A 31-year-old man comes to his physician’s office with a report of pain on urination for the past day. The patient also reports yellow-white discharge from the urethra. He is sexually active, occasionally uses condoms, and mentions that he has had three sexual partners in the last month. He denies fevers, chills, changes in weight, new rashes, and tingling/numbness in the extremities. The patient’s temperature is 37.5°C (99.5°F), pulse is 88/min, respirations are 14/min, and blood pressure is 135/70 mm/Hg. Physical examination does not reveal any tender lymph nodes, rashes, or skin lesions. The patient has full range of motion of his joints and normal strength and reflexes in all extremities. Urinalysis reveals:
Color: yellow
Appearance: clear
Specific gravity: 1.012
pH: 7.0
Protein: negative
Glucose: negative
Ketones: negative
Bilirubin: negative
Urobilinogen: normal
Blood: negative
Leukocytes: negative
Nitrite: negative
WBC: 1
RBC: 2
Bacteria: rare
Casts: 1 hyaline cast
Gram staining of the urethral discharge is shown in the image.
Which of the following describes a component of the most likely causative organism?
A. A helical shape with two cell membranes and flagella trapped between them
B. A polysaccharide capsule with the ability to ferment maltose
C. An infectious extracellular form and an intracellular form capable of replication
D. Antigenically variable pili
E. The ability to metabolize urea into ammonia and carbon dioxide
- “Easy to use platform, wide variety of questions with similar difficulty to nbme.” E.C., Vanderbilt
- “Helps me score really well in NBMEs and my school blocks. My scores went up by 20% just by using Rx.”
- “I think USMLE-Rx is a great way to prepare for step/NBME exam, providing high yield and challenging questions. As well as videos and resources to aid in the learning process.” B.V., Eastern Virginia Medical School
- “USMLE Rx helped me greatly in studying for the Comprehensive Basic Science Exam. My NBME scores went up over 15 points (on the USMLE predicted score) from going through the USMLE-Rx question bank and videos. I am so thankful.” K.S.
- “These questions have helped to prepare me for my med school NBMEs as well as with Step 1 preparation.” A.P., Indiana University
- “Because of USMLE-Rx I was able to pass my basic science nbme comprehensive exam. It has provided me with the ways to understand everything conceptually.” J.S.
- “The question bank is difficult but highly correlated to material seen on NBME examinations.” K.B., Ross University
- “Very helpful for exams, especially since our school uses NBME exams throughout the first two years. Also beneficial for step 1 prep and review and helps me utilize First Aid effectively.” J.B.
- “I already recommend Rx and the physical FA textbook to all of my classmates and the people in the year below me. The QMax tests represent NBME exams in my courses really well and I feel prepared for my exams after doing these as practice exams.” J.A., Florida International University
- “Excellent resource—practice questions are great, study materials and videos are good. Integration of first aid and flash facts and questions based on video sections watched is incredible. Extremely helpful for NBME exams and prep.” R.H.
- “When I was using this, it was teaching me some concepts that I never understood before. I also liked the cumulative/nbme type of test attached to Rx.” A.A.
- “Using this resource was essential in facilitating and solidifying my understanding prior to NBME exams during my didactic curriculum, as well as in preparation for Step 1….These videos and the question banks comprised over 95% of my studying during the didactics phase of my curriculum.” J.N., Oregon Health and Science University
