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Old 12-11-2011
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Question About microbiology and other demons...

A patient presents to the ER with sudden onset of headache, vomiting and nausea. She only referrers going on vacations last week. Spinal tap reveals neutrophilia, low glucose and hyperproteinemia. Gram stain is negative for bacteria.

1. What would be most likely to be found on microscopic examination?


a. Granuloma
b. Cyst and trophozoites
c. Intracelular organism
d. Granuloma with caseous
e. Trophozoites

Based on the results of the spinal tap and microscopic examination the patient is properly treated, however, after one week of therapy the patient dies.

2. What is the mechanism of action of the medicament she was given?


a. Protease inhibitor
b. Blocking ergosterol synthesis
c. Inhibition of 1,3 D-glucan synthase
d. Incrementing cell membrane permeability
e. Interfering with biosynthesis of mycolic acid
f. Inhibition of DNA dependent RAN polymerase
g. Competitive inhibition of the transpeptidase enzyme

Last edited by Dr. Mexito; 12-11-2011 at 12:59 AM.
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  #2  
Old 12-11-2011
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Naegleria Fowleri

e, b
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Old 12-11-2011
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is tis q al??? wats d age of pt?

lets c..

as low glucos ten has 2 b bacteria or fungal
neutrophilia so its bacterial

as recently immunized ill go wit immunosupresed
if age nt in q ill go wit middle age n say mycobacteria

so ans 4 1st part is D
2nd part is E

if age is a infant ill go wit listeria
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Old 12-11-2011
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CMMRS 3rd edn page 237
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  #5  
Old 12-11-2011
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I disagree The age...

She was an adult: 26 years old, single... Actually, she was preparing the "step 1" but decided to take a break for a weekend, so she decided to go on vacations to clear her mind. The rest of her history was unremarkable.

Quote:
Originally Posted by doxorubicin View Post
is tis q al??? wats d age of pt?

lets c..

as low glucos ten has 2 b bacteria or fungal
neutrophilia so its bacterial

as recently immunized ill go wit immunosupresed
if age nt in q ill go wit middle age n say mycobacteria

so ans 4 1st part is D
2nd part is E

if age is a infant ill go wit listeria
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Old 12-11-2011
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wat is d ans?
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Old 12-12-2011
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Correct Answer Answers~~~

Quote:
Originally Posted by deeqwerty View Post
Naegleria Fowleri

e, b
Yes, in deed, the answer for the first question is "e", becuase in the case of an infection with "Naegleria Fowlerionly" (the present case), microscopical analyzis will only reveal the mature form of this parasite (wich is a Trophozoite) no the cyst form. However, the answer for the second question is not "b" because the mechanism of action of "amphotericin B" (answer d) has nothing to do with the synthesis of ergosterol. Amphotericin B (The current recommended treatment in this kind of infections) acts by binding to the ergosteroles that are already synthesized and form part of the cell membrane. The mechanism of action is forming holes in ergosterol, thus increasing the membrane permeability resulting in cell death. The antifungal antibiotics that act by blocking ergosterol synthesis by inhibition of the cytochrome P450 enzymes are drugs like ketoconazole, miconazole and clotrimazole (Imidazoles) or fluconazol, itraconazole or variconazole (triazoles.)
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