Infectious Agents, Viruses, and Anemia

Question 1

CC: Pt presents w/ hx of sickle cell, fatigue, dyspnea, malaise
Labs: Low reticulocyte, Low Hb, IgM w/in 3 days of onset

Answer 1

Parvovirus B19
non-enveloped, ssDNA

Question 2

CC: 5-10 y/o child presents w/ mild flu-like symptoms, slapped cheeks rash that spreads to arms, legs, trunk
Labs: Low reticulocyte, Low Hb, IgM w/in 3 days of onset

Answer 2

Parvovirus B19
non-enveloped, ssDNA

Question 3

CC: from/travel hx to NE or upper mid-west USA. Tick bite. General malaise, fever, headache, chills, sweating, fatigue, weakness
Labs: PBS indicates maltese cross, ring form

Answer 3

Babesia

Question 4

CC: itch/rash between toes, bloody sputum, nausea, vomiting
Pt hx of walking barefoot (moist soil)
Xray: pulmonary infiltrate
Labs: microcytic hypochromic anemia

Answer 4

Hookworm

Question 5

CC: fever w/ chills, fatigue, general malaise, nausea, vomiting, tachycardia, headache
Pt hx of travel to Africa, Asia, and Latin America
*Possible symps: Blackwater fever, seizures (RBC adhesion to capillary walls around brain’s microvasculature)
Labs: Giemsa Stain, rapid antigen detection

Answer 5

Malaria
P. vivax - needs Duffy blood group antigen to bind to RBCs
P, falciparum binds to sialic acid residues on glycophorin A (most virulent - high number of parasitized cells, sausage shaped gametocyte)

Question 6

CC: epigastric pain, abd. pain, cramping,, dizziness, diarrhea, weight loss
Pt hx of eating raw fish
Labs: Low B12, megaloblastic anemia

Answer 6

Fish Tapeworm (Diphyllobothrium lactum)

Question 7

CC: chronic fatigue, pallor, numbness in extremities
Physical exam: glossitis, decreased vibratory sensation in L.E.
Labs: Low Hb, High MCV, Low B12, Megaloblastic Anemia, Neutopenia
PBS: hypersegmented neutrophils
Extra Tests: autoantibodies against gastric parietal cells

Answer 7

Pernicious Anemia
- autoimmune attack on parietal cells that secrete intrinsic factor

Question 8

CC: pallor, fatigue, abd. pain, dark urine, yellow eyes
Labs: Low Hb and Hematocrit, increased reticulocytes, High bilirubin slightly elevated LDH
(+) Direct Coombs Test

Answer 8

Immune Hemolytic Anemia

Question 9

CC: episodes of dark colored urine, especially in the mornings, fatigue, intermittent abd. pain.
Physical Exam: pallor
Labs: Low Hb, High LDH, No haptoglobin, (-) Coombs Test
HGIHT RISK OF DVT

Answer 9

Paroxysmal Nocturnal Hemoglobinuria

Question 10

Absence of CD55 and CD59 on erythrocytes
Mutation in: __________

Answer 10

DAF (CD55) or MAC-inhibitory protein (CD59)

Question 11

CC: fever, weakness/fatigue, headache/myalgias, sore throat, maculopapular rash. Followed by vomiting, diarrhea, impaired liver function, wasting, bleeding, hemorrhages

Answer 11

Ebola - Filoviridae (filamentous, enveloped, negative-strand RNA virus)

Question 12

CC: suddent onset of fever, chills, headache, myalgia. 5th day maculopapular rash, nausea, vomitting, chest pain, sore throat, abd. pain
Worse sympt: jaundice, pancreatitis, delirium, shock,massive hemorrhaging
fuit bats
Labs: lymphopenia, thrombocytopenia, abnormal platelet aggregation, HIGH AST (higher than ALT)

Answer 12

Marbug Virus - Filoviridae (filamentous, enveloped, negative-strand RNA virus)

Question 13

CC: flulike symptoms of fever, chills, headaches, backaches, lymphadenopathy rash, RETRO-ORBITAL PAIN

Answer 13

Dengue Virus - Flaviviridae (positive-sense ssRNA, lipid envelope)

Question 14

CC: severe systemic disease, infects liver, high fever, headachem jaudnice
Labs: HIGH bilirubinm elevated AST, ALT
PBS: councilman bodies
Pt hx of travel to tropical regions

Answer 14

Yellow Fever - Flaviviridae (positive sense ss rNA, lipid envelope)

Question 15

CC: rash and ecchymosis, fever headache, macular rash on palms and soles
Treatment: Doxycycline

Answer 15

R. rickettsii (Rocky Mt. Spotted Fever)