamous so E Coli the more likely answer. But again cont NBME 20 trend this one was pretty vague too. +1  
monkey  They classify at 35 year old (<35 = Chlamydia or Neisseria and > 35 = E.coli) +5  
mbourne  I put Pseudomonas, as that is a cause of prostatitis in older men, but it is less common than E. coli. Just keep that in mind, if E. coli wasn't an answer choice, the answer should have been Pseudomonas. If he was a younger male, then Chlamydia would have been acceptable. +4  
brotherimodu  @mbourne I think Pseudomonas is the more common etiology for acute prostatitis in the elderly (>65ish for exams), whereas E.Coli is the more common etiology in adults 35-64yo +1  



 +1 
submitted by stepwarrior(23),

They love picking these cases right on the border. Just barely outside of that sexually active age range