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Retired NBME 22 Answers

nbme22/Block 2/Question#48 (reveal difficulty score)
Clostridium perfringens-ฮฑ toxin affects cells ...
Splitting lecithin to phosphorylcholine and diglyceride ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—adisdiadochokinetic(89)
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The clostridium perfringens alpha toxin is a lecithinase which cleaves lecithin to phosphorylcholine and diglyceride. Essentially, alpha toxin mimics phospholipase C. This means it has a vaguely similar effect of the phospholipases seen in Bacillus Cereus and Listeria Monocytogenes. The end result of the toxin activation is activation of second messenger systems through diglyceride (AKA diacylglycerol), which activates several pathways, most notably in this case Arachidonic acid metabolism and IL-8, with the net effect of increased vascular permeability leading to edema.

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teepot123  fa 19 pg 138 +2
faus305  alpha-toxin is also known as lecithinase. I got this right because I remembered the sketchy. That being said, can someone explain how this possibly received a "13.1 difficulty score?" It does not seem like that easy of a question. +1



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