USMLE Step1 Goljan Integrated Notes

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/## INTEGRATED PATHOLOGY NOTES

C: Integrated Path Notes
Q: 23yo fem on the 3rd day of menses present with fever, severe lower abd pain and adnexal tenderness with movement of cervix. Hx - sex 3-4 days before menses.//Ds,Tx,
A: Gonorrhea (the short incub period)//Ceftriaxone and Doxycycline (for Chlamydia as a coinfection)
3: Clinical Vignettes
4: p.51

C: Integrated Path Notes
Q: 34 yo has had IntraUterine Device in place for 9mns and now vaginal discharge. Yelow flescks of material are attached to the IUD Gr(+), filamentous. Ds?
A: Actinomyces
3: Clinical Vignettes
4: p.51

C: Integrated Path Notes
Q: 46yo fem with dysuria, increased frequency and a mucopurulent vag discharge. Vag smears of the exudate and exam of the urin are (-) for m/o but show many leukocytes. Her last sex was 10 days ago. Ds?
A: Clamydia trachomatis.
3: Clinical Vignettes
4: p.51

C: Integrated Path Notes
Q: 32yo fem has a painful ulcer on the left labia majora and ipsilateral painful inguinal lymph nodes. Gr(-) rods in a 'school of fish' orientation. Ds?
A: Hemophilus ducreyi
3: Clinical Vignettes
4: p.51

C: Integrated Path Notes
Q: 25yo fem has a painless ulcer on the left labia majora and ipsilateral painful inguinal lymphadenopathy. Ds?
A: Treponema pallidum//Primary syphilis
3: Clinical Vignettes
4: p.51

C: Integrated Path Notes
Q: 23yo fem have fever, painful lymphadenopathy and painful visicles on her external genitalia that later ulcerate. A Tzanck prep is (+). Ds?
A: HerpesVirus II//Note how primary infection is systemic.
3: Clinical Vignettes
4: p.51

C: Integrated Path Notes
Q: 23yo fem have fern-like lesion around the labia and perianal area. Her RPR is (-) Ds?
A: -HPV//-Condyloma acuminata or venereal warts
3: Clinical Vignettes
4: p.51

C: Integrated Path Notes
Q: 30yo ornithologist with altered mental status, stupor, headacke. NO nuchal rigidity. Mosquito area in the Midwest. Gram stain and culture of the CSF is negative. Ds?
A: ArborVirus type of encephalitis.
3: Clinical Vignettes
4: p.51

C: Integrated Path Notes
Q: 18yo Navy have fever, headache and (+) Kernig's test. He is 10th case in the past week on the base. Ds?
A: Meningitis, most likely Neisseria, based on the crowded condition.
3: Clinical Vignettes
4: p.51

C: Integrated Path Notes
Q: 32yo renal transplant pt. who is immunosuppressed, has a positive India ink prep. Ds?
A: Cryptococcal meningitis
3: Clinical Vignettes
4: p.51

C: Integrated Path Notes
Q: Bilateral ophthalmia neonatorum during the first week. Ds?
A: N.Gonorrhoeae//transmitted on the way through the cervix.
3: Clinical Vignettes
4: p.51

C: Integrated Path Notes
Q: Granulocyte colony stim factor (G-CSF) produced by ..., stimulates ... development in the bone marrow
A: by fibroblasts// stimul neutrophil
3: Cells fx
4: p.51

C: Integrated Path Notes
Q: Granulocyte/Macrophae colony stimulating factor (GM-CSF) produced by ... and ..., stimulates ... and ... development in the bone marrow.
A: by macrophages and T_cells//stimul neutrophil and monocyte
3: Cells fx
4: p.51

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