Saturday, August 4, 2018

Repeated USMLE Questions Step 1- 224

A 35-year-old man comes to the clinic complaining of myalgias and fever. Two weeks ago, he had experienced a brief, self-limited spell of diarrhea after going to a barbecue party. After that, there were no more symptoms and the patient remained asymptomatic till yesterday night. He complains of fever of 103oF (39.4oC), severe muscle pain, and conjunctivitis. Physical examination shows that the patient is acutely ill with a high fever. There is also generalized muscular soreness along with a diffuse maculopapular rash. Several minute hemorrhages can be seen under his fingernails. A hemogram performed at the time of admission shows white blood cell count of 15,000/mm3 with 30% eosinophils.

Which causative agent is likely responsible for his infection?

A- Ovum

B- Cyst

C- Encysted larvae

D- Rhabditiform larvae


This patient is likely suffering from being infected by encysted larvae, also known as trichinosis. Infection occurs when humans have undercooked pork products. The common symptoms of infection include vomiting, sweating, diarrhea, facial edema, fever, intense muscle pain, low blood pressure, weakening of pulse, difficulty breathing, heart damage, etc. In severe cases, the condition may eventually lead to death from heart failure, kidney malfunction, or respiratory complications.

The correct answer is C

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