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|MainCategory=Microbiology
|MainCategory=Microbiology
|SubCategory=Neurology, Infectious Disease
|SubCategory=Neurology, Infectious Disease
|Prompt=A 28 year old woman has developed an inflammatory disease causing demyelination of peripheral nerves.  He began experiencing numbness in his toes which progressed to distal muscle weakness of his lower limb and has now progressed to include the entire lower limb and the distal upper limb.  CSF findings include increased protein with a normal cell count.  The patient is started on IV Ig.  Which of the following describes the organism most likely to have infected this patient prior to his developing this condition?
|Prompt=A 28-year-old male has developed an inflammatory disease causing demyelination of peripheral nerves.  He began experiencing numbness in his toes which progressed to distal muscle weakness of his lower limb and has now progressed to include the entire lower limb and the distal upper limb.  CSF findings include increased protein with a normal cell count.  The patient is started on intravenous immunoglubulin.  Which of the following describes the organism most likely to have infected this patient prior to his developing this condition?
|Explanation= The patient in this vignette has Guillain-Barre syndrome, a progressive autoimmune demyelinating disease of peripheral nerves.  Guillain-Barre is known to be preceded by Campylobacter Jejuni in particular.  Campylobacter jejuni is a comma shaped, oxidase positive, gram negative organism which grows at 42C.
|Explanation=The patient in this vignette has Guillain-Barré syndrome, a progressive autoimmune demyelinating disease of peripheral nerves.  Guillain-Barré is known to be preceded by Campylobacter jejuni in particular.  Campylobacter jejuni is a comma shaped, oxidase positive, gram negative organism that grows at 42C.
 
Educational Objective: Guillain-Barre is known to be preceded by Campylobacter Jejuni, a Comma shaped, oxidase positive, gram negative organism with grows at 42C.
#Microbiology #Neurology
 
|AnswerA=Comma shaped, oxidase positive, gram negative organism which grows at 42C.
|AnswerA=Comma shaped, oxidase positive, gram negative organism which grows at 42C.
|AnswerAExp=Correct - See Explanation
|AnswerAExp=Campylobacter jejuni is a comma shaped, oxidase positive, gram negative organism which grows at 42C. 
|AnswerB=Gram positive rod with tumbling motility
|AnswerB=Gram positive rod with tumbling motility
|AnswerBExp=Incorrect - This describes Listeria monocytogenes.
|AnswerBExp=Listeria monocytogenes is a gram-positive rod with tumbling motility.  L. monocytogenes causes meningitis in newborns and may cause food-borne illness through ingestion of unpasteurized milk.
|AnswerC=Gram negative, urease positive rod.
|AnswerC=Gram negative, urease positive rod.
|AnswerCExp=Incorrect - This describes Helicobacter Pylori.
|AnswerCExp=Helicobacter pylori is a gram negative, urease positive rod that causes gastric ulcers.
|AnswerD=Gram positive, spore forming rod
|AnswerD=Gram positive, spore forming rod
|AnswerDExp=Incorrect - This describes Clostridium species and Baccilus anthracis.
|AnswerDExp=[[Clostridium]] species and [[Baccilus anthracis]] are both gram positive, spore forming rods.
|AnswerE=Lancet shaped, gram positive diplococci.
|AnswerE=Lancet shaped, gram positive diplococci.
|AnswerEExp=Incorrect - This describes Strep. Pneumoniae.
|AnswerEExp=Streptococcus pneumoniae is a lancet shaped, gram positive diplococcus.
|EducationalObjectives= Guillain-Barré is known to be preceded by Campylobacter Jejuni, a Comma shaped, oxidase positive, gram negative organism with grows at 42C.
|References=First Aid 2014 page 140 (Camplyobacter)
First Aid 2014 page 484 (Guillan-Barré)
|RightAnswer=A
|RightAnswer=A
|WBRKeyword=Microbiology, Neurology, Bacteria, Gram stain, Autoimmune, Autoimmunity, Guillan-Barré, GBS, Campylobacter,  Campylobacter jejuni
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 22:00, 15 March 2014

 
Author PageAuthor::William J Gibson
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Microbiology
Sub Category SubCategory::Neurology, SubCategory::Infectious Disease
Prompt [[Prompt::A 28-year-old male has developed an inflammatory disease causing demyelination of peripheral nerves. He began experiencing numbness in his toes which progressed to distal muscle weakness of his lower limb and has now progressed to include the entire lower limb and the distal upper limb. CSF findings include increased protein with a normal cell count. The patient is started on intravenous immunoglubulin. Which of the following describes the organism most likely to have infected this patient prior to his developing this condition?]]
Answer A AnswerA::Comma shaped, oxidase positive, gram negative organism which grows at 42C.
Answer A Explanation AnswerAExp::Campylobacter jejuni is a comma shaped, oxidase positive, gram negative organism which grows at 42C.
Answer B AnswerB::Gram positive rod with tumbling motility
Answer B Explanation AnswerBExp::Listeria monocytogenes is a gram-positive rod with tumbling motility. L. monocytogenes causes meningitis in newborns and may cause food-borne illness through ingestion of unpasteurized milk.
Answer C AnswerC::Gram negative, urease positive rod.
Answer C Explanation AnswerCExp::Helicobacter pylori is a gram negative, urease positive rod that causes gastric ulcers.
Answer D AnswerD::Gram positive, spore forming rod
Answer D Explanation [[AnswerDExp::Clostridium species and Baccilus anthracis are both gram positive, spore forming rods.]]
Answer E AnswerE::Lancet shaped, gram positive diplococci.
Answer E Explanation AnswerEExp::Streptococcus pneumoniae is a lancet shaped, gram positive diplococcus.
Right Answer RightAnswer::A
Explanation [[Explanation::The patient in this vignette has Guillain-Barré syndrome, a progressive autoimmune demyelinating disease of peripheral nerves. Guillain-Barré is known to be preceded by Campylobacter jejuni in particular. Campylobacter jejuni is a comma shaped, oxidase positive, gram negative organism that grows at 42C.

Educational Objective: Guillain-Barré is known to be preceded by Campylobacter Jejuni, a Comma shaped, oxidase positive, gram negative organism with grows at 42C.
References: First Aid 2014 page 140 (Camplyobacter) First Aid 2014 page 484 (Guillan-Barré)]]

Approved Approved::Yes
Keyword WBRKeyword::Microbiology, WBRKeyword::Neurology, WBRKeyword::Bacteria, WBRKeyword::Gram stain, WBRKeyword::Autoimmune, WBRKeyword::Autoimmunity, WBRKeyword::Guillan-Barré, WBRKeyword::GBS, WBRKeyword::Campylobacter, WBRKeyword::Campylobacter jejuni
Linked Question Linked::
Order in Linked Questions LinkedOrder::