Hard
Hard
Hard
Brutal
HSS
100
A 45 year old woman presents with rare skin infections throughout her body. You tell here that this is caused by a infection of her skin by a bacteria. She is confused because she take 7 showers a day. While you refer her to a clinical psychologist for her bathing frequency, what has changed about her skin microbiota?
The resident microbiota have been complete washed away making way for an opportunistic infection.
100
Piperacillin-Tazobactam is an commonly used antibiotic. Initially, piperacillin was given by itself but do to resistance tazobactam is also given. The cooperation of these drugs is an example of what property of antibiotics?
Synergy
100
A 78 year old patient enters your clinic with a soft tissue infection which is revealed to be Staph. A. Following culture, the bacteria is determined to not be effected by beta-lactams. The patient is started on vancomycin and returns to good health. What is the toxin that likely caused this problem and how did this bacteria acquire it?
Panton-Valentine Leukocidin
Via a phage
100
(This is very much a level three/read my mind problem) A 63 year old, comes in the right lower quadrant pain with fever and high WBC. The patient has been ignoring this problem for a while and culture of his blood reveals an oxidase-negative gram-negative bacteria, identified by a pink hue on culture. The man appears cyanotic though his chest x-ray seems completely normal. Looks at his hemoglobin what has changed?
Fe2+ to Fe3+
100
Name one person what should be apart of the Antimicrobial stewardship program besides the doctor?
Pharmacists
Microbiologist
Epidemiologists
200
Following a shoulder arthroplasty, the 65 year old patient, returns to the office with a fever and a hot to the touch wound, that is severely swollen. The surgeon suggest they reoperate, lavage the wound, and then replace the hardware. Upon removal of the hardware a visible sheet can be seen surrounding the implant. What stage of bacterial infection has this bacteria reached?
Spread stage
(Attachment, persistence, spread)
200
200
A 78 year old patient with problems ambulating enters your office. He complains of a large reddened bump on his buttock. Looking at the area, you notice that it is large and involves many, many hair follicles and has seemed to progress to deeper tissue What is the name for this finding?
Carbuncle
200
A patient is visiting their family in CA when they are in a car accident and rushed to a local hospital. A few week after treatment has concluded, they receive a bill of the services provided total about $550. The man is surprised to see that the bill is greater than he expected for the services and when he calls the company to ask why, they said that he has not met his deductible yet. The man swears that the insurance through his company said his deductible was $300. What type of insurance plan must this many have?
PPO
300
A lab is testing the cultures of a patient with fever and elevated white blood cell count. Testing the sample reveals that bacteria has a significantly lower affinity for C3b convertase, what does this cell most likely have?
A capsule
300
Research have discovered a new bacteria in a pig who was receiving antibiotics for an infected hoof. The bacteria had acquired resistance to beta-lactams. The farmer who notices the problem complain of a large swine flu problem he has had on his farm. What process could have resulted in the bacteria developing this resistance?
Transduction
300
A culture form a 58 year old patient's infection wound is obtained. On culture, you identify it as a pink bacilli that cannot reduce O2 to H20 of H2O2 and do not poses a H-antigen. What is the name of this bacteria?
Klebsiella
300
Thomas has a HMO type insurance plan through his company. He recently has a rotator cuff repair totaling $50,000. His insurance says his maximum out of pocket is $11,500 with his plan with a $2500 deductible with a co-insurance of 75/25. Assuming that his hospital copay is $250. How much out of pocket is Thomas going to pay?
$11,500
400
A 45 year old patient enters the ER with complains of fever and diarrhea, as you are taking their information they faint. After moving them to a gurney you see their their BP is extremely low and culture reveals gram negative bacilli in their blood. What endotoxin domain would be most likely responsible for this reaction?
Lipid A domain
400
A 7 year old patient enters your office with a fever and elevated ESR and difficult moving their joints. Their mother has also complained of them moving their body in strange motions. What bacteria could be causing the problem?
Strep. Pyogenes
400
Two orthopaedic should surgeons are completing for the prestigious Neer Award, the Nobel prize in shoulder and elbow orthopaedic surgery. One researchers opts to perform a study where patient younger that 55 are retrospective identified with and with out shoulder arthritis and compared to see the factors that influenced their likely look to develop shoulder arthritis based off of their medical records. The other looks to see the likelihood of pitchers developing elbow arthritis after a major league carrier compared to their non-pitcher counterparts. Which of these studies would provided a greater level of evidence on their respective topics?
Case 2
500
You are attempting to classify a newly discovered endotoxin produced by a bacteria. Upon analysis, you determine that the domains of this toxin are similar the amphotericin B. What class of exotoxin would you classify this toxin?
Type 2 exotoxin
500
A pregnant woman has entered the ER after he water breaks (Grav II, Para I). After looking at her chart the attending orders IV penicillin to be administered to her. What bacteria is the attending worried about?
GBS
500
A patient enters your office with CA-MRSA. After culture, you see that the bacteria has an MIC of 2, lower than you expected. If you were able to analyze the bacteria more in-depth, what could you comment on about the number of cross-linkages see in the cell wall of these bacteria compared to their MIC>4 counterparts?
Increased crosslinkages