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14 blades

Detective d

Shaolin 2011

Call me nobody

IMMUNOSEROLOGY
1. Latex agglutination test: a) C- reactive protein LA

b) Anti Streptolysin O LA

c) Rheumatoid factor latex agglutination test

2. Rapid Plasma Reagin test

3. WIDAL test

4. ELISA

MYCOLOGY
Culture

1) YEAST:

a) Candida species

b) Cryptococci species

2) MOULDS

a) Apergillus flevus

b) Apergillus fumigates

c) Aspergillus niger

d) Pencillium species
e) Mucor species

f) Rhizopus

IMMUNOSEROLOGY
1. This case concerns a previously healthy 13 year-old male complaining of pain and
stiffness in his right knee and leg. Three weeks prior to presentation he was involved in a
accident resulting in an open wound on his right (R) leg. 10 days later, the surface skin
wound had healed but he complained of R knee and leg pain with nausea and vomiting.
When examined by his pediatrician, he was febrile and had a raised pulse of 120 beats/min.
Petechiae were noted on his R leg, and flexing the R knee caused severe pain. He was taken
to the local hospital emergency department, where on physical exam he had a fever of 39◦ C
(102.2◦ F), blood pressure of 93/58 mm Hg, and heart rate of 98 beats/min. Edema was noted
in his right tibia, the right knee was warm to the touch, but he had full range of motion and
walked without difficulty. The following test is done.

a) What is the name of the test?

b) Clinical significance of the test in above mentioned case

c) How do you interpret the results?

2. An 8-year-old girl develops Sydenham’s chorea (“St. Vitus’ dance”) with rapid
uncoordinated facial tics and involuntary purposeless movements of her extremities, strongly
suggestive of acute rheumatic fever. She has no other major manifestations of rheumatic
fever (carditis, arthritis, subcutaneous nodules, skin rash). The patient’s throat culture is
negative for Streptococcus pyogenes (group A streptococci). However, she, her brother, and
her mother all had sore throats 2 months ago. Then following test is carried out

a) What is the name of test?


b) How do you interpret the above test?

c) What is the significance of above test in present case?

3) A 37-year-old woman gradually developed painful wrists over 3 months; she consulted her
doctor only when the pain and early morning stiffness stopped her from gardening. On
examination, both wrists and the metacarpophalangeal joints of both hands were swollen and
tender but not deformed. There were no nodules or vasculitic lesions. On investigation, she
was found to have a raised C-reactive protein (CRP) level (27mg/l) (NR <10) but a normal
haemoglobin and white-cell count. Then following test is carried out

a) What is the name of test?

b) How do you interpret the above result?

c) Briefly mention the principle of above test?

4) A pregnant 18-year-old woman came to the urgent-care clinic with a low-grade fever,
malaise, and headache. She was sent home with a diagnosis of influenza. She again sought
treatment 7 days later with a macular rash on her trunk, arms, hands, and feet. Further
questioning of the patient when serology results were known revealed that 1 month
previously, she had a painless ulcer on her vagina that healed spontaneously. Following test is
carried out

a) What bacterial diseases can cause rashes?

b) What is your provisional diagnosis?

c) What serologic tests are used to diagnose above condition?


5) A 27-year-old woman is admitted to the hospital because of fever, with increasing
anorexia, headache, weakness, and altered mental status of 2 days’ duration. She works for an
airline as a cabin attendant, flying between the Indian subcontinent and other places in
Southeast Asia and the West Coast of the United States. Ten days prior to admission she had
a diarrheal illness that lasted for about 36 hours. She has been constipated for the last 3 days.
Her temperature is 39 °C, heart rate 68/min, blood pressure 120/80 mm Hg, and respirations
18/min. She knows who she is and where she is but does not know the date. She is picking at
the bedclothes. Rose spots are seen on the trunk. The remainder of the physical examination
is normal. Blood cultures and following serological test is carried out

a) What is the name of above test?

b) How do you interpret above test results?

MYCOLOGY

1. Identify the fungi with help of given culture morphology and LCB mount