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30 Cards in this Set
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- Back
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A middle aged man has complaints of a lumpy jaw, which started about a month ago. The physician notes that the lump extends from the site of a lesion to the skin. She notes a mass lesion consisting of soft, central pus surrounded by hard fibrous walls. Further examination reveals a sulfur granule.
Which question would be most beneficial for the doctor to confirm her diagnosis? A. Have you been travelling in the Southwest? B. Have you had any recent dental surgery? C. Are you immunocompromised? D. What's the weather like on your home world? |
Choice B.
This bug is actinomycosis, a Gram (+) bacteria. It starts in the mouth and causes infection when the mucosal barrer is broken, (possibly due to dental surgery). |
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You run a walk in clinic and it's Christmas Eve. Just as you are closing for the day, 33 year old male comes in complaining of a runny nose, sore throat, and a cough. He's been feeling this way for 2 days now. Before you can go a wassailing, you must make a diagnosis. Most likely, the bug that's causing his symptoms sticks to which cellular adhesion molecule?
Also, is the bug or the host response causing the symptoms? |
This is most likely the common cold. The most likely cause is the rhino virus, a type of picorno virus. Rhino virus uses ICAM-1 to stick to the epithelium.
With the common cold, typically the HOST response is what causes the symptoms |
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An 11 year old girl complains of a very sore throat. You examine her pharynx and note 2 large lesions with a central ulceration. The rapid strep test comes back negative.
You decide to get a culture, although you aren't surprised to learn her sore throat was caused by a virus. Specifically, which virus? Assuming it's the virus that you suspect, how long should it take the girl to get better? |
This is most likely Herpangina caused by the Coxsackievirus. It usually lasts around 7 days
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An 11 year old girl complains of a very sore throat and an annoying earache. According to her mom, she's been running a fever for a few few days. You notice red spots on the girl's throat. You also happen to notice that the girl's tongue looks like a strawberry.
What does the girl have? What's the major virulence factor in this case? What's causing the strawberry tongue? What are two complications that you must look out for once the girl gets better? Which drug should you use? |
The girl probably has Streptococcus pyogenes. The strawberry tongue is a sign of scarlet fever, which is caused by an exotoxin.
The major virulence factor is M protein (strongly anti-phagocytic, and involved in adherence). After she gets better, she could have Glomerulonephritis (caused by immune complexes on glom. basemet membrane) Or she could deveop Rheumatic fever (cross reactive antibodies) She should be treated with Penicillin |
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An 11 year old girl complains of a very sore throat. You examine her pharynx and note 2 large lesions with a central ulceration. The rapid strep test comes back negative.
You decide to get a culture, although you aren't surprised to learn her sore throat was caused by a virus. Specifically, which virus? Assuming it's the virus that you suspect, how long should it take the girl to get better? |
This is most likely Herpangina caused by the Coxsackievirus. It usually lasts around 7 days
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An 11 year old girl complains of a very sore throat and an annoying earache. According to her mom, she's been running a fever for a few few days. You notice red spots on the girl's throat. You also happen to notice that the girl's tongue looks like a strawberry.
What does the girl have? What's the major virulence factor in this case? What's causing the strawberry tongue? What are two complications that you must look out for once the girl gets better? Which drug should you use? |
The girl probably has Streptococcus pyogenes. The strawberry tongue is a sign of scarlet fever, which is caused by an exotoxin.
The major virulence factor is M protein (strongly anti-phagocytic, and involved in adherence). After she gets better, she could have Glomerulonephritis (caused by immune complexes on glom. basemet membrane) Or she could deveop Rheumatic fever (cross reactive antibodies) She should be treated with Penicillin |
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It' the middle of July and after 4 marvelous weeks of AHEC, you decide to travel overseas for a medical mission trip to Africa. While there, you see a young boy who complains of a really bad sore throat. The child has lots of problems breathing and swallowing. You notice a pseudomembrane growing on his throat that looks pretty nasty.
Describe what the boy's throat culture would look like on potassium tellurite agar. How do you treat the child? Assuming you followed the rules and got your vaccinations, are you likely to get this disease? |
The boy has Diptheria caused by Corynebcterium diphtheriae.
On culture, the organisms look like Chinese characters. You should start the kid on passive antibodies + antibiotics + adminster vaccine If you have the DPT vaccine, you are not at risk for getting the bug. |
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A 14 year old girl comes to you with a violent, dry cough that has been going on for a few weeks now. The girl suspects that the bug initially stuck to the cilia of her respiratory epithelium (she's smart like that).
What does this bug look like in culture? Not wanting to be outdone by a teenager, you explain to her that the binding is facilitated by which factor? How would you confirm your diagnosis? What treatment do you recommend? Would a vaccine have helped in this case? |
The bug is bordetella pertussis (whooping cough).
Looks like Gram (-) coccobacilli. It sticks to the cilia via FHA. Diagnose by PCR. Also, elevated WBC's (especially lymphocytes) Treat with erythromycin or trimeth/sulfa. Disease could've been prevented by DPT vaccine. |
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It's winter time in Russia, where you work. You see a young infant with respiratory distress, including wheezing and poor oxygen saturation. The baby has all the signs of inflammation. You perform a rapid antigen test for Paramyxoviridae which comes back positive.
What are two key virulence proteins? Assuming the baby is otherwise healthy, what should you use to treat the child? |
This is most likely RSV.
Key virulence proteins are the F protein and G protein. If the baby is healthy, supportive care is the best treatment. Ribavirin can be used for hospitalized babies. |
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You are a busy family practice doc in rural Ohio. One day, another doctor that you work with who got his MD from University of Phoenix Online starts telling you about this unusual case of a toddler with RSV he saw in the morning.
According to your colleague, what made this case so unusual is because the parents of the toddler say he had symptoms of lryngotracheitis prior to having the more classic symptoms of RSV. You explain to your friend that this wasn't a case of RSV, but instead a case of what? |
This is classic parainfluenza virus
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A 31 year old NFL linebacker comes to you complaining of an abrupt onset fever, chils, and shortness of breath, right sided chest pain and most concerning to guy, bloody purulent sputum.
You get a culture of his sputum which grows Gram (+) diplococci. The only thing you notice from his history is that he recently had his spleen removed after a bad injury What is the best treatment for this guy's bug? |
This guy has Streptococcus pneumoniae, an extracellular, CAPSULED pathogen.
You can give the guy Penicillin or cephalosporin. (You may want to also suggest Pneumovax to avoid future recurrences of this disease) |
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You need to diagnose which type of pneumonia a patient has based on a culture.
The bug is Gram (-), pleomorphic, capsuled, and grows on chocolate agar only when NAD and hemin are added. Once you make your diagnosis, which antibiotic should the patient be treated with? |
This is Haemophilus influenzae type B.
Since the bug often produces beta-lactamase, you should try a 3rd generation cephalosporin. Also, the patient should be vaccinated with HIB vaccine. |
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Bob, an acoholic for 20 years was recently injured in a drunken car chase.
Unfortunately for Bob, he didn't show up to WIP because he was too illl. He has pleuritic chest pain, dyspnea, fever, and cyanosis. Which drug should the doc use to treat this guy's infection? What would Bob's bug look like on culture? |
Bob most likely has Klebsiella pneumoniae.
This bug is a Gram (-), capsuled, rod bacteria. It is HIGHLY antibiotic resistant. Treat with 3rd generation Cephalosporin |
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An elderly immunocompromised patient was cooking dinner when she fell down and landed herself in the hospital with a hip fracture. A few days later she starts complaining of chest pain, and dyspnea.
Soon she develops and she starts seeing ulcerated skin lesions. Culture shows gam (-) colonies that smell like Kool-Aid. What are some virulene factors for this bug? |
This bug is pseudomonas Aeruginosa.
Factors include fimbriae, slime, pyocyanin (pigment), proteases/elastases exotoxin A, endotoxin, resistance genes |
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Four college students who share a dorm suite develop a chronic, dry cough, with sore throat, fever, and malaise.
None of the guys "look sick" although one of them develops arthritis. The one who developed arthritis went to the doctor who came to the correct diagnosis by doing a cold agglutination test. Which antibiotic(s) would help the patient get better? What antibodies are required to clear this bug? |
The guys have Mycoplasma pneumonia otherwise known as , "walking pneumonia."
The student w/ arthritis likely has developed cross reactive antibodies. Treatment for all atypical pneumonias are 1. Tetracycline, 2. Macrolides, 3. Quinolone IgG and IgA are required to clear the bug. |
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An elderly woman developed acute pneumonia caused by a facultative intracellular aerobic bacteria.
The doctor was able to diagnose her disease through the urine antigen test. Was this a community acquired bug, or an environmentally acquired bug? Does she have a productive cough? |
The woman probably has Legionnella.
This bug is NOT spread person to person, but through aerosolized droplets. It is an atypical pneumonia so you would expect her to have a nonproductive cough. |
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A man has "flu-like" symptoms. What does he probably have?
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The flu!
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Following a surgical procedure, an elderly man is placed on steroids. After a few weeks, he starts to notice that he has chest pain when breathing as well as a fever.
He eventually decides to go to the doctor who decides to get a tissue sample. The doc notices that the organism is weakly acid-fast staining, and has a beaded, filamentous appearance. What is a good drug to treat this infection? What is his immune system lacking that's preventing him from fighting this bug? |
The man has nocardiosis, an opportunistic infection.
Penicillin is a good drug of choice. The body needs a good TH1 response to fight this infection. |
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An 18 year old woman with AIDS has been living with a fevers, chills, night sweats, and productive cough that's lasted for months. Her TB skin test came back negative and unfortunately she was not able to receive treatment in time and soon died.
Following her death, an autopsy was performed which found areas of caseous necrosis in her lungs. What is the most likely cause of her disease? What reatments would have helped her fight the infection in her lungs? |
The woman most likely had TB. (Her skin test came back negative because she was so immunocompromised).
Treatment for TB is done by using at least two of the following drugs: -Isonaizid -Rifampin -Pyrazinamide -Ethambutol -Streptomycin |
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An HIV+ spelunker was exploring the facinating caves in Kentucky.
Over the last few months, he's developed an infection with TB like symptom. The doctor treated him with amphoteracin B. Describe the appearance of the organism causing this infection. |
The man has Histoplasma.
It is a dimorphic fungi. In living cells it appears as small intracellular yest inside of mononuclear cells. |
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A family of tourists from Dayton went on a vacation to California to visit family.
On their way back, they got caught in a dust storm in Arizona. Now the father is complaining of TB-like symptoms, mainly pneumonia. The doctor correctly diagnoses the man and starts him on amphoteracin B. Describe the appearance of the organism causing this infection. |
The man contracted Coccidioides.
This is a dimorphic fungi. In living cells it appears as spherules or endospores inside tissues or pulmonary secretions. |
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A woman from Illinois developes cutaneous infections that resemble skin cancer.
Luckily it turned out to be a fungal infection and the doctor started the patient on amphoteracin B. Describe the appearance of the organism most likely causing this infection. |
The woman most likely has Blastomyces dermatitidis.
This is a dimorphic fungi. In living cells it appears as broad based budding yeast. |
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A young couple visited a fertility clinic after months of failed attempts at pregnancy.
After taking a thorough history, the doctor determines that the most likely cause was a disease that the husband had a few years back. The main described the disease as dry mouth and testicular pain in both testicles. (Poor guy). What could the guy have done to avoid getting this disease? |
The guy most likely had mumps (Paramyxoviridae Rubulavirus)
The MMR vaccine would have stopped him from getting mumps |
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Parents of a seven month old girl are concerned beause she has a rapid rise in temperature.
Two days later her temperature dropped back to normal, but now she has a rash that started on the back of her neck. Despite these symptoms she doesn't "look sick" at all. In fact, she looks remarkably healthy. How do doctors typicially diagnose this kid's condition? What's the best treatment? |
The child most likely has Roseola (Herpesvirus 6)
Typically doctors make this diagnosis by symptoms alone, or serologic tests/isolation can be done Treatment is mostly supportive care. |
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You are asked to make a diagnosis of bug found in a lung biopsy of an 18 month old boy with leukemia. The bug is a fungus, but it has protozoa like properties. On the tissue sample you notice alveolar injury with leakage of exudate through the basement membrane.
Which type of immunity in a healthy person is most important for preventing an infection with this bug? A. TH1 response B. Innate immunity C. IgA response D. IgG response E. Spleen |
The boy most likely has Pneumocystis jirovecii (carinii)
The most important host defense is TH1 response so A is the correct answer. |
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Which of these situations is a person NOT at risk for asperigellus?
A. Persons with allergies to to asperigellus B. People eating spoiled fruit (although healthy) C. People with preexisting cavities D. An organ transplant recipient |
Choice B.
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A person is infected with the same bug that causes Burkitt's lymphoma. What virus is this?
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Epstein-Bar virus
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A young child recently received an organ transplant and is on immunosuppresion.
You find out that his family has a pet cat, but it has never been outdoors nor has it ever been fed raw food. Do you have to get rid of the cat? |
No!
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A 26 year old wildlife/ecology graduate student was recently out doing a landmark study on the mating habits of skunks in the midwest when he got bit by one of the skunks he was studying. He is now complaining of pain and tingling around the bite.
What stage of his disease is he most likely in? Assuming it's the start of this stage, how long does he have before treatment will be useless? |
The man probably has rabies.
Pain and paresthesia are typcial during the prodromal period of rabies, which follows the incubation period. The prodromal stage lasts 2 to 4 days before it progresses to the neurologic period, at which point death is inevitable. |
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Betty is a 66 year old former editor of Cat Fancy magazine. She strongly believes that every day you should start with a kiss on the lips from one of your feline friends.
She's been working on training a new cat that she got 2 weeks ago. Now she's feeling under the weather and has a nasty rash. Upon examination you notice early signs of necrosis on one of her inguinal lymph nodes. You start Betty on the appropriate treatment (by the way, what is the treatment?) and Betty now wants to know if she got the disease from kissing her cat. What do you tell her? |
Betty most likely has bubonic plague which is spread by fleas on the cat, unlike pneumonic plague which is spread through respiratory droplets.
Treatment for yersinia pestis includes tetracyclines, aminoglycosides, and chloramphenicol. |
