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  #1  
Old 10-19-2012
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Arrow Billy Step 1 Questions # 35

The parents of a 6-year-old child notice that she has decreased vision. Examination of the eye shows diffuse punctate
inflammation of the cornea and pannus extending as a growth of fibrovascular tissue from conjunctiva onto the cornea.
Microscopic examination of a corneal scraping shows lymphocytes, plasma cells, neutrophils, and scattered corneal
epithelial cells that have cytoplasmic inclusion bodies. What infectious agent is most likely to produce these findings?


□ (A) Herpes simplex virus
□ (B) Treponema pallidum
□ (C) Cytomegalovirus
□ (D) Rubella virus
□ (E) Chlamydia trachomatis
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  #2  
Old 10-19-2012
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looks like a.b.c are eliminated....(intranuclear in herpes)

between D and e..

will go with E) chlamydia trachomatis----trachoma????
(but not sure due to lymphocyte presence)
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Old 10-19-2012
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cmv retinitis with owl's eye cytoplasmic inclusion bodies?
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Quote:
Originally Posted by blade View Post
cmv retinitis with owl's eye cytoplasmic inclusion bodies?
CMV has intranuclear inclusions buddy...(like all herpes)

and also CMV retinitis occurs mostly in immunocompromised i guess
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Quote:
Originally Posted by venky2600 View Post
CMV has intranuclear inclusions buddy...(like all herpes)

and also CMV retinitis occurs mostly in immunocompromised i guess
you are right,i just checked;cmv is intranulear while chlamydia has cytoplasmic inclusions.
but the lymphocytes here is kind of confusing to choose viral cause.
lets see his xplanation but i will choose cmv in exam
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Quote:
Originally Posted by blade View Post
you are right,i just checked;cmv is intranulear while chlamydia has cytoplasmic inclusions.
but the lymphocytes here is kind of confusing to choose viral cause.
lets see his xplanation but i will choose cmv in exam
hmm ya i'm confused a bit due to lymphocytes too.....
but i'm sure buddy that, cmv is 100% not the right answer....may be rubella ...also have cytoplasmic inclusions but kinda rare though...

that inclusion kinda thing is more important in diagnosing.....so i dont think cmv as answer...anyways lets wait for explanation
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Default E is correct

10 (E) Trachoma is a major cause of blindness worldwide. The initial inflammation is followed by progressive scarring of
the conjunctiva and cornea. Herpetic keratitis can result in ulceration and scarring; herpesviruses have intranuclear
inclusions. Congenital infections with Treponema pallidum result in an interstitial keratitis. In children, cytomegalovirus,
one of the herpesviruses, is a rare cause of ocular infection. It produces prominent intranuclear inclusions. Congenital
rubella, which is now a rare disease because of immunization, produces a retinopathy.
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  #8  
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Welldone Venky
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This question is from ROBBINs
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What is the mode of transmission here ?
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That lymphocytes could be because of clamydia being an intracellular bacterium ...
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Cant comment about transmission
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Quote:
Originally Posted by alice View Post
What is the mode of transmission here ?
as the child is 6yrs old...thinking of infection from others(conjunctivits).....but not sure though..

thanks
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Checked .. May be hand eye contact ( thought chlamydia could only spread by vertical and sexual routes )... Anyway thanks
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  #15  
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Quote:
Originally Posted by alice View Post
Checked .. May be hand eye contact ( thought chlamydia could only spread by vertical and sexual routes )... Anyway thanks
ya it can spread via contaminated hand touching eye....
sexual and vertical transmission routes are most common ones though...but not in 6 yr old child i guess.....
thanks for the question......
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Thanks venky
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Default my answer :)

(E) Chlamydia trachomatis
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Old 10-20-2012
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my ans is trachoma
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