Diagnostic Flashcards
16/F presents with decreased sensorium; noted high-grade remittent fever associated with myalgia, malaise, and sore throat. Few hrs PTA, noticed dusky erythematous patches on extremities, non-blanching with progression of malaise. What is the char of causative organism?
Diagnosis: Meningococcemia
Causative organism: Neisseria meningitidis
Gram negative, intracellular, diplococci, Glucose (+) and Maltose (+)
What is the culture medium for meningococcemia diagnosis if the specimen you will use for culture will be a sterile site?
Chocolate agar
- Blood is supposedly a sterile site
- Thayer-martin agar are used for Neisseria from non sterile sites.
Antibiotics present in Thayer-martim medium.
Nystatin: fungi
Vancomycin: Gram (+)
Colistin: Gram (-)
15/F with history of RHD, went for her dental extraction but was not given antibiotic prophylaxis a week prior, now presents in the ER weak-looking, lethargic with high fever. What is the characteristic of causative agent?
Impression: Subacute bacterial endocarditis
Causative organism: Streptococcus viridans
Gram-positive cocci, Optochin-resistant, Bile insoluble
6 month old boy was rushed to the ER due to decreased activity. The mother recalled that aside from formula milk, patient was fed with honey, and several hrs later, observed patient was limp. What management is a NO-NO for this patient?
Impression: Botulism
Contraindications: Antibiotics
*In Botulism, the toxin is released during the death of bacterium. Antibiotics, therefore, will exacerbate the release of more toxins.
24/F, presents with generalized vesicular rashes after 3 days cough, colds, and high-grade fever. The lesions were extremely pruritic and some are drying up. What is the etiologic agent of this disease?
VZV (Varicella)
Patient with a history of varicella a weeks ago presented with Vesicular lesions on labia majora which are painful. What is more likely the diagnosis?
Herpes genitalis
*caused by HSV 2 infection.
Patient with history of Herpes genitalis also compalains of sore throat, fever, and lethargy. PE noted hyperemic, hypertrophic tonsils, grade2, no exudates, extensive CLAD, bilateral; CBS, tachycardic, obliterated Traube space, heterophil Ab (+). What is the etiologic agent?
Impression: Infectious mononucleosis (kissing disease)
Etiologic agent: EBV
6/M CC of weakness, sometimes complain of occasional coughing episodes and DOB. PE: pale and was quite emaciated; serpiginous tracts and abrasions on the plantar surface of both feet. Mother claimed that patient habitually plays on soil barefoot. CBC shows microcytic hypochromic anemia, low albumin. What is the diagnosis?
Hookworm infection
*serpiginous tract- cutaneous larva migrans
Treatment of choice for Cutaneous larva migrans.
Albendazole
- Praziquantel: trematode infection
- Pyrantel pamoate: enterobiasis
- Metronidazole: amebiasis
- Thiabendazole: trichinosis
23/M presents with hx of 3d fever, noticed some punctate erythematous rash on arms and legs. What is the characteristic of etiologic agent?
Enveloped, positive-sense ssRNA virus
Vector for dengue.
Aedes aegypti
- Culex and Mansonia: filarial worms (Brugia, Wuchereria)
- Anopheles: Plasmodium
25/M complaint of rash on his chest without any associated symptoms. PE: 5cm, hypopigmented patch without surrounding erythema appreciated. on KOH mount, noted spaghetti and meatballs appearance. What is the most likely diagnosis?
Pityriasis vesicolor
Treatment of choice for disease caused by Malassezia furfur.
Topical imidazole
KOH mount: branched hyphae with occasional arthroconidia. What is your diagnosis?
Dermatophytosis
