Pathophysiology

A patient presents to the ED with fever, chills, myalgia, and a dry cough.  He says he has recently traveled to China.   He says he got a flu shot a year
ago. Which is most likely in this case?    a. This disease is pertussis, probably contracted from an unvaccinated contact when he visited China. b. The disease is probably not influenza, since he had a flu shot during last year’s flu season. c. The diagnosis is influenza, probably contracted via fecal/oral route while in China. d. The diagnosis is influenza, possibly contracted because patient did not have this year’s flu shot.
2. The disease mentioned above has the following characteristic:    a. The causative microbe can also cause a membrane across the pharynx. b. This disease is difficult to treat because of the antigenic drift of its exotoxin.c. Mutations of proteins on the causative organism’s cell membrane result in a different version each year. d. A later outbreak may include skin lesions in a dermatome pattern.
3. A commonality of herpetic organisms that cause diseases like chicken pox and shingles is that  a. each is caused by a bacterial organism that penetrates the nervous system. b. the causative microbe can remain dormant in the nervous system. c. the causative microbe causes bloody diarrhea. d. each is transmitted via vector.
4. An otherwise healthy Texas rancher whose water supply comes from a well is more at risk for a _____infection than a Dallas suburbanite.   a. giardia  b. trichinosis c. C. diff  d. cysticercosis
5. A 4 year old patient presents with bloody diarrhea.  Possible causes include _______ because_______ a. shigella: the microbe has caused inflammation in the lining of the intestines. b. pseudomembranous colitis: C. diff has eradicated normal flora. c. giardia: this protozoa invades the intestinal wall and causes necrosis. d. diphtheria: this bacteria causes parotid enlargement.
6. After coming home from an overseas assignment a young army officer begins complaining of extreme fatigue and arthralgia.  He has a very high
fever and shaking chills, and he is anemic.  The most likely etiology of his S&S is   a. infection with rabies virus. b. protozoal invasion of his RBCs c. Staph aureus-related cellulitis. d. Guinea worm infestation.
Questions 7 – 10 refer to the following scenario: A patient presents to the ED with a local skin infection (cellulitis). She says she has no idea how she got it.
She is told that it is a staph infection.  A penicillin-type antibiotic called Augmentin is prescribed, and she is sent home.  A week later, despite taking all her
Augmentin, she is back with worsening of the local infection, plus fever and leukocytosis.  She is hospitalized.  A culture of the wound shows MRSA and she is placed
on more appropriate antibiotics.
7. Which best describes the pathology behind the events in this scenario? a. A certain Staphylococcus aureas species developed special bonding affinity with methicillin. b. The patient likely had a compromised immune system, as evidenced by the leukocytosis. c. A certain Staphylococcus aureas species developed beta-lactamase, which destroyed the penicillin molecule.d. Staphylococcus aureas is an organism that doesn’t respond to any kind of penicillin.
8. The fever and leukocytosis a. are evidence that the staph infection may have become systemic. b. show that the patient is unable to mount an appropriate inflammatory response to the infection. c. show that the patient’s third line of defense is not needed. d. are evidence that the patient likely has VRE.
9. After three of weeks of being on strong antibiotics, the patient develops chronic diarrhea.  Her stool is cultured. In this question’s context, what organism
would you expect the stool culture to grow?   a. MRSA. b. VRE. c. Salmonella. d. C. diff.
10. Choose the mini-concept map that best describes the links from the events and pathophysiology to the diagnosis. a. 3 weeks on antibiotics normal bowel flora wiped out Clostridium difficile has no competition and flourishespseudomembranous colitis.  b. 3 weeks on antibiotics normal bowel flora proliferate bowel walls are irritatedinflammationantibiotic-associated diarrhea. c. vancomycin destroys enterococcus in bowel other bowel flora have no competition and flourishpseudomembranous diarrhea. d. iatrogenic antibiotics normal bowel flora wiped out giardia invades bowel inflammationnosocomial diarrhea.