Billy Step 1 Questions # 34 - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 10-17-2012
billy's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 444
Threads: 109
Thanked 370 Times in 208 Posts
Reputation: 380
Arrow Billy Step 1 Questions # 34

A 32-year-old woman who lives in Pensacola, Florida, goes to the physician because of increasingly severe dyspnea,
orthopnea, and swelling of the legs for the past 2 weeks. She has no previous history of serious illness or surgery. On
physical examination, her temperature is 37.8°C, pulse is 83/min, respirations are 20/min, and blood pressure is
100/60 mm Hg. An ECG shows episodes of ventricular tachycardia. An echocardiogram shows right and left ventricular
dilation, but no valvular deformities. An endomyocardial biopsy shows focal myocyte necrosis and lymphocytic infiltrate.
Which of the following organisms most likely caused the infection?


□ (A) Trypanosoma cruzi
□ (B) Viridans streptococci
□ (C) Coxsackievirus A
□ (D) Toxoplasma gondii
□ (E) Staphylococcus aureus
□ (F) Mycobacterium kansasii
Reply With Quote Quick reply to this message
The above post was thanked by:
Talal Hussain (10-18-2012), vnagubandi (10-18-2012)



  #2  
Old 10-17-2012
blade's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS+3
Posts: 358
Threads: 22
Thanked 204 Times in 116 Posts
Reputation: 214
Default CC

..................CC
__________________
with God,nothing is impossible...PREMATCHED!!!
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message
The above post was thanked by:
Dr Jones (10-17-2012)
  #3  
Old 10-17-2012
venky2600's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,186
Threads: 119
Thanked 821 Times in 434 Posts
Reputation: 831
Send a message via Yahoo to venky2600
Post

a) trypanosoma cruzi-----------chagas disease causing DCM
Reply With Quote Quick reply to this message
 
  #4  
Old 10-17-2012
Teona's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 331
Threads: 39
Thanked 308 Times in 117 Posts
Reputation: 318
Default

I also think is C) Trypanosoma cruzi, causing Chagas disease.
Reply With Quote Quick reply to this message
  #5  
Old 10-17-2012
dr.Irina's Avatar
USMLE Forums Veteran
 
Steps History: 1 + CK
Posts: 229
Threads: 6
Thanked 73 Times in 62 Posts
Reputation: 83
Default

and me (A) Trypanosoma cruzi
Reply With Quote Quick reply to this message
  #6  
Old 10-17-2012
koolkiller88's Avatar
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 864
Threads: 62
Thanked 374 Times in 225 Posts
Reputation: 384
Default Trypanosoma

Only 2 things i can relate here with cardiological symptoms-

Trypanosoma cruzi- Chagas disease (also present with mega colon, mega esophagus)

Coxsackievirus A: MCC of myocarditis and pericarditis.

As they mentioned florida specifically. So my best guess would be

A. Tryponosoma cruzi
__________________
One day i will infect these microbes and they will search for "Anti-MEbiotic"....
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
  #7  
Old 10-17-2012
blade's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS+3
Posts: 358
Threads: 22
Thanked 204 Times in 116 Posts
Reputation: 214
Default

Quote:
Originally Posted by blade View Post
..................CC
T.cruzi and coxsackie virus cause infectious Dilated CM but abscence of valvular damage as seen in this pxt eliminates T.cruzi??hope am right
__________________
with God,nothing is impossible...PREMATCHED!!!
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message
  #8  
Old 10-17-2012
nishaa's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 203
Threads: 32
Thanked 126 Times in 52 Posts
Reputation: 136
Default

Coxsakie B causes myocarditis , pericarditis leading to DCM . So I would go with T.cruzi
Reply With Quote Quick reply to this message
  #9  
Old 10-17-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,039
Threads: 189
Thanked 570 Times in 323 Posts
Reputation: 580
Default my answer :)

(A) Trypanosoma cruzi
Reply With Quote Quick reply to this message
  #10  
Old 10-18-2012
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 8
Threads: 2
Thanked 1 Time in 1 Post
Reputation: 11
Default

Its Trypanosoma Cruzi ?? South America...
Reply With Quote Quick reply to this message
  #11  
Old 10-18-2012
billy's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 444
Threads: 109
Thanked 370 Times in 208 Posts
Reputation: 380
Correct Answer C is correct

Focal myocardial necrosis with a lymphocytic infiltrate is consistent with viral myocarditis. This is uncommon, and
many cases may be asymptomatic. In North America, most cases are caused by coxsackieviruses A and B. This illness
may be self-limited, end in sudden death, or progress to chronic heart failure. Trypanosoma cruzi is the causative agent of
Chagas disease, seen most often in children. This is probably the most common infectious cause of myocarditis
worldwide. Septicemia with bacterial infections may involve the heart, but the patient probably would be very ill with
multiple organ failure. Toxoplasma gondii may cause a myocarditis in immunocompromised patients. Mycobacterial
infections of the heart are uncommon, but pericardial involvement is the most likely pattern. Viridans streptococci and Staphylococcus aureus are better known as causes of endocarditis with neutrophilic inflammatory infiltrates.
Reply With Quote Quick reply to this message
The above post was thanked by:
nooranimm (10-18-2012), venky2600 (10-18-2012)
  #12  
Old 10-18-2012
USMLE Forums Addict
 
Steps History: Not yet
Posts: 126
Threads: 6
Thanked 43 Times in 22 Posts
Reputation: 53
Default

C. coxsakie

JUST REMENBER GOLJAN (page 184)

"Lymphocitic inflitrate high preictive of coxsackie virus"
Reply With Quote Quick reply to this message
  #13  
Old 10-18-2012
billy's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 444
Threads: 109
Thanked 370 Times in 208 Posts
Reputation: 380
Post

Yes Yes Yes
Reply With Quote Quick reply to this message
  #14  
Old 10-18-2012
nishaa's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 203
Threads: 32
Thanked 126 Times in 52 Posts
Reputation: 136
Default

Quote:
Originally Posted by billy View Post
Focal myocardial necrosis with a lymphocytic infiltrate is consistent with viral myocarditis. This is uncommon, and
many cases may be asymptomatic. In North America, most cases are caused by coxsackieviruses A and B. This illness
may be self-limited, end in sudden death, or progress to chronic heart failure. Trypanosoma cruzi is the causative agent of
Chagas disease, seen most often in children. This is probably the most common infectious cause of myocarditis
worldwide. Septicemia with bacterial infections may involve the heart, but the patient probably would be very ill with
multiple organ failure. Toxoplasma gondii may cause a myocarditis in immunocompromised patients. Mycobacterial
infections of the heart are uncommon, but pericardial involvement is the most likely pattern. Viridans streptococci and Staphylococcus aureus are better known as causes of endocarditis with neutrophilic inflammatory infiltrates.

can i know the source of this info. cuz after i googled about coxsackie virus, it only said B causes myocarditis , percarditis. A is consistant with herpangina and hand-foot-mouth disease . im confused now thanks
Reply With Quote Quick reply to this message
  #15  
Old 10-18-2012
MedicalExaminer's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 824
Threads: 66
Thanked 465 Times in 298 Posts
Reputation: 475
Default

thats from the robbins review of pathology
__________________
Everything is possible for him who believes (MARK 9:23)
245/247/passed on 1st attempt/223/2mos Obsie /3 US LORS/visa not needed/2008 grad
Reply With Quote Quick reply to this message






Reply

Tags
Microbiology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Billy Step 1 Questions # 22 billy USMLE Step 1 Forum 9 09-01-2015 01:47 AM
Billy Step 1 Questions # 21 billy USMLE Step 1 Forum 7 10-10-2012 10:43 AM
Billy Step 1 Questions # 19 billy USMLE Step 1 Forum 5 10-09-2012 12:27 PM
Billy Step 1 Questions #11 billy USMLE Step 1 Forum 6 10-06-2012 12:12 PM
Billy Step 1 Questions #6 billy USMLE Step 1 Forum 7 10-03-2012 11:53 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)