id q.5 - chapper - Printable Version +- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com) +-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1) +--- Forum: Step 3 (https://www.usmleforum.com/forumdisplay.php?fid=6) +--- Thread: id q.5 - chapper (/showthread.php?tid=613635) Pages:
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id q.5 - chapper - ArchivalUser - 09-12-2011 A 19 year old college student, comes with tender firm epitrochlear & axillary LNs. She also has a small painless nodule on her 3rd finger. She has low-grade fever for 2 weeks. She likes to garden, has fish collection & has many pets including cats & puppies. She is sexually active with her husband.She has also travelled across all countries including SE Asia ( 3 years before her symptoms started). What is your Diagnosis? 1. Sporothrix Schenkii 2. Staphylococcal infection. 3. Lymphoma. 4. Bartonella Hensalae infection. 0 - ArchivalUser - 09-12-2011 chapper I don't know question is too confusing bartonella will be faster day not 2 weeks sporothrix supurative lesion not sure what about 3 0 - ArchivalUser - 09-12-2011 give some hints 0 - ArchivalUser - 09-12-2011 The question shud read: The differential diagnosis includes all of the following except: 1. Sporothrix Schenkii 2. Staphylococcal infection. 3. Lymphoma. 4. Bartonella Hensalae infection. 0 - ArchivalUser - 09-12-2011 I know 0 - ArchivalUser - 09-12-2011 4. 0 - ArchivalUser - 09-12-2011 4 IS ANS 0 - ArchivalUser - 09-12-2011 Again....the question is The differential diagnosis includes all of the following except 0 - ArchivalUser - 09-12-2011 except sta give the answer for Forever can go 0 - ArchivalUser - 09-12-2011 The answer is 1. - Although patient’s gardening puts her at risk for Sporothrix, it causes a more localized streaking nodular lymphadenitis affecting forearm. - Nodular Adenities: DD are Sporothrix schenckii, Nocardia brasiliensis, Mycobacterium marinum,Leishmania braziliensis, and Francisella tularensis and is based on direct inoculation of organism due to contact from the soil, marine environment, insect bite, or animal bite. - In this patient, you see regional lymphadenitis that involved large lymph nodes that drain from the site of the inoculation. So most likely ot can be Bartonella ( based on cats) but Staph can also be the cause- therefore you need a LN biopsy for confirmation. |