Questions and Answers
What is the most likely diagnosis of the 5-year-old boy's illness?
Which of the following patients is at increased risk to acquire hep B infection?
What is the most likely causative agent of the HIV-positive patient's retinitis?
What is the most likely diagnosis of the patient with a cold that has been ongoing for 3 weeks?
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What is the main reason why no cultures are ordered for the 5-year-old boy's illness?
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What is the significance of the CD4 count in the HIV-positive patient's diagnosis?
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What is the significance of the patient's medical history being unremarkable?
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What is the likely route of transmission of the adenovirus infection in the 5-year-old boy?
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What is the significance of the 'floaters' in the HIV-positive patient's symptoms?
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What is the likely outcome of the 5-year-old boy's illness?
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Study Notes
Case Studies
- Patient with temperature 38º C, blood pressure 126/78 mmHg, pulse 92/min, and respiratory rate 18/min, with scleral icterus and tenderness in the right upper quadrant of the abdomen; likely diagnosis is Acute Hepatitis A or B.
- 33-year-old homeless man with HIV, complaining of generalized weakness and vision difficulties, with CD4 count of 35/mm3; likely diagnosis is Progressive multifocal leukoencephalopathy.
- 43-year-old man with flu-like symptoms, headache, photophobia, and pain in knees and lower back after returning from a rafting trip to South America; likely diagnosis is a mosquito-borne illness.
- 21-year-old man with AIDS and chronic herpes simplex virus (HSV) infection of the lip, resistant to acyclovir treatment; resistance likely developed due to alteration in thymidine kinase viral protein.
- 4-year-old boy with generalized rash, fever, and tender postauricular lymphadenopathy; likely diagnosis is Rubella virus.
- 6-month-old girl with difficulty breathing, nasal flaring, and suprasternal retractions; likely diagnosis is Respiratory Syncytial Virus (RSV) infection.
Viral Characteristics
- Herpes simplex virus (HSV) infection of the lip; resistance to acyclovir treatment developed due to alteration in thymidine kinase viral protein.
- Nonenveloped, single-stranded RNA virus; likely contracted by a pregnant woman after ingesting river water.
- Enveloped, linear DNA virus; likely causing illness in a pregnant woman after returning from a trip abroad.
- Single-stranded linear RNA virus; likely causing illness in a 32-year-old pregnant woman after ingesting river water.
- Double-stranded linear DNA virus with an envelope; likely infecting a 22-year-old man with flu-like symptoms.
Viral Infections
- Hepatitis A or B; likely diagnosis in a patient with temperature 38º C, blood pressure 126/78 mmHg, pulse 92/min, and respiratory rate 18/min, with scleral icterus and tenderness in the right upper quadrant of the abdomen.
- Progressive multifocal leukoencephalopathy; likely diagnosis in a 33-year-old homeless man with HIV, complaining of generalized weakness and vision difficulties.
- Mosquito-borne illness; likely diagnosis in a 43-year-old man with flu-like symptoms, headache, photophobia, and pain in knees and lower back after returning from a rafting trip to South America.
- Rubella virus; likely diagnosis in a 4-year-old boy with generalized rash, fever, and tender postauricular lymphadenopathy.
- Respiratory Syncytial Virus (RSV) infection; likely diagnosis in a 6-month-old girl with difficulty breathing, nasal flaring, and suprasternal retractions.
- Adenovirus; likely causative agent in a 5-year-old boy's illness with sore throat, conjunctivitis, rhinitis, and cough.
- Cytomegalovirus (CMV); likely causative agent in a patient's retinitis and pervivascular hemorrhages.
High-Risk Groups
- 44-year-old man with renal failure who receives a clotting factor transcription; at increased risk to acquire hepatitis B infection.
- Person with HIV; at increased risk to acquire cytomegalovirus (CMV) retinitis.
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Description
Identify the likely diagnosis based on a patient's symptoms and physical examination results.
