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Retired NBME 22 Answers

nbme22/Block 4/Question#34 (reveal difficulty score)
A 17-year-old boy comes to the physician ...
B lymphocyte ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—dr.xx(176)
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Epstein-Barr virus (EBV) is carried by most humans. It can cause several types of cancer. In healthy infected people, EBV persists for life in a "latent" state in B cells.

https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1004906

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plaguedbyspleen  For those wondering like me, a heterophile antibody test is referring to the monospot test here. Reactive heterophile antibodies in a patient with a compatible syndrome are diagnostic of EBV infection. (uptodate) +2



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submitted by โˆ—almondbreeze(110)
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uw: EBV commonly infects B cells, stimulating them to enter the cell cycle and proliferate continuously ("transformation or "immortalization"). this is accomplished when EBV-encoded activate proliferative and anti-apoptotic signaling pathways w/i the infected B cell. ... the immortalized B cells maintain the ability to secrete Ig and B-cell activation products (eg. CD23), with very few of them releasing virus particles at any one time.

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