21. RTI 8 Flashcards
A 50 y/o AIDS patient presents with progressive confusion, HA, neck pain, cough beginning over the last few weeks. He is retired due to his illness and spends most of his days feeding pigeons at the park. If a tissue sample of the patient is taken which of the following stains is appropriate?
A. India Ink B. Silver stain C. Ziel-Neelsen Stain D. Rhodamine-Auramine Fluorscent Stain E. Mucicarmine Stain
SZ
Ans. E. Mucicarmine Stain
The man has Crytococcus neoformans
India Ink is for Crytoccoccus CSF sample
Silver stain - Legionella
Ziel-Neelsen Stain - Mycobacterium tuberculosis
Rhodamine-Auramine Fluorscent Stain- Mycobacterium tuberculosis
A 45 y/o man from Missouri presents to his PCP for a large lesion on his neck. He states he noticed it growing in size the last few weeks and it is now being irritated by his hard hat he is required to wear while operating a Bulldozer at work. He is also c/o cough, dyspnea on exertion. Which of the following describes the infectious agent?
A. Narrow budding yeast with circular capsule
B. Non-encapsulated thick walled budding yeast
C. Broad Budding Yeast
D. Spherules containing spores
E. No ergosterol in cell wall
SZ
Ans. C. Broad Budding Yeast
Patient has Blastomyces dermatitidis
A. Narrow budding yeast with circular capsule = Crytococcus
B. Non-encapsulated thick walled budding yeast = Histoplasma
D. Spherules containing spores = Coccidiodes
E. No ergosterol in cell wall = Pneumocystis jirovecii
A 45 year old man is brought to the hospital with symptoms of sarcoidosis and liver disease. His medical history show that he had a splenectomy 3 months a ago and works as a mantiances and custodial engineer in a city park that is notable for is large pigeon population. Given the patients symptoms and personal history which is true of the infection he likely has?
A. Lacks Ergosterol in cell wall B. Endemic to desert southwest C. Endemic to Ohio River Basin D. E. Has Capsule composed of GXM
Ans. E. Has capsule in composed of GXM ( glucuronoxylomannan) - the infection is Cryptococcus neoformans the patient is a immunocompromised because he had a splenectomy also cryptococcus grows in soil with pigeon droppings and is found world wide related illnesses are Sarcoidosis and Liver disease
A. Lacks Ergosterol in cell wall- Pneumocystis jirovecii
B- Endemic to desert south west- Coccidioides
C. Endemic to Ohio River Basin- Histoplasma Capsulatum & Blastomyces dermatitidis
A 19 year old girl comes to the doctor with complaint of a persistent cough. Her history shows that she is going to college at the Ohio State University studying environmental science. The past semester she has been part of a work study program were she have been collecting soil samples along the Mississippi and Ohio river valleys testing for mineral composition. Her medical history is for splenectomy or genetic immunocompromised disease. During examination you note formation of skin lesions behind her ear and on her back. What is the most likely infection agent in regards to her history and examination?
A. Blastomyces dermatitidis B. Coccidioides immitis C. Cryptococcus neoformans D. Histoplasma capsulatum E.Aspergillus sp
RFA
Ans. A- Blastomyces dermatitidis- Ohio and mississippi river valleys and pulmonary issues fits both Blastomyces and Histoplasma but the formation of skin lesion leans it towards Blastomyces
B. Coccidioides immitis- found in desert southwest
C. Cryptococcus neoformans- is an opportunistic infection, would be asymptomatic in healthy patients
D.Histoplasma capsulatum- same geographic location and pulm issues but no skin lesion formation
E. Aspergillus sp.- is an opportunistic infection, would be asymptomatic in healthy patients
