• Module # 2

  Module # 2

  Module # 2 Case Studies

  Infectious Diseases

  Case Studies cannot be answered in this folder. Click on the link in the folder after this one to send me your answers. The answers to the case studies are very short answer, no explanation is needed. most of the time is just the name of the disorder or the disease.

  Your answers cannot be shared with other students. Cheating, copying or collaboration in answering these case studies is a form of academic dishonesty that cannot be tolerated.

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  Case Study # 1:

  Case Study # 1:

   

  A 16 year old girls is brought to your office because of sore throat, fever, and malaise. On physical examination she has cervical lymphadenopathy and a tender, slightly enlarged spleen.

  Laboratory studies show:

  • Hemoglobin 14.4 g/dL
  • Hematocrit 33.2%
  • Leukocyte count 12,000 mm³
  • A peripheral blood smear is shown.

  Questions

  1. What is the most likely diagnosis?

  2. What are those 2 WBC’s amongst the RBC’s in the smear shown above?
• 

  Case Study # 2:

  Case Study # 2:

   

  A 4-year-old child develops a fever, sore throat, ulcerated lesions on the oral mucosa, and a rash on the hands and feet. A photograph of the rash is shown.

  1.  What is the most likely causative organism?
• 

  Case Study # 3:

  Case Study # 3:

   

  A 40-year-old man has evidence of chronic heart failure. Clinical signs of both right and left heart failure are present. His heart is dilated and enlarged (x-ray). When he was a child, his family settled newly cleared land in the Brazilian Amazon forest, and he lived in a primitive shelter built of mud, wood, and stone for 12 years. A radiograph taken during his childhood is shown.

  1.  What is the causative organism?
• 

  Case Study # 4:

  Case Study # 4:

   

  A 9-year-old girl with Cystic Fibrosis (CF) is brought to the emergency department because of a 12-hour history of fever, severe shortness of breath, and cough productive of thick sputum. Her temperature is 39⁰C (102.2⁰F), pulse is 80/min, respirations are 30/min, and blood pressure is 90/60 mm Hg. Diffuse wheezing and scattered ronchi are heard on auscultation of the chest. The CT scan of the chest shown multiple dilated structures which are the result of multiple infections (as indicated by the arrows).

  Questions:

  1.  What are those dilated structures indicated by the arrows?

  2.  What is the most likely causative organism in this case?
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  Case Study # 5:

  Case Study # 5:

  Five member of a family develop severe cramping abdominal pain, vomiting, and diarrhea within 24 to 48 hours after eating sushi. An oxidase-positive, Gram-negative, curved rod is isolated from the stools of three of five patients.

  Question

  Which of the following is the most likely organism? (Hint: this organism is one of the most common organisms associated with raw seafood).

  a. Escherichia coli

  b. Helicobacter pylori

  c. Salmonella enteridis

  d. Salmonella typhi

  e. Shigella sonnei

  f. Vibrio cholera

  g. Vibrio parahaemolyticus
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  Case Study # 6:

  Case Study # 6:

   

  A 7-year-old boy is brought by his mother to the clinic because of the appearance of rash shown on the photograph. The mother states that the boy had sore throat and fever 4 weeks ago for which he was prescribed Amoxicillin. The mother did not give the antibiotic to the child and instead tried to treat him with natural herbs. Physical examination shows rash of the trunk that spares the extremities, fever, and joint pains. This disease commonly affects either one of two organs.

  Questions:

  1. What are the 2 organs commonly affected by the immunologic reaction to this organism?

  2. What is the causative organism?
• 

  Case Study # 7:

  Case Study # 7:

   

  A 54-yr-old man presents with severe itching especially at night, and the rash shown on the photograph. He has similar rash on the ulnar surface of the rist, the webs of fingers, and on the glans penis. Family history reveals similar Sx for his wife and 2 children, all are living together.

  1.  What is the diagnosis? (hint: you don’t want to touch that)

Solution:

Module # 2

Infectious Diseases – Case Studies & Answers

CASE STUDY # 1:

A 16 year old girls is brought to your office because of sore throat, fever, and malaise. On physical examination she has cervical lymphadenopathy and a tender, slightly enlarged spleen.

Laboratory studies show:

• Hemoglobin    14.4 g/dL
• Hematocrit      33.2%
• Leukocyte count   12,000 mm3
• A peripheral blood smear is shown.

Questions

1. What is the most likely diagnosis?
2. What are those 2 WBC’s amongst the RBC’s in the smear?

ANSWER

Infectious Mononucleosis

Atypical Lymphocytes: These are called mononucleocytes or mononuclear leukocytes and this is how the disease received its name.

Infectious Mononucleosis is commonly caused by Epstein-Barr virus (EBV), it can also be caused by Cytomegalovirus or Human Herpes virus-6. The disease results in an increase of mononuclear cells, which are mainly monocytes and lymphocytes. However, the ones we see in the picture are atypical lymphocytes since they have the kidney shaped nucleus of monocytes, therefore, these are lymphocytes that resemble monocytes.

EBV infects B-lymphocytes, remember the B of EBV with the B of B-cells. The cells that we see here are not the infected B-cells; these are the Cytotoxic T-Lymphocytes (CD8+) that react to limit the # of infected B-cells. Those T-cells are called Atypical Lymphocytes or Downy cells. ……. Click below to purchase full solution