Welcome to our USMLE Prep Question and Answer series!
We posed the following question on our social media (@sjsm_medicalschool) on Friday, April 15, 2022.
In this episode of the series, Dr. Aqsaa Chaudhry will break down this USMLE Step 1 Prep question and explain how you can get to the correct answer in order to prepare for the USMLE Step 1 Exam!
Question: A 15-year-old boy comes to the clinic with complaints of a bump on his stomach. He noticed the lesion a few days ago. He is currently sexually active with multiple partners and does not use protection consistently. He has not had a sexually transmitted infection in the past and his last annual check-up was 2 years ago. The lesion is flesh-colored with central umbilication near the lower abdomen.
What is the most probable cause of this patient’s lesion?
a. DNA virus, non-enveloped, single- stranded and linear structure
b. DNA virus, non-enveloped, double- stranded and circular structure
c. DNA virus, non-enveloped, double- stranded and linear structure
d. DNA virus, enveloped, partially double- stranded and circular structure
e. DNA virus, enveloped, double- stranded and linear structure
CORRECT:
e) This patient’s lesion describes molluscum contagiosum, a flesh-colored papule with central umbilication. Molluscum contagiosum belongs to the poxvirus family and is a enveloped, double- stranded linear DNA virus. It is often seen in children, however may be sexually transmitted in adults.
Shandera, Wayne X., and Eva Clark.. "Other Exanthematous Viral Infections." Current Medical Diagnosis and Treatment 2020 Eds. Maxine A. Papadakis, et al. New York, NY: McGraw-Hill,
, http://ezproxy.sjsm.org:2096/content.aspx?bookid=2683§ionid=225055143.
"Classification of Medically Important Viruses." Review of Medical Microbiology & Immunology: A Guide to Clinical Infectious Diseases, 15e Eds. Warren Levinson, et al. New York, NY: McGraw- Hill, , http://ezproxy.sjsm.org:2096/content.aspx?bookid=2381§ionid=187690830.
INCORRECT:
a) Parvovirus virus, a non-enveloped, single- stranded linear DNA virus, presents as erythema infectiosum (fifth disease, “slapped cheek” rash) in children. It may also present as aplastic crisis in sickle cell disease patients or hydrops fetalis.
b) Papillomavirus is a non-enveloped, single- stranded circular DNA virus, the family is human papilloma virus (HPV), which can cause papillomas (warts) without central umbilication and certain strains can lead to cervical carcinoma.
c) Adenovirus is a non-enveloped, double- stranded linear DNA virus, that may present with febrile pharyngitis, upper and lower respiratory tract disease.
d) Hepadnavirus is an enveloped, partially double- stranded circular DNA virus, that leads to hepatitis B virus that may lead to either acute or chronic hepatitis.
"Classification of Medically Important Viruses." Review of Medical Microbiology & Immunology: A Guide to Clinical Infectious Diseases, 15e Eds. Warren Levinson, et al. New York, NY: McGraw- Hill, , http://ezproxy.sjsm.org:2096/content.aspx?bookid=2381§ionid=187690830.
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