101. A 24-year-old woman comes to the physician because of a 2-day history of fever, cramping lower abdominal pain, and diarrhea with frequent, small bowel movements mixed with blood and mucus. Two children who attend the day-care center where this patient works have similar symptoms. Her temperature is 38°C (100.4°F). Physical examination shows no other abnormalities. Culture of the stool grows nonlactose- fermenting, gram-negative bacilli. Which of the following is the most likely mechanism of the pathogenesis of this infection? A) Antigen-antibody complexes B) Immune response to cross-reactive antigens C) Invasion of colonic mucosa D) Multiplication in the Peyer's patches E) Toxin binding to small intestinal mucosa

101. A 24-year-old woman comes to the physician because of a 2-day history of fever, cramping lower abdominal pain, and diarrhea with frequent, small bowel movements mixed with blood and mucus. Two children who attend the day-care center where this patient works have similar symptoms. Her temperature is 38°C (100.4°F). Physical examination shows no other abnormalities. Culture of the stool grows nonlactose- fermenting, gram-negative bacilli. Which of the following is the most likely mechanism of the pathogenesis of this infection? A) Antigen-antibody complexes B) Immune response to cross-reactive antigens C) Invasion of colonic mucosa D) Multiplication in the Peyer's patches E) Toxin binding to small intestinal mucosa

Curren'S Math For Meds: Dosages & Sol

11th Edition

ISBN:9781305143531

Author:CURREN

Publisher:CURREN

Chapter15: Adult And Pediatric Dosages Based On Body Weight

Section: Chapter Questions

Problem 31SST

See similar textbooks

Similar questions

Female, 26 years old, married. Abdominal pain, diarrhea, fever, vomiting for 20 hours After 24 hours of eating, the patient developed abdominal discomfort, paroxysmal with nausea, vomiting stomach contents, fever and diarrhea several times, loose stools, no pus and blood, body temperature 37-38.5°C, come to our hospital for emergency, the routine test of stool was negative. She was treated according to "acute gastroenteritis". The abdominal pain worsened in the evening, accompanied by fever of 38.6°C. Then, the abdominal pain moved from the stomach to the right lower abdomen, and there was still diarrhea, she come to see a doctor again at night, check blood routine WBC21×10%/L, and be admitted to the hospital urgently. Previous history: healthy, no history of drug allergy. Physical examination: T38.7°C, P120/min, BP 100/70mmHg, no bleeding spots and rashes on the skin all over the body, no large superficial lymph nodes, no pallor of the conjunctiva, no yellow staining of the sclera,…
65. A 45-year-old man with a history of type 2 diabetes mellitus, alcoholism, and liver disease develops fever, severe headache, and vomiting over the course of 12 hours. Physical examination shows nuchal rigidity. A lumbar puncture is done. Laboratory studies show: 180 mg/dL Serum glucose Cerebrospinal fluid Neutrophils Protein Glucose Culture Which of the following is the most appropriate pharmacotherapy? า A) Ceftriaxone -2 B) Clindamycin C) Erythromycin D) Gentamicin OE) Nafcillin x 300/mm³ 100 mg/dL 25 mg/dL gram-positive diplococci nudkal Rigidity
42. A 25-year-old woman comes to the physician because of a 2-week history of left flank pain. She has had progressive weakness and decreased appetite during this period. Her temperature is 38°C (100.4°F). Physical examination shows left flank tenderness. Laboratory studies show a leukocyte count of 18,500/mm³. Urinalysis shows numerous RBCs and WBCS. A CT scan of the abdomen confirms an abscess of the lower pole of the left kidney. Which of the following is most likely preventing the spread of the infection to the surrounding organs? A) Fatty layer (Camper fascia) of the abdominal tela subcutanea B) Greater omentum C) Membranous layer (Scarpa fascia) of the abdominal tela subcutanea D) Pararenal fascia E) Perirenal (Gerota) fascia
158. A 3-year-old girl is brought to the physician because of a 4-day history of irritability, vomiting, decreased urinary frequency and volume, and diarrhea. She visited a local petting zoo with her family 1 week ago. Her temperature is 38°C (100.4°F), pulse is 100/min, respirations are 30/min, and blood pressure is 130/100 mm Hg. Physical examination shows pallor, petechiae over the chest, and mild abdominal tenderness. Laboratory studies show: A) Elastin B) Fibrin Hemoglobin Hematocrit C) Hemosiderin D) IgA E) IgE F) IgG Erythrocyte count Leukocyte count Reticulocyte count Platelet count Serum Urea nitrogen Creatinine Bilirubin, total Direct Indirect Lactate dehydrogenase 5.9 g/dL (N=11-15) 31% (N=28% -45%) 3.1 million/mm³ (N=3.9-5.31) 18,000/mm³ (N=6000-17,500) 4.5% (N=0.5% -1.5%) 52,000/mm³ (N=150,000-400,000) Direct antiglobulin (Coombs) test result is negative. A photomicrograph of a peripheral blood smear is shown. Acetaminophen, amlodipine, and fluid and nutritional support…
169. A 65-year-old woman comes to the physician because of a 10-week history of low-grade fever, fatigue, and pain in her right arm. She recalls no trauma to the arm. She has a history of cancer treated with radiation therapy. Her temperature is 37.7°C (99.8°F). Physical examination shows tenderness of the right distal humerus. Laboratory studies show anemia. An x-ray of the right upper extremity is shown. This patient most likely has an abnormality of which of the following cell types? A) Hematopoietic stem cells B) Monomyelocytic stem cells C) Natural killer cells D) Osteoclasts E) Plasma cells
The patient is a 44-year-old, overweight female who presented to her primary healthcare provider yesterday with complaints of recent episodes of shortness of breath that occur with minimal activity such as walking a flight of stairs or with increased stress. Her symptoms are relieved with rest. She denied any chest, arm or jaw pain but did have some diaphoresis with one or two episodes. - She attributed her symptoms to her smoking one pack per day for the past 20 years and obesity. - She has gastroesophageal reflux controlled with ranitidine and has a history of elevated cholesterol (252), HDL of 46, and LDL of 180. Her triglycerides were 140. - She drinks three to four caffeinated beverages per day and denies alcohol use. -In addition, she has a history of situational anxiety since her mother's death and hypertension controlled with atenolol. - Her surgical history includes total abdominal hysterectomy six years ago and right carpal tunnel surgery two years ago. The patient's…
A 63-year-old woman presented with increasing darkening of the skin, dizziness, and easy fatigability, nausea with occasional vomiting and progressive weight loss over eight months prior to presentation. There were no headaches, blurred vision, and neither loss of consciousness nor change in her bowel habit. The medical history and systemic review revealed no abnormality and were not significant as to the likely cause of her disease state. Physical examination revealed an elderly lady, pale, asthenic with generalized hyperpigmentation especially on the face, oral mucosa, palmar creases and knuckles. No features of malnutrition or hypovitaminosis. There was no significant peripheral lymphadenopathy. Main findings in the systemic examination were a pulse of 106 bpm, regular and small; blood pressure 100/60 mmHg supine and 70/40mmHg sitting. She could not stand on account of severe postural dizziness. The apex beat was normal. Fundoscopy revealed a normal fundus. All other systems were…
A 63-year-ol woman presented with increasing darkening of the skin, dizziness, and easy fatigability, nausea with occasional vomiting and progressive weight loss over eight months prior to presentation. There were no headaches, blurred consciousness nor change in her bowel habit. The medical history and systemic review revealed no abnormality and were not significant as to the likely cause of her disease state. Physical examination revealed an elderly lady, pale, asthenic with generalized hyperpigmentation especially on the face, oral mucosa, palmar creases and knuckles. No features of malnutrition or hypovitaminosis. vision, and neither loss of There was no significant peripheral lymphadenopathy. Main findings in the systemic examination were a pulse of 106 bpm, regular and small; blood pressure 100/60 mmHg supine and 70/40mmHg sitting. She could not stand on account of severe postural dizziness. The apex beat was normal. Fundoscopy revealed a normal fundus. All other systems were…
35 year old white male presents to the ER with low back pain for two weeks with increasing severity. He had a normal Lumbar spine X-ray and had a normal CBC and blood chemistry. A urinalyisis was done to look for signs of nephrolithiasis and showed no white cells or red blood cells but large protein and no bacteria. He had a slight fever and was in such pain that IV morphine did not even touch it. Examination was difficult as he could not even get into a comfortable position to lessen his pain. Internet searches on the local state pain medication abuse systems did not show him to be drug seeking but the ER doctor considers him drug seeking and wants him out of his ER. You are called as the nurse practitioner helping the nighttime hospitalist admit new patients to the hospital and you are paged to consult as your physician is busy with another admission on the floor with an MI. You question this young man and find him to be in terrible pain and barely able to answer your…
Nutrition Case study of Maple Syrup Urine Disease GB is the second born child of a Lebanese family. He has an older sister who is normal. He was born after an uncomplicated pregnancy and labor. His birth weight is 3.2kg. He seemed normal and had no immediate neonatal complications. He fed well and was alert. At 7 days of age, GB stopped sucking and became lethargic. He was readmitted to the hospital. He was afebrile but had 3 episodes of apnea. The mother noticed that there was a sweet odor of the urine. Blood test and urine AA chromatography on 24-h urine collection were done. Normal plasma (mg/100mL) Plasma (mg/100ml) Patient urine (mg/24h) Leucine 1.5-3.0 57.49 Too high to read Isoleucine 0.8-1.5 14.10 41.1 Valine 2.0-3.0 14.76 77.28 Thus, GB was diagnosed with Maple Syrup Urine Disease. Thiamin responsiveness was evaluated: 510mg/kg/d of oral thiamin were prescribed for a period of 3 weeks. No improvement was noticed. GB was put from…
A 39 yearold woman comes to the clinic complaining of diarrhea and abdominal pain. “I feel so weak.” She reports having four to five loose, occasionally bloody stools per day for the past two weeks, with abdominal cramping beginning over the past 48 hours. She has been self-treating with occasional other-the-counter (OTC) antidiarrheals without success. She denies recent antibiotic use. She complains of severe fatigue. She gave birth to her third child 6 weeks ago. She is not breast feeding. A complete blood count, blood chemistry (including electrolytes, renal function tests and blood glucose) and serum iron is ordered along with stool cultures, colonoscopy and upper gastrointestinal (UGI) endoscopy with small bowel follow-through. Lab Data: Sodium 140 mmol/L Potassium 3.5 mmol/L Chloride 105 mmol/L Urea 3.57 mmol/L Serum creatinine 115 µmol/L Glucose 7.8 mmol/L Iron 4.3 µmol/L Hb 132 g/L Hct 0.39 L/L WBC 7.68 x 109 with normal differential She…
A 16-year-old nonsmoker teenager was admitted to the outpatient clinic complaining of a 14-month history of postprandial vomiting that progressed into hematemesis the last week. The patient was suffering from fatigue, dysphagia related to solid food, and loss of appetite which led to weight loss; the body mass index (BMI) dropped from 27.7 kg/m2 to 16.3 kg/m2 during this period; before that, the patient had been seeing many clinics outside the country without any conclusive diagnosis. Clinical examination revealed a pale-colored skin with mild jaundice, and the abdomen did not show any palpable mass (hepatomegaly, splenomegaly, and enlarged lymph nodes), tenderness, or rebound tenderness. The remainder of the physical examination was unremarkable. A lower esophageal sphincter narrowing was found by an upper gastrointestinal endoscopy (UGE) corresponding with a fragile bleeding gastric mass; that prevented from taking a biopsy. CT studies supported these findings by determining a large…