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Created page with "{{WBRQuestion |QuestionAuthor={{Rim}} |ExamType=USMLE Step 1 |MainCategory=Microbiology |SubCategory=Cardiology |MainCategory=Microbiology |SubCategory=Cardiology |MainCategor..."
 
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|MainCategory=Microbiology
|MainCategory=Microbiology
|SubCategory=Cardiology
|SubCategory=Cardiology
|MainCategory=Microbiology
|MainCategory=Microbiology
|MainCategory=Microbiology
|MainCategory=Microbiology
|MainCategory=Microbiology
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|Prompt=A 67 year old female patient presents to the emergency department for unremitting high grade fever and left leg pain.  The patient explains that she had a left total knee replacement done 5 months ago.  Following appropriate management, cultures reveal infection with a non-motile organism.  Which of the following pathogens is the most likely cause of the patient's symptoms?
|Prompt=A 67 year old female patient presents to the emergency department for unremitting high grade fever and left leg pain.  The patient explains that she had a left total knee replacement done 5 months ago.  Following appropriate management, cultures reveal infection with a non-motile organism.  Which of the following pathogens is the most likely cause of the patient's symptoms?
|Explanation=Staphylococcus epidermidis is a gram positive coagulase-negative non-motile organism that causes biofilms that grow on surgical implants or catheters.  Hip and knee procedures, such as total knee replacement.
|Explanation=Staphylococcus epidermidis is a gram positive coagulase-negative non-motile organism that causes biofilms that grow on surgical implants or catheters.  Hip and knee procedures, such as total knee replacement.
Educational Objective:
Staphylococcal epidermidis causes biofilms that bind to prosthetic surgical implants or catheters.
|AnswerA=Streptococcus bovis
|AnswerA=Streptococcus bovis
|AnswerAExp=Streptococcus bovis is usually infectious in patients who are found to have colon cancer.
|AnswerAExp=Streptococcus bovis is usually infectious in patients who are found to have colon cancer.
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|AnswerBExp=Streptococcus pyogenes commonly cause impetigo and pharyngitis.  They are not classically associated with prosthetic infections following total knee replacement.
|AnswerBExp=Streptococcus pyogenes commonly cause impetigo and pharyngitis.  They are not classically associated with prosthetic infections following total knee replacement.
|AnswerC=Neisseria gonorrhea
|AnswerC=Neisseria gonorrhea
|AnswerCExp=N. gonorrhea is a sexually transmitted infection that can cause infectious arthritis in sexually active individuals.  
|AnswerCExp=N. gonorrhea is a sexually transmitted infection that can cause infectious arthritis in sexually active individuals.
|AnswerD=Pseudomonas aeroginosa
|AnswerD=Pseudomonas aeroginosa
|AnswerDExp=P. aeruginosa may be an infectious cause of a complicated total knee replacement.  P. aeroginosa however is motile organism.
|AnswerDExp=P. aeruginosa may be an infectious cause of a complicated total knee replacement.  P. aeroginosa however is motile organism.
|AnswerE=Staphylococcus epidermidis
|AnswerE=Staphylococcus epidermidis
|AnswerEExp=S. epidermidis is commonly associated with infections following prosthetic implants.  
|AnswerEExp=S. epidermidis is commonly associated with infections following prosthetic implants.
|EducationalObjectives=Staphylococcal epidermidis causes biofilms that bind to prosthetic surgical implants or catheters.
|References=First Aid 2014 page 130
|RightAnswer=E
|RightAnswer=E
|WBRKeyword=staphylococcus, epidermidis, total, knee, replacement, prosthesis, prosthetic, staphylococcus epidermidis, total knee replacement, gram, positive, organism, bacteria, infection, fever
|WBRKeyword=staphylococcus, epidermidis, total, knee, replacement, prosthesis, prosthetic, staphylococcus epidermidis, total knee replacement, gram, positive, organism, bacteria, infection, fever
|Approved=No
|Approved=Yes
}}
}}

Revision as of 19:11, 14 September 2014
Author [[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Microbiology
Sub Category SubCategory::Cardiology
Prompt [[Prompt::A 67 year old female patient presents to the emergency department for unremitting high grade fever and left leg pain. The patient explains that she had a left total knee replacement done 5 months ago. Following appropriate management, cultures reveal infection with a non-motile organism. Which of the following pathogens is the most likely cause of the patient's symptoms?]]
Answer A AnswerA::Streptococcus bovis
Answer A Explanation AnswerAExp::Streptococcus bovis is usually infectious in patients who are found to have colon cancer.
Answer B AnswerB::Streptococcus pyogenes
Answer B Explanation AnswerBExp::Streptococcus pyogenes commonly cause impetigo and pharyngitis. They are not classically associated with prosthetic infections following total knee replacement.
Answer C AnswerC::Neisseria gonorrhea
Answer C Explanation AnswerCExp::N. gonorrhea is a sexually transmitted infection that can cause infectious arthritis in sexually active individuals.
Answer D AnswerD::Pseudomonas aeroginosa
Answer D Explanation AnswerDExp::P. aeruginosa may be an infectious cause of a complicated total knee replacement. P. aeroginosa however is motile organism.
Answer E AnswerE::Staphylococcus epidermidis
Answer E Explanation AnswerEExp::S. epidermidis is commonly associated with infections following prosthetic implants.
Right Answer RightAnswer::E
Explanation [[Explanation::Staphylococcus epidermidis is a gram positive coagulase-negative non-motile organism that causes biofilms that grow on surgical implants or catheters. Hip and knee procedures, such as total knee replacement.

Educational Objective: Staphylococcal epidermidis causes biofilms that bind to prosthetic surgical implants or catheters.
References: First Aid 2014 page 130]]

Approved Approved::Yes
Keyword WBRKeyword::staphylococcus, WBRKeyword::epidermidis, WBRKeyword::total, WBRKeyword::knee, WBRKeyword::replacement, WBRKeyword::prosthesis, WBRKeyword::prosthetic, WBRKeyword::staphylococcus epidermidis, WBRKeyword::total knee replacement, WBRKeyword::gram, WBRKeyword::positive, WBRKeyword::organism, WBRKeyword::bacteria, WBRKeyword::infection, WBRKeyword::fever
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