Case 1 PDF

Case 1 Beatrice Saviola, Ph.D. Jin Guo, M.D. Scenario In August 2002, The Oklahoma State Department of Health was informed of six patients with blood-borne infections who had received treatment from the same pain remediation clinic Question: What pathogens in this scenario are most like...

Case 1 Beatrice Saviola, Ph.D. Jin Guo, M.D. Scenario In August 2002, The Oklahoma State Department of Health was informed of six patients with blood-borne infections who had received treatment from the same pain remediation clinic Question: What pathogens in this scenario are most likely to be transmitted and result in an epidemiological outbreak? A. Salmonella Typhimurium B. Shigella sonnei C. Giardia lamblia D.Hepatitis B (HBV) * E. Hepatitis C (HCV) * F. Hepatitis A (HAV) G.Human immunodeficiency virus (HIV)* Signs and symptoms to be expected of cases? Clinical features indicated the patients suffered from: Fatigue/malaise Anorexia Nausea & vomiting Fever Jaundice Dark-colored urine Abdominal pain White stools Question: Given the presenting signs and symptoms, which of the following pathogens are most likely to be transmitted and result in an epidemiological outbreak and why? A. Salmonella Typhimurium B. Shigella sonnei C. Giardia lamblia D.Hepatitis B (HBV) * E. Hepatitis C (HCV) * F. Hepatitis A (HAV) G.Human immunodeficiency virus (HIV)  A preliminary investigation by the Oklahoma State Department of Health found a certified registered nurse anesthetist reused needles and syringes routinely during clinical sessions. A single needle and syringe were used to administer each of three sedation medications to up to 24 sequentially treated patients at each clinic session. These medications were administered through intravenous tubes.  On the basis of these findings, an investigation was initiated. Serological testing for blood-borne pathogens was completed for 793 (87%) of 908 patients attending the clinic. A total of 100 infections that probably were acquired in the clinic were identified. Question: Which of these two viruses would have been likely to infect the patients at the pain clinic? A B* Question: Patients’ blood was tested via ELISA and some test results revealed antibodies against an enveloped icosahedral partially double- stranded DNA virus. Which of the following viruses is dependent on this DNA virus for its replication? A. HAV B. HBV C. HCV D. HDV * E. HEV Question: In addition, ELISA of patients’ blood revealed antibodies against an enveloped positive-sense single-stranded RNA virus for some of the samples. What is a characteristic of the virus for which the antibodies were detected? A. It uses reverse transcriptase in its life cycle. B. It produces decoy particles. C C. It is acid resistant. His D. It has a helical nucleocapsid. E. It causes chronic infection at a high rate. * Hepati virus Question: For which of the following virus groupings is there a vaccine that protects against each virus in the group? A. HAV, HBV, HDV * B. HAV, HEV, HCV C. HBV, HCV, HEV D. HAV, HEV, HDV E. HBV, HDV, HEV  Due to the nature of the viruses and the manner in which the infections occurred, all infected individuals continued to be followed by the Oklahoma State Department of Health for the next decade. Of the 100 infected patients, 80 continued to respond to follow up inquiries. The investigation revealed that 20 of the patients went on to develop chronic liver disease and to required continued care. Liver biopsies demonstrated abnormal pathology in those individuals. Hepatitis B Hepatitis C Cirrhosis Hepatitis B Hepatitis C Hepatocellular carcinoma with cirrhosis