Clinical Lab Practice Quiz For Module 2

Possible cross-contamination of samples can be suspected based on the given results. Since only 1 out of the 4 bottles flagged positive and the preliminary gram stain showed GPC (Gram-Positive Cocci), it suggests that there may have been contamination during the collection or processing of the samples. This means that the positive result may not be due to an actual infection, but rather due to external factors. Further testing and evaluation would be needed to confirm the presence of endocarditis or bacteremia.

Endocarditis is an infection of the inner lining of the heart chambers and valves. It typically presents with symptoms such as fever, fatigue, and heart murmurs. Physical findings include splinter hemorrhages (tiny red or purple streaks under the nails), Janeway lesions (small, painless red spots on the palms and soles), and clubbing (enlargement of the fingertips). A rash on the upper torso is not a typical sign of endocarditis, making it the correct answer.

Isospora belli is not considered one of the top three parasites associated with GI pathology. The top three parasites are usually Giardia, Cryptosporidium, and Entamoeba. Isospora belli may still cause gastrointestinal symptoms, but it is not as commonly encountered or as significant in terms of its impact on GI pathology compared to the other three parasites.

The specific test that will identify the cause of the man's illness is the Ova and parasite test. This test is used to detect the presence of parasites or their eggs in the stool sample. Given the symptoms of watery, foul-smelling diarrhea and the history of drinking untreated water on a camping trip, it is likely that the man has contracted a parasitic infection. The Ova and parasite test will help identify the specific parasite responsible for his symptoms.

A Viral Load test measures the concentration of Hepatitis C Virus (HCV) in a patient's blood. This test is used to determine the amount of active virus present in the body, which helps in monitoring the progression of the infection and evaluating the effectiveness of antiviral treatment. By measuring the concentration of HCV, the test provides crucial information for both the patient and the clinician regarding the viral activity and the response to treatment.

Haemophilus ducreyi is the microbe attributed to Chancroid. Chancroid is a sexually transmitted infection caused by this bacterium. It is characterized by painful genital ulcers and swollen lymph nodes in the groin area. Treponema pallidum is the causative agent of syphilis, Herpes Simplex is responsible for genital herpes, Gardnerella vaginalis is associated with bacterial vaginosis, and Calymmatobacterium is not related to Chancroid.

Staphylococcus aureus is the most associated microbe with acute bacterial endocarditis. This bacterium is a common cause of endocarditis and is known for its ability to adhere to damaged heart valves. It can cause a severe infection in the heart, leading to symptoms such as fever, fatigue, and heart murmurs. Prompt treatment with antibiotics is crucial to prevent complications and further damage to the heart.

The most worrisome complaint among the given options is "Afebrile with bloody stool." This is because the presence of blood in the stool can indicate a serious underlying condition such as gastrointestinal bleeding or infection. The absence of fever suggests that the infection may not be the primary cause, making it even more concerning. Prompt medical attention is necessary to determine the cause of the bloody stool and provide appropriate treatment.

A pediatric patient presenting with a high fever of 103F and bloody stool is most likely suffering from infectious bacterial enteritis. This is because bacterial infections can cause inflammation and damage to the lining of the intestines, leading to symptoms such as bloody stool. Viral and fungal enteritis may also cause gastrointestinal symptoms, but the presence of bloody stool suggests a bacterial infection rather than a viral or fungal one.

If unable to send a stool specimen to the lab within 1 hour, the Carry-Blair transport media should be used to preserve specimen constitution.

The patient's presentation of a slapped cheek appearance on the face and a lacy rash on her extremities is consistent with Fifth disease (parvovirus). This viral infection commonly affects children and presents with a low-grade fever, headache, and a characteristic rash. Chickenpox, smallpox, German measles (rubella), and rubeola (measles) do not typically present with these specific signs and symptoms.

Hepatitis A infection would be classified as self-limiting because it typically resolves on its own without any specific treatment. The immune system is capable of clearing the virus from the body within a few weeks to months. Unlike Hepatitis B and C, which can become chronic and cause long-term liver damage, Hepatitis A does not persist in the body and does not lead to chronic infection. Strep throat, on the other hand, is a bacterial infection and not an example of a self-limiting infection.

To confirm the diagnosis of endocarditis, it is essential to run a blood culture. This test helps identify the presence of bacteria or other pathogens in the bloodstream, which could indicate an infection in the heart valves. Blood culture is a crucial diagnostic tool in determining the causative organism responsible for endocarditis, allowing for appropriate treatment and management of the condition. CBC (Complete Blood Count) and BMP (Basic Metabolic Panel) may provide additional information, but they are not specific for confirming endocarditis. Serology Titer may help in detecting antibodies but is not a definitive test for confirming the diagnosis.

An uncomplicated (simple) cystitis is a urinary tract infection that occurs in otherwise healthy individuals without any complicating factors. It is more common in females, especially those who are not pregnant. One of the characteristics of uncomplicated cystitis is the absence of flank pain, which is pain in the side or back. However, healthy adult males can also experience uncomplicated cystitis, so they are not excluded from this condition. Therefore, the correct answer is "Healthy adult male."

Bacillus cereus is commonly found in fried rice and its toxins are what impact patients.

The best way to identify Clostridium difficile is through the enzyme immunoassay for toxins A/B. This assay specifically detects the presence of toxins A and B, which are the main virulence factors produced by C. difficile. Fecal culture can also be used to identify the bacteria, but it is a more time-consuming and labor-intensive method. Blood culture is not a suitable assay for C. difficile as it primarily causes gastrointestinal infections. Clostridium difficile PCR is a molecular method that can detect the DNA of the bacteria, but the enzyme immunoassay for toxins A/B is considered the gold standard for C. difficile identification.

If the blood culture yielded a Streptococcal microbe and the patient has a "strawberry tongue," the most likely causal factor for the patient's signs and symptoms would be Group A Strep (S. pyogenes). Group A Streptococcus is known to cause various infections, including strep throat, scarlet fever, and invasive infections like bloodstream infections. The presence of a strawberry tongue, which is a characteristic symptom of scarlet fever, along with the identification of a Streptococcal microbe in the blood culture, strongly suggests Group A Strep as the causative agent.

Necrotizing fasciitis is a severe bacterial infection that rapidly spreads through the subcutaneous tissue and fascial planes. It is aided by bacterial toxins, leading to tissue death and necrosis. This condition is characterized by severe pain, redness, swelling, and a rapidly progressing infection. Prompt medical intervention is crucial to prevent further tissue damage and systemic complications.

Tinea infections are classified according to the location of the infection. This means that the classification is based on where the infection is located on the body. Different types of tinea infections can occur in various areas such as the scalp, feet, groin, or nails. By classifying the infections based on their location, healthcare professionals can better diagnose and treat the specific type of tinea infection a person may have.

The patient's symptoms of vaginal itching/irritation, vaginal discharge, foul vaginal odor, and dysuria are consistent with vulvovaginitis. Vulvovaginitis refers to inflammation or infection of the vulva and vagina, which can be caused by various factors such as yeast infection, bacterial vaginosis, or sexually transmitted infections. Urethritis refers to inflammation of the urethra, which typically presents with symptoms like dysuria and urinary frequency. Cervicitis refers to inflammation of the cervix, which may cause vaginal discharge but is less likely to cause itching or odor. Prostatitis refers to inflammation of the prostate gland, which is not relevant in this case as the patient is female.

A Tzanck prep is considered a direct detection assay for Herpes Simplex virus. This test involves obtaining a sample from a skin lesion and staining it with a special dye. The stained sample is then examined under a microscope to look for characteristic changes in the cells, such as giant cells or multinucleated cells, which are indicative of a Herpes Simplex infection. This method directly detects the presence of the virus in the sample, making it a direct detection assay.

Laryngotracheobronchitis (Croup) is the most common condition associated with the symptoms described. Croup is characterized by a barking cough, inspiratory stridor, and variable fever. These symptoms are typically more pronounced at night. Epiglottitis, although it can present with similar symptoms, is less common and usually affects older children. Parainfluenza virus is a common cause of croup. Diphtheria and pertussis can also cause similar symptoms, but they are less common in this age group. Therefore, the most likely explanation for the given symptoms is laryngotracheobronchitis (Croup).

Bronchitis is a general inflammation of the main air passages to the lungs. It is characterized by coughing, mucus production, and difficulty breathing. Pharyngitis refers to inflammation of the throat, Empyema is a condition where pus accumulates in a body cavity, and Bronchiectasis is a chronic lung condition characterized by the widening and scarring of the bronchial tubes. Therefore, the correct answer is Bronchitis.

In this scenario, the patient is suspected to have an acute infection of the blood, so a blood culture is requested. The techs were only able to obtain 10mLs of blood due to the patient's severe dehydration. The best option in this case would be to send the entire 10mL specimen into the aerobic tube. This is because aerobic cultures are used to detect bacteria that require oxygen to grow, which is the most common type of bacteria causing bloodstream infections. Sending the entire specimen in the aerobic tube maximizes the chances of detecting any potential pathogens present in the blood.

Viral pharyngitis is the most common type of pharyngitis observed in adult patients. This is because the majority of pharyngitis cases in adults are caused by viral infections, such as the common cold or influenza. Bacterial pharyngitis, diphtheria, and pertussis are less common causes of pharyngitis in adults.

Hantavirus is commonly carried by rodents and is associated with Adult Respiratory Distress Syndrome. This virus is transmitted to humans through contact with rodent urine, feces, or saliva. It can cause severe respiratory symptoms and can be fatal in some cases. Hantavirus outbreaks have been reported worldwide, particularly in rural areas with high rodent populations.

Based on the information provided, the patient recently ate sushi from a convenience store and the lab reported a culture of a "comma shaped" gram negative bacteria. Vibrio vulnificus is a gram-negative bacterium that is commonly associated with contaminated seafood, including raw or undercooked shellfish. Therefore, it is likely that Vibrio vulnificus is causing the patient's signs and symptoms.

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The correct answer is to collect a specimen from the nasopharynx using a swab. This is because the patient is presenting with symptoms of a respiratory infection, including a cough and nasal exudate. The nasopharynx is the area at the back of the nose and upper throat, where respiratory viruses are commonly found. Collecting a specimen from this area allows for the detection of viral pathogens that may be causing the patient's symptoms.

Based on the foul fish smell observed during the KOH amine test, the most likely infection is Vaginosis. Vaginosis is a common vaginal infection caused by an imbalance in the normal bacteria present in the vagina. This imbalance can lead to an overgrowth of certain bacteria, resulting in symptoms such as perivaginal itching and a characteristic fishy odor. Urethritis, candidiasis, and cervicitis are less likely to cause this specific symptom.

In order for a Western Blot test to be considered positive for HIV, it is necessary for at least one core protein, one envelope protein, and/or one enzyme protein to be present. This means that the presence of any one of these antigens would indicate a positive result for HIV.

Influenza A/B is not considered causal to the "Common Cold". The common cold is primarily caused by rhinoviruses, coronaviruses, and adenoviruses. Influenza A/B viruses are responsible for causing the flu, which is a different respiratory illness characterized by more severe symptoms compared to the common cold.

PCR assays are a powerful tool for detecting and amplifying specific DNA sequences, but one of their relative disadvantages is that they do not provide information about antimicrobial susceptibility. This means that PCR assays cannot determine whether the detected microorganism is resistant or susceptible to specific antimicrobial agents. This information is important in guiding appropriate treatment decisions, as it helps in selecting the most effective antibiotics for the infection. Therefore, the lack of antimicrobial susceptibility data is a limitation of PCR assays in the context of infectious disease diagnosis.

The patient's presentation of joint pain and pus-filled lesions on the hands and wrist is consistent with gonococcal arthritis. Gonococcal arthritis is caused by the bacteria Neisseria gonorrhoeae, which can spread to the joints and cause inflammation and infection. This type of arthritis typically affects young sexually active individuals and is associated with a history of recent gonorrhea infection. Prompt diagnosis and treatment with antibiotics is important to prevent complications and long-term joint damage.

Trophozoites are the vegetative form of parasites. This form refers to the active, motile, and feeding stage of a parasite's lifecycle. Trophozoites are typically found in the host's tissues or body fluids, where they actively feed and reproduce. They are responsible for causing infections and diseases in the host. Unlike spores, which are dormant and non-feeding, trophozoites actively seek out nutrients and multiply within the host's body. Pseudohyphae are a form of fungal growth, and trophoflagellates are a type of protozoa. Therefore, trophozoites are the correct answer as they specifically represent the vegetative form of parasites.

Salmonella enteritidis is the best microbe that meets the patient's signs and symptoms. Salmonella enteritidis is a bacterium commonly found in reptiles, including pet iguanas. The patient's symptoms of fever, nausea, vomiting, abdominal pain, bloody diarrhea, chills, and intense headache are consistent with a Salmonella infection. Other options like Listeria monocytogenes, Escherichia coli (EHEC), and Staphylococcus aureus may cause similar symptoms, but the history of cleaning up the iguana's egg shells suggests a potential source of Salmonella contamination.

A titer of 1:256 indicates a secondary response. A secondary response occurs when the immune system has been previously exposed to the antigen and has developed memory cells. These memory cells can quickly recognize and respond to the antigen, leading to a more robust and rapid immune response compared to the initial response. This results in a higher titer, indicating a stronger immune reaction.

Staphylococcus epidermidis is the correct answer because it is the most common microbe associated with prosthetic valve endocarditis. This bacterium is a part of the normal flora of the skin and can easily colonize prosthetic valves. It has the ability to form biofilms on the surface of the valves, making it difficult to eradicate with antibiotics. Additionally, Staphylococcus epidermidis is often resistant to multiple antibiotics, further complicating treatment.

The trachea is not associated with the upper respiratory tract. The upper respiratory tract consists of the mouth, epiglottis, and larynx, which are all located above the trachea. The trachea, also known as the windpipe, is a tube that connects the larynx to the bronchi in the lower respiratory tract. It is responsible for carrying air to and from the lungs. Therefore, the trachea is part of the lower respiratory tract, not the upper respiratory tract.

The symptoms described in the question, such as fever, chills, nonproductive cough, rhinitis, myalgias, headaches, and fatigue, are commonly associated with viral pneumonia. Viral pneumonia is caused by a viral infection in the lungs and is typically characterized by these respiratory symptoms along with systemic symptoms like fatigue and headache. Bacterial pneumonia may present with similar symptoms, but viral pneumonia is more commonly associated with these specific symptoms. Fungal and parasitic pneumonia are less common and typically present with different symptoms.

Stool pH is normally alkaline with a range of 7.1-7.5. This means that the pH level of the stool is slightly basic or higher than neutral. A pH value between 7.1 and 7.5 indicates a healthy digestive system. An alkaline pH in the stool helps in the proper digestion and absorption of nutrients. It also promotes the growth of beneficial bacteria in the gut.

A furuncle is a single boil or abscess on the skin, typically caused by a bacterial infection. A carbuncle, on the other hand, is a cluster of furuncles that are interconnected. Therefore, multiple furuncles constitute a carbuncle.

To confirm the suspicion of C. difficile antibiotic associated diarrhea (CDAD), a stool sample should be collected and a toxin assay should be run. This test is used to detect the presence of toxins produced by C. difficile in the stool, which is a key indicator of CDAD. Stool culture is not the recommended test for CDAD as it does not directly detect the toxins. Fecal smear is also not the appropriate test for CDAD. Blood culture is not necessary for the diagnosis of CDAD as the infection primarily affects the gastrointestinal tract.

Staphylococcus aureus is commonly associated with endocarditis. Endocarditis is an infection of the inner lining of the heart chambers and valves. Staphylococcus aureus is a bacteria that can cause severe infections and is a common cause of endocarditis. It is known for its ability to adhere to damaged heart valves and form biofilms, which can lead to the development of infection. Staphylococcus aureus endocarditis can be life-threatening and requires prompt medical intervention.

Inflammatory diarrhea is characterized by the presence of mucus and/or PMNs (polymorphonuclear leukocytes) in the stool. This indicates an inflammatory response in the intestines, usually due to an infection or inflammation in the gastrointestinal tract. The presence of mucus and PMNs suggests an active immune response, which is typically seen in conditions such as bacterial or parasitic infections, inflammatory bowel disease, or certain food intolerances. High voluminous watery stool is more commonly associated with osmotic or secretory diarrhea, while bright red stool may indicate bleeding in the lower gastrointestinal tract. Originating in the small colon is not a characteristic of inflammatory diarrhea.

Based on the symptoms described, including tissue paper-like wrinkling of the skin, large fluid-filled blisters, red and moist tender areas, and elevated levels of serum creatine phosphokinase, BUN, and bilirubin, the most likely initial diagnosis for this patient is Toxigenic Shock Syndrome (scalded skin syndrome). This condition is caused by a bacterial toxin that causes the skin to become red, blistered, and tender. The elevated lab values suggest systemic involvement and indicate the severity of the condition.

When patients present with lice, the active infection is typically seen along the hairline. Lice infestations commonly occur in the hair and scalp area, and the hairline is a common site for lice to lay their eggs and feed. Therefore, it is expected to find an active infection along the hairline in patients with lice.

The symptoms described by the patient, including intense cramps and watery diarrhea, are consistent with a Clostridium perfringens infection. Clostridium perfringens is a bacterium commonly found in meat and poultry products, and consuming contaminated food can lead to food poisoning. The bacteria produce toxins in the intestines, causing symptoms such as abdominal pain and diarrhea. Therefore, Clostridium perfringens is the best match for the patient's signs and symptoms.

The patient's symptoms, including severe abdominal cramps, profuse diarrhea, and the presence of blood and mucus in the stool, suggest that he may have developed Clostridium difficile infection (CDI). CDI is commonly associated with antibiotic use, as in this case. The most appropriate test to identify the causative agent of CDI is an enzyme immunoassay (EIA) for toxin A and B produced by Clostridium difficile. This test detects the presence of the toxins in the stool, confirming the diagnosis of CDI. Other tests listed, such as conventional stool culture, fecal leukocyte test, special request stool culture, and lactoferrin, are not specific for CDI and may not identify the causative agent.

The presence of Viridian Streptococci, Corynebacterium, Baccilus, and Propionbacterium in the blood culture results is consistent with endocarditis. Viridian Streptococci is a known causal microbe for endocarditis. Additionally, Corynebacterium, Baccilus, and Propionbacterium are part of the patient's skin flora, which can also be associated with endocarditis.

Erythema is not a symptom of endocarditis. Endocarditis is an infection of the inner lining of the heart, typically caused by bacteria entering the bloodstream. Common symptoms include chills and fever, excessive sweating, and weakness. Erythema refers to redness of the skin, which is not typically associated with endocarditis.

For patients who are physically unable to produce a sputum specimen for a lower respiratory infection culture, obtaining a gastric aspirate is the best alternative. A gastric aspirate involves collecting a sample of fluid from the stomach, which can contain respiratory secretions that have been swallowed. This can provide valuable information about the presence of pathogens causing the infection in the lower respiratory tract. Blood cultures may not accurately reflect the infection in the lungs, and throat swab or throat wash samples may not provide sufficient information about the lower respiratory tract. Therefore, obtaining a gastric aspirate is the most appropriate option in this scenario.

Bronchiolitis is the best classification for a swelling and/or mucus build up in the bronchioles. Bronchiolitis is a common respiratory condition that affects infants and young children, causing inflammation and congestion in the small airways of the lungs. It is usually caused by a viral infection, such as respiratory syncytial virus (RSV). Symptoms include coughing, wheezing, difficulty breathing, and mucus production. Therefore, bronchiolitis fits the description of a swelling and mucus build up in the bronchioles.

The symptoms listed are commonly associated with Helicobacter pylori infection, except for mild fever. Helicobacter pylori infection is known to cause coffee ground vomit, frequent burping, and acid reflux. However, mild fever is not typically a symptom of this infection.

The shiny, raised tender plaque-like lesions with distinct margins and "peau d'orange" color described in the question are characteristic of erysipelas. Erysipelas is a bacterial skin infection caused by Group A Streptococcus (s. pyogenes). The infection typically presents with red, swollen, and painful skin, often with a raised border. MRSA, impetigo, and folliculitis are not associated with the specific clinical features described in the question. Corynebacterium minutissimum causes erythrasma, which presents with brownish-red, scaly patches rather than shiny, raised plaque-like lesions.

The correct answer is Variola virus. The description of a maculopapular rash developing into pustules, along with the distribution of lesions on the forearms, calves, and face, is characteristic of smallpox, which is caused by the Variola virus. Serological testing should be performed to confirm the diagnosis.

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B. pertusiss is not considered normal flora of the respiratory tract because it is the causative agent of whooping cough, a highly contagious respiratory infection. Normal flora refers to the microorganisms that naturally reside in or on the human body without causing harm or disease. Streptococcus pyogenes, Haemophilus influenza, and Streptococcus pneumoniae are all examples of microbes that can be part of the normal flora of the respiratory tract.

Cytomegalovirus is a virus, not a microbe, and therefore does not require regular/standard media for growth. Microbes such as Salmonella, Shigella, and Campylobacter are bacteria and do require regular/standard media for their growth.

Point C represents the primary response. This is because the primary response is the initial immune response that occurs when the body is exposed to an antigen for the first time. It involves the activation and proliferation of specific immune cells, such as B cells and T cells, to produce antibodies and eliminate the antigen. Point C on the graph likely represents the time when the primary response is occurring, as the concentration of antibodies or immune cells is increasing.

Based on the symptoms and findings of pyuria and bacilli in the urinalysis, it suggests that the patient has an infection in the urethra, which is called urethritis. Urethritis is characterized by urinary frequency, dysuria, and sometimes low-grade fever. The fact that the patient has never had similar symptoms or treatment for urinary tract infection further supports the diagnosis of urethritis. Cervicitis refers to inflammation of the cervix, vaginosis refers to an imbalance of bacteria in the vagina, and herpes is a viral infection, all of which do not align with the given symptoms and findings.

A positive RPR confirms the presence of potential T. Pallidium antibodies. The RPR (Rapid Plasma Reagin) test is a blood test used to screen for syphilis. It detects the presence of antibodies produced by the body in response to the Treponema pallidum bacteria, which causes syphilis. A positive result indicates that the person has been exposed to the bacteria and has developed antibodies against it.

Staphylococcus aureus pneumonia generally follows an infection with the influenza virus. Influenza weakens the immune system and damages the respiratory tract, making it easier for Staphylococcus aureus bacteria to invade and cause pneumonia. This combination of infections can lead to severe complications and a high mortality rate.

Shigella is not a common cause of viral diarrhea because it is a bacterium, not a virus. Rotavirus, Norovirus, and Astrovirus are all well-known viruses that can cause diarrhea. Shigella, on the other hand, is a bacterium that causes a type of bacterial diarrhea called shigellosis.

Campylobacter does not require additional media for growth in a stool culture. This bacterium is microaerophilic and can grow well in the presence of oxygen, which is typically provided in a standard culture medium. On the other hand, Vibrio, Yersinia, and E. coli O157:H7 have specific growth requirements that are not met by the standard culture medium, hence requiring additional media for their growth.

The patient is a 26-year-old male presenting with a fever, intense pain in the knee, mild edema, and warmth to the touch. These symptoms are indicative of an inflammatory condition affecting the joint. Non-gonococcal arthritis refers to arthritis caused by organisms other than the gonococcus bacteria, such as bacteria like Staphylococcus aureus or Streptococcus. This type of arthritis typically presents with joint inflammation, pain, and swelling. Therefore, non-gonococcal arthritis is the best description for this patient's signs and symptoms.

Tinea versicolor is a skin infection caused by Malassezia furfur that manifests as tan, brown, salmon or white scaly patches on the trunk, neck, and abdomen. It is primarily asymptomatic in patients.

Candidiasis is a fungal infection caused by Candida species, commonly Candida albicans. It typically presents with symptoms such as itching, burning, and a thick white discharge. One of the characteristic signs of Candidiasis is a normal vaginal pH, which is usually between 4.0-4.5. In this case, the correct answer is "Abnormal vaginal pH" because an abnormal pH level would not be expected in Candidiasis.

Lactoferrin is a protein released by neutrophils. Neutrophils are a type of white blood cell that play a crucial role in the immune response by engulfing and destroying bacteria and other pathogens. Lactoferrin is an iron-binding protein that has antimicrobial properties and helps to prevent the growth of bacteria.

The correct answer is Escherichia coli (EHEC) because it is commonly associated with bloody diarrhea and cramping. EHEC is often transmitted through contaminated food or water, and exposure to animals, such as at a petting zoo, can increase the risk of infection. Other microbes listed may cause gastrointestinal symptoms, but EHEC is the most likely in this scenario based on the patient's symptoms and exposure history.

In a diascopy, inflammatory lesions are blanchable. This means that when pressure is applied to the lesion, the color fades or disappears temporarily. Inflammatory lesions are characterized by redness, heat, swelling, and pain, and they occur as a result of the body's immune response to infection, injury, or irritation. Blanching of the lesion indicates that the redness is due to increased blood flow and inflammation rather than a nonvascular or hemorrhagic cause. Petechia, on the other hand, refers to small, non-blanchable red or purple spots caused by bleeding under the skin.

The proper method of storage for the given specimens is as follows: Urine should be stored in the fridge, blood culture should be stored at room temperature, and pleural aspiration should also be stored at room temperature.

Trophozoites are the active, motile form of parasites that are found in the gastrointestinal (GI) tract. They are responsible for causing infections in the GI tract. Therefore, the likelihood of finding trophozoites is denoted by "B" in the figure.

The patient's symptoms of nausea, vomiting, cramps, and diarrhea are consistent with food poisoning. Staphylococcus aureus is a common cause of food poisoning and can be transmitted through contaminated food, especially if it is not properly stored or handled. Consuming homemade mayonnaise potato casserole could have provided an opportunity for Staphylococcus aureus to grow and produce toxins, leading to the patient's symptoms.

The patient's symptoms of constipation, rose spots, cough, mental confusion, and bradycardia, along with the history of being a relief worker in a tsunami-hit area, are consistent with typhoid fever caused by Salmonella typhi. Typhoid fever is commonly associated with contaminated food or water, which could be a likely source of infection in a disaster-stricken area. Listeria monocytogenes, Escherichia typhi, Escherichia coli (EHEC), and Staphylococcus aureus do not typically cause the characteristic symptoms seen in this patient.

After an earthquake, concerns about the water supply and hygienic conditions are valid as they can lead to the spread of diseases like cholera. Stool culture is a common diagnostic test used to identify bacterial infections, including cholera. The extended stool culture is more comprehensive and can help identify a wider range of pathogens, making it the specific test that can confirm the diagnosis in this case.

The correct answer is S. aureus. Staphylococcus aureus is a common bacterium that can cause a wide range of infections in humans. It is known to cause skin and soft tissue infections, pneumonia, bloodstream infections, and other serious infections. The presence of a staphylococcal microbe in the umbilical swab suggests that the patient may be experiencing signs and symptoms related to an infection caused by S. aureus.

In cases of Impetigo, an observed bullous is typically causal to S. aureus. Impetigo is a highly contagious bacterial skin infection, and S. aureus is one of the most common bacteria responsible for causing it. The bullous form of Impetigo is characterized by the presence of fluid-filled blisters on the skin. S. aureus produces toxins that cause the formation of these blisters, leading to the bullous Impetigo presentation.

The correct answer is Blastomycosis. Blastomycosis is a fungal infection caused by the organism Blastomyces dermatitidis. It commonly affects individuals who live or work in areas with moist soil, such as farmers. The infection can present with painless sores that resemble warts or ulcers. Microscopic examination of a skin scraping may reveal broad-based budding of various cells, which is characteristic of Blastomyces dermatitidis. Tinea versicolor is a fungal infection caused by Malassezia furfur, and it typically presents as scaly patches on the skin. Erythrasma is a bacterial infection that causes red, scaly patches in skin folds. Intertrigo is a skin condition caused by friction and moisture in skin folds. Sporotrichosis is a fungal infection caused by Sporothrix schenckii, and it typically presents as a skin lesion with nodules along the lymphatic channels.

Enterobacteriaceae is a family of bacteria that includes several species, such as Escherichia coli (E. coli) and Klebsiella. These bacteria are known to be the most common cause of urinary tract infections in males, especially in the case of a first occurrence. Staphylococcus is also a common cause of urinary tract infections, but it is less prevalent compared to Enterobacteriaceae. Chlamydia trachomatis is a sexually transmitted infection that can cause urinary tract infections, but it is less common in males compared to females. Therefore, the most prevalent microbe in male urinary tract infections (first occurrence) is Enterobacteriaceae.

Chlamydia trachomatis is the correct answer because it is the microbe that is best associated with Lymphogranuloma Venereum. Lymphogranuloma Venereum is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis. It primarily affects the lymph nodes in the genital area and can lead to symptoms such as swollen lymph nodes, ulcers, and discharge. Other microbes listed, such as Gardnerella vaginalis, Candida albicans, and Trichomonas vaginalis, are associated with different types of infections but not specifically with Lymphogranuloma Venereum.

The symptoms described in the question, such as cloudy or watery discharge, burning on urination, fever, and swollen or tender testicles, are consistent with a sexually transmitted infection known as epididymitis. Chlamydia trachomatis is a common causative agent of epididymitis in young sexually active males. Therefore, Chlamydia trachomatis is the most likely microbe responsible for the patient's infection.

Staphylococcus aureus is commonly found on the external nares and is known to identify "carriers" of the microbe.

Bacillus anthracis is the best associated with a widening mediastinum. This is because Bacillus anthracis is the causative agent of anthrax, which can lead to mediastinal widening due to the spread of infection to the lymph nodes in the mediastinum.

Crystalline structures would not be expected to be seen in the patient's lab work. Crystalline structures are not typically found in lab tests and are not indicative of any specific medical condition. Increased glucose levels, increased proteins, RBCs (red blood cells), and PMNs (polymorphonuclear leukocytes) are all commonly measured in lab work and can provide important information about the patient's health.

XDR organisms are distinguished from MDR organisms by being non-susceptible to at least 1 agent in all but two or fewer antimicrobial categories. This means that XDR organisms have developed resistance to a wide range of antimicrobial drugs, making them extremely difficult to treat. Unlike MDR organisms, which are resistant to multiple drugs but still have some treatment options available, XDR organisms have very limited options for effective treatment. This makes them a serious public health concern, as infections caused by XDR organisms are often difficult to control and can lead to higher mortality rates.

keratoconjunctivitis gives it away

Vitamin C supplement consumption is not a common cause for false positives of fecal occult blood smears. Foods such as broccoli, turnips, and horseradish can cause false positives due to their high levels of peroxidase activity, which can react with the guaiac reagent used in the test. Bleeding gums can also cause false positives if blood from the gums mixes with the stool sample. Stomach bleeding caused by NSAIDs can result in blood in the stool, leading to a false positive result. However, vitamin C supplement consumption is not known to cause false positives in fecal occult blood smears.

Cellulitis is a bacterial infection that affects the deeper layers of the skin. It is commonly caused by Streptococcus and Staphylococcus aureus bacteria. Cellulitis is characterized by redness, swelling, and pain in the affected area. It can occur anywhere on the body and is often associated with a break in the skin, such as a cut or wound. Prompt treatment with antibiotics is necessary to prevent the infection from spreading and causing complications.

Nucleic Acid Amplification is the best laboratory mechanism for the diagnosis of Urethritis/Cervicitis. This technique allows for the detection and amplification of specific nucleic acid sequences, such as DNA or RNA, from pathogens that cause these infections. It is highly sensitive and specific, providing accurate results even in cases with low pathogen levels. Urine culture, serology tests, and blood culture are not as effective in diagnosing Urethritis/Cervicitis as they may not directly detect the causative pathogens or may have lower sensitivity and specificity.

HBsAg (Hepatitis B surface antigen) is the best marker for chronic Hep B infection because it is present in the blood during the acute and chronic phases of the infection. It indicates ongoing viral replication and is used to diagnose and monitor the progression of the disease. HBeAg (Hepatitis B e antigen) is present during the acute phase but disappears during the chronic phase, indicating a decrease in viral replication. Anti-HBe (antibody to HBeAg) is produced during the chronic phase and indicates a decrease in viral replication. Anti-HBs (antibody to HBsAg) is produced after recovery from the infection or vaccination and indicates immunity to Hep B.

Donovanosis is the correct answer because it is a sexually transmitted infection caused by the bacteria Klebsiella granulomatis. It is characterized by painless, beefy, granulomatous ulcers that can appear on the genitals or other parts of the body. Syphilis, lymphogranuloma venereum, and herpes can also cause genital ulcers, but they have different characteristics and are not typically described as painless and beefy.

The signs and symptoms described in the question, such as fever, shortness of breath, productive cough, and loss of appetite, are indicative of a respiratory infection. The most likely causative agents for these symptoms in a 4-year-old female are H influenzae or Adenovirus. Community-acquired pneumonia refers to pneumonia that is acquired outside of a healthcare setting, which aligns with the scenario presented in the question. Therefore, H influenzae or Adenovirus causing community-acquired pneumonia is the most likely explanation.

Erythrasma is a bacterial skin infection that can be easily detected using a Wood's lamp. This lamp emits ultraviolet light, causing certain bacteria to fluoresce and appear as a distinctive coral-red color. While fungal, viral, and parasitic skin infections may also exist, erythrasma specifically refers to a bacterial infection, making the correct answer "Bacterial".

The correct answer is Sporotrichosis. Sporotrichosis is a fungal infection caused by the fungus Sporothrix schenckii. It typically presents as red, nodular lesions on the hands and arms, which is consistent with the patient's symptoms. The KOH prep would reveal fungal elements, confirming the diagnosis. Tinea versicolor is a superficial fungal infection that presents as patches of discolored skin, usually on the trunk. Erythrasma is a bacterial infection that presents as reddish-brown patches in skin folds. Intertrigo is a skin condition characterized by inflammation and rash in skin folds. Blastomycosis is a fungal infection that primarily affects the lungs but can also involve the skin.

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Neutrophils are not part of the adaptive immune response. While lymphocytes, plasma cells, and cytotoxic T-cells are all involved in adaptive immunity, neutrophils are part of the innate immune response. Neutrophils are the most abundant type of white blood cells and are responsible for phagocytosis and the initial response to infections. They are not involved in the specific recognition and memory response that characterizes the adaptive immune system.

The given serological results show that the patient is negative for HBsAg (Hepatitis B surface antigen) and IgM anti-HBc (IgM antibodies against Hepatitis B core antigen), indicating that the patient does not have acute Hepatitis B. The patient is also negative for IgM anti-HAV (IgM antibodies against Hepatitis A virus), ruling out acute Hepatitis A. However, the patient is positive for Anti-HCV (antibodies against Hepatitis C virus) and RIBA (recombinant immunoblot assay) which confirms the presence of Hepatitis C. The elevated ALT levels (1500, with normal range being 45) suggest liver pathology. Therefore, the correct interpretation is that the patient has resolved Hepatitis C but may still have liver pathology.