WBR0053: Difference between revisions
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{{WBRQuestion | {{WBRQuestion | ||
|QuestionAuthor=William J Gibson (Reviewed by {{Rim}} and Yazan Daaboul) | |QuestionAuthor=William J Gibson (Reviewed by {{Rim}} and Yazan Daaboul) | ||
|ExamType=USMLE Step 1 | |ExamType=USMLE Step 1 | ||
|MainCategory=Microbiology, Pathology | |MainCategory=Microbiology, Pathology | ||
| Line 22: | Line 22: | ||
|SubCategory=General Principles, Infectious Disease | |SubCategory=General Principles, Infectious Disease | ||
|Prompt=A microbiologist has been given a number of unknown clinical samples and is attempting to visualize the organisms by gram stain. Samples from which patient population will he be unable to visualize with this method? | |Prompt=A microbiologist has been given a number of unknown clinical samples and is attempting to visualize the organisms by gram stain. Samples from which patient population will he be unable to visualize with this method? | ||
|Explanation=''[[Legionella pneumophila]]'' is | |Explanation=''[[Legionella pneumophila]]'' is an intracellular organism which gram-stains poorly. The stain of choice for Legionella is a silver stain. ''Legionella'' causes [[atypical pneumonia]] and is transmitted by aerosols from contaminated water, such as air conditioning systems or cruises in lakes and rivers. ''[[Legionella]]'' infection can cause [[Legionnaires' disease]], which is a severe illness in older individuals. However, it may also cause a milder manifestation termed [[Pontiac fever]]. The treatment of choice for ''Legionella'' infections is a [[macrolide]] (e.g. [[erythromycin]]). | ||
''[[Legionella]]'' infection can cause | |||
|AnswerA=Sexually active college dormitory students | |AnswerA=Sexually active college dormitory students | ||
|AnswerAExp=''[[Nisseria meningitidis]]'' is a [[gram-negative]] dipoloccus. | |AnswerAExp=''[[Nisseria meningitidis]]'' is a [[gram-negative]] dipoloccus. | ||
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|AnswerCExp=''[[Group B streptococcus]]'' is a gram-positive coccus. | |AnswerCExp=''[[Group B streptococcus]]'' is a gram-positive coccus. | ||
|AnswerD=Patients with recent exposure to contaminated air conditioning systems | |AnswerD=Patients with recent exposure to contaminated air conditioning systems | ||
|AnswerDExp=''[[Legionella pneumophila]]'' is | |AnswerDExp=''[[Legionella pneumophila]]'' is an intracellular organism which gram-stains poorly. The stain of choice for ''Legionella'' is a silver stain. | ||
|AnswerE=Elderly patients with osteoarthritis who recently underwent a total hip replacement by prosthesis | |AnswerE=Elderly patients with osteoarthritis who recently underwent a total hip replacement by prosthesis | ||
|AnswerEExp=''[[Staphyloccocus epidermidis]]'' is a gram-positive coccus. | |AnswerEExp=''[[Staphyloccocus epidermidis]]'' is a gram-positive coccus. | ||
|EducationalObjectives=''[[Legionella pneumophila]]'' is | |EducationalObjectives=''[[Legionella pneumophila]]'' is an intracellular organism which gram-stains poorly. The stain of choice for ''[[Legionella]]'' is a silver stain. | ||
|References=First Aid 2014 page 121 | |References=First Aid 2014 page 121 | ||
|RightAnswer=D | |RightAnswer=D | ||
Latest revision as of 23:10, 27 October 2020
| Author | [[PageAuthor::William J Gibson (Reviewed by Rim Halaby, M.D. [1] and Yazan Daaboul)]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Microbiology, MainCategory::Pathology |
| Sub Category | SubCategory::General Principles, SubCategory::Infectious Disease |
| Prompt | Prompt::A microbiologist has been given a number of unknown clinical samples and is attempting to visualize the organisms by gram stain. Samples from which patient population will he be unable to visualize with this method? |
| Answer A | AnswerA::Sexually active college dormitory students |
| Answer A Explanation | [[AnswerAExp::Nisseria meningitidis is a gram-negative dipoloccus.]] |
| Answer B | AnswerB::Adult patients with a history of alcoholism |
| Answer B Explanation | [[AnswerBExp::Klebsiella pneumoniae is a gram-negative rod.]] |
| Answer C | AnswerC::Infants of pregnant women who were not screened during 3rd trimester |
| Answer C Explanation | [[AnswerCExp::Group B streptococcus is a gram-positive coccus.]] |
| Answer D | AnswerD::Patients with recent exposure to contaminated air conditioning systems |
| Answer D Explanation | [[AnswerDExp::Legionella pneumophila is an intracellular organism which gram-stains poorly. The stain of choice for Legionella is a silver stain.]] |
| Answer E | AnswerE::Elderly patients with osteoarthritis who recently underwent a total hip replacement by prosthesis |
| Answer E Explanation | [[AnswerEExp::Staphyloccocus epidermidis is a gram-positive coccus.]] |
| Right Answer | RightAnswer::D |
| Explanation | [[Explanation::Legionella pneumophila is an intracellular organism which gram-stains poorly. The stain of choice for Legionella is a silver stain. Legionella causes atypical pneumonia and is transmitted by aerosols from contaminated water, such as air conditioning systems or cruises in lakes and rivers. Legionella infection can cause Legionnaires' disease, which is a severe illness in older individuals. However, it may also cause a milder manifestation termed Pontiac fever. The treatment of choice for Legionella infections is a macrolide (e.g. erythromycin). Educational Objective: Legionella pneumophila is an intracellular organism which gram-stains poorly. The stain of choice for Legionella is a silver stain. |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::Bacteria, WBRKeyword::Microbiology, WBRKeyword::Legionella, WBRKeyword::Gram stain, WBRKeyword::Stain, WBRKeyword::silver, WBRKeyword::air condition, WBRKeyword::air conditioning |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |