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242 Cards in this Set
- Front
- Back
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1. Most common cause of pneumonia and bronchiolitis in infants
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respiratory syncytial virus
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2. Antigen shift requires a new egg-based vaccine
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Answer: E- influenzavirus
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3. Most common cause of viral meningitis, myocarditis, and pericarditis
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Answer: B- coxsackievirus
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4. Most common viral cause of gastroenteritis in adults
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Answer: T- Norwalk virus
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5. Acid labile virus transported by fingers to the eyes and nose
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Answer: A- Rhinovirus
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6. Virus destroying anterior horn cells leading to paralysis in an elderly man who recently visited his young great-grandchildren
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Answer: C- poliovirus
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7. Virus causing acute hemorrhagic conjunctivitis
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Answer: D- enterovirus
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8. Virus causing inspiratory stridor in 5 mth old infant with an anterior x-ray of the neck showing the "steeple sign"
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Answer: G-parainfluenza virus (Slide 3)
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9. Virus associated with acute appendicitis, giant cell pneumonia, and a slow virus disease causing demyelination
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Answer: I-rubeola (Slide 5)
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10. Virus transmitted by animal bites and aerosolization that causes hydrophobia and encephalitis
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Answer: K-rabies virus (Slide 7)
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11. Virus transmitted by mouse urine or feces to a man who has ARDS and renal failure. He lives on a Navajo reservation in Northern Arizona.
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Answer: M- Hantavirus
another mouse urine is lymphocytic choriomeningitis |
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12. Virus transmitted by mouse urine or feces that produces severe meningitis and encephalitis
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Answer: L- lymphocytic choriomeningitis virus
hanta virus is another one with mouse urine |
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13. Virus that produces severe encephalitis that is transmitted by mosquitos. The reservoir of the virus is wild birds. Humans and horses are dead end hosts.
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Answer: N- Eastern equine encephalitis virus
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14. Virus transmitted by mosquitos that produces encephalitis. Reservoir is crows and other birds. Disease began in New York and has now spread out West.
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Answer: R- West Nile virus
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15. Most common cause of gastroenteritis in children, particularly during the winter months. Virus produces a secretory diarrhea often requiring glucose-containing hypotonic salt solution replacement.
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Answer: S- rotavirus
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16. Most common acquired immunodeficiency syndrome. Virus is cytolytic to CD4 helper T cells.
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Answer: U- HIV
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17. Teratogenic virus that produces sensorineural hearing loss in neonates and a rash with painful postauricular lymphadenopathy in children and adults.
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Answer: J- rubella virus (Slide 6)
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18. Retrovirus that produces T-cell leukemia and lymphoma.
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Answer: V- HTLV
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19. Virus transmitted from infected patient secretions that produces a hemorrhagic fever in Africa
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Answer: W- Ebola virus
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20. DNA virus associated with heterophile antibodies against horse RBCs. Produces atypical lymphocytosis, nasopharyngeal carcinoma, and malignant lymphomas involving the CNS and lymph nodes.
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Answer: Z- EBV (Slide 14)
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21. Virus associated with parotitis, pancreatitis, orchitis, and a self-limited meningoencephalitis.
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Answer: H- mumps virus (Slide 4)
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22. Virus associated with recurrent infections on the lips, conjunctivitis, and hemorrhagic necrosis of the temporal lobes.
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Answer: X- HSV-1 (Slide 11)
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23. Virus transmitted by a mosquito bite that was a common cause of hemorrhagic fever in Vietnam.
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Answer: P- Dengue virus
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24. Virus transmitted by the bite of a tick that produces a biphasic fever, rash, and encephalitis.
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Answer: Q- Colorado tick fever virus
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25. Virus transmitted by a mosquito that produces midzonal liver cell necrosis often leading to fulminant hepatic failure.
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Answer: O- yellow fever virus
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26. Virus associated with recurrent vesicular lesions in the anogenital region, meningitis, and a congenital infection in neonates.
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Answer: Y- HSV-2 (Slide 13)
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The primary reservoir cell for HIV in the CNS is the…
A. neuron B. astrocyte C. microglial cell D. ependymal cell E. oligodendrocyte |
Answer: C. microglial cell: these cells are the macrophage of the CNS and used to a circulating monocyte, which carry the virus into the CNS (Slide 8)
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28. An HIV positive patient with fever, night sweats, cough, dyspnea with exertion, a CD4 T helper count of 350 cells/mm3, and cavitary apical lung disease most likely has an infection due to…
A. Pseudomonas aeruginosa B. Mycobacterium tuberculosis C. Streptococcus pneumoniae D. Histoplasma capsulatum E. Klebsiella pneumoniae |
Answer: B. Mycobacterium tuberculosis
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29. The most common fungal infection and cause of odynophagia in an HIV positive patient is…
A. coccidioidomycosis B. cryptococcosis C. histoplasmosis D. blastomycosis E. candidiasis |
Answer: E. candidiasis: Candida is the MC fungal infection in HIV
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30. The most common systemic fungus infecting the CNS in patients with AIDS is…
A. coccidioidomycosis B. cryptococcosis C. histoplasmosis D. blastomycosis E. candidiasis |
Answer: B. cryptococcus
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31. A patient with AIDS has protracted watery diarrhea. A stool sample reveals oocysts that are acid-fast. The most likely diagnosis is…
A. giardiasis B. amebiasis C. microsporidiosis D. cryptosporidiosis E. Mycobacterium avium-intracellulare |
Answer: D. cryptosporidiosis: a sporozoan. Isospora belli is also a sporozoan that produces AIDS diarrhea and also has partially acid fast oocysts. (Slide 102)
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32. A white, plaque-like lesion on the lateral aspect of the tongue that does not scrape off in an HIV positive patient with a CD4 T helper cell count of 350 cells/mm3 is most likely caused by…
A. Candida B. an Epstein-Barr virus C. a Herpes simplex virus D. the human papilloma virus E. the human immunodeficiency virus |
Answer: B. an Epstein-Barr virus: it is not premalignant and is not AIDS-defining (Slide 15)
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33. A patient with AIDS has cotton wool exudates in the retina, watery diarrhea, biliary tract disease, and odynophagia. The most likely pathogen is…
A. human immunodeficiency virus B. Toxoplasma gondii C. Epstein-Barr virus D. cytomegalovirus E. Candida |
Answer: D. cytomegalovirus: ganciclovir is the Rx of choice; use foscarnet if this does not work (Slide 16)
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34. A beefy red, exquisitely painful perirectal ulcer with vesicles involving the gluteal folds in an HIV positive patient is most likely due to…
A. Chlamydia trachomatis B. Neisseria gonorrhoeae C. Treponema pallidum D. Hemophilus ducreyi E. Herpes simplex |
Answer: E. Herpes simplex: in these locations, it is not AIDS-defining
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35. Which of the following opportunistic infections are more likely to be an early manifestation of AIDS? SELECT 3
A. Shingles due to Herpes zoster B. Cytomegalovirus retinitis C. Hairy leukoplakia due to EBV D. Herpes esophagitis E. Oral candidiasis |
Answers: A, C, E: A. Shingles due to Herpes zoster, C. Hairy leukoplakia due to EBV, E. Oral candidiasis: cytomegalovirus retinitis (B) and Herpes esophagitis (D) are AIDS-defining
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36. A patient with AIDS has raised, painful erythematous lesions that blanch with pressure. A biopsy reveals an inflammatory type of vasculitis. A silver stain reveals organisms in the endothelial cells. The patient most likely has…
A. autoimmune thrombocytopenia B. an immunocomplex vasculitis C. acute bacterial endocarditis D. bacillary angiomatosis E. Kaposi’s sarcoma |
Answer: D. bacillary angiomatosis: due to Bartonella henselae: it simulates Kaposi's sarcoma (E). Thrombocytopenia (A) causes petechia, which do not blanch. IC vasculitis (B) has palpable purpura. (C) has immunocomplex vasculitis. (Slide 74)
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37. The rapidly increasing incidence of primary central nervous system malignant lymphoma in the United States parallels the rapidly increasing incidence of…
A. human immunodeficiency virus infections B. Epstein-Barr virus infections C. non-Hodgkin's lymphoma D. viral-induced encephalitis E. autoimmune disease |
Answer: A. HIV: HIV in concert with EBV cause primary CNS lymphoma
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38. An anorectal biopsy in a 35 year old homosexual reveals infiltrating squamous cell carcinoma. This is most likely secondary to…
A. Crohn’s disease B. Herpes simplex proctitis C. ulcerative colitis D. human papilloma virus proctitis E. Chlamydia trachomatis proctitis |
Answer: D. HPV proctitis: due to unprotected anal intercourse
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39. Which of the following body fluids has the greatest risk for transmitting HIV?
A. Sweat B. Urine C. Tears D. Saliva E. Colostrum |
Answer: E. colostrum: next to blood, breast milk has the greatest viral burden. Breast feeding is contraindicated. Sweat (A) does not carry the virus, however, urine (B), tears (C), and saliva (D) carry the virus.
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40. The major mode of transmission of HIV in developing countries is…
A. receptive anal intercourse between men B. receptive anal intercourse between a man and a woman C. heterosexual vaginal intercourse D. transfusion of contaminated blood products E. vertical transmission between mother and fetus |
Answer: C. heterosexual vaginal intercourse: greatest risk is male to female. Receptive anal intercourse between men (A) is the MC mechanism in the United States.
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41. During the asymptomatic latent clinical phase of HIV infections, the virus is primarily trapped in the…
A. lymph nodes by follicular dendritic cells B. spleen by macrophages C. bone marrow by macrophages D. subcutaneous tissue by Langerhan’s cells E. endothelial cells in the microcirculation |
Answer: A. lymph nodes by follicular dendritic cells: reservoir of the virus during this stage
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42. In HIV positive patients, autoimmune disease is most commonly manifested by…
A. dementia B. Kaposi’s sarcoma C. thrombocytopenia D. skin rashes E. retinitis |
Answer: C. thrombocytopenia: it is the MC hematologic manifestation in AIDS; type II hypersensitivity reaction; IgG antibody directed against GpIIb:IIIa fibrinogen receptor
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43. Hypergammaglobulinemia in AIDS patient is most often secondary to…
A. chronic bacterial infections B. an increased incidence of multiple myeloma C. polyclonal stimulation of B cells by Epstein Barr virus D. reduced clearance of immunoglobulins E. decreased CD4 T helper cell counts |
Answer: C. polyclonal stimulation of B cells by EBV
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44. Which of the following tests is used initially to screen blood for the human immunodeficiency virus?
A. ELISA test for anti gp-120 antibody B. p24 capture assay C. HIV RNA by PCR D. Lymphocyte culture for HIV E. Western blot assay |
Answer: A. ELISA test for anti gp-120 antibody. The p24 capture assay to detect p24 antigen is positive when the patient initially contracts HIV and when they develop an AIDS defining lesion?
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45. Which of the following tests is used to confirm a positive or indefinite ELISA test for HIV?
A. ELISA test for anti gp-120 antibody B. p24 capture assay C. HIV RNA by PCR D. Lymphocyte culture for HIV E. Western blot assay |
Answer: E. western blot assay: it requires the presence of antibodies against p24, gp41 and either gp120 or gp160, hence, its greater specificity
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46. Which of the following tests is usually positive when the patient first contracts HIV and when the patient develops and AIDS defining lesion?
A. ELISA test for anti gp-120 antibody B. p24 capture assay C. HIV RNA by PCR D. Lymphocyte culture for HIV E. Western blot assay |
Answer: B. p24 capture assay: it detects p24 antigen and is positive when the patient initially contracts HIV and when they develop an AIDS defining lesion. It is negative during the early symptomatic phase.
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47. Which of the following tests provides the best overall information concerning the viral burden in a patient with AIDS?
A. ELISA test for anti gp-120 antibody B. p24 capture assay C. HIV RNA by PCR D. Lymphocyte culture for HIV E. Western blot assay |
Answer: C. HIV RNA by PCR
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48. Which of the following are AIDS-defining diseases? SELECT 3
A. Cervical dysplasia due to human papilloma virus B. Pneumocystis jiroveci pneumonia C. Systemic candidiasis D. Kaposi’s sarcoma E. Autoimmune thrombocytopenia |
Answers: B, C, D: B. Pneumocystis jiroveci pneumonia, C. Systemic candidiasis, D. Kaposi’s sarcoma. Invasive cervical cancer is AIDS-defining, not cervical dysplasia (A) due to human papilloma virus. Autoimmune thrombocytopenia (E) is not AIDS-defining.
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49. What is the most common mode of transmission of HIV in medical personnel?
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Answer: F. Needle stick exposure from an HIV positive person: ~ 1/300 chance of becoming HIV positive. Must go on triple therapy for 6 months (2 reverse transcriptase inhibitors + 1 protease inhibitor)
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50. What is the most common mode of transmission of HIV in the United States at the present time?
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Answer: A. Receptive anal intercourse between males
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51. What is the most common method of transmitting HIV to a fetus?
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Answer: G. Transplacental vertical transmission, with vertical transmission by breast feeding a close second
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52. A 23-yr-old pregnant woman is found to be positive for the HIV antibody. Which of the following statements apply to her or to her baby? SELECT 2
A. Newborn will have a positive ELISA test B. Newborn will have a positive HIV RNA by PCR C. Mother should be treated with zidovudine (AZT) D. Mother should be treated with a protease inhibitor E. Baby will invariably develop HIV unless the mother is treated |
Answers: A, C: A. Newborn will have a positive ELISA test (anti gp-120 is an IgG antibody), C. Mother should be treated with zidovudine (AZT, reduces the risk of baby becoming HIV positive to < 10%). Newborn will have a positive HIV RNA by PCR only if it is truly infected B). Mother should be treated with a AZT, not a protease inhibitor. Baby will not invariably develop HIV (E) unless the mother is treated (~30% chance if mother is not treated).
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53. Which of the following are expected test findings in a patient with AIDS? SELECT 2
A. Normal mitogen blastogenesis of T cells B. Anergy to cutaneous skin testing with Candida C. Decreased immunoglobulin G levels D. Caseating granulomas in lymph nodes E. Decreased CD4 T helper cell count |
Answers: B, E: B. Anergy to cutaneous skin testing with Candida, E. Decreased CD4 T helper cell count. Mitogen blastogenesis of T cells should be abnormal (A). Immunoglobulin G levels are increased (C), not decreased, due to EBV polyclonal stimulation. Lymph nodes will not show caseating granulomas (D) because helper T cells are required for granuloma formation.
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54. The median time from primary HIV infection to the development of AIDS is approximately…
A. 3 years B. 4 years C. 10 years D. 15 years E. 20 years |
Answer: C. 10 years: this is why the prevalence of HIV has increased in the United States. The longer the duration of a disease, the greater the prevalence.
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55. The most common cause of a space occupying lesion in the CNS in AIDS that presents with focal seizure activity is…
A. primary lymphoma B. cryptococcosis C. toxoplasmosis D. inappropriate ADH syndrome E. metastatic cancer |
Answer: C. toxoplasmosis (Slide 103)
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56. The treatment for the most common initial AIDS-defining illness is…
A. trimethoprim sulfamethoxazole B. penicillin C. erythromycin D. amphotericin B E. acyclovir |
Answer: A. TMP/SMX: Pneumocystis is the MC initial AIDS-defining illness (Slide 100)
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57. The most common cause of recurrent pneumonia in patients with AIDS is…
A. Pneumocystis jiroveci B. human immunodeficiency virus C. Mycobacterium avium-intracellulare D. Streptococcus pneumoniae E. Pseudomonas aeruginosa |
Answer: D. Streptococcus pneumoniae
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58. The most common cause of fever, night sweats, and weight loss in patient with AIDS, who has a CD4 T helper count of < 50 cells/mm3 is…
A. Pneumocystis jiroveci pneumonia B. disseminated Mycobacterium avium-intracellulare C. disseminated cytomegalovirus D. disseminated Kaposi’s sarcoma |
Answer: B. disseminated MAI: note the decreased helper T cell count. CMV (D) also occurs when the count is this decreased but is not associated with night sweats. (Slide 82)
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59. Which of the following complications in AIDS are directly due to the human immunodeficiency virus? SELECT 2
A. Recurrent pneumonias B. Primary CNS lymphoma C. Kaposi's sarcoma D. Dementia E. Wasting syndrome F. Progressive multifocal leukoencephalopathy G. Hairy leukoplakia on the tongue |
Answers: D, E: D. Dementia, E. Wasting syndrome: Recurrent pneumonias (A) are most commonly caused by Streptococcus pneumoniae, primary CNS lymphoma (B) is due to EBV, Kaposi's sarcoma (C) by herpesvirus 8, progressive multifocal leukoencephalopathy (F) by papovavirus, and hairy leukoplakia (G) on the tongue by EBV.
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60. Which of the following correctly describe the human immunodeficiency virus? SELECT 3
A. gp 120 antigen attaches to CD4 on the helper T cell B. p24 antigen peaks at two separate times during the infection C. reverse transcriptase converts genomic RNA into double stranded DNA D. env encodes for reverse transcriptase E. pol encodes for p24 antigen F. gag encodes for gp120 |
Answers: A, B, C: A. gp 120 antigen attaches to CD4 on the helper T cell, B. p24 antigen peaks at two separate times during the infection, C. reverse transcriptase converts genomic RNA into double stranded DNA. env (D) encodes for gp120/gp41, pol (E) encodes for reverse transcriptase and integrase, and gag (F) encodes for the p24 antigen
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61. Which of the following groups of immunizations can be given to a patient with AIDS? SELECT 3
A. Killed polio vaccine/hepatitis B vaccine B. Measles:mumps:rubella/Hemophilus influenzae type b C. Hepatitis B vaccine/oral polio vaccine D. Pneumovax/influenza E. Diptheria:tetanus:pertussis/varicella zoster |
Answers: A, B, D: A. Killed polio vaccine (cannot be live polio vaccine)/hepatitis B vaccine, B. Measles:mumps:rubella (only live viral vaccine permitted)/Hemophilus influenzae type b, D. Pneumovax/influenza. Hepatitis B vaccine can be given but oral polio vaccine, a live vaccine cannot. Diphtheria:tetanus: pertussis can be given, but the live varicella zoster vaccine cannot
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62. Virus that produces congenital infection, atypical lymphocytosis, infection transmitted by blood transfusion, and disseminated disease in AIDS (pneumonia, pancreatitis, diarrhea, retinitis). It produces hypertrophied cells with basophilic intranuclear inclusions.
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Answer: A- CMV (Slide 16)
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63. Pathogen that is transmitted sexually and produces PID and non-specific urethritis.
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Answer: S- Ureaplasma urealyticum
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64. Childhood viral infection associated with high fevers often precipitating febrile convulsions. When fever breaks, a rash occurs.
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Answer: B- HHV-6 (roseola) (Slide 18)
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65. Most common viral cause of hemorrhagic cystitis.
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Answer: E- adenovirus
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66. Intraleukocytic pathogen that is transmitted by a tick that produces a disease resembling Rocky Mountain spotted fever except for the absence of a rash.
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Answer: Q- Ehrlichia chaffeensis (Slide 32)
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67. Viral gene products inactivate the TP53 and RB suppressor genes. Associated with lesions in the anogenital region that are either benign or malignant.
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Answer: F- human papillomavirus (Slide 21)
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68. Virus that produces a slow virus type of encephalitis that is commonly seen in AIDS patients.
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Answer: G- JC virus (progressive multifocal leukoencephalopathy)
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69. Virus that is latent in sensory ganglia that produces painful vesicular rashes that follow a sensory dermatome. Like HSV-1 and -2, the Tzanck prep is positive.
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Answer: D- Varicella-zoster virus (shingles) (Slide 20)
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70. Pathogen associated with an atypical pneumonia and coronary artery disease.
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Answer: M- Chlamydia pneumoniae
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71. Pathogen transmitted by a tick that produces a vasculitis producing lesions that begin on the palm and extend to the trunk.
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Answer: O- Rickettsia rickettsiae (Slide 31)
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72. Virus that produces multiple, raised umbilicated lesions with a central crater containing granular material that can produce other skin lesions.
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Answer: I- Molluscum contagiosum virus (Slide 24)
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73. Virus associated with macules, papules, vesicles, and pustules that are at different stages of development. Associated with Reye's syndrome. Influenza virus can also be associated with Reye syndrome.
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Answer: C- varicella virus (Slide 19)
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74. Virus, now eradicated by immunization, that produces pustular lesions that are at the same stage of development. May be used for biological warfare.
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Answer: H. smallpox virus (Slide 23)
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75. Spongiform encephalopathy leading to dementia.
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Answer: K- Creutzfeldt-Jakob disease: caused by infectious particles lacking DNA and RNA (called prions) (Slide 26)
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76. Pathogen that produces atypical pneumonia in areas with crowded conditions and is associated with cold agglutinins and bullous myringitis.
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Answer: R- Mycoplasma pneumoniae (Slide 33)
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77. Pathogen not transmitted by a vector that produces atypical pneumonia and granulomatous hepatitis. It commonly occurs in veterinarians, those in contact with farm yard manure, and those who work in slaughterhouses.
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Answer: P- Coxiella burnetii (Q fever)
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78. Pathogen with elementary bodies within metaplastic squamous cells. Associated with STDs and blindness.
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Answer: L- Chlamydia trachomatis (Slide 27-29)
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79. Virus associated with a "slapped face" appearance, aplastic anemia, arthritis, and spontaneous abortions.
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Answer: J- parvovirus (Slide 25)
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80. Pathogen that produces a zoonosis in those who own pet stores that cell parrots and parakeets.
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Answer: N- Chlamydia psittaci
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81. Patient with hepatitis B who is non-infective and in the serologic gap
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neg HBsAg, HBeAg HBVDNA, anti-HBc-IgG, anti-HBs
positive anti-HBc-IgM |
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82. Patient who has recovered from hepatitis B
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neg HBsAg, HBeAg HBVDNA, anti-HBc-IgG, anti-HBc-IgM
positive anti-HBs, |
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83. Patient who has been vaccinated
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negative HBsAg , HBeAg, HBV DNA, Anti-HBc-IgM, Anti-HBc-IgG positive Anti-HBs
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84. Patient with symptomatic acute hepatitis B
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positive=HBsAg, HBeAg, HBV DNA
Anti-HBc-IgM negative=Anti-HBc-IgG Anti-HBs |
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85. Patient with infective chronic hepatitis B
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positive HBsAg HBeAg, HBV DNA
positive Anti-HBc-IgM positive Anti-HBc-IgG negative Anti-HBs |
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86. Patient who is a "healthy" carrier for hepatitis B
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positive HBsAg
negative HBeAg, HBV DNA, Anti-HBc-IgM postive Anti-HBc-IgG negative Anti-HBs |
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87. Type (s) of hepatitis with no protective antibodies
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Answer: G. Hepatitis C and D: presence of IgG antibodies indicates that they have active disease
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88. Type (s) of hepatitis with no chronic state
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Answer: F. Hepatitis A and E
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89. Most common type of hepatitis found in day care centers
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Answer: A. Hepatitis A: reason why all day care children are vaccinated against HAV
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90. Most common type (s) of hepatitis leading to hepatocellular carcinoma
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Answer: J. Hepatitis B and C
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91. Most common hepatitis associated with polyarteritis nodosa:
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Answer: B: HBV; produces vasculitis
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92. Most common hepatitis in traveler's to places outside the United States
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Answer: A. Hepatitis A
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93. Most common hepatitis in jails and corrective institutions
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Answer: A. Hepatitis A
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94. Most common sexually transmitted types of hepatitis
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Answer: K. Hepatitis A, B, C
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95. Most common cause of posttransfusion hepatitis and chronic hepatitis
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Answer: C. Hepatitis C: also MC hepatitis without jaundice
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96. Most common type (s) of hepatitis prevented by immunization with hepatitis B vaccine
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Answer: L. Hepatitis B, D: also prevents hepatocellular carcinoma from HBV postnecrotic cirrhosis
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97. Most common type (s) of hepatitis transmitted parenterally
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Answer: I. Hepatitis B, C, D
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98. Most common type (s) of hepatitis with protective antibodies
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Answer: H. Hepatitis A, B, and E (think ABE Lincoln)
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99. Most common hepatitis producing fulminant hepatitis in a patient with a pre-existing hepatitis
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Answer: D. Hepatitis D
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100. Most common type (s) of hepatitis transmitted by the fecal-oral route
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Answer: F. Hepatitis A and E
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101. Most common type of hepatitis in homosexuals
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Answer: A. Hepatitis A: unprotected anal intercourse; virus is in feces
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102. Most common type (s) of hepatitis that may lead to chronic hepatitis
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Answer: I. Hepatitis B, C (most common), D
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103. Most common type of hepatitis associated with cryoglobulins, type I membranoproliferative glomerulonephritis, and porphyria cutanea tarda
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Answer: C. Hepatitis C: HBV has membranous glomerulonephritis and polyarteritis nodosa association
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104. Most common type of hepatitis transmitted by accidental needle stick
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Answer: B. Hepatitis B: also underscores why HBV hepatitis is the MC systemic disease in IVDU. HBV is also the most common viral hepatitis.
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105. Most common cause of nosocomial septicemia, urinary tract infections, spontaneous peritonitis in ascites in adults, traveler's diarrhea, and hemolytic uremic syndrome.
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Answer: Y- Escherichia coli (Slide 60)
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106. Most common cause of toxic shock syndrome in menstruating women, wound abscesses, osteomyelitis, impetigo, and acute bacterial endocarditis in IV drug abusers
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Answer: A- Staphylococcus aureus (Slide 36-38)
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107. Pathogen that produces a rash in fish handlers.
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Answer: V- Erysipelothrix rhusiopathiae
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108. Pathogen responsible for poisoning producing paralysis in young children who eat honey
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Answer: P- Clostridium botulinum (infant botulism, toxin develops after colonization of bowel)
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109. Farmer and his wife are brought into an ER with paralysis and mydriasis
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Answer: P- Clostridium botulinum (adult botulism, preformed toxin that blocks release of ACh, improperly sterilized bottled goods) (Slide 53)
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110. Most common cause of spontaneous peritonitis in ascites in children with nephrotic syndrome, otitis media, sinusitis, community acquired typical pneumonia, sepsis in sickle cell disease, and meningitis in patients over 18 yrs old.
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Answer: E- Streptococcus pneumoniae (Slide 43)
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111. Most common cause of rheumatic fever and glomerulonephritis
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Answer: D- Streptococcus pyogenes (rheumatic fever is a type II and IV hypersensitivity and post-streptococcal glomerulonephritis is a type III hypersensitivity) (Slide 39)
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112. Patient with colon cancer due to ulcerative colitis develops acute endocarditis.
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Answer: I- Streptococcus bovis
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113. Infant whose umbilical cord has not yet fallen off develops opisthotonus
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Answer: O- Clostridium tetani (Slide 52)
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114. Sexually active 23 yr-old-woman develops dysuria. Urine culture grows out a coagulase negative organism.
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Answer: C- Staphylococcus saprophyticus
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115. 65-yr-old woman with a recent total hip replacement develops acute endocarditis.
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Answer: B- Staphylococcus epidermidis
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116. 24-yr-old man develops gastroenteritis after eating refried beans. Gram positive rods are present in the stool.
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Answer: N- Bacillus cereus (Slide 51)
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117. 35-yr-old man with a history of congenital heart disease develops fever and a pansystolic murmur at the apex that does not increase in intensity with deep held inspiration shortly after a root canal.
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Answer: G- Streptococcus viridans
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118. 24-yr-old woman with a history of PID complains of right upper quadrant pain when she twists her torso doing aerobics. A laparoscope reveals adhesions between the liver capsule and peritoneum.
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Answer: J- Neisseria gonorrhoeae (Fitz-Hughes-Curtis syndrome) (Slide 46-48)
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119. 65-yr-old type 2 diabetic with severe peripheral vascular disease develops an infection of the big toe. The toe is gangrenous and has a foul smelling exudate and crepitance in the underlying subcutaneous tissue.
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Answer: Q- Clostridium perfringens (Slide 54)
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120. A 32-yr-old heroin addict is unable to open his jaw and has painful muscle contractures.
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Answer: O- Clostridium tetani (neurotoxin inhibits glycine) (Slide 52)
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121. A 62-yr-old woman with scurvy had numerous dental cavities.
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Answer: H- Streptococcus mutans (Slide 45)
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122. A 14-yr-old boy develops fever, petechiae, and nuchal rigidity. He later develops septic shock and bleeding from all orifices. Autopsy reveals bilateral adrenal hemorrhage.
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Answer: K- Neisseria meningitidis (Waterhouse-Friderichsen syndrome with DIC) (Slide 49)
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123. A pregnant woman, who eats goat cheese for lunch, delivers a baby with sepsis and meningitis.
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Answer: U- Listeria monocytogenes
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124. A pregnant woman with premature rupture of her membranes has a newborn that develops sepsis and meningitis.
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Answer: F- Streptococcus agalactiae (Slide 44)
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125. A 70-yr-old woman develops diarrhea while in the hospital with pneumonia. A proctoscope reveals a yellow pseudomembrane in the rectum.
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Answer: R- Clostridium difficile (Slide 55)
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126. An unimmunized child develops dysphonia and painful cervical adenopathy. Oral exam reveals a shaggy gray membrane in the posterior pharynx.
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Answer: S- Corynebacterium diphtheriae (Slide 56)
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127. A 62-yr-old man with COPD develops fever and a cough productive of greenish yellow sputum. A gram stain reveals gram negative diplococci.
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Answer: L- Moraxella catarrhalis
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128. A 22-yr-old man has severe cystic acne.
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Answer: T- Propionibacterium acnes (Slide 57)
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129. A 45-yr-old woman develops a draining sinus tract in the jaw 6 weeks following removal of an abscessed tooth on the same side. Yellow granules are present in the draining exudate.
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Answer: W- Actinomyces israeli; also commonly infects intrauterine devices. (Slide 58)
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130. A 45-yr-old man, who works in a post office, opens a letter that has a white powder in it. He develops a lung condition and dies.
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Answer: M- Bacillus anthracis (Slide 50)
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131. A 2-yr-old child in a day care center develops fever and bloody diarrhea. The fecal smear for leukocytes is positive. The organism is gram negative and does not ferment lactose.
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Answer: Z- Shigella sonnei
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132. A 49-yr-old man, who is post heart transplant, develops a severe pneumonia. A gram stain of sputum reveals a gram positive filamentous bacteria that is partially acid fast.
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Answer: X- Nocardia asteroides (Slide 59)
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133. A 23-yr-old woman complains of a foul smelling vaginal discharge after sexual intercourse. Vaginal pH is 5.5. A cervical Pap smear reveals organisms adhering to superficial squamous cells.
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Answer: Z- Gardnerella vaginalis (bacterial vaginosis, clue cells) (Slide 75)
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134. A 30-yr-old man with a pet iguana develops severe enterocolitis with a positive fecal smear for leukocytes.
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Answer: A- Salmonella enteritidis (iguanas are reservoirs for Salmonella)
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135. A 48-yr-old woman has an alkaline urine that smells like ammonia. An ultrasound reveals a large calculus in the renal pelvis of the right kidney.
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Answer: F- Proteus mirabilis (magnesium ammonium phosphate or struvite stone, urease producers) (Slide 65)
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136. A febrile 22-yr-old man with sickle cell disease develops a lytic lesion in the right femur.
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Answer: B- Salmonella paratyphi (osteomyelitis)
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137. An 82-yr-old man in a nursing home develops fever and a cough productive of thick, bloody, mucoid sputum. A chest x-ray reveals a right lower lobe lobar pneumonia.
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Answer: D- Klebsiella pneumoniae (MC typical pneumonia in nursing home residents, also common in alcoholics, but S. pneumoniae is still the MC typical pneumonia) (Slide 63)
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138. A 28-yr-old man develops a severe, secretory type of diarrhea shortly after eating oysters in New Orleans. Physical exam reveals gram negative comma shaped organisms in his stool. SELECT 2
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Answers: H, I- Vibrio cholerae or I. Vibrio parahaemolyticus
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139. A veterinarian develops a cellulitis of the right index finger shortly after being bitten by a cat.
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Answer: V- Pasteurella multocida (Slide 72)
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140. A 30-yr-old woman develops a high fever, abdominal pain, and bloody diarrhea after eating improperly cooked chicken. The fecal smear for leukocytes is positive and S-shaped gram negative bacteria are noted in the stool.
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Answer: K- Campylobacter jejuni
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141. A febrile 5-yr-old child complains of severe abdominal pain. Laparotomy reveals a normal vermiform appendix but enlarged mesenteric lymph nodes. Frozen section reveals granulomatous microabscesses without caseation.
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Answer: G- Yersinia enterocolitica (mesenteric adenitis simulating acute appendicitis)
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142. A patient with AIDS develops pneumonia with a cough productive of a red-pigmented sputum.
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Answer: E- Serratia marcescens (produces red pigment, mainly in immunocompromised hosts) (Slide 64)
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143. A 48-yr-old smoker, who works in the grocery produce section, develops a high fever, cough with bloody sputum, and muscle aches and pains. A silver stain of sputum reveals organisms.
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Answer: S- Legionella pneumophila (mists can transmit the organism) (Slide 71)
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144. A 28-yr-old man with AIDS develops red, non-pruritic lesions. A biopsy reveals vessel inflammation and small organisms that are visible with a silver stain.
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Answer: X- Bartonella henselae (also causes cat-scratch disease) (Slide 74)
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145. A 42-yr-old alcoholic with cirrhosis develops a skin and soft tissue infection. He normally shucks oysters for a living in a restaurant in New Orleans.
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Answer: J- Vibrio vulnificus
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146. A 2-yr-old child, who has not been immunized properly, has had rhinorrhea and a conjunctivitis for the last week and now has developed a cough at the end of expiration followed by an inspiratory whoop. His WBC count shows a 40,000 cells/mm3 with predominantly mature lymphocytes.
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Answer: R- Bordetella pertussis (whooping cough with absolute lymphocytosis) (Slide 70)
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147. A physician in Iraq has a patient with fever, diarrhea, splenomegaly, sinus bradycardia, and absolute neutropenia.
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Answer: C- Salmonella typhi (Slide 61-62)
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148. Pathogen that causes pneumonia in ICUs, death in burn patients, malignant external otitis in diabetics, death in cystic fibrosis patients, and osteomyelitis in puncture wounds through rubber footwear.
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Answer: M- Pseudomonas aeruginosa
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149. Pathogen that causes peptic ulcer disease, gastric adenocarcinoma, and malignant lymphoma
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Answer: L- Helicobacter pylori (Slide 66)
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150. A rabbit hunter develops ulceration of a papular lesion on the forearm and painful axillary lymphadenopathy. He recalls picking off a tick in the area of the skin lesion.
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Answer: U- Francisella tularensis
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151. A mammalogist studying prairie dogs in Arizona develops painful, enlarged draining inguinal lymph nodes. He recalls being bitten by fleas when examining dead prairie dogs.
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Answer: W- Yersinia pestis (Slide 73)
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152. A 4-yr-old child develops pink eye. A gram stain of the watery exudate reveals small gram negative coccobacillary organisms.
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Answer: P- Haemophilus aegyptius
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153. A 3-yr-old child who has not been properly immunized develops fever and nuchal rigidity. A spinal tap reveals increased protein, neutrophils, and decreased glucose. A gram stain reveals small gram negative coccobacillary organisms.
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Answer: O. Haemophilus influenzae
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154. A 48-yr-old man who works in the Grand Canyon as a mule handler for trips into the canyon develops ulcerative lesions on the skin of his forearm along with painful regional lymphadenopathy. A biopsy of the lesion reveals granulomatous inflammation.
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Answer: N- Burkholderia mallei (patient has glanders)
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155. A 24-yr-old man develops a painful ulcer on his penis and painful inguinal lymph nodes. A gram stain of the ulcer reveals gram negative rods oriented in the same direction like a "school of fish".
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Answer: Q- Haemophilus ducreyi (chancroid) (Slide 69)
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156. A sheepherder develops high fever, generalized lymphadenopathy, and hepatospleno-megaly. He later develops osteomyelitis.
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Answer: T- Brucella melitensis (brucellosis-- undulant fever)
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157. A man from New Guinea develops genital ulceration without lymphadenopathy. A Giemsa stain of a biopsy of the lesion shows a granulomatous reaction with macrophages containing phagocytosed organisms.
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Answer: Y- Calymmatobacterium granulomatis (granuloma inguinale, note absence of lymphadenopathy, macrophage with organisms called Donovan bodies)
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158. Street person with punched out erosions of interdental papillae covered by gray, necrotic pseudomembrane.
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Answer: S- Fusobacterium (trench mouth)
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159. Anaerobe involved in subdiaphragmatic abscess.
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Answer: Q- Bacteroides fragilis
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160. Anaerobes involved in lung abscess due to aspiration of oropharyngeal material SELECT 2
|
Answers: R- Prevotella melanogenicus, S- Fusobacterium
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161. Pathogen involved in hand infection in a patient recovering from a fist fight
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Answer: A- Eikenella corrodens
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162. 25-yr-old woman with a maculopapular, erythematous rash on the palms and soles develops fever and intensification of the rash after being treated with penicillin
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Answer: D- Treponema pallidum (secondary syphilis, Jarisch-Herxheimer reaction) (Slide 76)
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163. Non-spirochetal pathogen responsible for rat bite fever in slum areas
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Answer: B- Streptobacillus moniliformis (Spirillum minor is a spirochete that produces rat bite fever)
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164. 52-yr-old man with decreased vibratory sensation, ataxic gait, absent DTRs in the lower extremities, pupils that accommodate but does not react to direct light, and a positive VDRL in the CSF
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Answer: D- Treponema pallidum (tabes dorsalis with Argyll-Robertson pupil) (Slide 76)
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165. Teenager with blindness, peg teeth and mulberry molars, saddle nose deformity, rhagades.
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Answer: D- Treponema pallidum (congenital syphilis, blindness due to interstitial keratitis) (Slide 77)
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166. Farm boy with fever, jaundice, conjunctivitis, and dark field positive tightly coiled spirochetes in the urine. The boy commonly swims in ponds.
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Answer: G- Leptospira interrogans (Weil's disease) (Slide 79)
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167. Patient with reactivation TB develops small bowel obstruction. A barium study reveals narrowing of the lumen in the terminal ileum.
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Answer: H- Mycobacterium tuberculosis (intestinal TB from swallowing organisms)
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168. Atypical Mycobacteria that requires light for growing in culture. It produces lung disease similar to M. tuberculosis
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Answer: K- Mycobacterium kansasii
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169. Surgical removal of enlarged lymph nodes in a child reveals granulomatous inflammation and acid-fast bacilli.
|
Answer: M- Mycobacterium scrofulaceum
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170. A patient with a prosthetic hip joint develops acid-fast disease
|
Answer: N- Mycobacterium fortuitum-chelonei
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171. Patient in Long Island with a history of tick bite develops an erythematous, concentric appearing rash in the area of the tick bite. The patient also has a hemolytic anemia with intraerythrocytic organisms noted in the peripheral smear.
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Answer: F- Borrelia burgdorferi (Lyme disease with erythema chronicum migrans and hemolytic anemia due to Babesia) (Slide 78)
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172. Patient in Colorado with a history of a previous tick bite develops high fever with periods of relapse, an erythematous rash, and hepatosplenomegaly. Spirochetal organisms are present in the peripheral blood smear.
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Answer: E- Borrelia recurrentis (relapsing fever, develops new antigen types)
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173. Patient in Texas has multiple hypopigmented macular skin lesions. He has a positive lepromin skin test.
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Answer: O- Mycobacterium leprae: tuberculoid (intact cellular immunity, granulomas present, no organisms, autoamputation of digits) (Slide 83)
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174. Patient from India has nodular lesions on the face. Lepromin skin test is negative. Skin biopsy reveals a Grenz zone underlying which are foamy macrophages with acid fast organisms. During treatment, she develops erythema nodosum and is placed on thalidomide.
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Answer: P- Mycobacterium leprae: lepromatous (deficient cellular immunity, no granulomas, numerous organisms, erythema nodosum leprosum during dapsone Rx) (Slide 84)
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175. Patient with AIDS develops malabsorption. Small bowel biopsy reveals foamy macrophages in lamina propria that has acid fast bacilli.
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Answer: J- Mycobacterium avium intracellulare (MAI produces Whipple's like syndrome, CD4 count < 100) (Slide 82)
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176. Farmer, who drinks unpasteurized milk, develops small bowel obstruction. A barium study reveals a string sign in the terminal ileum.
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Answer: I- Mycobacterium bovis
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177. A man who works in a pet store in the fish department develops a rash on his hands. Culture reveals acid fast organisms that grow best in light.
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Answer: L- Mycobacterium marinum
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178. A sexually active woman has flat, raised lesions in the anogenital area. A few weeks ago, she had a painless ulcer on the labia majora. An RPR test is initially reported as negative but becomes positive after multiple dilutions of the serum.
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Answer: D- Treponema pallidum (secondary syphilis with condyloma latum, prozone phenomenon-- antibody excess) (Slide 76)
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179. Spelunker in Ohio develops a solitary coin lesion in the right upper lobe
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Answer: L- Histoplasma capsulatum (bat/chicken excreta, macrophages phagocytose yeast forms) (Slide 96)
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180. Chicken farmer in Arkansas has multiple calcifications in the lungs and spleen.
|
Answer: L- Histoplasma capsulatum (chicken excreta, marked dystrophic calcification)
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181. Anthropologist studying Native-American artifacts in Sonoran desert develops a painful nodule on the shins.
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Answer: J- Coccidioides immitis (erythema nodosum association, arthrospores in dust) (Slide 94)
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182. Pulmonary infections after earthquake in Southern California
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Answer: J- Coccidioides immitis (erythema nodosum association, arthrospores in dust) (Slide 94)
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183. Bridge painter in New York city develops a lung infection
|
Answer: K- Cryptococcus neoformans (pigeon excreta) (Slide 95)
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184. Patient with AIDS develops meningitis. Positive India ink prep of CSF.
|
Answer: K- Cryptococcus neoformans (pigeon excreta) (Slide 95)
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185. Wildlife manager in Great Lakes area, who occasionally traps beavers, develops a verrucoid appearing skin lesion and lung disease.
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Answer: M- Blastomyces dermatitidis; beavers are also reservoirs for Giardia (Slide 97)
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186. Bronchial asthma, fungus balls, hemorrhagic infarctions in the lungs
|
Answer: O- Aspergillus fumigatus (Slide 98)
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187. Diabetic recovering from ketoacidosis develops a frontal lobe abscess
|
Answer: P- Mucor species (rhinocerebral mucormycosis) (Slide 99)
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188. Wood's light positive circular erythematous lesion with clear center on the skin
|
Answer: D- Trichophyton rubrum (tinea corporis) (Slide 86)
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189. Skin hypopigmentation, scaly dermatitis of the scalp
|
Answer: E- Malassezia furfur (tinea versicolor, seborrheic dermatitis, spaghetti and meatballs KOH) (Slide 88, 92)
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190. Wood's light positive area of alopecia with black dots
|
Answer: B- Microsporum canis (tinea capitis, infection outer hair shaft)
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191. Wood's light negative area of alopecia with black dots
|
Answer: A- Trichophyton tonsurans (tinea capitis, infection of inner hair shaft
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192. Lobster fisherman, forester planting pine seedlings, elderly woman who is a rose gardener develop an area of ulceration on the hands and lymphocutaneous nodules
|
Answer: H- Sporothrix schenckii (sporotrichosis, the first 2 due to sphagnum moss) (Slide 93)
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193. Alopecia with crusting of the scalp
|
Answer: C- Trichophyton schoenleinii (tinea capitis, favus)
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194. Patient living in swamps in southern Georgia develops a lesion in the foot characterized by subcutaneous swelling and multiple draining sinuses with granules. The patient walks barefoot most of the time.
|
Answer: I- Pseudallescheria /Nocardia asteroides (mycetoma)
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195. Carpenter develops a raised, verrucoid lesion. Biopsy reveals a granulomatous reaction and brown staining organisms.
|
Answer: G- Phialophora, Cladosporium (chromomycosis, splinters, dematiaceous fungi)
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196. Infant with fiery red rash and white exudate in gluteal folds
|
Answer: F- Candida albicans (yeasts and pseudohyphae) (Slide 90)
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197. HIV positive patient with oral thrush and hairy leukoplakia develops fever, dyspnea, tachypnea, and lung consolidation in both lungs. CD4 T helper count is 200.
|
Answer: Q- Pneumocystis jiroveci (Slide 100)
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198. Patient from South America develops lung disease. Biopsy reveals yeast with multiple buds resembling a ship's wheel.
|
Answer: N- Paracoccidioides braziliensis (South American blastomycosis)
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199. AIDS diarrhea with acid-fast oocysts. SELECT 3
|
Answers: D, G, H: D- Cryptosporidium parvum (sporozoan, also contaminates water supply, positive string test), G- Cyclospora cayetanensis (sporozoan) H- Isospora belli (sporozoan) (Slide 102)
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200. AIDS diarrhea with spores in stool
|
Answer: F- Microsporidia species
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201. Newborn infection with calcification of basal ganglia and blindness in woman who breeds cats; space occupying lesion in the brain in a patient with AIDS
|
Answer: E- Toxoplasma gondii (Slide 103)
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202. Patient returning from Mexico develops bloody diarrhea. Trophozoites with erythrophago-cytosis noted in stools.
|
Answer: A- Entamoeba histolytica (flask shaped ulcers in cecum, liver abscess) (Slide 101)
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203. Soft lens wearer who does a lot of fresh water skiing develops meningoencephalitis and severe keratitis
|
Answer: C- Acanthamoeba castellanii (Naegleria fowleri also causes meningoencephalitis)
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204. Hemolytic anemia associated with a tick bite.
|
Answer: I- Babesia microti (carried by Ioxides tick) (Slide 104)
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205. Malaria associated with fever every 72 hrs and diffuse membranous glomerulopathy
|
Answer: K- Plasmodium malariae (Slide 105-107)
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206. Malaria not contracted by blacks who are Duffy antigen negative
|
Answer: J- Plasmodium vivax (tertian fever pattern-- q. 48 hrs) (Slide 105-107)
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207. Malaria associated with multiple ring form infestation and banana shaped gametocytes
|
Answer: L- Plasmodium falciparum (quotidian fever pattern, severe disease often involving CNS) (Slide 105-107)
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208. Blood sporozoans transmitted by bite of female Anopheles mosquito SELECT 3
|
Answers: J, K, L: J- Plasmodium vivax, K- Plasmodium malariae, L- Plasmodium falciparum (Slide 105)
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209. Ciliate producing colonic ulcers and bloody diarrhea
|
Answer: M- Balantidium coli (large cysts and trophozoites in stool) (Slide 108)
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210. Hemoflagellate with only trypanosomes that produces an encephalitis leading to sleeping and eventual starvation. Transmitted by tsetse fly.
|
Answer P: Trypanosoma gambiense (African sleeping sickness, increased IgM, antigen variation, Winterbottom's sign)
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211. Pathogen associated with chronic heart failure, acquired achalasia and Hirschsprung's disease. Trypanosomes in blood and amastigotes in tissue. Xenodiagnosis is frequently used.
|
Answer: Q- Trypanosoma cruzi (American trypanosomiasis, reduviid bug used to make Dx, Romana's sign in area of bite on face; called a chagoma) (Slide 111)
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212. Woman with severe cervicitis and vaginitis. Frothy green exudate. Male partner with urethritis.
|
Answer: O- Trichomonas vaginalis (Slide 110)
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213. Chronic diarrhea with malabsorption in a patient with IgA deficiency. Positive string test and urine antigen test.
|
Answer: N- Giardia lamblia (contaminates water supply and mountain streams; beaver is a reservoir) (Slide 109)
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214. Transmitted by sandfly and produces massive hepatosplenomegaly. Macrophages phagocytose leishmanial forms.
|
Answer: R- Leishmania donovani (visceral leishmaniasis, kala azar, only leishmanial forms in tissue)
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|
|
215. Transmitted by sandfly and produce cutaneous and mucocutaneous disease that offers immunity with recovery
|
Answer: S- Leishmania tropica/braziliensis
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216. Invasive helminth that has a larval phase in the lungs and is often disseminated in AIDS patients and a common cause of autoinfection and superinfection. Filariform larvae in soil. No eggs in stool
|
Answer: E- Strongyloides stercoralis (intestinal nematode) (Slide 116)
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|
217. Produces eosinophilia in its transmigration through the lungs and bowel obstruction in its adult form
|
Answer: C- Ascaris lumbricoides (intestinal nematode) (Slide 114)
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218. Invasive helminth that is associated with rectal prolapse in children
|
Answer: B- Trichuris trichiura (intestinal nematode) (Slide 113)
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219. Invasive helminth with a larval phase in the lung that is associated with iron deficiency
|
Answer: D- Necator americanus (intestinal nematode) (Slide 115)
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220. Associated with eating sushi and sashimi
|
Answer: I- Anisakis simplex (intestinal nematode, Rx is surgical excision)
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|
221. Invasive helminth where the adult can be the definitive host in one manifestation of the disease and the intermediate host in another manifestation of the disease associated with focal epileptic seizures
|
Answer: N- Taenia solium- (cestode, human who eats infected pork with larvae develops adults in the intestine- definitive host. Human who ingests eggs develops cysticerci (larvae) that produce retinitis and CNS cysts- man is intermediate host) (Slide 120)
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222. Invasive helminth associated with vitamin B12 deficiency that cannot be corrected with intrinsic factor, pancreatic enzymes, or antibiotics
|
Answer: L- Diphyllobothrium latum (cestode, fish tapeworm)
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|
|
223. Non-invasive helminth associated with pruritus ani, appendicitis, and urethritis in little girls
|
Answer: A- Enterobius vermicularis (intestinal nematode and MC helminth in U.S., scotch tape test for embryonated eggs) (Slide 112)
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224. Basque sheepherder has cystic lesion in the liver.
|
Answer: O- Echinococcus granulosis (cestode, hydatid cyst, dog is definitive host and man the intermediate host) (Slide 121)
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225. Pig farmer develops muscle pain. Exam reveals splinter hemorrhages in nails and pain in deltoid muscle. Radiograph reveals numerous areas of dystrophic calcification in muscle. Marked eosinophilia is present.
|
Answer: F- Trichinella spiralis (trichinosis, intestinal nematode, eating improperly cooked pork, larvae encyst in striated muscle) (Slide 117)
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226. Adult with 3 dogs and 20 cats has pronounced eosinophilia. Physical exam reveals hepatomegaly.
|
Answer: G- Toxocara canis/cati (intestinal nematode, visceral larva migrans, man dead end host for larvae)
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227. Child, who commonly plays in an uncovered sandbox, develops a pruritic skin lesion with tunnels in the subcutaneous tissue.
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Answer: H- Ancyclostoma species (intestinal nematode, cutaneous larva migrans, man dead end host) (Slide 118)
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228. A cattle farmer has proglottids in his stool.
|
Answer: M- Taenia saginata (cestode, beef tapeworm)
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229. Pathogen transmitted by a mosquito that produces lymphedema. Microfilaria are present in the blood at night.
|
Answer: J- Wucheria bancrofti (tissue nematode, elephantiasis) (Slide 119)
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|
230. Most common tapeworm infection in the United States
|
Answer: K- Hymenolepis nana
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231. Spider with painful bite that causes severe thigh and abdominal muscle cramps and hypertensive crisis.
|
Answer: R- Latrodectus mactans (neurotoxin of black widow, red hour glass on ventral surface) (Slide 124)
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232. Spider that commonly bites at night and produces necrotic skin ulcers
|
Answer: S- Loxosceles recluses (necrotoxin of brown recluse spider) (Slide 125)
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233. Pathogen causing "pipe stem" cirrhosis leading to portal hypertension, ascites, and esophageal varices. Eggs have prominent lateral spines.
|
Answer: P- Schistosoma mansoni (trematode, adults lay eggs in portal vein) (Slide 122)
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234. Pathogen causes squamous cell carcinoma of bladder. Egg has nipple at the end.
|
Answer: Q- Schistosoma hematobium (adults lay eggs in urinary venous plexus, Clonorchis sinensis, Chinese liver fluke, is the only other parasite that produces cancer- cholangiocarcinoma. Second intermediate host is transmitted by eating fish paste) (Slide 123)
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235. Hiker in the Sonoran desert feels sharp pain in his foot when he puts on his hiking boots. His big toe initially hurts and then becomes numb as well as the rest of the leg. Another hiker calls in for help. In the ER, the patient has hypertension and is beginning to exhibit signs of paralysis. Later he develops pancreatitis.
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Answer: T- Centruroides gertschi (scorpion, presence of hypertension is very characteristic). Pancreatitis is another characteristic finding. (Slide 126)
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236. A patient develops a pruritic erythematous rash while at a picnic. Patient noticed tiny red organisms on the skin.
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Answer: U- chiggers (mite) (Slide 127)
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237. A patient develops an intensely pruritic rash in the web space of his right hand. A burrow is noted in the space.
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Answer: V- Sarcoptes scabies (human itch mite, spares palms and soles, children do not develop intertriginous lesions but lesions on palms and soles) (Slide 128)
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238. A second year medical student recognizes a moving organism in the pubic hairs in a man he is checking for a hernia.
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Answer: Y- Phthirus pubis (crabs) (Slide 131)
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239. A second year medical student notices white eggs attached to hairs in a child he is examining.
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Answer: W- Pediculus humanis capitis (head lice, eggs called nits) (Slide 129)
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240. A second year medical student notices moving organisms in the underwear of a patient he is examining.
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Answer: X- Pediculus humanis corporis (body lice, adults live in clothes and do not attach to skin). Rx not for patient but for clothes with malathion or DDT. (Slide 130)
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241. A plumber crawling under a house develops numerous painful bites that quickly develop a wheal and flare followed by vesiculation and skin necrosis
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Answer: Z- fire ants
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242. A patient from China, who sells herbs and other produce, develops a severe lower respiratory tract infection that spreads systemically. Other members of the family develop the same infection.
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Answer: AA- palm civet. The patient has severe acute respiratory syndrome (SARS), which is first transmitted to humans via handling of palm civets. The disease then spreads to other family members through human to human contact. The diagnosis is made by viral detection by PCR or detection of antibodies.
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