WBR0084: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 20: Line 20:
|MainCategory=Microbiology
|MainCategory=Microbiology
|SubCategory=General Principles
|SubCategory=General Principles
|Prompt=A 28 year old female immigrant from Africa presents with complaints of an itchy swelling over her entire body. She is also concerned about body aches. On physical examination, non-tender swelling is noted over her the limbs on the right side of her body.  Laboratory findings show eosinophilia. Microscopic examination of the blood shows the microfilaria of loa loa, and a diagnosis of loa loa filiariasis is made. The vector for this condition is:
|Prompt=A 28-year-old female immigrant from Africa presents with complaints of an itchy swelling over her entire body and body aches. On physical examination, non-tender swelling is noted over her right arm and leg.  Laboratory tests are remarkable for eosinophilia. The diagnosis is confirmed when microscopic examination of the blood shows microfilaria of loa loa. Which of the following is the most likely vector for this condition?
|Explanation=The deerflies (genus Chrysops) that transmit Loa loa bite during the day.  Most people with [[loiasis]] do not experience signs or symptoms of infection, though persons who do not live in areas where the parasite is found, such as travelers to the area, are more likely to experience them. The most common manifestations of the disease are Calabar swellings and eye worm. Calabar swellings are localized, non-tender swellings usually found on the limbs and near joints. They are associated with [[itching]] that occurs in the area of the swelling or is generalized to the large areas of the body. Eye worm is the visible migration of the adult worm across the surface of the eye. Eye worm can be accompanied by eye congestion, itching, pain, and light sensitivity. Although eye worm can be very distressing, it usually lasts less than one week (often just hours) and commonly causes minimal damage to the eye. Other manifestations of disease include generalized itching, hives, muscle pains, joint pains, fatigue, and adult worms visibly migrating under the surface of the skin. Increased numbers of [[eosinophils]] are usually found on blood tests. Persons with long-term infection might develop kidney damage through immune complex deposition, though progression to [[chronic kidney disease]] is not common. Other uncommon manifestations include inflammation of the lymph glands, scrotal swellings, and lung infiltrates along with collections of fluid around the lung. Loiasis may also be associated with scarring of [[heart muscle]].
|Explanation=The deerflies (genus Chrysops) that transmit Loa loa bite during the day.  Most people with [[loiasis]] do not experience signs or symptoms of infection, though persons who do not live in areas where the parasite is found, such as travelers to the area, are more likely to experience them. The most common manifestations of the disease are Calabar swellings and eye worm. Calabar swellings are localized, non-tender swellings usually found on the limbs and near joints. They are associated with [[itching]] that occurs in the area of the swelling or is generalized to the large areas of the body. Eye worm is the visible migration of the adult worm across the surface of the eye. Eye worm can be accompanied by eye congestion, itching, pain, and light sensitivity. Although eye worm can be very distressing, it usually lasts less than one week (often just hours) and typically causes minimal damage to the eye. Other manifestations of disease include generalized itching, hives, muscle pains, joint pains, fatigue, and adult worms visibly migrating under the surface of the skin. Increased numbers of [[eosinophils]] are usually found on blood tests. Persons with long-term infection might develop kidney damage through immune complex deposition, though progression to [[chronic kidney disease]] is not common. Other uncommon manifestations include inflammation of the lymph glands, scrotal swellings, and lung infiltrates along with collections of fluid around the lung. Loiasis may also be associated with scarring of [[heart muscle]].
|AnswerA=Black fly
|AnswerA=Black fly
|AnswerAExp=The black fly is the vector for [[onchocerciasis]].
|AnswerAExp=The black fly is the vector for [[onchocerciasis]].
Line 27: Line 27:
|AnswerBExp=The soft tick is a vector for [[relapsing fever]].
|AnswerBExp=The soft tick is a vector for [[relapsing fever]].
|AnswerC=Hard tick
|AnswerC=Hard tick
|AnswerCExp=The hard tick is a vector for [[lyme diseae]], [[rocky mountain spotted fever]], [[babesiosis]], [[ehrlichiosis]], tick-borne meningoencephalitis, [[colorado tick fever]], [[Crimean-Congo hemorrhagic fever]], and tick paralysis.
|AnswerCExp=The hard tick refers to a family of ticks including the Dermacentor and Ixodes ticks.  Hard ticks are the vectors for [[lyme diseae]], [[rocky mountain spotted fever]], [[babesiosis]], [[ehrlichiosis]], tick-borne meningoencephalitis, [[colorado tick fever]], [[Crimean-Congo hemorrhagic fever]], and tick paralysis.
|AnswerD=Deerfly
|AnswerD=Deerfly
|AnswerDExp=Deerfly is the vector of [[loa loa]].
|AnswerDExp=Deerfly is the vector for [loa loa]].
|AnswerE=Sandfly
|AnswerE=Sandfly
|AnswerEExp=Sandfly is the vector for [[leishmaniasis]].
|AnswerEExp=Sandfly is the vector for [[leishmaniasis]].
|EducationalObjectives=The deerflies bites transmit the infectious organism loa loa that cause [[loiasis]], a disease characterized by  Calabar swellings and eye worm.
|EducationalObjectives=Deerlies transmit the infectious organism loa loa that causes [[loiasis]], a disease characterized by  Calabar swellings and eye worm.
|References=CDC.gov
|References=First Aid 2014 page 154, [http://www.cdc.gov/parasites/loiasis/ CDC page]
|RightAnswer=D
|RightAnswer=D
|WBRKeyword=Loa Loa, Infectious disease, Deerfly, Deerflies, eye worm
|WBRKeyword=Loa Loa, Infectious disease, Deerfly, Deerflies, eye worm
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 00:56, 21 March 2014

 
Author PageAuthor::Kalsang Dolma
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Microbiology
Sub Category SubCategory::General Principles
Prompt [[Prompt::A 28-year-old female immigrant from Africa presents with complaints of an itchy swelling over her entire body and body aches. On physical examination, non-tender swelling is noted over her right arm and leg. Laboratory tests are remarkable for eosinophilia. The diagnosis is confirmed when microscopic examination of the blood shows microfilaria of loa loa. Which of the following is the most likely vector for this condition?]]
Answer A AnswerA::Black fly
Answer A Explanation [[AnswerAExp::The black fly is the vector for onchocerciasis.]]
Answer B AnswerB::Soft tick
Answer B Explanation [[AnswerBExp::The soft tick is a vector for relapsing fever.]]
Answer C AnswerC::Hard tick
Answer C Explanation [[AnswerCExp::The hard tick refers to a family of ticks including the Dermacentor and Ixodes ticks. Hard ticks are the vectors for lyme diseae, rocky mountain spotted fever, babesiosis, ehrlichiosis, tick-borne meningoencephalitis, colorado tick fever, Crimean-Congo hemorrhagic fever, and tick paralysis.]]
Answer D AnswerD::Deerfly
Answer D Explanation [[AnswerDExp::Deerfly is the vector for [loa loa]].]]
Answer E AnswerE::Sandfly
Answer E Explanation [[AnswerEExp::Sandfly is the vector for leishmaniasis.]]
Right Answer RightAnswer::D
Explanation [[Explanation::The deerflies (genus Chrysops) that transmit Loa loa bite during the day. Most people with loiasis do not experience signs or symptoms of infection, though persons who do not live in areas where the parasite is found, such as travelers to the area, are more likely to experience them. The most common manifestations of the disease are Calabar swellings and eye worm. Calabar swellings are localized, non-tender swellings usually found on the limbs and near joints. They are associated with itching that occurs in the area of the swelling or is generalized to the large areas of the body. Eye worm is the visible migration of the adult worm across the surface of the eye. Eye worm can be accompanied by eye congestion, itching, pain, and light sensitivity. Although eye worm can be very distressing, it usually lasts less than one week (often just hours) and typically causes minimal damage to the eye. Other manifestations of disease include generalized itching, hives, muscle pains, joint pains, fatigue, and adult worms visibly migrating under the surface of the skin. Increased numbers of eosinophils are usually found on blood tests. Persons with long-term infection might develop kidney damage through immune complex deposition, though progression to chronic kidney disease is not common. Other uncommon manifestations include inflammation of the lymph glands, scrotal swellings, and lung infiltrates along with collections of fluid around the lung. Loiasis may also be associated with scarring of heart muscle.

Educational Objective: Deerlies transmit the infectious organism loa loa that causes loiasis, a disease characterized by Calabar swellings and eye worm.
References: First Aid 2014 page 154, CDC page]]

Approved Approved::Yes
Keyword WBRKeyword::Loa Loa, WBRKeyword::Infectious disease, WBRKeyword::Deerfly, WBRKeyword::Deerflies, WBRKeyword::eye worm
Linked Question Linked::
Order in Linked Questions LinkedOrder::