USMLE Forum Archives - USMLE Step 1 - Pathology 39
Pathology 39
TheOne - 11-26-06 16:40
A 24-year-old summer camp counselor complains of a severe headache and weakness. His condition rapidly deteriorates over a period of hours, and he is airlifted to a nearby hospital. A lumbar puncture is performed and a Gram's stain of spinal fluid reveals gram-negative diplococci. Infection with this organism is also associated with which of the following?
A. Dysentery
B. Erythema chronicum migrans
C. Myocarditis
D. Ophthalmia neonatorum
E. Waterhouse-Friderichsen syndrome
TheOne - 11-26-06 16:40
A 24-year-old summer camp counselor complains of a severe headache and weakness. His condition rapidly deteriorates over a period of hours, and he is airlifted to a nearby hospital. A lumbar puncture is performed and a Gram's stain of spinal fluid reveals gram-negative diplococci. Infection with this organism is also associated with which of the following?
A. Dysentery
B. Erythema chronicum migrans
C. Myocarditis
D. Ophthalmia neonatorum
E. Waterhouse-Friderichsen syndrome
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#4
Re: Pathology 39
TheOne - 11-30-06 20:17 Explanation: The correct answer is E. The Neisseria are gram-negative diplococci, and have two clinically important species, N. meningitidis and N. gonorrhoeae.N. meningitidis can either cause a sudden, fulminant, life-threatening meningitis or meningococcemia with a vasculitic purpura and disseminated intravascular coagulation. The latter presentation may be complicated by adrenal involvement, precipitating the usually fatal Waterhouse-Friderichsen syndrome with coagulopathy, hypotension, adrenal cortical necrosis, and sepsis. N. gonorrhoeae causes gonorrhea and ophthalmia neonatorum (choice D), a neonatal eye infection. Classical dysentery (multiple, small-volume stools with blood, mucus, and pus associated with abdominal cramps and tenesmus); (choice A) is caused by Shigella dysenteriae. A similar syndrome can be caused by other bacteria or amoebae as well. Erythema chronicum migrans (choice B) is the pathognomonic dermatologic manifestation of Lyme disease. This skin lesion consists of an expanding erythematous lesion, with central clearing. Bacterial myocarditis (choice C) is uncommon, and when it does occur, it usually involves Staphylococcus aureus or Corynebacterium diphtheriae.
#6
Re: Pathology 39 galaxy - 05-28-10 02:39 A 24-year-old summer camp counselor complains of a severe headache and weakness. His condition rapidly deteriorates over a period of hours, and he is airlifted to a nearby hospital. A lumbar puncture is performed and a Gram's stain of spinal fluid reveals gram-negative diplococci. Infection with this organism is also associated with which of the following?
E. Waterhouse-Friderichsen syndrome
#7
Re: Pathology 39 babbu5508 - 06-21-10 15:38 E. Waterhouse-Friderichsen syndrome is associated with meningococcemia .. it is massive hemorrhage into one or both adrenal glands
#8
Re: Pathology 39 bingousmle - 06-30-10 21:50 E. Waterhouse-Friderichsen syndrome as N. meningitidis causes a sudden, fulminant, life-threatening meningitis and meningococcemia with a vasculitic purpura and disseminated intravascular coagulation
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