clinical cases Flashcards
What is a likely cause of this illness?
a) Salmonella typhi
b) Giardia lamblia
c) Ascaris lumbricoides
d) Staphylococcus aureus
c) Ascaris lumbricoides
How is this illness typically diagnosed?
a) Microscopic identification of eggs in the stool
b) Gram stain of stool samples to detect organisms
c) Dark field microscopy of blood smear
d) Indirect immunofluorescence of blood smear
a) Microscopic identification of eggs in the stool
How is this illness transmitted?
a) ingestion of infective eggs from contaminated soil
b) ingestion of the adult organism from contaminated food
c) ingestion of infective cysts from contaminated water
d) ingestion of trophozoites from contaminated water
a) ingestion of infective eggs from contaminated soil
Which of the following stages is NOT involved in the pathogenesis of this organism?
a) larvae hatch and invade intestinal mucosa
b) larvae are carried by blood to the lungs
c) larvae mature and penetrate walls of alveoli
d) larvae ascend bronchial tree and are swallowed
e) all of these stages occur with this organism
e) all of these stages occur with this organism
Which drug was used for the successful treatment of this patient?
a) Metronidazole
b) Chloroquine
c) Mebendazole
d) Ciproflozacin
c) Mebendazole
What diagnosis is consistent with these symptoms?
a) contact dermititis
b) ascaris worms
c) chicken pox
d) scabies
d) scabies
Which organism causes this illness?
a) varicella zoster virus
b) a mite, sarcoptes scabiei
c) an ascaris worm
d) an allergic reaction to laundry detergent
b) a mite, sarcoptes scabiei
How is this illness transmitted?
a) close contact with infected individuals
b) unsanitary conditions
c) sexual contact
d) all of these
d) all of these
How should all family members be treated?
a) apply a permethrin-based insecticide cream to the affected areas
b) apply fluconazole ointment to the affected areas
c) apply topical antihistamines or calamine lotion to help control itching
d) use of antibiotics if secondary bacterial infection is present
e) a, c, and d
f) b, c, and d
g) all of these
e) a, c, and d
Which of these will NOT prevent a reoccurrence of this illness?
a) clothing should be boiled and washed
b) fingernails should be trimmed
c) bed linens should be boiled and washed
d) vaccination
d) vaccination
The organism was subsequently shown to form germ tubes. What is the organism?
a) pseudomonas aeruginosa
b) aspergillus fumigatus
c) staphylococcus aureus
d) legionella pneumophila
b) aspergillus fumigatus
What other lab tests would confirm this diagnosis?
a) direct microscopy of sputum
b) cytology staining using KOH/calcifluor
c) all of these may be necessary
d) fungal cultures
e) serum antigen testing for fungal galactomannan
c) all of these may be necessary
What morphology does this organism exhibit?
a) thin hyphae characteristic of a mold
b) germ tubes characteristic of a yeast
c) dimorphic
d) a and b
a) thin hyphae characteristic of a mold
How should this infection be treated?
a) amphotericin B
b) voriconazole
c) intraconazole
d) any of these would be effective
d) any of these would be effective
How could this infection be prevented?
a) vaccination
b) HEPA filtration of room air
c) decrease chemotherapy drugs
d) administer colony-stimulating factors like granulocyte-stimulating factor (GCSF)
e) a, b, and c
f) b, c, and d
f) b, c, and d
Whith which organism were the patients infected?
a) streptococcus pneumoniae
b) histoplasma capsulatum
c) mycobacterium tuberculosis
d) candida albicans
b) histoplasma capsulatum
Which of these tests may be required to confirm the diagnosis?
a) direct microscopy of lung and spleen tissue biopsy specimens
b) mycologic cultures
c) all of these may be necessary
d) antigen detection test
e) serology
c) all of these may be necessary
How could this illness have been prevented?
a) use of proper PPE
b) vaccination
c) preventing contact with sick people
d) avoiding contaminated food
a) use of proper PPE
What treatment is indicated for this organism?
a) any beta-lactam antibiotic
b) a combination of antibiotics
c) itraconazole
d) amoxicillin
c) itraconazole
Which of these groups would be of high risk of infection by this pathogen?
a) spelunkers in the Ohio and Mississippi River valleys
b) hunters
c) immunocompromised persons
d) a and c
e) b and c
d) a and c
With which organism were the patients infected?
a) treponema pallidum
b) candida albicans
c) mycobacterium tuberculosis
d) cryptococcus neoformans
d) cryptococcus neoformans
Which of these tests may be required to confirm the diagnosis?
a) gram and acid-fast stain of CSF and respiratory specimens
b) india-ink stain of CSF
c) all of these may be necessary
d) cultures of CSF and blood for bacteria, fungi, and mycobacteria
e) CSF VDRL
c) all of these may be necessary
What is the most common symptom of primary lung infection by tis organism?
a) asymptomatic
b) fever
c) productive cough
d) arthritis and pain in joints
a) asymptomatic
What treatment is indicated for this organism?
a) itraconazole
b) amphotericin B alone
c) amphotericin B plus flucytosine (5-FC), followed by life-long fluconazole
d) amoxicillin
c) amphotericin B plus flucytosine (5-FC), followed by life-long fluconazole
How could this infection have been prevented?
a) it could not have been prevented
b) improvement of immune system through antiretroviral therapy (HAART therapy)
c) use of PPE
d) stay away from persons who show symptoms
b) improvement of immune system through antiretroviral therapy. (HAART)
The cultured organism was subsequently shown to form germ tubes. What is the organism?
a) histoplasma capsulatum
b) candida albicans
c) saccharomyces cerevisiae
d) cryptococcus neoformans
b) candida albicans
What othe lab tests would confirm this diagnosis?
a) detection of L-proline aminopeptidase enzymatic activity
b) detection of beta-galactosaminidase enzyme activity
c) detection of beta-lactamase enzymatic activity
d) a and b
e) a and c
d) a and b
Is this organism part of the normal flora in humans?
a) yes; of the skin, GI tract, oropharynx, and cervix
b) Yes; of the lungs
c) no
d) yes; of the GI tract only
a) yes; of the skin, GI tract, oropharynx, and cervix
How should this patient be treated?
a) amphotericin B
b) the piperacillin-tazobactam should be continued
c) fluconazole
d) a and b
e) b and c
f) a or c
g) all of these
f) a or c
Which of these signs or symptoms created favorable circumstance for growth of this organism?
a) high blood lipid levels
b) high blood glucose
c) treatment with broad-spectrum antibiotics
d) recent abdominal surgery
e) the in-dwelling central line
f) all of these contributed to the infection
f) all of these contributed to the infection
What additional tests should be performed?
a) look for presence of specific IgM in serum or CSF
b) test for elevated arboviral IgG
c) PCR or RT-PCR amplification of viral nucleic acid from CSF to rule out a virus that can replicates in neurons, like HSV-1 or poliovirus
d) all of these tests should be performed
d) all of these tests should be performed
What is the causative organism
a) west nile virus
b) ebola virus
c) marburg virus
d) hepatitis C virus
a) west nile virus
How is this virus transmitted?
a) contamination of an open wound with soil pathogens
b) via an insect vector
c) via a rodent vector
d) consumption of contaminated water
b) via an insect vector
How can this virus be controlled or prevented?
a) surveillance to detect the presence of the virus in areas where humans are at risk
b) elimination of standing water
c) control of the animal or insect vector
d) public education
e) all of the above
e) all of the above
Which of the following species provides the natural reservoir host for this virus?
a) humans
b) horses
c) birds
d) cattle
c) birds
You should perform ALL EXCEPT which of the following tests to confirm the diagnosis?
a) serology to test for IgG antibodies
b) culture the virus from teh patient’s tissues or bodily fluids
c) acid-fast stain of your patient’s bodily fluids
d) EM on tissue sections from a deceased patient
c) acid-fast stain of your patient’s bodily fluids
If the patient does have a viral hemorrhagic fever, her doctors can protect themselves from the illness by using ALL EXCEPT which of the following measures?
a) avoid unprotected contact with infectious body fluids
b) wear long pants, long sleeves, and use an insect repellent that contains DEET
c) avoid unprotected contact with contaminated medical supplies
d) avoid accidnetal needle sticks
b) wear long pants, long sleeves, and use an insect repellent that contains DEET
How did your patient most likely contract the disease?
a) she got some of the patient’s blood on the outside of her glove
b) she failed to wash her hands after removing her gloves
c) she inhaled aerosolized fluids while tending her patients
d) it had nothign to do withthe recent outbreak
c) she inhaled aerosolized fluids while tending her patients
How should this patient be treated?
a) metronidazole
b) supportive care to maintain hydration and blood volume
c) ceftriaxone
d) acyclovir
b) supportive care to maintain hydration and blood volume
What is the most likely cause of your patient’s illness?
a) clostridium perfringens
b) sin nombre hantavirus
c) bacillus anthracis
d) ebola virus
d) ebola virus
