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Retired NBME 18 Answers

nbme18/Block 3/Question#14 (reveal difficulty score)
2 yo boy, 2 days of fever, sore throat, rash
Erythrogenic toxin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—breis(56)
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Streptococcus Pyogens (group A strep) has a superantigen causing shock. This antigen Erythrogenic Exotoxin A causes a Toxic shock-like syndrome: Fever, Rash, Shock, Scarlet Fever.

FA pg 133 (2019)

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extraordinr  correction: GAS erythrogenic toxin causes scarlet fever specifically in this question there is no reason for this child to have TSS +6
loaloagubba  SpeA and SpeC toxin is erythrogenic toxin referred to here. +4
baja_blast  Erythrogenic exotoxin A + Strep Pyogenes is responsible for BOTH Scarlet Fever and Toxic Shock Like Syndrome. It can also cause Necrotizing Fasciitis. It's definitely Scarlet Fever in this question but I just don't want people to get confused. FA2019 pages 133, 136 +
baja_blast  Sorry, not A. Just Erythrogenic Exotoxin +. +

"sandpaper-like" rash ==> Scarlet fever (strep exotoxin)

+/- bswsu(-1)

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