5. A 35-year-old man comes to the physician because of a 3-day history of fever, chills, muscle aches, headache, and diarrhea. He immigrated to the USA from Nigeria 12 years ago, but herecently returned from a 2-week visit to his native country. He takes no medications. His temperature is 38.8°C (101.8°F), pulse is 94/min, respirations are 16/min, and blood pressure is125/82 mm Hg. Physical examination shows diaphoresis, scleral icterus, and a supple neck. The remainder of the examination shows no abnormalities. Which of the following is most likely toconfirm the suspected diagnosis in this patient?A) Examination of stool for ova and larvaeB) Gram stain and culture of cerebrospinal fluid for bacteriaC) Peripheral blood smears for protozoaD) Serologic testing for filariaE) Urine antigen testing for fungiA or C

This is a case of a 35-year-old man who presented with fever, chills, muscle aches, headache, and…

Answered: A 35-year-old man comes to the…

Microbiology for Surgical Technologists (MindTap Course List)

2nd Edition

ISBN:9781111306663

Author:Margaret Rodriguez, Paul Price

Publisher:Margaret Rodriguez, Paul Price

Chapter22: Emerging, Recurring, And Reappearing Diseases

Section: Chapter Questions

Problem 1UTM

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1. A previously healthy 25-year-old-woman comes to the emergency department because of a 3-day history of fever, chest pain, and rapidly progressive shortness of breath. Use of an over-the-counter cold medication has not relieved her symptoms. She has no history of serious illness and takes no other medications. Her temperature is 40oC (104o F), pulse is 128/min and regular, respirations are 28/min and blood pressure is 80/54 mm Hg. Physical examination shows jugular venous distention and weak pulses in all extremities. Auscultation of the chest shows diffuse crackles bilaterally, muffled heart sounds, and a soft S2 gallop. After 30 minutes she goes into ventricular fibrillation and cannot be resuscitated. At autopsy, the heart is diffusely pale and floppy with focal petechiae, all chambers are markedly dilated.Histologic examination of cardiac tissue shows a lymphocytic infiltrate and myocardial necrosis. Which of the following infectious agents is the most likely cause these…
28. A previously healthy 17-year-old boy is brought to the emergency department because of a 12-hour history of temperatures to 39.7°C (103.5°F), nausea, muscle aches, and progressive confusion. He has had an episode of syncope. His palpable blood pressure is 80 mm Hg. Physical examination shows a rash on his lower extremities and feet. His leukocyte count is 26,000/mm³. Serum tumor necrosis factor-a and interleukin-1 (IL-1) concentrations are increased. Blood and cerebrospinal fluid cultures grow an oxidase-positive, gram-negative diplococcus. Which of the following effector cells is primarily responsible for production of the factors inducing the patient's hemodynamic state? O) AB lymphocytes B) Eosinophils C) Macrophages D) Neutrophils E) T lymphocytes
A 35 year alcoholic male who had a heart surgery before was admitted with a three week history of fever and gum infection which leads to poor appetite since he cannot eat properly. On physical examination, his body temperature is at 39 degrees celsius. Pulse is 96 beats per minute, respiratory rate is 20 breaths per minute, and BP is 120/80 mm. There are many missing teeth with gingivitis and dental caries which gives off an unpleasant breath odor every time he speaks. He has with him a pack of sugar candies that he brought secretly. What type of infection is suggested by his foul breath? What group of organisms could be responsible for this patient's condition? What complications are associated with this infection?v
21. A 45-year-old man is brought to the physician because of a 3-week history of fever and facial pain. His temperature is 38°C (100.4°F), pulse is 74/min, and respirations are 14/min. Physical examination shows tenderness, edema, and erythema around the left zygomatic bone. A CT scan of the head shows that the left maxillary sinus is filled with fluid. Fiberscopic rhinoscopy is done to examine the maxillary sinus. The inserted endoscope is most likely to traverse which of the following spaces before immediately entering the maxillary sinus in this patient? OA) Frontonasal duct B) Inferior meatus Oc) Middle meatus OD) Nasolacrimal duct E) Parotid duct OF) Sphenoethmoidal recess G) Superior meatus the
1. A 3-year-old girl is brought to the physician by her mother because of a 2-day history of cough and runny nose. She attends a day-care center. The mother says that the patient’s appetite and activity levels are only mildly decreased and that she sleeps through the night. Her temperature is 37.8C (100 F) pulse is 100/min, and respirations are 19/min. Physical examination shows mildly injected conjunctivae, clear nasal discharge, and mild pharyngitis. A throat culture grows viridans streptococci. A heterophile antibody titer is negative. Which of the following is most likely the diagnosis?A. Common ColdB. Infectious mononucleosis c. croup d. pertussis e. streptococcal pharyngitis 2. A 33-year-old woman comes to the physician’s office because of increasing fatigue and shortness of breath over the past 2 years. She has also noted chest pressure with exertion and recently almost fainted while walking. Examination shows increased jugular venous distention, a right ventricular heave,…
4. Male patient Howard Long, 50 year of age , has been identified as having bronchiectasis. For 35 years, he smoked one pack of cigarettes per day. He's had recurrent bronchial infections for a very long time. He constantly produces a lot of purulent sputum while coughing. Even when at rest, the patient laments being out of breath. The tips of his fingers are clubbed. Bronchial dilatation can be seen on the chest CT scan. (Learning Objectives 2, 5, and 6) a.How should the nurse explain to the patient and family the pathophysiology of bronchiectasis as it is related to the symptoms the patient is experiencing? b.How should the nurse explain to the patient and family the goals of medical management that may be used to treat bronchiectasis? c.What does the nursing management for bronchiectasis entail?
113. A 10-month-old girl develops a cough and grunting following a 3-day hospital stay for surgical repair of a cleft palate. Her temperature is 39.2°C (102.6°F), and respirations are 40/min. Crackles are heard over most lung fields, and breath sounds are decreased. There is a mild pleural rub in the right upper thorax. Her leukocyte count is 68,000/mm³ (85% segmented neutrophils, 10% bands, and less than 5% myeloblasts, promyelocytes, and myelocytes). Which of the following mechanisms most likely caused the increased leukocyte count in this patient? A) Accelerated release of cells from the bone marrow postmitotic reserve pool B) Decreased margination and rolling of circulating cells C) Increased production of myeloblasts in the spleen D) Shift in bone marrow from eosinophil production to segmented neutrophil production E) Transformation of myeloid stem cells
A 65-year-old female is driven to the hospital emergency room with severe shortness of breath, cough, and fever. She is also complaining of muscle aches stating, “It feels like I was hit by a truck.” She has a long-standing history of severe lung disease (chronic obstructive pulmonary disease) requiring home oxygen because of a 45-pack-per-year smoking history. It is January, and she declined influenza vaccination when she was seen by her primary care physician in November. She is admitted to the hospital with a diagnosis of severe exacerbation of her chronic lung disease. The next day her attending physician decides to test her for influenza. The test is reported back to the floor as a critical value because the result is positive for influenza Type A. She is started on an antiviral medication for influenza. Discuss the following questions: What type of transmission-based precautions should be used to isolate this patient? What could have been done differently with this case starting…
A 45-year-old male patient comes to the clinic for his fever and cough. His symptoms started about a week ago. He reports a sharp chest pain which worsens when he coughs or takes a deep breath. He also complains of some associated fatigue, headaches, achy joints, and sweating at night. The patient has no history of pulmonary diseases and has never smoked cigarettes. He had no exposure to ill contacts. He shares that he traveled 3 weeks ago for a 5-day golf vacation to Texas. Except for fever, his vital signs are otherwise normal. Pulmonary examination reveals some faint expiratory wheezing and crackles in the left upper lung field. A chest x-ray was ordered and shows hilar adenopathy. A CBC shows a normal total white blood cell count but with a high percentage of circulating eosinophils. His sputum was treated with KOH and microscopic examination reveals numerous spherules. 1. What is the most likely cause of this patient’s symptoms? 2. How did the patient possibly acquired the…
21. A 70-year-old man is brought to the emergency department because of a 3-day history of fever and progressive shortness of breath. He also has a history of cough productive of yellow sputum that has recently become thick and green. He has smoked 1 to 2 packs of cigarettes daily for 40 years. His temperature is 40°C (104°F), and respirations are 22/min. Physical examination shows decreased breath sounds. A chest x-ray shows right lower lobe infiltrates surrounding a 3-cm, rounded lesion containing an air-fluid level. Which of the following immune cell activities most likely predominates in the center of this lesion? A) B-lymphocyte antibody production B) Macrophage free-radical generation C) Natural killer cell-mediated killing D) Segmented neutrophil acid hydrolase activation E) T-lymphocyte perforin synthesis W
- Section 12 Hom 93 of 145 در ∞ 93. A 16-year-old boy with sickle cell disease comes to the physician because of a 6-hour history of a persistent, paintu penile eraction. He says that the word stimulation. Physical examination shows no other abnormalities. Which of the following is the most likely mechanism of this condition? A) Hyperactivity of the bulbospongiosus and ischiocavernosus muscles CB) Hyperactivity of the parasympathetic cavernous innervation OC) Occlusion of arteriovenous anastomoses that bypass the corpora cavernosa OD) Occlusion of venous channels in the corpora cavernosa E) Response to ischemia secondary to arteriolar occlusion
A 50-year-old man who lives in Indiana comes to the physician because of a 1-month history of fever and nonproductive cough. He is a construction worker. His temperature is 38.4 C (101.1F), 84/min, respirations 14/min, and blood pressure is 110/70 mm Hg. Scattered crackles are heard over all lung fields. Bilateral interstitial infiltrates is seen on CXR. A photomicrograph of a specimen obtained via transbronchial biopsy is shown. The most likely causal organism in this patient has a cell wall composed of which of the following? A) N-Acetylglucosamine-N-acetylmuramic acid B) Cellulose C) Glucans D) Polyglutamic acid E) Teichoic acid

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