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|SubCategory=Dermatology, General Principles, Infectious Disease
|SubCategory=Dermatology, General Principles, Infectious Disease
|Prompt=A 34-year-old woman who works in a wool factory presents to the emergency room with a boil-like black ulcer which developed on her forearm over the past 3 days.  Which component of the organism causing this disease induces the production of TNF and IL-1?
|Prompt=A 34-year-old woman who works in a wool factory presents to the emergency room with a boil-like black ulcer which developed on her forearm over the past 3 days.  Which component of the organism causing this disease induces the production of TNF and IL-1?
|Explanation=The patient in this passage has become infected with Bacillus anthracis, a gram-positive, spore forming rod.  In this case, the patient has contracted Cutaneous anthrax.  Patients are often exposed to anthrax in the occupations where they come in frequent contact with animals or their products (such as skin, wool and meat).  Inhalational anthrax has alternatively been called ‘Woolsorter’s Disease’
|Explanation=The patient in this passage has become infected with Bacillus anthracis, a gram-positive, spore forming rod.  In this case, the patient has contracted Cutaneous anthrax.   
 
When anthrax spores get into the skin, usually through a cut or scrape, a person can develop cutaneous anthrax. This can happen when a person handles infected animals or contaminated animal products like wool, hides, or hair. Cutaneous anthrax is most common on the head, neck, forearms, and hands. It affects the skin and tissue around the site of infection.
 
Cutaneous anthrax is the most common form of anthrax infection, and it is also considered to be the least dangerous. Infection usually develops from 1 to 7 days after exposure. Without treatment, up to 20% of people with cutaneous anthrax may die. However, with proper treatment, almost all patients with cutaneous anthrax survive.
 
Patients are often exposed to anthrax in the occupations where they come in frequent contact with animals or their products (such as skin, wool and meat).  Inhalational anthrax has alternatively been called ‘Woolsorter’s Disease’.
|AnswerA=Peptidoglycan
|AnswerA=Peptidoglycan
|AnswerAExp=Peptidoglycan is composed of a sugar backbone with cross-linking by peptide side chains.  It provides support for bacterial cells and protects against osmotic forces but does not directly induce IL-1 and TNF.
|AnswerAExp=Peptidoglycan is composed of a sugar backbone with cross-linking by peptide side chains.  It provides support for bacterial cells and protects against osmotic forces but does not directly induce IL-1 and TNF.

Revision as of 22:29, 20 March 2014

 
Author PageAuthor::William J Gibson
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Microbiology, MainCategory::Pathology
Sub Category SubCategory::Dermatology, SubCategory::General Principles, SubCategory::Infectious Disease
Prompt [[Prompt::A 34-year-old woman who works in a wool factory presents to the emergency room with a boil-like black ulcer which developed on her forearm over the past 3 days. Which component of the organism causing this disease induces the production of TNF and IL-1?]]
Answer A AnswerA::Peptidoglycan
Answer A Explanation AnswerAExp::Peptidoglycan is composed of a sugar backbone with cross-linking by peptide side chains. It provides support for bacterial cells and protects against osmotic forces but does not directly induce IL-1 and TNF.
Answer B AnswerB::Lipoteichoic acid
Answer B Explanation AnswerBExp::Cutaneous anthrax is known for causing black eschar lesion. Anthrax is a gram positive rod, whose lipoteichoic acid stimulates IL-1 and TNF.
Answer C AnswerC::Lipid A
Answer C Explanation AnswerCExp::Lipid A is a molecule found on the outer membrane of gram negative bacteria. It does induce the production of TNF and IL-1, but the bacteria suspected by this clinical presentation is Bacillus anthracis, a gram-positive organism.
Answer D AnswerD::D-Glutamate Capsule
Answer D Explanation AnswerDExp::Bacillus anthracis is the only organism with a D-Glutamate capsule. However, it does not induce the production of IL-1 and TNF.
Answer E AnswerE::Glycocalyx
Answer E Explanation AnswerEExp::The glycocalyx mediates bacterial adhesion to structures such as catheters, biological membranes and other surfaces. It does not directly induce IL-1 and TNF.
Right Answer RightAnswer::B
Explanation [[Explanation::The patient in this passage has become infected with Bacillus anthracis, a gram-positive, spore forming rod. In this case, the patient has contracted Cutaneous anthrax.

When anthrax spores get into the skin, usually through a cut or scrape, a person can develop cutaneous anthrax. This can happen when a person handles infected animals or contaminated animal products like wool, hides, or hair. Cutaneous anthrax is most common on the head, neck, forearms, and hands. It affects the skin and tissue around the site of infection.

Cutaneous anthrax is the most common form of anthrax infection, and it is also considered to be the least dangerous. Infection usually develops from 1 to 7 days after exposure. Without treatment, up to 20% of people with cutaneous anthrax may die. However, with proper treatment, almost all patients with cutaneous anthrax survive.

Patients are often exposed to anthrax in the occupations where they come in frequent contact with animals or their products (such as skin, wool and meat). Inhalational anthrax has alternatively been called ‘Woolsorter’s Disease’.
Educational Objective: Cutaneous anthrax is known for causing black eschar lesion. Anthrax is a gram positive rod, whose lipoteichoic acid stimulates IL-1 and TNF.
References: First Aid 2014 page 133 First Aid 2012 page 146.]]

Approved Approved::Yes
Keyword WBRKeyword::Microbiology, WBRKeyword::Bacteria, WBRKeyword::Anthrax, WBRKeyword::Inflammation, WBRKeyword::Immune
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