Questions: 1. Identify the following periods: incubation, prodromal, illness, and decline. 2. Identify the etiologic agent of this disease. Briefly explain how you arrived at your conclusion. 3. What microbiological tests would you perform to verify the etiology? 4. How might the patient have been treated between February 7 and 12? 5. What special precautions needed to be taken by the hospital and mortuary personnel?
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- A 62-year-old male, his back has been red and swelling for 1 week. At first it was a small piece of skin induration of about 3×2cm, with multiple pus spots, then the skin swelling area expanded, infiltrating edema appeared, local pain increased, the surface skin was purple-brown with area about 6×5cm, the body temperature was 39.2℃, and he had diabetes history for 10+ years. The following treatment measures are incorrect for this patient: Remove pus and inactivated tissue The incision line should exceed the edge of the lesion The incision can be filled with yarn One-stage suture of the incision Make a "++" incisionLin, a 5-year-11-month-boy. He-had a fever 20 days ago with no obvious trigger and reached the highest oral- temperature of- 40°C, no obvious cough, runny nose, vomiting, headache, dizziness, melena, urinary frequency, urgency, and dysuria but had nose bleeding. He visited a local hospital and-underwent a blood routine test: WBC=8.7X10°L, N=21%, RBC= 3.36X10%/L, BPC=75X 10°/L, Hb=109g/L; peripheral -blood smear shows: atypical cells 29%. The local hospital suspected "infectious mononucleosis", thus intravenous ganciclovir was given and his blood was extracted to check for anti-EBV antibody simultaneously. After 6-days of intravenous ganciclovir, his body temperature still fluctuated at around: 38°C. Anti-EBVVCA-IgM(-), anti-VCA-IgG(+) 1. Do you think the doctor's diagnosis is correct? And what do you think the next step would the doctor take? 2. How long does a normal fever and infectious fever last?Lin, a 5-year-11-month-boy. He-had a fever 20 days ago with no obvious trigger and reached the highest oral- temperature of- 40°C, no obvious cough, runny nose, vomiting, headache, dizziness, melena, urinary frequency, urgency, and dysuria but had nose bleeding. In the first hospital, he was suspected to have EBV infection and "infectious mononucleosis". He was given intravenous ganciclovir at first. However, Lin's oral temperature still fluctuated at around 38.5°C after the regimen and complained of weakness, significant headache, and bilateral elbow joints pain. He then visited another outpatient clinic of a pediatric hospital, and physical examination in the department shows: well physical development, conscious, steady breathing, well mental response, no anaemic face, temperature 37.5°C. No superficial lymph nodes were obviously enlarged. Skin rash (-). No neck stiffness, Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-). All joints had no swollen and tenderness but…
- a 58-year-old Asian male .He visited his physician because he noticed dark colored lesions on his inner thighs, have increased in number, size. For the last three months he has been feeling weaker and more fatigued than usual; his weight dropped from 170 to 155 pounds. Xin’s blood was drawn and testing was conducted. His hematocrit was 45% and white-blood cell count was 2,500 white-blood cells/mm3, with the differential showing neutrophils 65%, lymphocytes 25%, monocytes 10%. A biopsy was taken of one of the discolored lesions and grown in cell culture. After three days of growth the cells were confirmed as coming from malignant cancerous tissue. A magnetic resonance image (MRI) of the area around the skin lesions on Xin’s inner thigh revealed enlarged lymph nodes, a sign of potential metastasis. What possible Diagnosis or disorders can you rule out for this paitentLin, a 5-year-11-month boy. He had a fever 20 days ago with no-obvious trigger and reached- the highest oral temperature of 40°C, no obvious cough, runny nose, vomiting. headache. dizziness, melena, urinary frequency, urgency, and dysuria but had nose bleeding. He visited a local hospital and underwent a blood-routine test: WBC 8.7X 10°/L. N 21%. RBC 3.36X 10/L. BPC 75 X 10°L, Hb 109g/L; peripheral blood smear shows: atypical cells 29%. The local hospital suspected "infectious mononucleosis", thus intravenous ganciclovir was given and his blood was extracted to check for anti-EBV antibody simultaneously. 1.- What are the main symptoms found on this patient? According to the patient's history and- presentations, what are the probable issues that you will need to think of?30) A 45-year-old man is evaluated by his primary care physician for complaints of early satiety and weight loss. On physical examination,his spleen is palpable 10 cm below the left costal margin and is mildly terder to palpation. His laboratory studies show a leukocyte count of 125,000/Ml with a differential of 80% neutrophils, 9% bands, 3% myelocytes, 3% metamyelocytes,1% blasts, 1% lymphocytes, 1% eosinophils, and 1% basophils. Hemogicbin is 8.4 g/dL, hematocrit 26.8% ,and platelet count is 668,000/uL. A bone marrow biopsy demonstrates increased celluarity with an increased myeloid to erythroid ratio. Which of the following cytogenetic abnormalities is most likey to be found in this patient? A Deletion of a portion of the long arm of chromosome 5, del(5q) B Inversion of chromosome 16,inv(16) C Reciprocal translocation between chromosomes 9 and 22 (Philadelphia chromosome D Translocations of the long arms of chromosomes 15 and 17 E Trisomy 12
- A 38-year-old woman came in the outpatient department because of headache.She has no vomiting, fever, changes in sensorium and nuchal rigidity. Shedescribed the headache as ”band-like” and has been occurring intermittentlyespecially during stressful situations. Vital signs and physical examinations areall normal. The physician diagnosed her as having tension headache andprescribed Acetaminophen 1g/ tab PO q6H for 3 days. The pharmacy only hasthe 250mg tablet preparation. How many tablets does she need to take perdose? How many tablets should the pharmacist give her to complete the entiretreatment regimen?A 62-year old, recently widowed male Hispanic patient, KB. was brought in to the emergency department (ED) by his daughter for progressively worsening shortness of breath, fatigue, a lingering non-productive cough, and generalized edema. One month prior, he noticed dyspnea upon exertion, loss of appetite, nausea, vomiting and malaise, which he attributed to the flu. In the emergency department, he appeared anxious and pale, and had a dry yellow tint to the skin. He denied any chest pain, and he could not recall the last time he urinated. He has history of benign prostatic hyperplasia, diabetes mellitus type 2, hypertension, dyslipidemia, and renal insufficiency for the past two years. His ED assessment findings included: 1+ pedal edema, basilar crackles in the lungs bilaterally, and a scant amount of urine according to a bladder scan. His lab results indicated a glomerular filtration rate (GFR) of 12. Based on his subjective and objective symptoms, he was admitted with a diagnosis of…A 62-year old, recently widowed male Hispanic patient, KB. was brought in to the emergency department (ED) by his daughter for progressively worsening shortness of breath, fatigue, a lingering non-productive cough, and generalized edema. One month prior, he noticed dyspnea upon exertion, loss of appetite, nausea, vomiting and malaise, which he attributed to the flu. In the emergency department, he appeared anxious and pale, and had a dry yellow tint to the skin. He denied any chest pain, and he could not recall the last time he urinated. He has history of benign prostatic hyperplasia, diabetes mellitus type 2, hypertension, dyslipidemia, and renal insufficiency for the past two years. His ED assessment findings included: 1+ pedal edema, basilar crackles in the lungs bilaterally, and a scant amount of urine according to a bladder scan. His lab results indicated a glomerular filtration rate (GFR) of 12. Based on his subjective and objective symptoms, he was admitted with a diagnosis of…
- 10-An 80-year-old man with a history of recurrent urinary tract infectionpresentswith fever, tachypnea, tachycardia, mental obtundation, and reduced bloodpressure. Which of the following forms of shock is most likely.A- Cardiogenic shockB- Hypovolemic shockC- Neurogenic shockD- Septic shockCase 1 A 20-year-old man presents for evaluation of a rash that he thinks is an allergic reaction. For the past 4 or 5 days, he has had the "flu," with fever, chills headache, and body aches. He has been taking an over-the-counter flu medication without any symptomatic relief. Yesterday he developed a diffuse rash made up of red, slightly raised bumps. It covers his whole body, and he says that it must be an allergic reaction to the flu medication. He has no history of allergies and takes no other medications, and his only medical problem in the past was being treated for gonorrhoea approximately 2 years ago. On further questioning, he denies dysuria or penile discharge. He denies any genital lesions now but says that he had a "sore" on his penis a few months ago that never really hurt and went away on its own after a few weeks so he didn't think much about it. On exam, his vital signs are all normal. He has palpable cervical, axillary, and inguinal adenopathy. His skin has an…38) Female,35 years old in the past six months, she had recurrent fever with joint swelling and pain in both hands,periungual erythema and purpura in both lower extremities. Laboratory examination showed tinrombocytopenia, positive urnine protein, and decreased complement. The most likely diagnosis is? A Systemic lupus erythematosus B Rheumatoid Arthritis C Allergic purpura D Vasculitis E Glomerulus nephritis