Microbio Final Study Guide Fact Sheet Questions

John Smith went on a relaxing vacation to a hotel spa and resort for a weekend. When he returned to work on Monday he had developed a dry cough. By Wednesday he had developed a headache that persisted until the weekend. On Friday John checked his temperature and it measured at 101̊ F. It was determined that John was infected with a type of pneumonia associated with contaminated water systems. 1) What disease has John likely contracted from the spa? 2) What organism causes this disease? 3) What complications are associated with this disease?

1) Legionnaire's disease 2)Legionella pneumophila 3)If untreated, Legionnaires disease will cause acute kidney failure, complications of the gastrointestinal tract, and complete respiratory failure

Larry is a resident of Arizona and works as a construction worker. Most of the construction sites are dusty due to the machines constantly kicking up soil. Even though he is in his early 60s, Larry is known to be a hard worker. Recently, however, he has developed flu-like symptoms, a rash, and a dry cough. After a blood test, his local health care provider diagnosed Larry with Coccidioidomycosis also known as valley fever. 1. Antibodies and antigens for what causative agent were found in Larry's blood sample? 2. Larry is considered a high-risk case. Which of the following treatment methods is Larry most likely to undergo? 3. Besides Southwestern United States where Larry resides, in what other geographical locations is Coccidioidomycosis considered endemic?

1)Coccidioides immitis 2)Antifungal medication like fluconazole 3) Mexico, South America

A young boy was brought to the hospital with a fever, a red rash with fluid-filled blisters covering his skin, and complaining of itching and a headache. It was determined that the boy had the chickenpox. Though he had been vaccinated as a baby, he never received his second dose. Since he had built some immune response to the virus, he had a much milder case than had he not been vaccinated at all. 1. What is the portal of entry for varicella-zoster virus? 2. How will the doctors treat this infection? 3. Aspirin increases the incidence of what complication associated with chickenpox?

1)Vehicle Transmission-Airborne: coughing or sneezing Contact transmission by touching or breathing in the virus particles from chickenpox blisters (Chicken Pox) 2) Treatment is supportive, no treatment other than relief of the symptoms with acetaminophen and antihistamines, possible use of acyclovir may reduce the severity and duration of the infection 3) Asprin increases the risk of contracting Reye's syndrome-- a condition which the liver and brain cease to function (this syndrome is associated with aspirin usage during several viral diseases

Jane, a four-year old child, was admitted to the hospital in 1952 for a high fever, neck pain, and stiffness. She received the dreaded diagnosis of Poliomyelitis hours after arriving to the emergency center. 1. What is the most likely situation in which Jane contracted Poliomyelitis? A. Her infected classmate sneezed on her B. She played with a toy that had infected fecal matter on it and put her hand in her mouth C. She ate meat from an animal that was infected with polio D. An infected classmate had an open wound that may have infected Jane 2. How likely would this scenario happen today in the U.S.? 3. Which accurately describes Poliomyelitis? A. Poliomyelitis is a viral disease that can affect nerves and can lead to partial or full paralysis B. Poliomyelitis is a deadly enveloped virus that affects the nervous system C. Poliomyelitis is common childhood illness that is still very apparent today D. Poliomyelitis can be treated with antibiotics due to modern medicine

1. B 2. This would happen if the child had not been vaccinated; or possibly if she was vaccinated with the live Sabin vaccine. 3. A

18-year-old Cassie just returned to the U.S. from a summer trip to England. Within the first few days of returning, Cassie began to complain about a stiff neck and nausea. When her symptoms did not improve she decided to go to the hospital. When asked about her trip to England, Cassie also noted that she had gone swimming the day before she got on the plane back home. As a result of her symptoms and history of travel/activities, the doctors suspected meningitis and proceeded to run tests on her cerebrospinal fluid via a spinal tap. The doctors came to the conclusion that she had viral meningitis. Within the next week Cassie began to feel better, but was cautioned to stay away from people for about 10 days. 1. How were the doctors able to identify this infection as viral meningitis as opposed to bacterial meningitis? 2. Even though her symptoms had faded, why was Cassie cautioned to stay away from people for another week or so?

1. Bacterial meningitis CSF is cloudy; viral meningitis CSF is clear 2. Patients with viral meningitis remain contagious for up to 10 days

A 40-year-old man comes to the doctor and complains of an inability to open his jaw for the past two days. When asked if he had any recent injuries that punctured the skin deeply, he said that ten days ago he had accidentally hit himself with a hammer (which has been in his shed for years) in the shin, and the hammer punctured relatively deep into the skin. He did not seek immediate medical attention, and the wound was infected. When checking his fever, he had a 99.5 degree Fahrenheit temperature. His blood pressure and the sound of his lungs sounded normal and he only represented signs of "lockjaw" as well as a stiff neck, infected puncture site and fever. 1) What is the likely agent that caused this disease? 2) What was the mode of transmission? 3) How could this man have prevented this infection?

1. Clostridium tetani 2. His contaminated wound from the old hammer. 3. If patient has been given the vaccine within 5 years, no action is required. If the patient has not been givin the vaccine within 5 years then the patient is to be given the Tetanus Diphtheria Toxoid .

A 22-year old girl has just returned home from her study abroad travel in Japan. She developed a fever and vomiting with sudden and violent body chills 3-4 weeks after her flight landed. While on her trip she had come into contact with water rats and mice while working in the rice fields for a week. Her symptoms progressively worsen so she is rushed to the hospital and is diagnosed with Tularemia. 1. What organism is the causative agent of tularemia? 2. How is tularemia primarily transmitted? 3. Would the patient's family be at risk of contracting tularemia?

1. Francisella tularensis 2. Insect bites, handling infected tissue and fluids of the animals, ingestion of infected material, inhalation of infectious aerosols. NO human-to-human transmission. 3. No

1. Which of the following is the most effective way to prevent yellow fever? 2. Which regions of the world are most affected by yellow fever? 3. Through what vector is yellow fever virus transmitted?

1. Immunization 2. Africa and South America 3. In urban areas - Humans and Aedes mosquitos. In forest areas - mainly monkeys and marsupials (via bites)

A woman and her son are hiking in the densely wooded area around their home in Vermont. A few days later, the son complained of muscle cramps, had a fever, and had developed a large rash with a red center. 1. What is the likely cause of his symptoms and rash? 2. What is typically the identification method for confirming this disease? 3. What occurs during the final stage of this disease?

1. Lyme Disease 2. Erythema migrans (EM) rash. The rash expands gradually over a period of days reaching up to 12 inches or more across, it may feel warm to the touch but is rarely itchy or painful, sometimes clears as it enlarges, resulting in a target or "bull's-eye" appearance. 3. Severe headaches and neck stiffness, additional, EM rashes on other areas of the body, ARTHRITIS with severe joint pain and swelling, particularly the knees and other large joints, facial or Bell's palsy intermittent pain in tendons, muscles, joints, and bones HEART PROBLEMS heart palpitations or an irregular heart beat (Lyme carditis), episodes of dizziness or shortness of breath inflammation of the brain and spinal cord nerve pain, shooting pains, numbness, or tingling in the hands or feet Problems with short-term memory

About a week and a half ago nine-year old Robert went on a camping trip with his Boy Scout troop. When he returned, his mother noticed a strange looking rash resembling a bulls-eye target followed by the apparent on-set of a flu-like illness. 1. If you were Ryan's doctor, how would you diagnose him? 2. What organism is responsible for this disease? 3.) How is this disease transmitted?

1. Lyme Disease 2. Borrelia burgdorferi 3. Lyme disease spreads through the bite of infected ticks usually in the nymphal stage. The infection moves through the blood and lymph.

A 5-year old male went to the doctor with symptoms consisting of a high fever, runny nose/dry cough, and conjunctivitis. Several days later, the patient developed an extensive red rash on his body, had a 104 degrees fever, and had white spots inside his mouth. 1. What disease does this doctor suspect the male patient has? 2. How would the following male patient have become infected? 3. How could this disease have been prevented?

1. Measles 2. Coughing and sneezing (respiratory droplets), can live up to 2 hours in airspace, if others breathe contaminated air/touch infected surface, they can become infected. Infected people can spread measles from 4 days before-4 days after the rash appears. 3. MMR (measles, mumps, rubella) vaccine

A 22-year-old female was experiencing a fever, dry cough, and conjunctivitis. After a few days of feeling sick, the female began to notice small clustered white lesions on the inside of her cheeks. The next day she decided to visit the doctor as raised red lesions began to spread all over her body. 1. What would be the doctor's diagnosis to this patient? 2. Which of the following is a possible way that the female became infected with the disease? 3. What complications are associated with this disease?

1. Measles 2. Respiratory droplets from coughing and sneezing (often transmitted easily in dense population areas) 3. Children younger than 5 years of age and adults over 20 years of age are more likely to suffer from complications. Rare complications include pneumonia, encephalitis, and the extremely serious subacute sclerosig pancephalitis (SSPE). Common complications include ear infections and diarrhea

In June 2012, a middle-aged male arrives to the doctor with a fever, dry cough, and diarrhea. He had recently returned from a trip to Saudi Arabia for the Hajj pilgrimage where he rode camels. All tests, including agglutination, ELISA, and indirect fluorescent antibody tests, come back negative for any known infection, although his white blood cell count is unusually high. Four days later, his symptoms have severely worsened and he returns. X-rays show pneumonia and he has developed kidney failure. Again, no known cause can be found. He is given IV fluids, analgesics, and oxygen. Unfortunately, 5 days later, he dies of multi-organ failure. 1. What disease did the man likely have? 2. Why were doctors unable to identify his infection? 3. How did he contract the virus?

1. Middle East Respiratory Syndrome 2. The early symptoms are non-specific (Fever, cough, shortness of breath, diarrhea) 3. Respiratory droplets, indirect contact. Often found in bats and camels.

A 60-year-old diabetic woman was concerned about an infection on her left hip. She had a three-day history of increased fatigue, fever, vomiting, and left hip and thigh pain. The skin overlying her left hip and thigh was very warm with red areas of swelling. The patient was unable to put weight on her leg because of the excruciating pain. 1.) Given these symptoms, which disease is the most likely cause? 2.) What is the causative agent of this disease? 3.) What serves as the primary reservoir for this bacteria?

1. Necrotizing Fasciitis 2. Group A Streptococcus (streptococcus pyogenes) 3. Humans are primary reservoir.

Mary is a middle-aged woman who has recently started feeling ill. She has a fever, her muscles ache, has rust-colored sputum, and has shortness of breath. She travels a lot for work and is in close proximity (on airplanes) with many different people that may be sick. The Doctor says that Mary is most likely suffering from Pneumococcal Pneumonia. 1. What organs/tissues are being affected in Mary's body? 2. If Mary goes untreated, what complications could arise? 3. What organism is responsible for the disease?

1. One or more lobes of the lungs; Bacterium binds to epithelial cells of the pharynx 2. Pneumococcal bacteremia, Empyema, pericarditis, endobronchial obstruction, Death can occur if untreated 3. streptococcus pneumoniae

An eight-year old year boy is brought into the clinic with a mild rash on his face and neck, but then after closer examination, you observe a more distinct rash with red macules on the chest, back and trunk. As you continue a more thorough investigation, you notice very swollen lymph nodes in his neck. You take his temperature and record a fever of 100 degrees Fahrenheit. Your first question to the boy is "how long have you had the rash?" He says it started out on the face a couple of days ago but then moved more inferiorly. He then goes on to say that he's had a headache for several days as well. He doesn't seem to be in any significant amount of pain so you take your time to observe and record all the signs and symptoms. Once the consultation is done, you diagnose the child with the Rubella Virus. 1. How did the child most likely become infected with the Rubella virus? 2. What complication is of major concern to pregnant women? 3. What vaccine could have prevented the development of this disease?

1. Patients shed virions via respiratory droplets for approximately two weeks before and after the rash. The virus is spread through respiratory secretions and only infects humans. 2. Congenital rubella syndrome (CRS): causes severe birth defects, including deafness, congenital heart disease, damage to brain, liver, lungs, or bone marrow 3. MMR vaccine-attenuated vaccine (2 doses)

Madison has been sick for about 2 weeks. The first week she was having symptoms of a common cold, including a mild fever. After about a week she began to have severe coughing fits. Madison has also had a few incidences where she has vomited because she was coughing so hard, and she has been extremely exhausted after each of the coughing fits. Her mom has decided to take her to the doctor. 1. What is the likely disease that Madison has? 2. The symptom of coughing during Bordetella pertussis is due to: A. The pathogen's attack on ciliated cells B. The pathogen's attack on the nuclear membrane C. Inflammation of the lymph nodes D. Microbes in the mucosa membrane 3. How is Bordetella pertussis most commonly transmitted?

1. Pertusis aka Whooping Cough 2. A 3. respiratory droplets

Makenzie is a 5-year-old child from Africa who was recently adopted by an American family in Chicago. Makenzie started to have diarrhea, abnormal breathing, and bleeding. Her family was not sure what was wrong because she was perfectly fine when they first got her. They took her to the Doctor and found out that she had malaria. 1.) What is the organism that causes malaria? 2.) What are other serious signs and symptoms are associated with malaria? 3.) Through what vector is the organism causing malaria transmitted?

1. Plasmodium. (typesL P. falciparum, P. vivax, P. ovale, P. malariae. P. falciparum and P. malariae cause more serious malaria) 2. Fever and chills, impaired consciousness, prostration, convulsions, deep breathing and respiratory distress, abnormal bleeding, and jaundice, anemia, and vital organ dysfunction. In many severe cases, malaria can attack the brain. 3. Transmission is usually seen only through a mosquito bite in underdeveloped countries but other modes of transmission are through blood transfusions, use of contaminated needs, or organ transplantation. Anopheles mosquito

John, a young boy growing up in a developing country, had polio at the age of four. His symptoms at the time included fever, malaise, sore throat, and headache. He never received a vaccine at birth, and his treatment and recovery were limited but overall successful. He no longer shows symptoms or signs of having the disease. 1. John is now 40 years of age and he is beginning to experience great nerve pain in some of his polio-infected muscles from childhood. His doctor assures him this pain is not due by a reemergence of the poliovirus but is most likely_________. 2. Which of the following polio conditions did John most likely have based on his symptoms? 3. Which of the following routes of transmission could John have received the virus from?

1. Post polio syndrome 2. Minor polio 3. Person-to-person spread of poliovirus via the fecal-oral route is the most important route of transmission, although the oral-oral route is possible

A woman is admitted to the hospital for nausea, vomiting, fever and a headache. She does not have blood in her stool. A stool sample is taken, and it is determined that the woman has salmonellosis. 1.) What serotype(s) of Salmonella causes Salmonellosis? 2.) Through what transmission mode is Salmonella commonly transmitted? With what food is it commonly associated? 3.) What is the best treatment for Salmonellosis?

1. Salmonella enteritidis and Salmonella typhimurium 2. Fecal-oral transmission route, (eggs, milk, poultry) 3. Replace lost fluids and electrolytes

An elderly man comes in to the hospital with a fever of 102.5 and has several blisters on his arms. His skin is very red and has covered most of his arms. He explains the symptoms began shortly after meeting his newborn granddaughter, about a week ago. We see an open wound on his forearm. When asked more questions about his granddaughter, we find out she had similar symptoms and he even noticed that her skin would slough off with gentle pressure. 1. What disease are both the grandfather and granddaughter suffering from? 2. This disease is caused by: 3. What causes the skin to slough off when a patient is suffering from this disease? 4. How is the bacterium that causes this disease transmitted?

1. Staphylococcal Scalded-Skin Syndrome 2. Staphylococcus Aureus 3. Skin slips off with gentle pressure, leaving wet red areas 4. Direct contact between individuals as well as via fomites

A middle-aged woman comes into the ER complaining of high fever, abdominal cramping and that she cannot find the tampon that she put in yesterday. She is admitted to the hospital and immediately given an IV to start treatment. 1.What organism is most likely the cause of this infection? 2.The woman is given an IV to start treatment but what is another route of treatment the doctor could suggest? 3.What ethnicity is most common for Toxic Shock Syndrome?

1. Staphylococcus aureus or streptococcus pyogenes 2. If an object triggered the toxic shock, the doctor may need to remove the object in order for your body to heal. Other possible treatments may include medication to stabilize blood pressure, IV fluids to fight dehydration, and gamma globulin injections to suppress inflammation and boost your immune system. 3. White women

Lila, an eight-year-old girl, has recently experienced fever, headache, malaise, dry mouth and difficulty swallowing. She recently traveled from Japan back to her hometown in Colorado. Her symptoms have lasted for two or three days, and she has also developed left-sided facial swelling that has arisen within the previous 24 hours. She is diagnosed with mumps. 1.What symptom that is characteristic to mumps is causing Lila's difficulty to swallow? 2.What vaccine could Lila have gotten twice as a child to prevent mumps? 3.If Lila's disease is not treated, what could the disease possibly progress to permanently cause?

1. Swelling of the salivary glands, especially the parotid glands, is characteristic. 2. MMR (measles, mumps, rubella) vaccine 3. Permanent hearing loss; possible brain damage from meningitis and encephalitis

1. In which cell type does HIV replicate?

CD4 (helper T cells)

2. To what viral family does HIV belong and what type of nucleic acid is its viral genome?

Retroviridae Ribonucleic acid (+ssRNA)

3. What are the signs and symptoms required for diagnosis of AIDS?

The presence of several opportunistic or rare infections along with infection by human immunodeficiency virus (HIV) or as as severe decrease in the number of lymphocytes called helper T cells and a positive blood test showing the presence of HIV must have anti-HIV antibodies

Joseph returned from a trip to Ecuador where he was backpacking through the rainforest with a group of friends. It was during the fall—a heavy rainfall period for Ecuador—and there were an unusual amount of mosquitos. Soon after he returned, he developed a 104 degrees fever with a very painful headache and a slight rash all over his body. Serological testing determined that Joseph has dengue fever. 1. What is the type of mosquito that caused the infection? 2. What complication will likely arise if Joseph is re-infected with dengue virus? 3. On average, how many cases are there worldwide each year?

1) Aedes mosquitos 2)Reinfection with a perviously encountered strain does not produce dengue fever, but it can trigger fatal dengue hemorrhagic fever as a result of a hyperimmune fever as a result of a hyperimmune response 3)50-100 million cases worldwide each year

A patient reports to a local clinic in Mexico who has a fluctuating fever spiking 104oF every afternoon. He also has a headache and reported recent weight loss. Diagnostic tests indicate that the man is suffering from Brucellosis. 1. Which bacteria would be responsible for the symptoms found in this patient? 2. What transmission routes are associated with this disease? 3. What is most likely the occupation of the patient?

1) Brucella melitensis 2)Consumption of unpasteurized dairy products or through contact with animal blood, urine, or placentas in workplaces such as slaughterhouses, veterinary clinics, and feedlots Eating undercooked meat or consuming unpasteurized/raw dairy products, Breathing in the bacteria that cause brucellosis (inhalation), Bacteria entering the body through skin wounds or mucous membranes 3)slaughterhouses, veterinary clinics, and feedlots

4-year old Travis is transported to urgent care due to the presence of a large blister, a low-grade fever, and swollen lymph nodes near the site of the blister. The nurse asks him if he has come in contact with a cat in the past week, and he recalls that his friend's cat scratched him when he was spending the night at his friend's house. Question 1: What is the likely cause of this blister? Question 2: What is a possible consequence of having Cat-Scratch Disease? Question 3: Where would there most likely be an elevated number of cases of Cat-Scratch Disease?

1) Cat scratch disease (Bartonella henselae), he was scratched or bit by a cat that introduced the bacterium into the skin 2) Bartonella releases endotoxin when it dies, which can trigger fever, blood clotting, inflammation, and possible shock 3) Those who are exposed to cats on a regular basis

Zack, a 20-year-old college student, had unprotected sex with his girlfriend for the first time. Before having sex he asked her if she had been tested. Her response was, "No, but I don't have any symptoms so I know I'm fine." A week later he began to notice abnormal discharge coming from his penis and urinating was becoming painful. Zack went to the doctor where he was diagnosed with chlamydia. 1. What organism causes chlamydia? 2. What is the best way for Zack to prevent getting chlamydia in the future? 3. If Zack's girlfriend continues to go untreated what other disease can occur?

1) Chalmydia trachomatis 2) Abstinence or faithful mutual monogamy are the only preventatives, using a condom during every sexual interaction 3)If untreated, chlamydia can spread to the uterus and fallopian tubes causing pelvic inflammatory disease. This can damage the reproductive system and inhibit the ability to get pregnant.

Pat, a 22-year old woman, comes into the Emergency Room with a serious case of diarrhea. Her stool is clear, odorless, and contains flecks of mucus. She cannot remember eating anything out of the ordinary in the past 24 hours that would have upset her stomach, but she just returned from a mission trip in Haiti several days ago. 1. From what infectious disease is Pat suffering? 2. Pat, having been admitted to the hospital, wonders if she should have her mom come keep her company and take care of her. However, she doesn't want her mom to get sick as well. Would this be a logical concern? 3. After learning her diagnosis, Pat rejects the idea that she was infected while in Haiti because she arrived home slightly less than a week ago. Is the timing of her symptoms questionable?

1) Cholera 2) This is not a concern because Cholera is spread through the consumption of undercooked seafood or contaminated water 3) It is probable that she was infected with Cholera from consumption of the bacteria in Haiti because Vibrio cholarae has an incubation period between 2 hours to 5 days

Taylor, a patient in the hospital who is recovering from a severe illness, has been taking multiple antibiotics. Since taking the antibiotics, Taylor started experiencing watery diarrhea. The diarrhea worsened and she began experiencing nausea, high fever, and abdominal pain. Gram-positive bacilli containing endospores were observed in her feces when viewed under the microscope. 1. What digestive disease would be responsible for Taylor's symptoms? 2. What would be the best possible treatment methods for this infection? 3. If the infection worsens or goes untreated, what complications or secondary infections may occur?

1) Clostridium difficile diarrhea 2) Generally, cessation of the causative antimicrobial may be all that is necessary to restore normal microbiota, treatment for moderately severe cases entails the use of oral metronidazole or vancomycin, and eating probiotics, also fecal transplants containing fecal material, collected from a close relative or spouse of the patient 3) Pseudomembranous colitis (life-threatening inflammation of colon), toxic megacolon, perforations of the colon, sepsis, and death (rare) can result from C. diff.

Mallory is 16 years old, and has been taking penicillin for a recent infection. She begins to experience abdominal pain and nausea, as well as watery diarrhea three or four times a day. 1) What is the organism that causes this infection? 2)What is it called when the normal flora of the body prevents pathogens from creating disease due to competition? 3)What characteristic of this organism causes it to be resistant to many chemical and physical antimicrobial methods?

1) Clostridium dificile 2) Microbial antagonism 3) Able to thrive in very harsh conditions, is a part of normal microbiota, thrives when normal bacteria is depleted so it has no competition

Charlotte, a six-month-old baby attended her first family thanksgiving at her grandparents where she was the center of attention to her large number of relatives. She is at the age where she can begin eating solid foods and therefore was being fed all kinds of snacks throughout the day, which included a cracker with cheese and honey. A week later, Charlotte's mother noticed that she had a loss of appetite, was constipated, weak, and had an unusual cry. 1. Charlotte is experiencing symptoms of botulism due to eating what? 2. What organism is causing Charlotte's Botulism? 3. How can Infant Botulism specifically be prevented in the future and in other infants?

1) honey 2) Clostridium botulinum 3) Do not feed honey to infants less than one year of age

Joe Dirt had gone down to the Guadalupe River one day to escape the heat. Since he was soaking wet, he decided to not ruin his leather boots with his wet feet and walked through the pasture barefoot. On his way back to his house he stepped on the remains of a broken bottle and cut his foot. Joe Dirt is a tough guy and didn't care much about that cut and decided to suck it up and "rub some dirt on it" as his father used to tell him when he was being a crybaby. So he continued his walk back home through the dust pasture barefoot with his bleeding foot until he could rinse it off in the tub. A few days later he had major swelling, pain, and foul smelling drainage where he had cut his foot recently. His mother Luanne dragged him to the doctor to get that nasty thing fixed. When he went to the doctor, he was told he had developed Gas Gangrene. 1. What type of bacteria commonly causes Gas Gangrene? 2. How was the disease transmitted? 3. How should this disease be treated?

1) Clostridium perfringens causes gas gangrene 2)Clostridium perfringens endospores are introduced into dead tissue via breaks in the skin, generally is found in soil so the cut in his foot then walking in the soil transmitted the bacteria 3) A physician must intervene quickly and aggressively to stop the spread of necrosis in gas gangrene by surgically removing dead tissue and administering antitoxin and large doses of intravenous penicillin and clindamycin, oxygen applied under high pressure may also be effective

A man in central Africa comes to a clinic reporting of fever, muscle pain, headache, vomiting, and unexplained bruises and bleeding. Upon closer examination the man had begun bleeding from various orifices of his body. The man also tells doctors that he had recently explored a cave inhabited by native fruit bats, where he had cut his hand. He noted that there were fruit bat feces littering the ground, but stressed that he thoroughly washed his hand after the accident. 1. Based on the symptoms and location described by the patient what diagnosis would you consider? 2. What treatment would be best for the patient, given your diagnosis? 3. At what point(s) did the patient most likely first become infected with the pathogen?

1) Ebola Hemorrhagic Fever 2) Supportive care with fluid and electrolyte replacement, maintaining blood oxygenation and pressure, replacing lost blood, and treating secondary infections or complications 3)Coming into direct contact with infected bodily fluids, especially blood, through broken skin or mucous membranes, or through contact with a bat, or bat's bodily fluids or wastes

A Liberian woman seeks medical care with symptoms of headache, muscle pain, sore throat, and fatigue that have been persisting for about a week with no relief. You take her temperature and note that she also has a fever. Soon after she is admitted to a hospital, her symptoms progress into vomiting, diarrhea, and external bleeding from her ears. Based on the symptoms, with what disease could this woman be diagnosed? How did she most likely contract the disease? What treatment approach should you take?

1) Ebola Hemorrhagic Fever 2)Infect humans via contact with a host (probably bats) or to the host's bodily fluids or wastes Humans can also infect each other via contact with bodily fluid, especially blood 3)Supportive care with fluid and electrolyte replacement, maintaining blood oxygenation and pressure, replacing lost blood, and treating secondary infections or complications

A female 23 yr old patient comes into the hospital while you are working. She looks slightly yellow, appears extremely tired, underweight, has been vomiting, is running a fever, and says her urine has been looking really dark. She provides a lot of information about herself, she is sexually active and always uses protection, denied illegal drug use, was born to healthy parents, and is generally in good health. This leaves doctors puzzled and excludes diseases usually transmitted via sexual intercourse, BUT you notice the patient has quite the tattoo collection. 1. The patient is diagnosed with Hepatitis B infection. What complications can occur with this disease? 2. What major organ is at risk if this goes untreated? 3. What is the best prevention against this disease?

1) HBV can lead to hepatic (liver) cancer, or acute liver failure, can also lead to chronic liver infection which can lead to cirrhosis or liver cancer 2) the liver 3) the best method of prevention is avoiding sharing needles for drugs, tattooing, or piercing, there is also a vaccine against HBV which is given over a six month period resulting in protection against the virus in 95% of individuals

John has recently noticed some discolored lesions on his skin. In the area where the lesions are, he also is experiencing numbness. He is in extreme pain and has noticed that the location of the pain seems to be towards the extremities of his body. He did travel to Brazil about 5 years ago on a medical mission trip. He tells this to his doctor and the doctor immediately puts him on the drugs rifampin, clofazimine, and dapsone. 1. What is John's diagnosis? 2. What is the causative agent of this disease? 3. How is this disease transmitted?

1) Hansen's disease (leprosy) 2) Mycobacterium leprae 3)Person-to-person contact, inhalation of respiratory droplets, breaks in the skin can also lead to infection

Kate, 24 years old, came into the hospital with complaints of diarrhea, a stiff neck, and aching muscles. She had had a tough workout a few days ago so it could just be soreness from her workout. When the nurse asked what she had been eating she mentioned she had a veggie omelet, a turkey sandwich, beef stir fry, and Blue Bell ice cream. She was diagnosed with Listeriosis. 1. If Kate had been pregnant, would the effects of Listeriosis make any difference to the patient? 2. How would you treat Listeriosis? 3. Through what routes of transmission is Listeria transmitted?

1) Infection in pregnant women can be severe, causing bacterial meningitis and possible death Human to human transmission is limited to the transfer of Listeria from pregnant women to fetuses leading to premature delivery, miscarriage, stillbirth, or meningitis in the newborn 2) Penicillin and erythromycin inhibit listeria 3)Foodborne; Infections follow consumption of contaminated food

After a week of constant rainfall, nine-year old David was playing outside one fall afternoon when he stumbled across what looked like a small animal's nest hidden in the bushes. Being a patient little boy, he waited to see if any creature would turn up. Eventually, he noticed a little mouse crawl up, tidy its nest and then lay down to sleep. David watched this mouse every day after school for a week until one day he decided to clean up the nest himself and make a new one for the mouse. When his mother called him in for dinner that night, he washed his hands like a good little boy, but did not tell his mother that he had playing with the mouse's nest. A few days later, David came down with apparent flu-like symptoms: chills, headache, diarrhea, vomiting and a cough. It was also difficult for him to breathe and he complained that his body hurt. David's mother, unsure of what was wrong with her child, brought him immediately to Urgent Care 1. What is the most probable cause of David's illness? 2. What is the correct pathogenesis of Hantavirus? a. Hantavirus is inhaled and invades the lungs where it infects blood capillary walls and causes fluid leakage into surrounding tissue. b. Hantavirus is inhaled and forms syncytia which is hidden from the immune system. c. Hantavirus is a normal microbiota of the respiratory system and can become opportunistic in immunocompromised individuals. d. Hantavirus spreads from the pharynx to the sinuses, causing inflammation and infection in the body. 3. All of the following describe Hantavirus Pulmonary Syndrome EXCEPT: a. Cannot be treated with pharmacological drugs. b. Treatment is supportive and consists of oxygen supply, fever-reducing drugs, pain medication and pulmonary intubation. c. The identifying factor of Hantavirus is a characteristic "whoop" of the cough. d. Often occurs after long periods of rain that produce increased vegetation for mice.

1) Inhalation of dried deer mouse urine, feces or saliva that infects the lungs of humans (where Hantavirus is found) 2)Following inhalation, Hantavirus enters the blood and travels throughout the body infecting the cells that make up blood capillary walls, particularly the lungs. The body responds with inflammation, which causes capillaries to leak fluid into the surrounding tissue BP drops precipitously and about 50% of patients die from pneumonia and shock .A. 3) The identifying factor of Hantavirus is NOT whoop

Over the summer, Lauren went on a mission trip to El Salvador. She formed relationships with the poor children in a rural village. On her last day, the mother of one child decided to thank Lauren by giving her fresh fruit from a community garden. Lauren was starving and ate the fruit right away. About 2 weeks after returning to the United States, Lauren experienced stomach cramping and diarrhea. Her symptoms developed into a fever, bloody stools, and sharp stomach pain. Her mother rushed her to a doctor who performed several tests. One test showed that Lauren's liver was malfunctioning. Lauren is diagnosed with amebiasis. 1) Based on Lauren's signs and symptoms, what type of amebiasis does Lauren have? 2) How did Lauren become infected with Entamoeba histolytica? 3) How will Lauren's disease be treated?

1) Invasive extraintestinal amebiasis (because the disease has spread to the liver) 2) The disease is spread through consumption of contaminated water or food, ingestion from contaminated hands, or oral-anal intercourse Consumption of the contaminated fruit. 3)Oral rehydration therapy and antiamebic drugs. Metronidazole followed by Iodoquinol (symptomatic infections) and antibacterial agents (to prevent secondary infections)

Two boys, Jake and Nick, were born in a rural area in Latin America where the triatomine bug, or kissing bug, that carries the parasite Trypanosoma cruzi is prevalent. When Jake was ten, he was infected by the kissing bug and started experiencing body aches, a headache, and his face began to swell around one of his eyes. He was diagnosed with Chagas disease. Nick never was bitten by an infected triatomine bug, but because of liver disease, he required blood transfusions and a liver transplant at the age of thirty. At the age of sixty-five, Nick started experiencing difficulty passing stool and suffered from congenital heart failure. Nick was also diagnosed with Chagas disease. 1. During what phase did Jake experience symptoms of Chagas disease? During what phase did Nick experience symptoms? 2. What treatments can be used to cure Nick? 3. How did Nick become infected with Chagas disease?

1) Jake experienced the acute phase, Nick developed the chronic phase of the disease 2) Nick cannot be treated because he was not diagnosed early enough for antitrypanosome drugs to be effective 3) Nick became infected through either the blood transfusion with infected blood or organ transplantation from an infected donor

A patient comes in complaining of symptoms that include a sudden onset of high fever, runny nose, cough, and sore throat. He is diagnosed with influenza. 1. Within how many hours of showing symptoms of the flu should a person start treatment of antiviral drugs? 2. Which body system does influenza mostly affect? 3. The traditional flu vaccine protects against how many strains of influenza?

1) Oseltamirvir pills or inhaled zanamivir mist inhibit type and and type B neruaminidase, must be taken during the first 48 hours of infection in order to be effective because they cannot prevent later manifestations of the disease 2) Lungs (the deaths of epithelial cells infected with influenzaviruses eliminate the lung's first line of defense against infection, the epithelial lining) 3)The traditional flu vaccine is a trivalent vaccine which protects against 3 flu viruses

Susan has been having terrible itching lately. She had several white pumps appear on her legs after she shaved. The bumps then progressed into pus-filled, red, pimple-like lesions. She has these bumps on both legs and in the axillary region. 1.) Most likely what are the two pathogens that are causing this disease? 2.) The red bumps do not subside after two days. Susan goes to the doctor to get treated for her irritated, itchy red bumps. Most likely what will the doctor prescribe? 3.) Susan's disease has seemed to worsen. Her bumps are now oozing, and have become more painful than itchy. Susan is confused as to why since she has been following her doctor's instructions to practice better hygiene. Lab tests indicate that she is infected with MRSA. To what antibiotics is this organism resistant?

1) Staphylococcous aureus and Staphylococcus epidermidis 2) After cleaning and draining abscesses of pus for subsequent contamination, topical antibiotic therapy with mupriocin is effective. Dicloxacillin- a semisynthetic form of penicillin not inactivated by B lactamase Dicloxaillin is an oral form of Penicillin. However, Staphyloccous Aureus is very drug-resistant so sometimes can be treated with Vancomycin 3)Methicillin- resistant S. aureus

A group of 15 campers went on an annual weekend trip over Labor Day weekend. The group went to a camping ground with a warm climate and located near a freshwater stream. The group brought foodstuffs for each meal that weekend, and canteens to fill with water from the stream, which was separated into a few different portions. One day into the trip, three of the 15 campers experienced severe abdominal cramping. The next day, and continuing for a week after, two of the three people experienced severe diarrhea. At first, the group considered the symptoms as a result of food poisoning from the slightly undercooked meat they consumed the night before, but when the symptoms lasted for several days, they decided to seek medical advice. The three were asked to give stool samples, and it was found that two of the three had cysts in their stool. It was later found that the campsite rangers discovered a beaver dam in one portion of the freshwater stream. The rangers collected a sample of the beaver's stool, and the same cysts were discovered in this sample as were in two of the three ill campers' stool samples. In conclusion, the two people with continued diarrhea and the beaver were all diagnosed with Giardiasis. 1. What was the mode of transmission of Giardiasis to the two campers? 2. It could be concluded that the third camper did not have Giardiasis because he was missing one key symptom, which was what? 3. If it were discovered that another camper also had cysts in his stool but was asymptomatic, what would be the best treatment for this camper?

1) The consumption of water from the stream that was contaminated by infected beaver feces 2) The third patient did not have Cysts found in feces. 3) There is no treatment for asymptomatic individuals

A 23-year-old woman is admitted to the hospital feeling fatigued and flu-like. She reports having lost a substantial amount of weight recently. The doctors also noted that she appears to be experiencing drug withdrawal. 1) She attributed the weight-loss to the increase in heroine use, but it may due to infection with HIV. Does this patient have AIDS? Why or why not? 2) Which cells will HIV infection target? 3) What treatment is best for patients with HIV infection?

1) The patient does not necessarily have AIDS, for HIV infection to lead to aids there are more signs and symptoms which include succombing to opportunistic pathogens and low helper T cell count 2) HIV primarily targets *helper T cells*, cells of the macrophage lineage, including monocytes, macrophages, and microglia, smooth muscle cells, and dendritic cells 3) Antiretroviral therapy (ART), a cocktail of three or four antiviral drugs reduce viral replication with nucleotide analogs, integrase inhibitors, protease inhibitors, attachment inhibitors, and reverse transcriptase inhibitors.

A 55-year-old veterinarian has developed itchy sores all over his skin. He developed these sores on his head, neck, and forearms about 7 days after he was asked to come to a farm in South America to examine disease-stricken sheep. The veterinarian did not know that he had a cut on the side of his arm while handling the sheep. It was eventually determined that the sheep were infected with Bacillus anthracis. As his symptoms progressed the sores became blisters, which were filled with bloody and clear fluid and formed black ulcers. Though significant swelling surrounded the sores, they were painless, so he did not seek immediate treatment. Two weeks later a scab formed, dried, and fell off. After this occurrence, the veterinarian attained proper medical treatment, and was able to fully recover. 1. How was the veterinarian infected? 2. What treatment should be administered to the infected veterinarian? 3. If the veterinarian overlooked his infection and did not get treatment, what complication could he experience?

1) The veternarian was infected when endospores from the infected sheep entered into his bloodstream after being handling the animals 2)Treated with antibiotics, most often doxycycline or ciprofloxacin. Ciprofloxacin has been the antibiotic of choice during a suspected anthrax outbreak 3)Inhalation anthrax and its subsequent systemic infection (eg, septicemia, hemorrhagic leptomeningitis)

Snoop Dogg is a 44-year old male. One night, Snoop got a tattoo. That same evening, he had unprotected sexual intercourse with an unknown woman. A few days later Snoop Dogg went to the doctor reporting dysuria and purulent discharge. His partner was said to be asymptomatic. Snoop Dogg was diagnosed with gonorrhea. 1. What was the mode of transmission? 2. What pathogen causes gonorrhea? 3. A woman who has gonorrhea most likely has what signs and symptoms?

1) Unprotected sexual intercourse with the unknown woman because even asymptomatic carriers can transmit STI's 2) Neisseria gonorrhoeae 3)Painful or frequent urination,Anal itching, discomfort, bleeding, or discharge, Abnormal vaginal discharge. Abnormal vaginal bleeding during or after sex or between periods.Genital itching.Irregular menstrual bleeding. Lower abdominal (belly) pain.Fever and general tiredness.Swollen and painful glands at the opening of the vagina (Bartholin glands). Painful sexual intercourse. Often asymptomatic

Haiden is a 24-year old adult woman with a weakened immune system. She is 15 weeks pregnant and has recently been taking antibiotics. Shortly after beginning the antibiotics, she began experiencing itching in her vaginal area, thicker discharge than normal, and frequent irritation when she urinates. 1.) What infection does Haiden have? 2.) Why do antibiotics increase the likelihood of developing this infection? 3.) What are some factors that increase the likelihood of developing this infection? 4.) What is the etiology of this infection?

1) Vaginal Candidiasis (caused by Candida albicans) 2)C. albicans normally lives in the vagina in competition with lactobacilli and other bacteria. If normal bacterial populations are reduced by antibiotics, Candida can multiply rapidly 3)If the vaginal pH becomes more alkaline than usual, the patient is on antibiotics, in immunocompromised, especially AIDS patients it can become systemic, Most common in adult women with weakened immune systems or pregnant, predisposing factors for the development of andidiasis include cancer, invasive hospital procedure, antibacterial treatments, diabetes, severe burns, intravenous drug abuse, and AIDs 4) candida albicans is an opportunistic ascomyete yeast, common members of the microbiota of the skin and mucous membranes, the depletion of normal microbiota leads to the allowance of Candida to multiply rapidly

Nathan, a four-year-old boy, complains to his mom that he is itchy. Nathan has a red rash with fluid filled blisters all over his body and is running a fever. Nathan was never received the Chickenpox vaccine. 1. What organism causes Chickenpox? 2. Should Nathan's mom be worried that Nathan's six-year-old sister will catch the infection? 3. How should Nathan's mom treat Nathan's infection?

1) Varicella Zoster Virus 2)If Nathan's sister was given the Varicella vaccine than no, she should not be worried. But if his sister has not been vaccinated, there is a high chance that she will also get the vaccine because chicken pox is highly virulent 3)Treatment is supportive, also antiviral drug acyclovir may reduce the severity and duration of chicken pox Aspirin should not be given to children because of this risk of contracting Reye's syndrome

Janie, a 20-year-old girl, meets with her doctor and complains about having a cold sore outbreak during finals week. She claims she has had cold sore outbreaks before but they have stopped happening since freshman/sophomore year of high school (about 5 years). She has never been tested for STD's because she has never had sex. 1. Is it possible that Janie can have Type 1 Herpes? 2. If she does test positive for Type 1 Herpes, how could she have contracted it? 3. What treatments should the doctor consider to treat Janie's cold sores?

1) Yes it is possible, herpes virus is not only spread through intercourse. 2) Herpesviruses are most often spread between mucous membranes of the mouth and genitals, this includes kissing on the mouth or oral sex 3) Infections can be controlled with chemotherateputic agents such as acyclovir or its derivatives Topical applications of the drug limit the duration of the lesions and reduce viral shedding, though the drug does not cure the diseases or free nerve cells of viral infections

Zack processes the wool and hides of sheep. One day, Zack notices a headache, shortness of breath, and cough. These symptoms later progress into extreme chest discomfort, fever, and shock. Zack soon passes away from these symptoms. An autopsy reveals pleural effusion in the lungs. 1) Which type of anthrax did Zack likely contract? 2) What complications are associated with this disease? 3) For what length of time is this disease treated?

1) Zack most likely contracted inhalation anthrax 2)B. anthracis can also cause cutaneous anthrax, gastrointestinal anthrax, and injection anthrax. Severe inhalational anthrax can lead to ARDS (Acute Respiratory Distress Syndrome), hemorrhagic meningitis, shock, and death. 3)Since anthrax spores could take weeks or months to activate in the body, treatment usually lasts around 60 days.

A two-year old boy complained of a sore throat to his mother. After two weeks of no improvement, he lost his appetite and became lethargic. The concerned mother admitted him to the hospital. The doctor examined the boy, and he had a 103.8 degrees fever, pharyngitis, clear chest, swollen lymph nodes, and a yellowish thick pseudomembrane near the pharynx. 1. What disease does the boy have? 2. What pathogen causes this disease? 3. With what drug should he be treated?

1) diptheria 2)Corynebacterium diptheriae 3)The most important aspect of treatment is administering an antitoxin to neutralize the diptheria toxin before it binds to cells; Penicillin or erythromycin kills Cornyebacterium, preventing the synthesis of more toxin

Lauren is a young, healthy college girl who attends Texas Christian University. Even though she got 10 hours of sleep, Lauren awoke one morning feeling extremely tired, her body ached, and her throat hurt. She went to the doctor and tested negative for Strep. The doctor gave her antibiotics to see if it could be a bacterial infection, but they didn't help at all. Lauren does have a boyfriend, and she does share drinks with her friends frequently. Her boyfriend also has been feeling achy and extremely fatigued with a sore throat and fever. Finally, the doctor tested Lauren and her boyfriend for another infection, and they both came out positive. The doctor warned them not to participate in contact sports, because that could cause the spleen to rupture. The doctor also informed them not to be alarmed if they feel symptoms for many weeks. 1. Since Lauren and her boyfriend both tested positive for the infection, it can be concluded that one gave the other the sickness. Considering their symptoms, what is likely their infection? 2. Based on the infection diagnosed, Lauren and her boyfriend can conclude that most likely the infection spread about 4-6 weeks ago, and they are just now experiencing the symptoms. What virus caused this? 3. How should Lauren and her boyfriend go about treating this "kissing disease?"

1) infectious mononucleosis 2) caused by Epstein Barr Virus (HHV-4) 3) Relief of symptoms, most patients recover without treatment in 2-4 weeks though infection is permanent, avoid contact sports to reduce the risk of rupturing an enlarged spleen Relieve symptoms by staying hydrated and drinking fluids, getting plenty of rest, and taking over the counter medications to help the fever and pain (CDC, 2014); Over the counter medications such as acetaminophen and ibuprofen can help decrease fever and pain; warm salt water may help sore throat (JAMA, 2015); some clinicians say corticosteroids help with the treatment of uncomplicated infectious mononucleosis

A mother notices that her 5 month old infant is much more lethargic and less playful than normal. The infant develops a fever, begins throwing up frequently, and is having trouble moving her neck. You also notice that the baby is squinting and covering her face when the light gets brighter. The mother takes the baby to the doctor, who diagnoses the baby with bacterial meningitis. 1. What diagnostic test must be performed to determine that the baby has bacterial meningitis and not aseptic meningitis? 2. What is the best way to treat bacterial meningitis? 3. What are the possible complications even after treatment?

1)Following a spinal tap the culturing of bacteria in Cerebrospinal Fluid (CSF). (CSF is cloudy vs. in Viral meningitis CSF is clear) 2) Intravenuously administered antimicrobial drugs, including ceftriazone, cefotazime, meropenum, vancomycin, or ampicillin 3) Death can occur and in the nonfatal cases, hearing loss and brain damage can occur

Courtney, a 22-year old TCU senior, was very excited about graduation approaching so to celebrate, she decided to go out one Friday night. Courtney had a little too much to drink which interfered with her better judgment. Courtney met a nice guy and had unprotected sexual intercourse. She woke up the next morning feeling ashamed but decided to forget about it and went on about her normal everyday life. A month later Courtney began to feel pain and irritation in her lower abdomen and vaginal area. Not suspecting anything of it, she decided to take over the counter medication to alleviate the pain. Around the same time, Courtney realized that her menstruation cycle was late so as a precaution she decided to take a pregnancy test and to her surprise, it came out positive. Disappointed and depressed, Courtney decided to wait on telling her parents and seeing a doctor until after she graduated which was still 3 months away. As time passed, Courtney began to have weird colored discharge and increased pain around her pelvic and vaginal area. Courtney ignored all signs believing that these were changes that her body was going through due to the sudden pregnancy. One morning, about a week later, Courtney was awakened by excruciating pain in her pelvic area along with a fever of 100 degrees Fahrenheit. Around 11p.m, Courtney experienced bleeding in her vaginal area and rushed to the restroom where the bleeding and pain increased. Courtney realized then that she had miscarried her baby and rushed to the emergency room. 1. What prescription will the doctor prescribe for Courtney and why do you think so? 2. What disease that caused the excruciating pelvic pain do you think manifested from the prolonged exposure of the bacteria in her body? 3. If Courtney would have carried her baby to term without ever realizing that she had an infection, what disease could the baby have contracted at birth that resulted in blindness of the infant?

1)Her physician would prescribe doxycycline or erythromycin to eliminate her bacterial chlamydia infection 2)Pelvic inflammatory disease: in infection of the female reproductive organs that causes pelvic pain, fever, and vaginal discharge and causes infertility 3) Trachoma

One Saturday evening, 22-year-old Poppy matches with a guy on Tinder, Paul, and after some time texting he asks her if she would like to come over to his place to "Netflix and chill". Since Poppy has nothing to do and she is single, she agrees to come over and they watch Aziz Ansari's new Netflix original Master of None. About 30 minutes into "Netflix and chill", Poppy and Paul start kissing and the clothes come off. About a week later, Poppy notices small, red, itchy lesions on her external genitalia and she goes to her gynecologist who diagnoses her with genital herpes. She was horrified because she knew she was clean of STDs before hanging out with Paul and he was the only recent sexual partner she's been with. They used a condom and she did not notice any lesions on his genitalia that night. 1. Which virus is primarily responsible for causing Poppy's genital herpes? 2. Is it possible for Poppy's lesions to spread to other parts of her body? 3. Although they used a condom how did Poppy contract genital herpes?

1)Human herpesvirus-2 (Human Herpes Simplex Virus II) 2)A person with genital herpes can also spread the infection to other parts of his or her body by direct contact (i.e., by touching the sores and then touching other body parts) 3) Herpes lesions in women are usually on the external genitalia, so condoms during sexual intercourse provides little protection However, outbreaks can also occur in areas that are not covered by a condom so condoms may not fully protect you from getting herpes.

Angela is 30 years old and recently went to Africa for humanitarian work. When she came back to the US, she started developing symptoms such as fatigue, abdominal pain, loss of appetite, clay-colored stool, and jaundice 3 weeks after her trip. She went to the doctor after experiencing these symptoms. The doctor drew blood to diagnose the problem and found levels of IgM anti-HAV antibodies, indicating that she had been infected with Hepatitis A virus. 1)What treatment would be recommended? 2)What preventative measures could be taken to avoid infection with HAV? 3) What was most likely to be the mode of transmission for Angela's HAV infection?

1)No special treatment/ cure-doctors recommend rest, adequate fluids, and nutrition. Symptoms may take a couple months to subside Immunoglobulin can be given immediately after exposure which can provide a little bit of protection against the virus 2)Hepatitis A Vaccination-inactivated-2 doses, given 6 months apart (CDC, 2015), Avoid undercooked foods and contaminated water in endemic areas 3) HAV can survive on surfaces such as countertops and cutting boards for days, and is transmitted in fecally contaminated food or water

A nurse goes to dispose of a needle she just used to give a patient a shot in the waste disposal bin located on the wall of a hospital room. The waste bin was overflowing with previously used needles and when she went to dispose of the needle, another needle sticking out of the bin stuck her hand. About two months later, she began having a fever and feeling very fatigued. She had a loss of appetite, yellowing of her skin, and dark colored urine. She went to the doctor, where they did an enzyme immunoassay and determined that she was infected with Hepatitis C. 1. What is the transmission mode of Hepatitis C? 2. What are the best preventatives against contracting Hepatitis C? Is there a vaccine? 3. What chronic disease(s) could the nurse possibly develop as a result of contracting this disease?

1)Primarily through percutaneous exposures to infected blood through injected drug use, receipt of donated blood or organs, needle stick injuries in health care settings, birth to an HCV- infected mother, sex with HCV- infected person 2) avoid sharing needles for drugs, tattoos, or piercings, health care workers should be cautious with needles and other sharp instruments, all blood and blood products should be screened before use, there is no vaccine against HCV though scientists have identified a protein-digesting enzyme required for HCV development 3)Chronic liver disease, cirrhosis, liver cancer, chronic hepatitis c

A 32-year old male presents with a severe skin lesion that is forming around a bite wound and complaints of a fever. The physician notes that the patient's weight has dropped significantly and that his platelet count is relatively low. Recently, the patient travelled to North Africa where he spent a large amount of time outside at dusk conducting environmental research. It is determined that the patient has Leishmaniasis. 1. What form of Leishmaniasis does the patient likely have, based on his signs and symptoms? 2. What are the best preventatives against Leishmaniasis? 3. What is the vector that transmits Leishmaniasis?

1)Visceral Leishmaniasis: fever, weight loss, organ enlargement, low blood counts 2)Prevention is limited to reducing exposure by controlling reservoir host and sand fly populations 3)Sand flies of the genera Phlebotomus and Lutzomyia

17-year old Jacob went camping 2-3 weeks ago. Ever since he has experienced a persistent mild fever but has had no other symptoms. His mother brought him into the doctor where he explained to the doctor that after camping he returned home with many mosquito bites. The doctor decided to conduct an antibody test and it concluded that Jacob was in fact positive for West Nile Virus. 1. The majority of West Nile virus cases result in what type of symptoms? 2. Which pairing is correct for reservoir and the way West Nile Virus is transmitted to humans a) Bird: Mosquito b) Bird: Roaches c) Rats: Fleas d) Rats: Birds 3. According to the CDC, what percentage of people become seriously ill from a West Nile virus mosquito bite?

1. 80% of people who are infected will not show any symptoms 2. A (bird: mosquito) 3. 1%

A thirty-year old man came into the emergency room complaining of a sore jaw and a stiff neck. After getting him settled and started doing a full body exam, I noticed a healing wound, which looked like remnants from a splinter in his hand. I asked him where it came from and he said that he works construction so it could have come from that. He said that the wound was healing though and he was feeling fine. I asked him when his last round of vaccination boosters were. He said that he hadn't been vaccinated for much since he was a child. The doctor then immediately started him on the tetanus immunoglobulin and penicillin to fight the infection he seemed to have. Passive immunotherapy and antibiotics were going to be the best course of action for this man since he hadn't been vaccinated and the bacterial infection he was fighting was tetanus. The doctor confirmed it diagnostically and we took the preventative course to stop the tetanus toxin from continuing to infect and allow the new neuronal terminals to grow to allow for recovery since we couldn't fix what was already damaged, just stop it from damaging more. 1. What would happen to the patient if he did not get treatment for tetanus? 2. How can tetanus be prevented? 3. What toxin is released by Clostridium tetani and how does it work?

1. Broken bones-severity of spams can cause spine/other bones to break; disability-prolonged sedatives to control muscle spasms can lead to permanent disability from immobility of muscles. Infants can have lasting brain; death- severe tetanic muscle spasms can interfere with breathing leading to respiratory failure or cardiac arrest. 2. DTaP vaccine series of 5 shots given at ages 2 mo., 4 mo. 6 mo. 15-18 mo., 4-6 yrs. Recommended ages 11-12 get Tdap and then a Td booster given every 10 years thereafter 3. Tetanus toxin tetanospasmin (tetanospasmin blocks release of inhibitory neurotransmitter, as a result, motor neurons are not inhibited but instrad generate nerve impulses that stimulate continuous muscle contraction) (continuous release of acetylcholine)

A woman is admitted to the E.R after complaining of an animal bite she received while camping. She says the wound is very painful and itchy, and she also displays a fever. The hospital becomes concerned that she may have been infected with the Lyssavirus. 1. Which best describes the Lyssavirus that causes rabies? a) Lyssavirus is a naked negative sense single stranded RNA virus b) Lyssavirus is an enveloped positive sense double stranded DNA virus c) Lyssavirus is an enveloped negative sense single stranded RNA virus d) Lyssavirus is a naked negative sense double stranded RNA virus 2. What animals are commonly reservoirs for Rabies? 3. If rabies is not treated promptly, to what area of the body could it spread?

1. C 2. Raccoons, skunks, foxes, and coyotes; some insectivorous bats 3. Central Nervous System

Samantha is a 26-year-old woman who loves traveling. She spent two weeks last summer in Indonesia, exploring the culture and nature there. Part of her trip was to take a tour through the rainforest, culminate in a picnic and swim at a waterfall. A day after the tour, she experienced some itching and papules on her skin. She later came back to the States and presents at the emergency room with high fever and unbearable abdominal pain. The patient reported that 8 days before admission to hospital she had a fever, weight loss, bloody diarrhea, intestinal cramping and dry cough. Examination of her lung shows no abnormality. Her stool test result shows no pathogenic bacteria cultured; however, there were viable trematode eggs present. 1. How did Samantha become infected with the disease? a. She was bitten in the rainforest by a tick that carried the infective agent in its salivary glands. b. She got infected through eating the picnic's grilled chicken containing the infective agent. c. The infective agent in the contaminated waterfall water penetrated her skin during her swimming. d. The strenuous trip through the rainforest caused her immune system to become vulnerable to the airborne infective agent found prevalent in tropical countries. 2. What is the most effective prescription for Samantha's case? 3. What kind of infective agent has Samantha been infected with based on the geographic distribution of the causative species?

1. C (The infective agent in the contaminated waterfall water penetrated her skin during her swimming) 2. Praziquantel 3. Schistosoma japonicum

Melanie is a 6-month old baby whose mother noticed a rather blue tint to her skin, trouble inhaling, and cold-like symptoms (fever, runny nose, cough). She was very worried and went to the doctor to see what was wrong with Melanie. The doctor concluded that she had RSV. Her case became very severe and she was sent to the NICU. 1. What additional complication could be of concern for Melanie? 2. What type of treatment would Melanie expect to have since she has a severe case of RSV? 3. Which of the following is true of RSV? a. It is the number 1 respiratory killer of infants worldwide b. It is only found in the U.S. c. It is most dangerous for young adults d. It is rare to get RSV more than one time

1. Causes syncytia in the lungs; Immune response to RSV further damages lungs; can cause upper respiratory tract infections (i.e. colds) and lower respiratory tract infections (i.e. bronchiolitis and pneumonia 2. Supplemental oxygen, suctioning of mucus from the airways, or intubation (have breathing tubes inserted) with mechanical ventilation 3. A

A patient was admitted into the ER last night with pain in his chest, nocturnal sweating, fatigue and a cough that has been keeping him up all night for over 3 weeks. The patient recently traveled around the world, visiting over 5 countries by different modes of transportation: airplane, train and bus. A TB skin test was performed following his travels, and a firm red bump about 5mm was observed. The doctor ordered a chest x-ray and found a cavity in the upper left lung as well as some scarring. The doctor confirmed the patient with TB after a sputum test was performed. 1.) What is the most common antibiotic treatment for Tuberculosis? 2.) What is the best prevention method against Mycobacterium tuberculosis? 3.) What is the prevalence of tuberculosis worldwide?

1. Common antibiotics that are used to treat active TB: •isoniazid (INH) •rifampin (RIF) •ethambutol (EMB) •pyrazinamide (PZA) The most common antibiotic used to treat latent TB: •Isoniazid (INH) 2. The main way to avoid a TB infection is to avoid individuals who are infected with it. Doing this may mean avoiding places with large gatherings of people or use less public transportation. There is a vaccine for TB called BCG, which can be used as a preventative measure. 3. 1/3 of the world's population is infected

Lila, a 10-year-old girl comes into the doctor's office with her mom. Her mom is concerned because Lila has a rash and a fever, and she complains of a very sore throat. Being the best nurse in the world, you calm her and her mother down and take a peak inside Lila's mouth. In the back of her mouth you see swollen tonsils and pus pockets on the surface of them. Lila is also allergic to penicillin and some other antiviral drugs. 1. How might Lila have contracted Streptococcal Pharyngitis? 2. What would be the best treatment drug for Lila? 3. If Lila and her mom had not come in to get antibiotics, what could have happened to Lila?

1. Contact with droplets after an infected person coughs or sneezes or contact with sores from group A strep skin infections 2. Erythromycin 3. Bacteria can get into the blood, muscles or lungs (where it is not usually found) and cause pneumonia, necrotizing fasciitis (flesh eating bacteria), acute rheumatic fever, rheumatic heart disease, post-streptococcal glomerulonephritis, and invasive infections. Other conditions such as Laryngitis and Bronchitis may occur if not treated.

The year is 2016 and radical Islamic terrorist groups have waged biological war against the United States. An individual posing as a deliveryman dropped off a package at the World Bank in the District of Columbia. Dave, an employee of the World Bank, was the unfortunate recipient of the package. He became ill 12 days later, first experiencing malaise and body aches. He then developed a rash that developed into sores. At this time (having visible sores), Dave was most contagious. Dave sought medical treatment and was quarantined. It wasn't long after Dave sought treatment that many others began to exhibit similar symptoms and were also quarantined. The government's response to this type of biological warfare was slow. However, the recent research of prophylaxis in treatment of smallpox (rather than vaccination), proved a successful treatment, and the outbreak was controlled. After heavy sanitation and quarantine measures, the city of DC was safe again. Questions: 1. By which mode of transmission would you most likely expect an employee of the World Bank that did not work in the same area as Dave to have contracted smallpox? 2. What was the cause for the latest and final recorded cases of small pox (excluding the case-study)? 3. Besides scabbing, what other complications may small pox present?

1. Direct contact or inhalation of aerosols. Virus is present in nasal and oral secretions and in scabs from the skin 2. The last naturally acquired case of smallpox occurred in 1977 and the last two laboratory-acquired infections in 1978. 3. Complications of pregnancy (higher miscarriage and premature birth rates). Blindness. Permanent scarring.

Greg traveled to Thailand with his wife, where they enjoyed sightseeing, kayaking and hiking. One night they splurged on a large dinner of local food, including uncooked vegetables, and walked the Chiang Mai night market sampling hot, fresh BBQ street food. Two days later, Greg woke up complaining of diarrhea, abdominal pain, stomach cramps, and fever. 1. Travelers' Diarrhea is most commonly caused by what organism? 2. Through what mode of transmission did Greg contract Travelers' Diarrhea? Which of the following is NOT a good form of treatment for his disease? A. Antidiarrheal medication B. Oral Rehydration Therapy C. Avoiding dairy D. Antimicrobial drugs

1. Escherichia Coli 2. Consumption of contaminated food and water 3. A (Antidiarrheal medication)

On July 14, a 26-year old man who had resided in Kenya arrived to Puerto Rico. The man reported having a 3-day period of chest discomfort, tingling, and tremors on his right lower back. The pain intensified and alternated with abdominal discomfort. He was admitted to a local hospital for bowel obstruction on July 18. He developed onset symptoms of dysphagia, diaphoresis, delirium, confusion, anxiety, and insomnia. During examination, the patient appeared paranoid and had right flank tenderness, spontaneous ejaculation, and vomiting. A few hours later he developed a fever of 100.4 F, dizziness, and dyspnea. The patient's blood pressure began to drop. On July 22, the patient had cardiac arrest, was resuscitated, and treated with a defibrillator. The patient's heart rate and respiration decreased and died on July 26. The patient did not report coming into contact with a wild animal, but a sibling later reported that he had gotten bit on his leg and hand by an unvaccinated dog while in Kenya. 1. Based on the transmission and signs and symptoms of the patient, what disease did the man likely have? 2. What treatment methods could have potentially saved the patient's life? 3. Which animal is most likely to transmit rabies to humans by mere contact (as opposed to a bite?) A. raccoon B. bat C. skunk D. cat

1. Rabies 2. Series of injections and wound cleansing; the combination of human rabies immune globulin (HRIG) and rabies vaccine prevents rabies, can be treated with active immunization 3. B (bat)

Chanel went on a vacation to Tennessee and Arkansas to visit some of her friends from college. While she was there, her and her friends decided to go on some hiking trails and explore the nature scenery. When she returned home a couple of days later, she had a sudden onset of a fever and headache and started to become nauseas and vomited every now and then. Shortly after that, she developed a spotted, red rash on her trunk and appendages of her body that weren't itchy. She also noticed some muscle pain and got the chills every now and then. 1.) What bacterium causes Rocky Mountain Spotted Fever? 2.) Which of the following is the preferred method of treatment for Rocky Mountain Spotted Fever? 3.) Where do the majority of cases for Rocky Mountain Spotted Fever occur?

1. Rickettsia rickettsii 2. Doxycycline is the drug of choice, although chloramphenicol is also effective 3. North Carolina, Oklahoma, Arkansas, Tennessee and Missouri account for over 60% of RMSF cases; the disease is most prevalent in the eastern and southeastern parts of the US where typhus is an endemic

A 68-year old woman went to the doctor complaining she has had itchy skin for about 3 months now. She told the doctor that she tried cortisone to stop the itchiness, as well as highly hydrating lotion in case her skin was just itchy due to dryness. However, she said neither helped. When the doctor asked if she has been anywhere odd in the past year, the woman replied saying she was released from prison just three months ago. He did multiple tests on her to figure out what was going on, including blood tests, which all came back healthy. Finally, he took a small skin sample and viewed it under the microscope where he saw mites. 1. What disease does this patient have? 2. What organism causes this disease? 3. Which areas of the skin are most targeted for infection?

1. Scabies 2. Sarcoptes scabiei 3. Lesions between the fingers, around genitalia, wrists, elbows, and knees

A 75-year old man visits his doctor complaining of an intensely painful burning sensation on the skin along the right side of his abdomen. Additionally, he has noticed the development of fluid-filled blisters in that area. He reports to the doctor that he had chickenpox as a child. 1. What is the man's likely diagnosis? 2. What microbe causes this disease? 3. What is the doctor likely to suggest as treatment for the man? 4. Is it wise for this man to babysit his grandchildren while he is experiencing these symptoms?

1. Shingles 2. Varicella Zoster Virus 3. Antiviral medication such as acyclovir, valacyclovir, and famciclovir which all reduce the length of time of the illness as well as its severity. Pain medications such as analgesics may ease the pain of shingles. To relieve itching, wet compresses, calamine lotion, and colloidal oatmeal baths may be used 4. No, he could transmit the virus and cause them to get chickenpox

A 30 year-old female enters a clinic where you are working as a nurse; she reports that she has been experiencing flu-like symptoms for a few weeks (sore throat, body aches, malaise). During your examination of your patient, you notice a spotted rash spread across her back. Further examination revealed the same rash on the soles of her feet. She claims that she had no knowledge of the rash, as it hadn't been irritating her. As part of the general patient history, you inquire about her sexual history; which she reports having had four sexual partners in the past six months, her last encounter happening five weeks ago. 1. What sexually transmitted disease does this patient likely have? 2. What organism causes this disease? 3. What are complications that can occur during the tertiary stage of this disease?

1. Syphilis 2. Treponema pallidum 3. Gummas [rubbery and swollen lesions in bones, nervous tissue or on skin] in addition to dementia, blindness, paralysis [overall neural deterioration] and/or heart failure; lasts until the death of patient

A woman went to her OB/GYN because she realized that she was pregnant. The doctor ran some tests and informed her that she has Trichomoniasis. The woman reported that she hadn't had any symptoms. She also reported that she had been having unprotected with her husband, but she thinks that he is having an affair. 1. What organism caused this disease? 2. What could happen if she does not get treatment? 3. A person with Trichomoniasis has an increased likelihood of developing what other infection?

1. Trichomonas vaginalis 2. In pregnant women, trichomoniasis can result in low birth weight and premature birth of baby. 3. HIV

John Brown went to the Democratic Republic of Congo to help with humanitarian aid. However, when he came back to America he began experiencing changes of behavior, confusion, sensory/sleep disturbances, and poor coordination. He was diagnosed with African Sleeping Sickness. 1. What causative agent causes African Sleeping Sickness? 2. Because John has progressed to the second stage of African Sleeping Sickness, he has been receiving 3 different types of drugs to better his condition. What must these drugs do in order to be successful? 3. What length of time must pass before a person can be diagnosed as disease-free of African Sleeping Sickness?

1. Trypanosoma brucei 2. They must cross the blood-brain barrier to reach the parasite. 3. 2 years.

15-year-old Delaney complains to her mom that she frequently feels the need to urinate and that when she does urinate it is very painful. Delaney also explains to her mom that her urine looks very cloudy and has a foul smelling odor. Her mom takes her to the doctor and a urinalysis is performed which reveals the presence of Escherichia coli in Delaney's urine. 1. Based on Delaney's symptoms, what diagnosis can be made? 2. How did Delaney most likely acquire the presence of this bacterium in her urine? 3. Who has the highest risk for experiencing similar signs/symptoms to the ones Delaney has experienced?

1. Urinary Tract Infection 2. Usually through fecal contamination of the urinary tract while going to the bathroom 3. Sexually active women

A woman walked into the office with blistery lesions on the left side of her face. She says that she also has had severe pain and numbness in that area. She is diagnosed with shingles. 1. What organism is the causative agent of shingles? 2. How does the disease shingles develop? 3. The woman is worried that she will infect her son with the same disease. Is this a possibility?

1. Varicella Zoster virus 2. The varicella zoster virus can be spread from a person with shingles to another person causing him or her to develop chicken pox. The virus is spread through direct contact with fluid from the rash blisters caused by shingles. The virus is spread when the rash is in the blister phase. A person is not infectious before developing the blisters and once the rash has developed into crusts it is no longer contagious. dormant chickenpox virus (varicella-zoster) is reactivated in your nerve tissues 3. No, shingles patients can't cause others to get it; it can cause them to cause chickenpox though

A 48-year old woman who works in a medical laboratory is accidentally exposed to a vial of a pathogen. She begins to experience high fever, malaise, headache and body aches. Three days later she notices red spots in her mouth and on her tongue. These spots eventually escalate to open sores which spreads to her arms, legs, and finally her hands and feet. However, her fever begins to subside and she starts feeling better. After having the rash for three days, the sores turn into raised bumps. By the fourth day of the rash, the bumps have filled with an opaque fluid. 1. What pathogen most likely caused this disease? 2. When is the woman no longer contagious? 3. Who developed the vaccine against smallpox?

1. Variola 2. Once her scabs fall off she is no longer contagious. 3. Edward Jenner

A newly pregnant woman owned three cats. On a regular basis she emptied their litter boxes during her pregnancy. She never thought anything of it until her newborn baby girl was born ill. The doctors used molecular technique serology tests and confirmed the newborn had Toxoplasmosis. 1. What is a sign or symptom that may lead one to suspect Toxoplasmosis in a newborn? 2. What is the recommended treatment for Toxoplasmosis? 3. What is the causative agent of Toxoplasmosis?

1. abnormal enlargement, smallness of the head, epilepsy, encephalitis, jaundice, blindness, deafness 2. Most healthy, non-pregnant people will recover without treatment. A combination of drugs such as pyrimethamine and sulfadiazine, plus folinic acid can help treat people who are sick. For Pregnant women, newborns, and infants it is difficult to fully eliminate the parasite from tissue cells, but they can be treated. For immunocompromised people they need to continue treatment until they have improvement in their conditions. 3. Toxoplasma gondii

John and his wife Christine are on their honeymoon cruise in the Caribbean. On their first night at dinner John decides to get the salmon as his meal. While on their following day's adventures John starts to feel uneasy and starts to experience stomach pain. Later in the evening her is vomiting and has severe diarrhea. 1.. John has been diagnosed with Norovirus gastroenteritis. Which part of his body is the virus directly affecting? 2. To what family of viruses does Norovirus belong? 3. What is the best treatment for John on the cruise?

1. epithelia of the small intestine 2. Calicviruses 3. Supportive care; administer fluids to keep him from getting dehydrated

A patient has been experiencing burning pain in the middle stomach and has been nauseous. The patient told the doctor that he has been taking aspirin for about a month for stress headaches caused by work, but that he began to have symptoms after going to a Chinese restaurant with his girlfriend, even though his girlfriend did not show any signs. The doctor did a serological test and found a spiral, gram-negative bacteria in both the patient and his girlfriend. 1) What organism is most likely the cause of the disease? 2) If the patient goes untreated, what complications could arise? 3) What is the primary reservoir for this disease?

1. helicobacter pylori (causing peptic ulcer disease) 2. Internal bleeding, Obstruction, Perforation, Peritonitis 3. Humans

Annie goes on a trip to India to help in the rural towns. One woman that Annie worked very closely with is very thin, coughs up blood and complains of pain in the chest. Annie blows it off as a bad cold and continues to work with her. A few months after Annie has come back to America, Annie starts to experience a cough that will not go away for weeks and has a mild fever. 1. What might be the causative agent of the disease Annie contracted? 2. What vaccine should Annie have taken to prevent herself from getting this disease? 3. When a person is diagnosed with this disease, they must take ___________________ for about __________________. a. A combination of drugs; 3 months b. A single drug; 3 months c. A combination of drugs; 6 months d. A single drug; 3 months

1. mycobacterium tuberculosis 2. BCG vaccine 3. C (combination of drugs for 6 months)

A young woman goes on a mission trip to Tanzania and spends her nights there in a rundown facility where one can find many rodents and fleas. When she returns from her trip, she is very sick. She has developed a fever, muscular pain, and a severe headache. She also notices a large, smooth bump on her neck. She goes to the hospital as soon as she can, and they diagnose her with bubonic plague. However, before they are able to start her on treatment, she starts to develop difficulty breathing, her fever worsens, and she also develops a severe cough with blood and frothy sputum. 1. The disease she was originally diagnosed with most likely progressed to ___. 2. What bacterial agent is the cause of her illness? 3. What was the most likely source of the bacteria?

1. pneumonic plague 2. yersinia pestis 3. Fleas who have bitten rodents; bite humans when rodents have faced high rates of infection that increase the rate of their death because the flees then need an alternative source of blood cause bubonic which if spread to lungs through blood causes pneumonic; contact with contaminated fluids

Sophia was in her grandfather's old barn cleaning out all the old farming instruments when she stumbled upon a couple of rats. She jumped and ran out of the barn. Several days later, Sophia developed a fever and had severe abdominal pain with extremely swollen lymph nodes in the groin area. She quickly started to decline so her mother rushed her to the hospital. Sophia was diagnosed with bubonic plague. The doctor told Sophia and her mother that they had come in just in time because this could have spread to her lungs and become something way more serious. A.What happened to Sophia when she stumbled in to the rats and what did this cause her to develop? 1. How might a person contract the bubonic plague? 2. What treatment method is recommended for bubonic plague? 3. What complication might arise if the infection spreads to the lungs? How does this affect the route of transmission?

A. Bubonic plague. 1) Infected fleas that have left their normal animal hosts can spread plague to humans, who can also become infected through direct contact with infected animals or flea feces "transmitted from the bite of a flea from infected rodent" 2)Antibacterial drugs, preferably streptomycin or gentamicin 3)Pneumonic plague- can spread from person to person through aerosols and sputum, very lethal