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NBME 20 Answers

nbme20/Block 2/Question#2

Following a wedding reception that was attended by ...

Norovirus

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submitted by beeip(66),

How to differentiate between Norovirus and Rotavirus here? Must be related to the the contagious nature of the illness?

strugglebus  You know it’s Noro because people are vaccinated against Rota at 2,4,6 months. +  
beeip  @strugglebus: I didn't know about the vaccine schedule. Thanks! +  
strugglebus  As an addendum, you know it’s not staph aureus b/c that is rapid onset within 4 hours. +  
asapdoc  @Beeip If you go to the vaccines page in first aid it gives you all the high yield vaccinations. I didnt realize to correlate that page to a lot of questions until I got this answer wrong +  
savdaddy  its norovirus b/c it can survive ~2 weeks without a host, which is why we see family members with symptoms 3 days after the initial virus. +  
savdaddy  ***after the initial outbreak +  
eacv  for me this was a discart qx: 1.Giardia lamblia not showed steatorrhea and it needs medication to go away. 2. Rotavirus normally in unvaccinated kids. 3. Shiguella VERY inflammatory stool test do not show anything 4.S areus is very FAST 2-6 hr after eat the contaminated food. +  
link981  Norovirus is the most common cause of viral gastroenteritis in the USA due to vaccination. + Rotavirus is the most common cause of viral gastroenteritis in the rest of the world. In this question you had to know the most common cause. +  




Norovirus (Sketchy) = Affects where a lot of people are in close quarters - especially common on cruises - 90% of all diarrheal outbreaks on cruises

sbryant6  Rotavirus occurs in unvaccinated children. In order for it to spread, all those kids would have to be unvaxxed. +  




i think because they were so specific in detail for when the sx began, theyre trying to test us if we know the onset of rota vs norovirus. also if you look at the transmission of rotavirus its FO and respiratory, so unless youre playing with poop at a wedding, its much more likely food was the transmission. sketchy says anytime you touch food with your hands its noro

heres a table for reference. https://contemporaryclinic.pharmacytimes.com/journals/issue/2016/february2016/best-approaches-to-acute-gastroenteritis





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submitted by beeip(66),

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 +0  upvote downvote
submitted by link981(38),

Norovirus is the most common cause of viral gastroenteritis in the USA due to vaccination. + Rotavirus is the most common cause of viral gastroenteritis in the rest of the world. In this question you had to know the most common cause