5.0 of 6 Ratings
A 22-year-old female is brought to the emergency department by her roommate with a one day history of fever and malaise. She did not feel well after class the previous night and has been in her room since then. She has not been eating or drinking due to severe nausea. Her roommate checked on her one hour ago and was alarmed to find a fever of 102°F (38.9°C). On physical exam temperature is 103°F (40°C), blood pressure is 110/66 mmHg, pulse is 110/min, respirations are 23/min, and pulse oximetry is 98% on room air. She refuses to move her neck and has a rash on her trunk. You perform a lumbar puncture and the CSF analysis is shown below.Appearance: CloudyOpening pressure: 180 mm H2OWBC count: 150 cells/µL (93% PMN)Glucose level: < 40 mg/dL Protein level: 50 mg/dLGram stain: gram-negative diplococci Based on this patient's clinical presentation, which of the following should most likely be administered?
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A 19-year-old college student is brought to the emergency department by her roommate. Her roommate reports that the patient was complaining of a headache this morning. A few hours later, the patient seemed lethargic and confused. In the emergency department, the patient's vital signs are as follows: HR 98, BP 110/70, T 38.7 degrees Celsius. Her neurological exam is notable for flexion at the hips when her neck is passively flexed. A lumbar puncture is performed, and Gram stain results are shown in Figure A. Which of the following bacterial structures does the involved organism use to adhere to the nasopharynx?
An 18-year-old male in his first year of college presents to the emergency room with a fever and a severe headache. He reports having unprotected sex with several partners over the past few weeks. Upon examination, the male demonstrates nuchal rigidity and photophobia. His past medical history is notable for a lack of vaccinations beginning from infancy due to his parents' belief that vaccinations may cause autism. The bacteria causing these symptoms would most likely demonstrate which of the following?
Positive quellung reaction
Negative quellung reaction
Negative catalase test
A 15-year-old female is brought to the emergency room with high fever and confusion. She complains of chills and myalgias, and physical examination reveals a petechial rash. Petechial biopsy reveals a Gram-negative diplococcus. The patient is at greatest risk for which of the following?
Bilateral adrenal destruction
Pelvic inflammatory disease
A 19-year-old man is admitted to the medical intensive care unit with suspected sepsis. Blood cultures grow Gram-negative cocci containing lipooligosaccharide in their cell wall. Which of the following would you expect to find on a detailed history and physical examination of this patient?
History of consuming undercooked beef
History of exposure to rabbit hides
Rice water stools