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NBME 24 Answers

nbme24/Block 3/Question#25 (71.3 difficulty score)
An investigator is studying a new virus ...
Coronavirus🔍,📺
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 +35 
submitted by azibird(184),

Who else came here after getting triggered by this answer?

yousif11  This question did not age well +12  



 +24 
submitted by aneurysmclip(154),

anyone else get this wrong while the current coronavirus "pandemic" (acc to some sources) is happening? feeling reaaallll dumb 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. +54  
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! +  



 +10 
submitted by tea-cats-biscuits(239),
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ouY nkow s’ti na pnlodeeve ivrsu iecns it dentos’ hold pu ot aidc ro nbieg edird. ouY kwon it scueas a efrev adn a ,oughc eihlw cigetfnaf eth ylrxan. nyOl ursiv tyrcegoa ttha sift lla thta onfi si hte sorvcuaonir c(seuas ASSR) mfor ttah istl.

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(896),
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BEV is otn a ora“rpyirtes virsu” -- ’sit a B lelc isvur. It isctefn B lcsle; ton gaanellry lelsc.

Enev ugthoh yuo mhgit tscoaeasi it tiwh eth u“rpep rasyertpoir trcat” sinsg(ki= )eaei,ssd ti ’nsodet eascu iryeoaptsrr nomiatialmfn ceisn hst’ta otn tis tp.eor B llcse rea sit pe!ort ’tashT hyw BEV si eciaipdlmt in kiuBttr omLpmhay, ayrih ikepolkulaa nad ohtre oldob c.sencra BVE( si salo nwkno sa tphipsyu“lryom”rvco -- it saw ilgnoiraly ddeevrscio “”ghidin in sltcyhmypeo of kno)e.msy ,oS EVB = ithkn B .llces oFrm teh eMHS lryra:ib

eTh teyp iseecsp of TYPVOPYHURCOSRMIL, sfimyabul GRMAMRSEINPIEEVAHA, eitfgincn Bslce-l ni hnau.sm tI si thouthg to eb the itcsuaeav entag fo INCSUIFEOT CUINMLOOENSSO dan si ygltnors osicaastde ihwt oalr hryai kpoullaiake (UAEOKLI,KALP ARHYI;), URTIBKT MHAOLYMP; and teroh ealascgiin.mn

ihUa?/vMhEs.-nvdoeleVn/mEemt2b.eH:RrSp%sr,R0/i=m2chpPng4%.rASHUutIoN/0




 +5 
submitted by staghorn(6),

too real rn...

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(6),

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




 +0 
submitted by theunscrambler(3),

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.




 +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(18),

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




 -2 
submitted by madojo(178),
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.cdw/tcktedcaolamsamh/woluycth/:espw/igo.rttcps

ACOROSUVRNI TECKSHY

psovieti sesne RNA usv,ir o uwsrcnn ciaknogro n rwageni erob - alicehl apnaseldetuc vrsui - gaplisnir ,drao chliela zegistenrn ees dna gnwiblo nkig - mnocom dclo htwi ihoolbrcn rtee on ikng itpgionn to ASSR dan dmldie aets piyrrosrate mrednyso aet(cu htrniisc)bo

This uvsir rieslcpate ni eht cymplsoat tstha ywh inKg is seouidt sih tlseac ucn)ul(es

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