A 12-year-old boy is brought in by his mother with a 2-day history of fever and generalized weakness. She says that her son was involved in a school fight with some other kids 4 days ago and sustained minor injuries to the face. He was otherwise well, until this morning, when he complained of pain in his right eye. Physical examination reveals periorbital erythema and edema of the right eye, along with ophthalmoplegia and proptosis. Which of the following findings will most likely be present in this patient on the affected side as a sequela of his current condition? A. Anesthesia along the CN V, distribution B. Decreased vision with sparing of the optic disc C. Monocular diplopia D. Intact sympathetic innervation to the pupil, but not parasympathetic innervation O E. Absent blink reflex
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- The mother of a 6-year-old child brings her daughter to the pediatrician's office because she has had a sore throat, cough, and fever for several days. She reports a fever up to 104°F that worsens at night, but seems to respond to treatment with acetaminophen. The child has not been eating or drinking well because she says, "it hurts to swallow." She is ill appearing, and does not seem interested in playing with the toys that are in the examination room. The physician notes a thick, white exudate on both of the patient's tonsils, which also seem enlarged. A throat culture and complete blood count with differential is ordered. 1) The patient's mother expresses concern about her daughter's fevers. She states that the fevers are a sign that her child is unable to fight this infection. What is a proper response to these concerns? A) It is impossible to determine exactly why she is having these fevers. Doctors call this a fever of unknown origin. B) Fevers are a natural response by the…A 63-year-old international telecommunications executive visits your office with complaints of a high fever. The fever is not constant, but intermittent. When you press him for details he estimates that every three days or so he suffers these debilitating “sweats”. He usually has headaches and muscle aches during the episodes. They keep him home from work. After half a day or so, he feels better. He reports that he has experienced these episodes for about two months. What is the name of the condition you suspect? What is the causative organism? Is this pathogen eukaryotic or prokaryotic? What should be your first question about the patient’s history? What are the two main places in the human body that are exploited by the causative organism in this disease? Can this individual transmit this infection to others? Why or why not? How should this patient be treated (general treatment procedures/explain)?Sir Robert, a 42-year-old male, returned to his home in England after an adventure along the Nile Delta. On arrival at his estate, Sir Robert began to experience chills and a fever. The fever remained high for about 2 days and then subsided but spiked again after 5 days. He also noticed an abscess on his right leg, which had become swollen, inflamed, and hot. After a few days, his leg began to enlarge. A this point, Sir Robert promptly set-up an appointment with his physician for 4:00pm the next day. On determining the patient's recent travel history and performing a physical examination, the physician ordered blood and stool samples for parasite study. In addition, the physician surgically opened the abscess and obtained a sample of the contents for parasitic examination. Laboratory examination of the abscess and stool specimens revealed no parasites. However, the Giemsa-stained slide of the blood contained suspicious organisms, each measuring approximately 260μm in length.…
- A pediatric client presents to the office with ruddy checks and a low-grade fever of 101oF. The client’s mother states that the child has been acting normal, but now she notices the child has a slight rash, mainly on the torso. Which disease do you suspect based on this clinical presentation?a. scarlet feverb. fifth diseasec. rubeolad. roseolaA child has a runny nose and high fever for four days. Their fever breaks (starts to go away) on the fifth day. On the sixth day, they break out in a rash across their chest and abdomen. What is the likely cause of this child's illness?A 35-year-old African American woman complains of shortness of breath and cough for the last 2 months. She also has had fatigue and mild subjective fever. Physical examination reveals several discrete subcutaneous nodules. No masses or organomegaly is found. A chest radiograph shows bilateral hilar lymphadenopathy but no lung or mediastinal masses. A biopsy of one of the skin nodules shows noncaseating granuloma. What are the diagnostic considerations? What serum blood test can help confirm the diagnosis?
- JA is a 28-year-old female who presents with a rash over her arms, buttocks, lower back, and legs. The small pink papules are at the hair follicles. She and a friend completed a "mud run" three days ago. What would you recommend? JA did as you instructed for the past several days and while some areas improved, others are worse, pink or red papules with pustules, and she has a low-grade fever.A 30-year-old rancher was admitted to a hospital on February 12 because of a two-day history of headache, chills, and 40 degree Celsius fever. Before he was admitted, he began vomiting. During his admission it was found out that he has an orange-sized swelling in the left axilla. A laboratory analysis was administered using lymph-node aspirate and smear of peripheral blood, the result was reported to contain gram-positive cocci, often in pairs. Due to this situation he was given cefoxitin. The patient was acutely ill. Within a few hours of admission, he had a cardiopulmonary arrest. During resuscitation efforts, he vomited and aspirated his vomitus; a chest X-ray showed bilateral infiltrate. The patient was also bled from several body sites. Six hours after admission the patient died. Based on data given, the patient had trapped, killed, and skinned 3 kit foxes, 4 coyotes, and 1 bobcat. The patient cut his left hand shortly before skinning the bobcat on February 7. After his death,…A 33-year-old man presents to his primary doctor complaining of high fever and chills that lasted for one week. He complained that his chest hurts when he coughs, and the sputum has a greenish tint. During this time, the patient has had an unproductive cough and shortness of breath when he exerts himself. He has a general feeling of malaise and has noticed a decrease in appetite. He has been using an over-the-counter cold medicine for symptom relief, but symptoms return when the medication wears off. The patient has been working outside on a construction job this winter. He is under a lot of stress with the recent move into a new apartment with his pregnant wife. Physical examination (PE): Patient breathing pattern is rapid and shallow, with some dyspnea during deep breaths. Cough produces green/yellow sputum. Vital signs: Temperature: 40°C, Pulse: 90/min, Respiratory rate 25/min, Blood pressure: 112/70 mm Hg BMI=20 Laboratory Test Blood cultures : Positives with Streptococcus…
- Sarah passed out during a track meet. Her coach rushed her to the hospital, guessing she had a heat stroke. However, she also had fever and rashes. Medical staffs suspected toxic chock, which was supported by a soaked strong odor tampon removed from her body. List the key factors and the mechanism that cause this life-threatening disease.Portal of entry and portal of exit of dengue feverThree-week-old Xavier Capelleto was brought to the emergency room with a bright scaly rash that first developed on his legs and then spread to his trunk and face. He also had blisters on his palms and the soles of his feet. Xavier’s parents said that he had been experiencing looser bowel movements than expected, a large amount of yellow pus had been accumulating around his swollen eyelids, and he showed signs of oral thrush. Tests revealed that Xavier’s lymphocyte count was only 8% of total white blood cells (normal = 50%), all immunoglobulins were markedly decreased except for IgE, and no thymic shadow was detected on a chest X-ray. Eosinophilia was also detected. His parents were told that Xavier had an autosomal recessive form of severe combined immunodeficiency (SCID) known as Omenn syndrome, which affects the development of both B cells and T cells. A bone marrow transplant was recommended; however, Xavier died from respiratory failure due to an opportunistic bacterial infection.…