NBME Form 2 ?

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NBME Form 2 ?

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17 Posts

pearljam59
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04/05/06 - 08:18 AM

A 15-year-old girl has had a sore throat and temperatures to 37.7 C (100 F) for 3 days. Physical examination shows erythematous pharyngeal mucosa and cervical lymphadenopathy. Leukocyte count is 12,000/mm3 with 60% lymphocytes. A slide agglutination test is positive for antibodies against Epstein-Barr virus. This virus is most likely to replicate initially in which of the following cells?

A) Peripheral blood B lymphocytes

B) Peripheral blood monocytes

C) Peripheral blood T lymphocytes

D) Pharyngeal B lymphocytes

E) Pharyngeal monocytes

F) Pharyngeal T lymphocytes

shocked

yasmeen
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04/05/06 - 08:25 AM

robin082006
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04/05/06 - 10:01 AM

A

EBV can replicate in B cells and epithelial cells

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pocas
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04/08/06 - 09:59 AM

ts97
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08/21/06 - 11:50 AM

I've answered D, because it said "initially" in the question

giovanni83
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08/24/06 - 01:05 PM

yes it's D, remeber that pharigeal B cell are the only ones "permissive" for EBV....read Harrison's Internal medicine.....

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mousa
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08/25/06 - 01:13 PM

i am thinging D nod

disha
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08/28/06 - 01:13 AM

ya its d

drfax
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09/03/06 - 11:19 AM

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docsrinu
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09/03/06 - 06:02 PM

#10

its either A or D. cant figure out which.

aisha2
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09/04/06 - 02:39 PM

#11

EBV is present in oropharyngeal secretions and most commonly is transmitted through saliva. After initial inoculation, the virus replicates in nasopharyngeal epithelial cells. Cell lysis is associated with release of virions, with viral spread to contiguous structures, including salivary glands and oropharyngeal lymphoid tissues. Further viral replication results in viremia, with subsequent infection of the lymphoreticular system, including the liver, spleen, and B lymphocytes in peripheral blood. Host immune response to the viral infection includes CD8-positive T lymphocytes with suppressor and cytotoxic functions, the characteristic atypical lymphocytes found in the peripheral blood. The T lymphocytes are cytotoxic to the EBV-infected B cells and eventually reduce the number of EBV-infected B lymphocytes.

To initiate cellular infection, a viral particle attaches via its major outer envelope glycoprotein, ie, gp350/220, to the EBV receptor CD21 on a B lymphocyte.

SO I THINK ILL GO WITH "A" .

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aisha2
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09/04/06 - 02:42 PM

#12

THIS IS THIS LINK I GOT THE INFORMATION FROM

http://www.emedicine.com/PED/topic705.htm

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docarchana
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09/04/06 - 02:45 PM

#13

so it is pharyngeal epithelial cells and later peripheral B cells. so the final ans is A. thanx aisha.

docswapna
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09/26/06 - 09:08 PM

#14

yes A. pharyngeal EPITHELIAL cells intially and peripheral B cells later.

klimt
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10/15/06 - 03:16 PM

#15

thanks for clarifying that guys

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ManuNastai
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10/16/06 - 02:08 AM

#16

nice discusion

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fongch
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10/26/06 - 11:00 AM

#17

Doesn't it also say EBV will infect oropharyngeal lymphoid tissue before the viremia?

aisha2 wrote:
EBV is present in oropharyngeal secretions and most commonly is transmitted through saliva. After initial inoculation, the virus replicates in nasopharyngeal epithelial cells. Cell lysis is associated with release of virions, with viral spread to contiguous structures, including salivary glands and oropharyngeal lymphoid tissues. Further viral replication results in viremia, with subsequent infection of the lymphoreticular system, including the liver, spleen, and B lymphocytes in peripheral blood. Host immune response to the viral infection includes CD8-positive T lymphocytes with suppressor and cytotoxic functions, the characteristic atypical lymphocytes found in the peripheral blood. The T lymphocytes are cytotoxic to the EBV-infected B cells and eventually reduce the number of EBV-infected B lymphocytes.

To initiate cellular infection, a viral particle attaches via its major outer envelope glycoprotein, ie, gp350/220, to the EBV receptor CD21 on a B lymphocyte.

SO I THINK ILL GO WITH "A" .

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