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NBME 24 Answers

nbme24/Block 3/Question#25 (75.2 difficulty score)
An investigator is studying a new virus ...
Coronavirus🔍,📺
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 +36 
submitted by azibird(198),

Who else came here after getting triggered by this answer?

yousif11  This question did not age well +14  
helppls  I'm going to be taking Step with this song stuck in my head lol +  



 +25 
submitted by aneurysmclip(166),
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nyeona eesl gte isht onrgw wiehl teh terrncu oarivnruosc pea"mc"dni c(ac ot esmo uoss)erc is e? nfnlagpepiinehg llearlala bmud rn

targetmle  yes because i thought they wont give ques on current coronavirus situation so early!! +  
adamventure  I thought to myself "damn it sure would be fuckin hilarious if Coronavirus was the answer".. turns out it was and it wasn't hilarious since I got it wrong. +56  
asdfjkl  no quotes needed for pandemic anymore :( big sad +13  
yesa  Yes! but also, coronaviruses often cause the common cold, not all of them are really bad! So this 4yo girl could literally just have the common cold, and the coronavirus isolated from her likely doesn't have pandemic potential. So this question has nothing to do with the ongoing pandemic--it's just coincidence! +  
jaramaiha  Was I the only one that thought it was cause it is enveloped and easily destroyed? lol I didn't even bother with descriptors. +  



 +10 
submitted by tea-cats-biscuits(251),
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ouY wnok it’s an epldveeno uvsir nsice it e’sdotn hldo up to dcia or igben dred.i ouY wnko ti ssucae a fvere dan a ,ohcgu ihewl afciftegn teh lraxyn. nlOy urvsi geoctayr taht tsfi all taht ionf si het unoovrsaric aue(scs S)RSA rmof tath s.tli

zelderonmorningstar  EBV doesn’t cause fever and cough? +1  
zelderonmorningstar  Wow, just checked First Aid and it doesn’t list “cough” as a symptom of EBV. +4  
drdoom  EBV is not a “respiratory virus”; it’s a *B cell virus*. Even though you might associate it with the “upper respiratory tract” (=kissing disease), it doesn’t cause respiratory inflammation since that’s not its trope. B cells are its trope! That’s why EBV is implicated in Burkitt Lymphoma, hairy leukoplakia and other blood cancers. (EBV is also known as “lymphocryptovirus” -- it was originally discovered “hiding” in *lymphocytes* of monkeys.) So, EBV = think B cells. +27  
fulminant_life  EBV does cause pharyngeal and laryngeal inflammation along with fever, malaise, and cough and LAD. The only thing that pointed me away from mono and towards coronavirus was the patients age. +7  
nbmehelp  Can someone explain what not holding up to acid or being dried has to do with being enveloped? +  
yb_26  @nbmehelp, the envelope consists of phospholipids and glycoproteins => heat, acid, detergents, drying - all of that can dissolve the lipid bilayer membranes => viruses will loss their infectivity (because they need an envelope for two reasons - to protect them against host immune system, and to attach to host cells surface in order to infect them) +10  
lowyield  @yb_26 does that mean that non-enveloped viruses hold up better to acid/dryness? +2  
rina  yes enveloped viruses are easier to kill (see post from drsquarepants: https://www.nbmeanswers.com/exam/nbme23/1161). also i think the "when dried" might refer to the fact that coronavirus is spread by respiratory droplets (don't even need to read first aid can just read the news at this point!) +3  



 +7 
submitted by drdoom(957),
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BVE is tno a eorpyt“rrasi vr”ius -- tsi’ a B cell suivr. tI secnitf B sclel; nto elaglynra e.llcs

evEn othhgu uoy tihgm ietsosaac ti twih eth uepr“p tpeasyorrir ”trcat isng=si(k s),asdeie it ’tndseo sucea pteaorysrri fmnanaoltmii secin shat’t ton tis o.tepr B llesc aer ist r!tope aTts’h yhw BVE is cpdmliatie ni rikttBu ao,yLhmmp ihray eaolaklkpiu and rhteo dolob ccran.es B(VE si slao konwn as ”movltspyph“ocyurri -- it wsa iyioanrlgl dvrcsdeieo nghi“id” in tscyyplheom fo ms.)yneko So, VBE = khitn B slcle. morF het HSMe librr:ya

hTe ytpe eiecpss of HRIYOTUPSRYVPMOCL, alfmuisby EAVMGAEISRNRAPHEMI, gcnentiif -slleBc ni hnsmu.a tI si uthgoht to be teh cvasauiet ngtae fo CITFESUNIO LOEMUONNOCSIS nad is nolsgytr sisaetcaod htwi rola hyair auilelkpkoa (EO,KLLKUIPAA HRYAI),; TBKRTUI ALMHMOYP; dna ethor aealn.nigicms

A2tnUaRtr/2hh/enmvevspURluN:/Ii=0b/PVmoHn0EimeS.r.rhco%dg4E%.Sse-pM?H,




 +5 
submitted by staghorn(6),
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oot rela ..r.n

thotcandy  right? nbme predicting the future +  



 +2 
submitted by usmleaspirant2020(7),

quarantined at home during the coronavirus pandemic and selecting the right answer as CoRona without thinking twice as i use the sanitizer to kill those little bastards knowing they are enveloped..wow what has life become

procrastinator  Lol, I couldn't really figure this question out so I was like F it. Coronavirus it is. +  



 +1 
submitted by covid2019(7),

Hi there! Predicting some questions on pandemics in STEP1s in the near future. Stay tuned!




 +0 
submitted by usmleaspirant2020(7),

quarantined at home during the coronavirus pandemic and selecting the right answer as CoRona without thinking twice as i use the sanitizer to kill those little bastards knowing they are enveloped..wow what has life become




 +0 
submitted by 123ojm(10),

Specifically didn't choose coronavirus due to the evidence that COVID-19 is spread fecal-orally. How does it get through the GI tract if it's inactivated by pH < 6? Can someone explain why my thinking is wrong?

hello  ...COVID-19 is transmitted via respiratory droplets. +3  
123ojm  Right but some research has come out saying it's also spread fecal-orally. So I'm wondering what I'm missing in this question. +  
tyrionwill  Don't trust US CDC in this pandemic. They always downplayed the truth. Cronavirus does spread mainly by droplets, when they drop, they contaminate the surface, then fecal-oral could be a second pathway. Wearing mask, social distancing are both to prevent a droplet. +  
boostcap23  I thought covid used to be low yield when this test was made and they didn't mention helical so I didn't pick it smh I'm an idiot. +1  



 +0 
submitted by rockodude(24),

eliminate fecal oral viruses then you're down to EBV and corona. corona is a respiratory virus, second most common cause of common cold, and EBV causes mono, not really associated with a cough. thats how I looked at it




 -1 
submitted by theunscrambler(2),

Amboss:

Envelope: Lipid bilayer around the capsid that contains viral glycoproteins and host cell proteins. The presence of the lipid bilayer makes nearly all enveloped viruses vulnerable to rapid inactivation by organic solvents (e.g., alcohol), detergents, and dry heat.

Where as non-enveloped viruses are generally resistant to the environment.




 -2 
submitted by madojo(181),
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cwoacd.cply//ststi/dr/umo.geatwtwhmkcalpoe:sthc

VOONRIACRUS EYKCTSH

ptioeisv sense RNA ,suivr c onnrswu roi oankgcn rwenaig eorb - caeehcllaiadn lputse irvus - lsnirgaip dor,a aecillh ee enriszstegn nda ibwnglo ingk - nomcmo oldc tiwh cobhlinro erte no gnik piogtnni ot SSRA adn iledmd atse yroierpstar myrdnoes utcae( norhi)stcbi

This ruisv lpsracteei in eht yoctmspla shatt yhw King is uoidtse hsi aelcts e)cunlus(

j44n  I'm so glad i dont have to take step one once they discover all this shit about the new corona strain. +