Question

Please give genus and species for each answer.

41. A 8-year-old boy is brought to the doctor with a 3-day history of fever and a rash. He has a mild sore throat and felt tired. His mom is concerned that he might have scarlet fever. The rash started on his face and then spread to his arms and legs. He has only been given acetaminophen for the fever. He has no allergies and no significant medical history. His temperature is 101.5 F and his vital signs are normal. His cheeks are notably red, almost as if they had been slapped. There is a fine erythematous maculopapular rash but no vesicles or petechiae. A rapid group A streptococcal antigen test done was negative.

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42. A 46-year-old male with known HIV is brought to the hospital with diarrhea. He has had between 15 – 25 watery stools for the past two weeks. He has allow grade fever an feels fatigued but no vomiting. He has lost 10 pounds. He is on AZT, 3TC and a protease inhibitor for his HIV. His CD4 count is 149 cells. His temperature is 98.9 F. His mucous membranes are moist. He has tachycardia and hyperactive bowel sounds. His stool is heme negative. A modified acid-fast stained feces reveals multiple red and pink, round oocysts.

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43. A 3-year-old male infant is brought to the emergency room in the middle of February with fever, vomiting and diarrhea for the past day. He has not been able to keep anything down and he has a watery diarrhea. He goes to daycare and many of his classmates are also sick with the same symptoms. He has tachycardia and a fever (100.2 F). His eyes appear sunken, he has active bowel sounds and his stool is watery and pale. His feces was negative for blood and white blood cells.

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44.A 29-year-old female presents complaining of a 3 day itchy vaginal discharge. A week previously she was treated for a UTI with antibiotics. She denies abdominal pain and there is no dysuria. A pelvic examination reveals a thick, curd like, white discharge in her vagina.

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45. A 5-year-old boy is seen by his pediatrician because of anal itching. His mother has noticed him scratching and rubbing his anal area. His anal area is red and raw from all the scratching. His mother has applied hydrocortisone but it hasn’t helped. He does not have diarrhea. His vital signs are normal. The doctor performs a microscopic examination of a sample collected by touching the perianal area with double sticky tape.

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46. You met your wife at the local hospital where you work. You were married 18 months ago and now she discovers she is pregnant. You are both very she goes to the obstetrician for her first prenatal visit. Everything looks good; she is seven weeks into a normal pregnancy. About 10 days later you come home from work and she is waiting for you in the kitchen, looking very upset. She tells you that she tested positive for a STD. She says it must mean that you have been unfaithful because she has not had relations with anyone since you were married. Which of the following infections is possible if both of you have been monogamous for at least two years?

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47. A 40-year-old man with a history of intravenous drug use entered the local clinic with complaints of a dry, persistent cough; fever; malaise; and anorexia. Over the preceding 4 weeks, he had lost 12 pounds and experienced chills and sweats. A chest x ray revealed patchy infiltrates throughout the lung fields. Because the patient had a nonproductive cough, sputum was induced and submitted for bacterial, fungal and mycobacterial cultures, as well as examination for Pneumocystis. Blood cultures and serologic tests for HIV infection were performed. The patient was found to be HIV positive. The results of all cultures were negative after 2 days of incubation; however, cultures were positive after an additional 10 days of incubation. The most likely organism isolated from this patient is:

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48. You are called to the home of Michael, a 13 week – old baby boy who has become listless and is having trouble breathing. The parents report that he used to smile, but lately he has not smiled, nor has he had other noticeable facial expressions in the last two days. His eyes are open when you arrive, but he does not seem to be focusing. You place your out stretched finger under his but he can not grasp it.

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49. On an autumn day a number of people became ill working at the Widget Company. It is an industrial plant in the heart of Cincinnati, Ohio. Their symptoms ranged from simple coughing and other respiratory symptoms to pneumonia. At least one of fifty people showing symptoms died. The company voluntarily closed the building upon recommendation from the health department. After all of the water and cooling systems at the plant were evaluated and disinfected, it reopened and no new cases were reported. What is the causative agent at the factory?

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50. Jane has been on multiple antibiotics for the past few months for a severe sinus infection. She has been losing weight and looks especially pale. She has emerged from the ladies room. This her fourth trip today. She collapses and is taken to the hospital. 51. When you left for work this morning your 3-month old daughter

Answer 1

41. A 8-year-old boy is brought to the doctor with a 3-day history of fever and a rash. He has a mild sore throat and felt tired. His mom is concerned that he might have scarlet fever. The rash started on his face and then spread to his arms and legs. He has only been given acetaminophen for the fever. He has no allergies and no significant medical history. His temperature is 101.5 F and his vital signs are normal. His cheeks are notably red, almost as if they had been slapped. There is a fine erythematous maculopapular rash but no vesicles or petechiae. A rapid group A streptococcal antigen test done was negative.

Answer- Measles (Rubeola virus)

42. A 46-year-old male with known HIV is brought to the hospital with diarrhoea. He has had between 15 – 25 watery stools for the past two weeks. He has allowed grade fever a feel fatigued but no vomiting. He has lost 10 pounds. He is on AZT, 3TC and a protease inhibitor for his HIV. His CD4 count is 149 cells. His temperature is 98.9 F. His mucous membranes are moist. He has tachycardia and hyperactive bowel sounds. His stool is heme negative. Modified acid-fast stained faeces reveals multiple red and pink, round oocysts.

Answer- Diarrhoea- Cryptosporidium (C. parvum and C. hominis)

43. A 3-year-old male infant is brought to the emergency room in the middle of February with fever, vomiting and diarrhoea for the past day. He has not been able to keep anything down and he has a watery diarrhoea. He goes to day-care and many of his classmates are also sick with the same symptoms. He has tachycardia and a fever (100.2 F). His eyes appear sunken, he has active bowel sounds and his stool is watery and pale. His faeces were negative for blood and white blood cells.

Answer- Rotavirus diarrhoea (Rotavirus)

44.A 29-year-old female presents complaining of a 3-day itchy vaginal discharge. A week previously she was treated for a UTI with antibiotics. She denies abdominal pain and there is no dysuria. A pelvic examination reveals a thick, curd like, white discharge in her vagina.

Answer- yeast infection - Candida albicans

45. A 5-year-old boy is seen by his paediatrician because of anal itching. His mother has noticed him scratching and rubbing his anal area. His anal area is red and raw from all the scratching. His mother has applied hydrocortisone but it hasn’t helped. He does not have diarrhoea. His vital signs are normal. The doctor performs a microscopic examination of a sample collected by touching the perianal area with double sticky tape.

Answer- Pin worm - Enterobius vermicularis

46. You met your wife at the local hospital where you work. You were married 18 months ago and now she discovers she is pregnant. You are both very she goes to the obstetrician for her first prenatal visit. Everything looks good; she is seven weeks into a normal pregnancy. About 10 days later you come home from work and she is waiting for you in the kitchen, looking very upset. She tells you that she tested positive for a STD. She says it must mean that you have been unfaithful because she has not had relations with anyone since you were married. Which of the following infections is possible if both of you have been monogamous for at least two years?

Answer- STD- Gonorrhoeae caused by Neisseria gonorrhoeae

47. A 40-year-old man with a history of intravenous drug use entered the local clinic with complaints of a dry, persistent cough; fever; malaise; and anorexia. Over the preceding 4 weeks, he had lost 12 pounds and experienced chills and sweats. A chest x ray revealed patchy infiltrates throughout the lung fields. Because the patient had a non-productive cough, sputum was induced and submitted for bacterial, fungal and mycobacterial cultures, as well as examination for Pneumocystis. Blood cultures and serologic tests for HIV infection were performed. The patient was found to be HIV positive. The results of all cultures were negative after 2 days of incubation; however, cultures were positive after an additional 10 days of incubation. The most likely organism isolated from this patient is:

Answer- Mycobacterium tuberculosis

48. You are called to the home of Michael, a 13 week – old baby boy who has become listless and is having trouble breathing. The parents report that he used to smile, but lately he has not smiled, nor has he had other noticeable facial expressions in the last two days. His eyes are open when you arrive, but he does not seem to be focusing. You place your out stretched finger under his but he cannot grasp it.

Answer- Moebius syndrome or Bell’s palsy – Herpes Simplex infection

49. On an autumn day a number of people became ill working at the Widget Company. It is an industrial plant in the heart of Cincinnati, Ohio. Their symptoms ranged from simple coughing and other respiratory symptoms to pneumonia. At least one of fifty people showing symptoms died. The company voluntarily closed the building upon recommendation from the health department. After all of the water and cooling systems at the plant were evaluated and disinfected, it reopened and no new cases were reported. What is the causative agent at the factory?

Answer- Legionnaires' disease caused by Legionella pneumophila

50. Jane has been on multiple antibiotics for the past few months for a severe sinus infection. She has been losing weight and looks especially pale. She has emerged from the lady’s room. This her fourth trip today. She collapses and is taken to the hospital.

Answer- Bacterial Sinus Infection- Haemophilus influenzae and Streptococcus pneumonia