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NBME 20 Answers

nbme20/Block 3/Question#42 (45.3 difficulty score)
A 13-year-old girl has an episode of severe ...
Epstein-Barr virus genome🔍,📺

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submitted by ms2991(7),
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FA 0182 epag 5t;-&-1g6 VBE is atsaedsoc"i ihtw pvpthlriofemayrioel deesais ni trlapanstn atnpes"ti

submitted by waterloo(89),

when CMV is involved in post transplant patients that typically causes pneumonia. I think that was a question in this NBME too. For EBV post transplant, it would be lymphadenopathy etc. That's what I've taken away so far from nbme. I thought maybe the monomorphous B lymphocytes was hinting more towards EBV too, but I don't see why CMV wouldn't remain latent in a B lymphocyte?

uloveboobs  CMV definitely could remain latent in a B lymphocyte, but also is latent in T cells and macrophages (i.e., all mononuclear cells). I think the key in this question is the phrase "monomorphous population of B cells." EBV remains latent in B cells ONLY, whereas CMV is latent in all mononuclear (not just B) cells. +7  
rockodude  ^this is the main point of the question. CMV can cause lymphadenopathy and hepatosplenomegaly as well. Key is the monomorphous phrase. +1  

submitted by nickybeezle(1),
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amnHu B lclse ear teh ariypmr getrats fo pniteEs Barr urisv (EB)V nn.oicitef In smto ssaec VBE ciotfinen si tymctmaapsio aescebu of a yghihl eeffvctei soth muenim rosseepn ubt oems unadiliisvd edlveop lgilimn-etfis iicetsufon olsneuc,oionsm wehil ohtser vpeeold Bt-aVecdaiEsos myidolph or llaeiteiph ga.ensinilmca

submitted by medbitch94(38),
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masonkingcobra  The pathogenesis of post-transplant lymphoproliferative disorders (PTLD) in most patients relates to the outgrowth of Epstein-Barr virus (EBV)-positive B cell proliferations in the setting of chronic T cell immunosuppression. +2