Microbiology Vignettes p174

An alcoholic vomits gastric

contents and has foul
Anaerobes
smelling sputum. What
organisms are most likely?

Middle-age man has acute

monoarticular joint pain and
Lyme, Ixodes tick
bilateral Bell's palsy. What
disease and how?

Pt with Mycoplasma
pneumoniae, cryoagglutinins. IgM
What Ig types?
 U/A with WBC casts. Dx? Pyelonephritis

Young child with tetany,

candidiasis, hypocalcemia,
Tcell (DiGeorge)
and immunosuppression.
What cell is deficient?

Pt with "rose
gardener's" (thorn prick,
Sporothrix schenckii
ulcers along lymph drainage).
What bug?

25yr old med student has

"burning" gut after meals.
H. pylori
Gram negative rods in Bx.
What organism?
32yr old man w/ "cauliflower"
skin lesions. Bx shows broad-
Blastomyces
based budding yeasts.
Organism?

Breast feeding woman w/

redness & swelling of right Mastitis by S. aureus
breast. Fluctuant mass. Dx?

Young child w/ recurrent lung

infxns & granulomatous NADPH oxidase (chronic
lesions. What defect in granulomatous disease)
neutrophils?

20yr old college student w/

lymphadenopathy, fever, B-cell (EBV; infectious
hepatosplenomegaly. Serum mononucleosis)
agglutinates sheep RBCs.
What cell infected?
 Microbiology Vignettes p175

1hr after eating custard at a

picnic, whole family vomits. S. aureus(produces
After 10hrs all better. preformed enterotoxin)
Organism?

Infant eats honey -> flaccid. Clostridium botulinum;

Organism? Mechanism? inhibited release of Ach

Man w/ squamous cell

HPV
carcinoma, penis. what virus?
Pt w/ endocarditis 3wks after
prosthetic heart valve. S. aureus or S. epidermis
Organism?

Pathology Vignettes p220

Woman w/ previous C-
section has scar in lower
Placenta previa
uterus close to opening of the
os. Risk for what?

35yr old man w/ hi BP in

Coarctation of Aorta
arms. Low in legs. Dx?
Woman w/ diffuse goiter and
Low TSH, and high thyroid
hyperthyroidism. Values of
hormones
TSH and thyroid hormones?

Pt w/ extended expiratory
Obstructive Lung Disease
phase. Disease process?

Woman w/ headache, visual

disturbance, galactorrhea, Prolactinoma
amenorrhea. Dx?

Baby has foul smelling stool

Cystic fibrosis. Chloride sweat
and recurrent pulmonary
test.
infxns. Dx? Test to confirm?
 Obese woman w/ hirsutism
and hi serum testosterone. Polycyctic ovarian syndrome
Dx?

Man w/ pain and swelling in

knees, subcutaneous nodules
around the joints and
Achilles, exquisite pain in the Gouty arthritis
metatarsophalangeal join of
right big toe. Bx shows
needle-like crystals. Dx?

48yr old female w/

progressive lethargy and
Hypothyroidism
extreme sensitivity to cold
temp. Dx?

Pt w/ elevated serum cortisol

levels undergoes
dexamethasone supp. test. Pituitary tumor.
1mg doesn't lower cortisol.
8mgs does. Dx?
 During a football game,
player collapses/dies
Hypertrophic cardiomyopathy
immediately. Likely Cardiac
disease?

Pathology Vignettes p221

Child anemic since birth.

Splenectomy -> increased Spherocytosis
Hct in what disease.

43yr old man experiences

dizziness/tinnitus. CT shows
Schwannoma
enlarged internal acoustic
meatus. Dx?
 Child exhibits weakness and Duchenne's muscular
enlarges calves. Disease? How dystrophy, X-linked
inherited? recessive.

25yr old female w/ sudden

uniocular vision loss and
slightly slurred speech. Hx of Multiple Sclerosis
weakness and pareshesias
that have resolved. Dx?

Teenager w/ nephritic
Alport's syndrome
syndrome & hearing loss. Dx?

Tall thin male teenager w/

abrupt-onset dyspnea & left-
sided chest pain.
Hyperresonant percussion on Pneumothorax
the affected side &
diminished breath sounds.
Dx?
Young man concerned about
wife's URIs and inability to
Dynein (Kartagener's)
conceive. Also dextrocardia.
What protein?

55yr old man who smokes &

drinks has cough & flu-like
Sx. Gram stain shows Legionellapneumonia
nothing. Silver shows gram-
neg rods. Dx?

Pt has stoke after incurring

multiple long bone fractures
Fat emboli.
in trauma stemming from
MVA. Cause?

25yr old woman w/ a low

grade fever, rash across nose
from sun, widespread edema. SLE
Should be concerned about
what disease?
 Pathology Vignettes p222

50yr old man w/ diarrhea, PE

reveals plethoric face and Carcinoid syndrome
heart murmur. Dx?

Elderly woman w/ a headache

and jaw pain. Elevated ESR. Temporal arteritis.
Dx?

Pregnant woman @16wks w/

an atypically large abdomen.
High hCG, hydatidiform mole
Blood test abnormality?
Disorder?
 80yr old man w/ a systolic
crescendo-decrescendo Aortic stenosis
murmur. Most likely cause?

Woman of short stature w/

Albright's hereditary
short 4th and 5th
osteodystrophy or
metacarpals. Endocrine
pseudohypoparathyroidism
disorder?

After stressful event, 30yr old

man w/ diarrhea and blood
per rectum. Intestinal bx Crohn's
shows transmural inflamm.
Dx?

Young man w' mental

deterioration and tremors. Penicillamine for Wilson's
Brown pigmentation in a ring disease.
around periphery of cornea
and altered LFTs. Tx?
 Pt w/ fatigue, blood tests
Masks signs of neural
show macrocytic,
damage w/ vitamin B12
megaloblastic anemia. Why
deficiency
danger to give folate alone?

10yr old "spaces out" in class

(stops talking midsentence
and then continues as if Absence seizure.
nothing had happened).
During spells, quivering of
lips. Dx?

85yr old man w/ knee pain

and swelling. X-ray shows Pseudogout. Rhomboid
increased joint space w/o calcium pyrophosphate
erosion. Dx? What does crystals.
aspirate show?

Pathology Vignettes p223

X-ray shows bilateral hilar
Sarcoidosis.
lymphadenopathy. Dx?

5yr old boy w/ systolic

murmur and a wide, fixed ASD
split S2. Dx?

Pharmacology Vignettes p286

28yr old chemist w/ MPTP

exposure. Neurotransmitter Dopamine
depleted?
Woman taking tetracycline is
Rash on sun-exposed regions
photosensitive. Clinical
of body
manifestations?

Non-diabetic pt has
hypoglycemia but low C- Surreptitious insulin injection
peptide. Dx?

African-american man who

goes to Africa develops a Glucose-6-Phosphate
hemolytic anemia after taking Dehydrogenase
malarial prophylaxis. Enzyme
deficiency?

27yr old female w/ hx of

psych illness now has urinary
Bethanechol
retention due to a
neuroleptic. Tx?
Farmer presents w/ dyspnea,
salivation, miosis, diarrhea, Insecticide poisioning;
cramping, blurry vision. inhibition of AChE
Cause & mechanism?

Pt w/ recent kidney transplant

is on cyclosporine for
immunosuppression. Ketoconazole
Requires antifungal agent for
candidiasis. What antifungal -
> cyclosporine toxicity?

Man on several meds

including antidepressants and
antihypertensives, has TCA
mydriasis and becomes
constipated. Cause?

55yr old postmenopausal

woman is on tamoxifen Endometrial carcinoma
therapy. Risk?
 Woman on MAO inh has
hypertensive crisis after a Tyramine (wine/cheese)
meal. What did she eat?

After taking clindamycin, pt

Clostridium
dev toxic megacolon and
difficileovergrowth
diarrhea. Mechanism?

Pharmacology Vignettes p287

Man starts meds for

hyperlipidemia. Then rash, Niacin
pruritus, and upset GI. Drug?
 Pt on carbamazepine. What
routine workup should always LFTs
be done?

23yr old female who is on

rifampin for TB prophylaxis Rifampin augments estrogen
and on birth control metabolism in the liver,
(estrogen) gets pregnant. rendering it less effective.
Why?

Pt develops cough and must Losartan, an angiotensin II

discontinue captopril. What is receptor antagonist, does not
a good replacement? Why not increase bradykinin as
same side effects? captopril does.