Final Exam Practice Cases

Case study A 7 year old child is brought to the clinic by her mother after developing clusters of golden honey colored crusts around the nose and mouth over the past three days following a minor scratch from playing outside the lesions began as small red bumps that quickly ruptured and formed thick crusts the child has mild itching but no fever and her younger sibling recently had a similar rash the diagnosis is _

impetigo

Case study A 62 year old woman presents with sudden onset of a bright fiery red sharply bordered swollen rash on her left cheek accompanied by fever chills and a burning sensation she reports that the redness spread rapidly over the last 24 hours and the area is warm tender and slightly raised she has a recent history of a small cut from gardening the diagnosis is _

erysipelas

Case study A 54 year old man comes to the emergency department with progressive redness warmth and swelling of his lower leg that started two days ago after he scraped his shin the area has expanded significantly and is now painful to walk on he has a low grade fever chills and no visible abscess formation he denies trauma but reports uncontrolled diabetes the diagnosis is _

cellulitis

Case study A 40 year old diabetic patient presents with excruciating pain in the thigh that seems far worse than the physical findings would suggest the area has rapidly expanding redness purple discoloration dark bullae and the skin feels tense and tender the patient is febrile hypotensive and reports that this all developed within hours after a minor injury while working outside the diagnosis is _

necrotizing fasciitis

Case study A 16 year old student presents with sudden severe sore throat difficulty swallowing fever swollen tender anterior cervical lymph nodes and white patches covering enlarged tonsils she reports no cough but severe fatigue and pain when speaking symptoms began abruptly the morning after cheerleading practice the diagnosis is _

strep throat

Case study A 33 year old man presents with a three month history of persistent dry cough progressive fatigue weight loss night sweats and occasional coughing up of blood he recently immigrated from an area with high prevalence of lung disease and chest x ray shows upper lobe cavitary lesions he reports living in crowded housing conditions the diagnosis is _

tuberculosis

Case study A 72 year old woman presents with acute fever chills shortness of breath productive cough with rusty colored sputum and pleuritic chest pain that worsens when she inhales a chest x ray reveals consolidation in the right lower lobe she recently recovered from a viral illness and now appears weak tachypneic and febrile the diagnosis is _

pneumonia

Case study A college student begins experiencing sudden episodes of intense vomiting just four hours after eating leftover fried rice from a takeout restaurant the vomiting is repeated forceful and not accompanied by fever or diarrhea roommates who shared the same food are also sick the symptoms resolve rapidly within several hours the diagnosis is _

bacillus cereus

Case study A 25 year old woman develops abrupt vomiting nausea abdominal cramping and feeling faint three hours after eating cream filled pastries at a bakery the symptoms began rapidly and were extremely intense but she has no fever and minimal diarrhea others at the same event also fell ill shortly afterward the diagnosis is _

staphylococcus aureus

Case study A man reports profuse watery diarrhea and gas starting 10 hours after eating large amounts of reheated meat from a buffet he denies vomiting but experiences cramping that improves after bowel movements friends who ate the same food developed similar symptoms the illness is self limited and resolves within 24 hours the diagnosis is_

clostridium perfringens

Case study A 30 year old man develops fever severe abdominal cramps nausea and watery stool that becomes greenish and later bloody within 24 hours of eating undercooked chicken at a barbecue he reports headache chills and repeated bowel movements with mucus pain intensifies before each bowel movement the diagnosis is _

salmonella enterica

Case study A 5 year old child from daycare presents with high fever severe tenesmus and multiple small volume bloody mucus filled stools the child screams in pain during bowel movements and looks dehydrated a classmate recently had similar symptoms the illness began suddenly after exposure to contaminated food at daycare the diagnosis is _

shigella dysenteriae

Case study A 29 year old woman presents with severe abdominal cramping fever malaise and bloody diarrhea after eating undercooked chicken at a restaurant she describes the pain as “twisting and stabbing” and notes that it worsens before bowel movements she also reports nausea and a foul smelling stool sample the diagnosis is _

campylobacter jejuni

Case study A hospitalized patient who received broad spectrum antibiotics a week ago suddenly develops profuse watery foul smelling diarrhea abdominal pain and fever the stool is watery with mucus and she reports urgency and cramping a stool toxin test comes back positive the diagnosis is _

clostridium difficile

Case study A traveler returning from an area with poor sanitation presents with massive watery diarrhea described as “rice water” severe dehydration sunken eyes muscle cramps and profound weakness symptoms began after drinking untreated local water fluids pour out rapidly and the patient becomes hypotensive within hours the diagnosis is _

vibrio cholerae

Case study A 43 year old man experiences nausea vomiting dry mouth and blurred vision followed by difficulty swallowing slurred speech and progressive descending muscle paralysis several hours after eating home canned vegetables family members who ate the same food have mild nausea the patient becomes weak and has trouble breathing the diagnosis is _

clostridium botulinum

Case study A 7 year old child develops watery diarrhea that progresses to bloody diarrhea severe abdominal pain and decreased urine output after attending a family cookout where she ate undercooked burgers the parent reports the child now looks pale fatigued and is bruising easily the diagnosis is _

escherichia coli O157H7 Case study A 38 year old woman presents with burning urination urinary frequency urgency and suprapubic discomfort that has steadily worsened over two days she denies fever or back pain but reports that her urine smells strong and looks cloudy she recently became sexually active with a new partner and has no prior history of kidney disease the diagnosis is _

Case study A 22 year old woman presents with mild pelvic pain dysuria and a thin watery discharge after unprotected intercourse with a new partner she is afebrile but reports spotting between periods and discomfort during intercourse a pelvic exam reveals cervical motion tenderness and a nucleic acid test is positive the diagnosis is _

chlamydia

Case study A 27 year old man presents with severe burning during urination and thick yellow purulent urethral discharge that began abruptly two days after unprotected intercourse he appears uncomfortable and notes that urine dribbling causes intense pain a gram stain of urethral discharge shows intracellular diplococci the diagnosis is _

gonorrhea

Case study A 32 year old patient presents with a painless firm genital ulcer that appeared two weeks after a sexual encounter and does not hurt to touch the lesion has clean borders and mild inguinal lymphadenopathy several weeks later the patient develops a diffuse rash involving the palms and soles along with fever and malaise the diagnosis is _

syphilis

Case study A 19 year old college student presents with painful grouped vesicles around the lips that appeared during a stressful exam week the lesions burn and tingle before erupting and recur in the same location during periods of illness or fatigue the diagnosis is _

HSV1

Case study A 24 year old woman presents with painful genital ulcers fever tender inguinal lymph nodes and burning during urination she reports that the lesions began as small red bumps that progressed to tender fluid filled blisters which then ruptured the diagnosis is _

HSV2

Case study A healthcare worker arrives with intense throbbing pain swelling and clusters of fluid filled vesicles on the thumb after accidentally touching saliva during a dental procedure the finger is extremely tender and movement worsens the pain the diagnosis is _

herpes whitlow

Case study A high school wrestler develops painful clusters of vesicles on the face and ears a few days after a tournament involving close skin to skin contact he has a low grade fever swollen lymph nodes and a burning sensation in the affected area teammates also reported similar outbreaks the diagnosis is _

herpes gladiatorum

Case study A child with a history of severe eczema develops sudden widespread painful punched out erosions over eczematous skin accompanied by fever irritability and swollen lymph nodes the lesions rapidly multiply and become crusted causing the child significant discomfort the diagnosis is _

eczema herpeticum

Case study A 6 year old child develops fever malaise and a pruritic rash that starts on the trunk and spreads outward forming multiple fluid filled vesicles that eventually crust over at different stages the child was recently exposed to another classmate with similar symptoms the diagnosis is _

chicken pox

Case study A 17 year old presents with profound fatigue sore throat swollen tonsils diffuse lymphadenopathy and an enlarged tender spleen after sharing drinks at a party the patient also reports night sweats and prolonged malaise a heterophile antibody test is positive the diagnosis is _

mononucleosis

Case study A 48 year old immunocompromised man develops multiple dark purplish red vascular nodules on the legs face and inside the mouth the lesions slowly enlarge and can bleed he has unintentional weight loss and recent recurrent infections the diagnosis is _

kaposi sarcoma

Case study A 9 year old child from west africa develops a rapidly enlarging jaw mass that distorts facial structures and is associated with fever night sweats and weight loss imaging reveals a destructive bone lesion and biopsy shows starry sky appearance the diagnosis is _

burkitt lymphoma

Case study A 29 year old patient presents with persistent fever weight loss recurrent infections chronic diarrhea night sweats and generalized lymph node enlargement testing reveals a significant reduction in immune cell count after unprotected sexual exposure months earlier the diagnosis is _

HIV

Case study A 35 year old patient with known immune suppression presents with thrush chronic diarrhea wasting opportunistic infections and a dangerously low cd4 t cell count indicating progression of untreated viral infection the diagnosis is _

AIDS

Case study A patient presents with cough nasal congestion mild fever chest discomfort and wheezing after a viral upper respiratory infection lungs are clear except for mild rhonchi and symptoms worsen with cold air or exertion the diagnosis is _

viral bronchitis

Case study A 70 year old man presents with acute high fever chills shortness of breath and productive cough bringing up yellow sputum chest x ray reveals lobar consolidation and he appears weak tachycardic and diaphoretic the diagnosis is _

bacterial pneumonia

Case study A patient presents with high fever chills severe muscle aches sore throat nonproductive cough and complete exhaustion symptoms began abruptly and several coworkers are also sick the diagnosis is _

influenza

Case study A patient presents with runny nose sneezing mild sore throat congestion and low grade fever that developed gradually symptoms are mild and self limiting the diagnosis is _

common cold

Case study A college student presents with sudden high fever severe headache neck stiffness photophobia and vomiting the patient has difficulty bending the neck and appears lethargic and confused the diagnosis is _

meningitis

Case study A patient presents with fever altered mental status seizures and focal neurological deficits following a mosquito bite weeks earlier imaging shows inflammation of brain tissue the diagnosis is _

encephalitis

Case study A patient presents with fever severe headache neck stiffness confusion and seizures indicating involvement of both the brain and meninges the diagnosis is _

meningoencephalitis

Case study A traveler returns with fever agitation confusion hydrophobia difficulty swallowing and a history of being bitten by a stray animal weeks before symptoms progressed rapidly into neurological decline the diagnosis is _

rabies

Case study A patient develops fever muscle weakness headache and a diffuse rash after multiple mosquito bites while hiking neurological symptoms follow and testing confirms a mosquito borne viral infection the diagnosis is _

west nile virus

Case study A child returns from a camping trip with watery foul smelling diarrhea abdominal cramps and dehydration the stool sample reveals small oocysts and the illness worsens after drinking unfiltered river water the diagnosis is _

cryptosporidiosis

Case study A pregnant woman develops fever headache swollen lymph nodes and fatigue after cleaning a litter box and eating undercooked meat imaging shows potential fetal complications the diagnosis is _

toxoplasmosis

Case study A patient presents with fever muscle pain eyelid swelling and gastrointestinal symptoms after eating undercooked wild game days earlier followed by periorbital edema and muscle tenderness the diagnosis is _

trichinosis

Case study A hiker develops prolonged foul smelling greasy diarrhea weight loss bloating and cramping after drinking untreated stream water stool testing reveals flagellated trophozoites the diagnosis is _

giardiasis

Case study A traveler from an endemic region presents with cyclical high fevers chills sweating severe fatigue jaundice and anemia blood smear reveals parasitized red blood cells the diagnosis is _

malaria

Case study A child presents with fatigue pallor shortness of breath and pica along with itchy skin at night and a history of walking barefoot in contaminated soil the diagnosis is _

hookworm

Case study A patient from rural south america presents with fever swelling near the eye fatigue followed years later by heart arrhythmias digestive problems and megacolon after exposure to kissing bugs the diagnosis is _

american trypanosomiasis

Case study A swimmer develops fever abdominal pain diarrhea and later bloody urine after swimming in freshwater containing infected snails chronic infection leads to liver and urinary tract disease the diagnosis is _

schistosomiasis

Case study A patient presents with nausea abdominal discomfort weight loss and the passage of long flat white segments in stool after eating undercooked pork the diagnosis is _

tapeworms

A child presents with intense scalp itching visible white nits attached to hair shafts and excoriations on the scalp after sharing hats at school the diagnosis is _

pediculosis head lice

Case study A traveler presents with a painless ulcerating lesion on the arm that slowly enlarges after returning from an area with sandfly exposure the diagnosis is _

leishmaniasis

Case study A patient presents with abdominal bloating coughing up worms and seeing long white worms in stool after consuming contaminated soil or produce the diagnosis is _

ascariasis

Case study A patient develops intense itching in the pubic area with visible small lice attached to coarse hairs after sexual contact the diagnosis is _

pubic lice

Case study A patient presents with extreme itching especially at night and small burrows in the skin between fingers wrists and waistline after exposure in a crowded shelter the diagnosis is _

scabies

Case study A child presents with nocturnal itching around the anus difficulty sleeping behavioral irritability and visualizing small white threadlike worms on the perianal skin tape test is positive the diagnosis is _

enterobiasis pinworm