DISCUSSION 2: SERENA Serena is a 21-year-old, African-American who presents with a 3-day history of a painful sore throat. She has pain with swallowing and even with talking. She also has felt feverish for the past 2 days and somewhat listless. She does not complain of a cough, runny nose or shortness of breath. She just started a new job at a Daycare Center and notes that one of her charges is an 18- month-old baby who has been fussy, feverish and not eating well. Her prior medical history is unremarkable except for eczema as a child. She is not on any medications, has no drug allergies and is not sexually active. Her physical exam reveals temperature of 101o F, Heart rate 88, Blood pressure 100/70 and Respiratory rate 12. On oropharyngeal examination, her posterior pharynx is erythematous, swollen and coated with a whitish exudate. Bilateral tonsils are swollen, red and covered with similar exudates. The lymph nodes in her neck are also swollen and tender just beneath the angle of the mandible. Lung exam is clear. Laboratory testing revealed a WBC of 10,000 and a differential with 80% neutrophils. Rapid Strep test was positive.
CASE QUESTIONS: Tell me what is right and why it is right as well as for the wrong answers, why they are wrong.
1. Streptococcus pyogenes is a:
A) Bacterium transmitted by fecal-oral contamination
B) Virus transmitted by an arthropod (insect)
C) Bacterium typically transmitted by air-borne droplets
D) Fungus transmitted through inhalation of dust particles
E) Virus transmitted by contaminated blood products
2. The elevated neutrophil count, is an attempt to control the infection by:
A) Activating coagulation to prevent spread of the bacteria
B) Releasing histamine and serotonin to initiate inflammation
C) Releasing caustic proteins that dissolve the bacteria
D) Ingesting the bacteria and cell debris through phagocytosis
E) None of the above
3. People at risk for complications from a Strep throat typically develop high levels of antibodies against Streptolysin O (ASO), a Streptococcal antigen. Which of the following statements about antibody production is/are TRUE?
A) Antibodies are produced by T helper 2 cells with help from B cells
B) Antibodies are produced by B cells with help from Th2 cells
C) Antibodies are the antigen receptor for T cells
D) Antibodies bind antigen in association with Class I MHC molecules
DISCUSSION 2: SERENA Serena is a 21-year-old, African-American who presents with a 3-day history of a painful sore throat. She has pain with swallowing and even with talking. She also has felt feverish for the past 2 days and somewhat listless. She does not complain of a cough, runny nose or shortness of breath. She just started a new job at a Daycare Center and notes that one of her charges is an 18- month-old baby who has been fussy, feverish and not eating well. Her prior medical history is unremarkable except for eczema as a child. She is not on any medications, has no drug allergies and is not sexually active. Her physical exam reveals temperature of 101o F, Heart rate 88, Blood pressure 100/70 and Respiratory rate 12. On oropharyngeal examination, her posterior pharynx is erythematous, swollen and coated with a whitish exudate. Bilateral tonsils are swollen, red and covered with similar exudates. The lymph nodes in her neck are also swollen and tender just beneath the angle of the mandible. Lung exam is clear. Laboratory testing revealed a WBC of 10,000 and a differential with 80% neutrophils. Rapid Strep test was positive.
CASE QUESTIONS: Tell me what is right and why it is right as well as for the wrong answers, why they are wrong.
1. Streptococcus pyogenes is a:
A) Bacterium transmitted by fecal-oral contamination
B) Virus transmitted by an arthropod (insect)
C) Bacterium typically transmitted by air-borne droplets
D) Fungus transmitted through inhalation of dust particles
E) Virus transmitted by contaminated blood products
2. The elevated neutrophil count, is an attempt to control the infection by:
A) Activating coagulation to prevent spread of the bacteria
B) Releasing histamine and serotonin to initiate inflammation
C) Releasing caustic proteins that dissolve the bacteria
D) Ingesting the bacteria and cell debris through phagocytosis
E) None of the above
3. People at risk for complications from a Strep throat typically develop high levels of antibodies against Streptolysin O (ASO), a Streptococcal antigen. Which of the following statements about antibody production is/are TRUE?
A) Antibodies are produced by T helper 2 cells with help from B cells
B) Antibodies are produced by B cells with help from Th2 cells
C) Antibodies are the antigen receptor for T cells
D) Antibodies bind antigen in association with Class I MHC molecules
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