Question

Case #1

A 24-year old female automotive technician presents herself at the doctor’s office. She complains of fever and of pain in her left hand. On physical examination, the patient had a deep wound on her left palm that was oozing pus. She had purplish, red streaks running up her left arm. She had enlarged lymph nodes at the elbow and under her arm. The patient’s skin was warm and dry. In her history, the patient had punctured her left palm with sharp metal from the undercarriage of a"real cherry" 1977 Malibu about a week earlier. She said the wound had bled for a few minutes and she thought that she had washed it "real good" with soap and water. She had covered the wound with a large "band-aid" and gone back to work. She developed a fever about three days later. For the past couple of days, she "did not feel so good" and had vomiting and diarrhea

1.

The bacteria that caused the infections is:

	a.	a gram-negative rod.
	b.	acid-fast.
	c.	an endospore former.
	d.	a gram-positive coccus.

2.

From complaint and physical examination, which of the symptoms lead you to your choice ofagent?

	a.	the warm dry skin
	b.	the fever, wound with oozing pus and enlarged lymph nodes
	c.	the fever and pain in the hand
	d.	the pain, red streaks and enlarged lymph nodes
	e.	the lymph nodes and red streaks

3.

The most important preventive measure to prevent the spread of this bacteria is:

	a.	administering the vaccine for the bacteria.
	b.	hand-washing.
	c.	surgical removal.
	d.	administering penicillin to the patient.

4.

clinical isolate of the wound is sent to the microbiology lab. Which medium would be inoculated to identify of the bacteria causing the infection?

	a.	Eosin-Methylene Blue
	b.	Sheep Blood Agar
	c.	MacConkey's Agar
	d.	Mannitol Salt Agar
	e.	Nutrient Agar

5.

The medium used to identify the bacteria causing the infection is:

	a.	assay and enumeration.
	b.	selective and differential.
	c.	general and complex.
	d.	enriched and transfer.

6.

causative agent of infection is capable of causing disease in the _______________ system.

	a.	integumentary
	b.	lymphatic
	c.	cardiovascular
	d.	all of the choices are correct
	e.	nervous

7.

Pathogenic strains of the causative agent of the infection produce an enzyme called:

	a.	all of the choices are correct.
	b.	penicillinase.
	c.	coagulase.
	d.	hyaluronidase.
	e.	enterotoxins.

8.

What type of infection do you believe she has in this hand?

	a.	Staphylococcus aureus
	b.	Pasteurella multocida
	c.	Pseudomonase
	d.	Clostridium
	e.	Streptococcus pyogenes

9.

From the history, which of the information confirmed your choice?

	a.	The wound was cleaned with soap and water.
	b.	She had diarrhea and vomiting
	c.	The cut was from a rusting car frame.
	d.	The wound had been covered and had perhaps become anaerobic.
	e.	The wound had bled for a while.

10.

Which of the following is most likely to follow this infection?

	a.	neurological disfunction of the hand
	b.	arthritis
	c.	gangrene and amputation
	d.	toxic shock syndrome

Answer 1

1. The bacteria that caused the infections is:

d.a gram-positive coccus.

2. From complaint and physical examination, which of the symptoms lead you to your choice of agent?

b. the fever, wound with oozing pus and enlarged lymph nodes

3. The most important preventive measure to prevent the spread of this bacteria is:

b. hand-washing.

4.clinical isolate of the wound is sent to the microbiology lab. Which medium would be inoculated to identify of the bacteria causing the infection?

b. Sheep blood Agar

Staphylococcus aureus yellow colonies on sheep blood agar.

5. The medium used to identify the bacteria causing the infection is:

d. enriched and transfer.

6. causative agent of infection is capable of causing disease in the _______________ system.

They can often cause skin infections but can cause pneumonia, heart valve infections, and bone infections.

d. all of the choices are correct.

7.Pathogenic strains of the causative agent of the infection produce an enzyme called:

Some of the enzymes include: coagulase, catalase, hyaluronidase, penicillinase, enterotoxins, etc.

a.all of the choices are correct.

8.What type of infection do you believe she has in this hand?

a.Staphylococcus aureus

9.From the history, which of the information confirmed your choice?

b.She had diarrhea and vomiting

10.Which of the following is most likely to follow this infection?

Toxic shock syndrome is a sudden, potentially fatal condition. It's caused by the release of toxins from a Staphylococcus aureus overgrowth.

d.toxic shock syndrome.