Chapter 2, Problem 2.8.13C

Julian contracted syphilis twenty years ago. What is the most likely symptom he could be having today? Barrel teeth O Chancre O Thrush O Elephantiasis O Gumma

Why does necrotizing fasciitis require immediate surgery?

Can you tell me about the survival and prognosis of malaria today, please?

A 27-year old white female presented at the walking clinic of her local physician on August 15. On physical exam, the patient had a fever of 38.5C. She appeared fatigued, had tender joints, and complained of a headache, a stiff neck and a backache. The physician noticed a circular "rash" about 5 inches in diameter, with a bright red leading edge and a dim center in the form of a "bull's eye." The physician noted an irregular heartbeat. The patient complained of lack of ability to concentrate. The patient gave the following history: She is a graduate student in the wildlife program at the university in town. She was in the field for three weeks in Wisconsin during the months of May and June. She tracks small mammals in the field and studies their behavior. It had been a warm, wet spring and she complained of a large number of biting flies, mosquitoes and ticks in the area. She felt well until about two weeks after returning to her home. Since that time, many of her symptoms had…

This 19-year-old college student went to the Student Health Services because she had a slowly developing rash on both earlobes, hands and wrist, and around her neck. Her medical history revealed that she had eczema in childhood. During her early teens, she had facial acne, for which she was given tetracycline. Physical examination revealed a rash of erythema and small blisters, with marked excoriation because of the itching. Her hands were red, scaly, and dry. The rash on her hands was different from the eruptions on her neck and ears. A contact hypersensitivity was suspected. Follow-up patch tests included a standard battery of agents—rubber, cosmetics, plant extracts, perfumes, nickel, and makeup. Strongly positive reactions for rubber and nickel were observed. The student was advised to eliminate contact with rubber (e.g., rubber gloves) used at home or on the job. Her jewelry probably contained nickel and was believed to be the source of the irritation to her earlobes, neck, and…

15 year old African American male presents with his mother to the ER where you are the physician assistant helping the ER attending in a very busy rural hospital.  He is complaining of abdominal pain for one day and nausea with vomiting.  His mother reports a fever and malaise.  He has no significant medical history but his mother is concerned that he may have the "kissing disease" as he has a boy friend who had mononucleosis six months ago and she does not approve of him anyway.    He describes the abdominal pain as sharp and points to his umbilical region.  He ranks it 10/10 on a 1-10 scale at its worse and he says it gets worse with sudden movements or if he sits up too quick or laughs.  He is not on any medications and his vital signs are normal except for a temperature of 101 degrees Fahrenheit.  On examination he looks sick and his skin is clammy to the touch.  Heart and lung examination is unremarkable.  Abdominal examination shows good bowel sounds and umbilical tenderness and…

Maria Corazon is a 25-year-old graphic artist who came in the outpatient department for evaluation of fever. The fever started 10 days ago. She states that the fever comes and goes it lasts for 30 - 60 minutes; she takes paracetamol, and it gets better, but then it comes back after 4 hours. She has checked her temperature; the highest was 38.6ºC and the lowest was 37.9ºC. She denies any sick contacts. She has lost her appetite and has been trying to drink more fluids to avoid dehydration. She has lost almost 5 kilograms. She has a throbbing headache that seems to remain after the fever goes down and some neck soreness. She denies changes in her vision or her hearing, but her ears hurt. She has a sore throat and increased drainage out of her nose as well as nasal congestion. She has pain in her face and in her teeth. She has a cough but denies any sputum production. She has no chest pain but sometimes experienced palpitations. She has no abdominal pain, diarrhea, dysuria, pelvic pain,…

A 25 years pregnant woman admitted to hospital after having four recurrent abortion. After doing the necessary test and according to case history of this woman, she said that she has two cats at home. What do you think the causes of her recurrent abortion? O Ancylostoma duodenale Giardia lamblia Fasciola hepatica Toxoplasma gondii

5 year old African American male presents with his mother to the ER where you are the physician assistant helping the ER attending in a very busy rural hospital.  He is complaining of abdominal pain for one day and nausea with vomiting.  His mother reports a fever and malaise.  He has no significant medical history but his mother is concerned that he may have the "kissing disease" as he has a boy friend who had mononucleosis six months ago and she does not approve of him anyway.    He describes the abdominal pain as sharp and points to his umbilical region.  He ranks it 10/10 on a 1-10 scale at its worse and he says it gets worse with sudden movements or if he sits up too quick or laughs.  He is not on any medications and his vital signs are normal except for a temperature of 101 degrees Fahrenheit.  On examination he looks sick and his skin is clammy to the touch.  Heart and lung examination is unremarkable.  Abdominal examination shows good bowel sounds and umbilical tenderness and…