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{{WBRQuestion | {{WBRQuestion | ||
|QuestionAuthor={{Ochuko}} (Reviewed by Will Gibson and {{YD}}) | |QuestionAuthor= {{Ochuko}} (Reviewed by Will Gibson and {{YD}}) | ||
|ExamType=USMLE Step 1 | |ExamType=USMLE Step 1 | ||
|MainCategory=Microbiology | |MainCategory=Microbiology |
Latest revision as of 02:56, 28 October 2020
Author | [[PageAuthor::Ogheneochuko Ajari, MB.BS, MS [1] (Reviewed by Will Gibson and Yazan Daaboul, M.D.)]] |
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Exam Type | ExamType::USMLE Step 1 |
Main Category | MainCategory::Microbiology |
Sub Category | SubCategory::Pulmonology, SubCategory::Infectious Disease |
Prompt | [[Prompt::A 4-year old boy is brought to the emergency department by his mother with complaints of fever, cough, runny nose, and a rash. The mother reports that the rash began on the forehead and progressively moved downwards. The patient's past medical history is unremarkable. Physical examination is remarkable for post-auricular lymphadenopathy. Which of the following is the most likely pathogen responsible for this patient's symptoms?]] |
Answer A | AnswerA::HHV-6 |
Answer A Explanation | AnswerAExp::HHV-6 causes Roseola, a macular rash over the body that appears several days after a high-grade fever. |
Answer B | AnswerB::Varicella zoster virus |
Answer B Explanation | AnswerBExp::Varicella zoster virus (VZV) causes chicken pox, in which the rash typically begins from the trunk and then spreads to the face and extremities. |
Answer C | AnswerC::Mumps virus |
Answer C Explanation | AnswerCExp::Mumps virus causes mumps, which typically presents with no rash but with parotitis and/or meningitis (pancreatitis, orchitis/oophoritis in young adults). |
Answer D | AnswerD::Rubella virus |
Answer D Explanation | AnswerDExp::Infection with the Rubella virus is associated with the development of a descending rash and post-auricular lymphadenopathy. |
Answer E | AnswerE::Measles virus |
Answer E Explanation | AnswerEExp::Measles virus causes measles. The rash in measles is preceded by cough, coryza, conjunctivitis and blue-white (Koplik) spots on the buccal mucosa. |
Right Answer | RightAnswer::D |
Explanation | [[Explanation::The patient is most likely diagnosed with Rubella virus infection (German measles). The primary symptom of rubella virus infection is the appearance of a rash (exanthem) on the face which spreads to the trunk and limbs and usually fades after three days. Other symptoms include low grade fever, swollen glands (typically post-cervical/post-auricular lymphadenopathy), joint pains, headache, and conjunctivitis. The swollen glands or lymph nodes can persist for up to a week, and the fever rarely rises above 38 oC (100.4 oF). The rash disappears after a few days with no staining or peeling of the skin. Educational Objective: Rubella virus causes German measles with the clinical presentation of post-auricular lymphadenopathy and rash. |
Approved | Approved::Yes |
Keyword | WBRKeyword::Microbiology, WBRKeyword::Virus, WBRKeyword::Viruses, WBRKeyword::Rubella, WBRKeyword::Rash, WBRKeyword::Skin, WBRKeyword::Togavirus |
Linked Question | Linked:: |
Order in Linked Questions | LinkedOrder:: |