SIMPIC Final Question 2015

A 35 years old man suffered from rash for three weeks. What is the phyllum of natural reservoir if this causative agent? Additional informations: Diffusely umbilicated papular rash over several areas of the body. Microscopic examination shows septate yeast. He has lost weight up to 10 kg in 2 months. Serology anti HIV positive. CD4 140 cells/mm3. Answers: Name of causative agent: Penicilliosis marnefferi Phyllum: Chordata --A 39 years old man suffered from fever and dyspnea for 1 week. What virulence factor of this causative pathogen plays an important role in immune evasion? Additional informations: Blood culture: found Gram positive cocci in clusters (2 samples) Answers: Name of causative agent: Staphylococcus aureus Diagnosis: Acute endokarditis Immune evasion strategy: Protein A --10 years old boy suffered from diarrhea for 3 days. What is the first line drug to treat the patient? Additional informations: Stool test: face like organisms with 2 nuclei Answers: Giardia lamblia Metronidazole --A 25 years old woman suffered from high grade fever for 1 day. What is major mechanism that the causative pathogen used to evade immune response? Additional informations: Blood test: WBC 20000 cells/mm3, 90% neutrophil Biochemical tests: Gram negative bacilli, lactose fermenting, negative oxidase test, positive Voges Proskauer test, non-motile Answers: Name of causative agent: Klebsiella pneumoniae or Klebsiella oxytoca Diagnosis: Klebsiella sepsis Immune evasion strategy: antiphagocytic trait --A 3 years old newborn boy had jaundice since birth. What is the estimated duration of infection caused by causative pathogen?

Additional informations: HBsAg negative Anti-CMV IgM positive The baby was born as fullterm History of seizure 2 days ago CT scan result: brain intracranial calcification Answers: Name of causative agent: CMV Diagnosis: congenital CMV infection Duration of infection: lifelong --A 45 years old man suffered from... ... What is the natural reservoir of causative pathogen? Additional information: Bronchial wash culture showe no growth in CGB (canavanine glycine bromothymol blue) agar History as heavy smoker History of fully treated pulmonary TB 10 years ago Recent sputum acid fast stain showed no acid fast bacteria India ink preparation showed encapsulated yeast Answers: Name of causative agent: Cryptococcus neoformans Natural reservoir: soil contaminated by pigeon dropping --A 40 years old man suffered from progressive memory loss for 2 months. What is the natural reservoir of the causative pathogen? Additional informations: Negative Mycobacterial culture He has pigeon at home Diagnosed with Kaposi sarcoma Gram stain of LCS showes no bacteria Answers: Name of causative agent: HIV Diagnosis: HIV dementia Reservoir: human --A 35 years old man suffered from fever and headache for 3 days. What is the serotype that is most virulent? Additional informations: Negative Ag of Streptococcus pneumoniae Negative Ag of Haemophilus influenzae Blood test showed Gram positive cocci, alpha hemolyticus, with negative PYR test and negative bile esculin test Gram stain of blood showed Gram negative cocci in short chains He works as a butcher

He also suffered from sensorineural hearing loss and neck stiffness Answers: Name of causative agent: Streptococcus suis The most virulent strain: serotype 2 --A patients suffered from fever for 5 days. What is the organ that this causative agent resides? Additional informations: Sufferrd from diarrhea for 10 days Gram stain of the stool showed Gram negative bacilli, with negative oxidase test and positive citrate test Positive HAV IgA Answers: Name of causative agent: Salmonella enterica Diagnosis: typhoid fever Residing organ: gall bladder --A 30 years old man presented with rash for 1 week. What is the specific pathology of bone disease caused by this causative pathogen? Additional informations: Blood test showed no growth Positive anti measles IgG? Positive FTA-ABS test History of unsafe sex Also presents with painless ulcer on genetalia since 1 month ago Physical examination showes maculopapular rash on both palms Answers: Name of causative agent: Treponema pallidum Diagnosis: secondary syphillis Name of pathology: gumma