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|AnswerDExp=Incorrect.  Oval yeast cells within macrophages is commonly is a feature commonly seen in histoplasmosis.
|AnswerDExp=Incorrect.  Oval yeast cells within macrophages is commonly is a feature commonly seen in histoplasmosis.
|AnswerE=Broad-base budding
|AnswerE=Broad-base budding
|AnswerEExp=Incorrect.  Broad-base budding is a pathognomic feature seen in blastomycosis.
|AnswerEExp=Incorrect.  Broad-base budding is a pathognomonic feature seen in blastomycosis.
|RightAnswer=B
|RightAnswer=B
|Approved=No
|Approved=No
}}
}}

Revision as of 12:26, 9 September 2013

 
Author [[PageAuthor::Ayokunle Olubaniyi, M.B,B.S [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Microbiology
Sub Category SubCategory::Endocrine, SubCategory::Infectious Disease
Prompt [[Prompt::A 40 year old male was rushed in unconscious to the ER after his wife found him. Laboratory studies revealed a pH of 7.10 and the serum was positive for ketones. He was subsequently treated for diabetic ketoacidosis and his condition improved. On day three, he developed fever, headache and eye pain. Examination of the nasal cavity revealed a black necrotic eschar. Which of the following is needed to make a diagnosis.]]
Answer A AnswerA::Presence of pseudohyphae
Answer A Explanation AnswerAExp::Incorrect. Presence of pseudohyphae is a feature seen in Candida albicans infection
Answer B AnswerB::Broad non-septate hyphae with right angled branching
Answer B Explanation AnswerBExp::Correct. Broad non-septate hyphae with right angled branching is a feature seen in mucormycosis
Answer C AnswerC::Septate hyphae with V-shaped branching
Answer C Explanation AnswerCExp::Incorrect. Septate hyphae with V-shaped branching is a feature seen in Aspergillus infections.
Answer D AnswerD::Oval yeast cells within macrophages
Answer D Explanation AnswerDExp::Incorrect. Oval yeast cells within macrophages is commonly is a feature commonly seen in histoplasmosis.
Answer E AnswerE::Broad-base budding
Answer E Explanation AnswerEExp::Incorrect. Broad-base budding is a pathognomonic feature seen in blastomycosis.
Right Answer RightAnswer::B
Explanation [[Explanation::Fever, headache and facial pain in a diabetic patient with diabetic ketoacidosis is highly suggestive of Mucormycosis – caused by Mucor, Rhizopus and Absidia. Rhizopus has a high affinity for ketones, and the black necrotic eschar in the nasal cavity is a characteristic finding. These fungi show broad non-septate hyphae with right angled branching. Treatment consists of surgical debridement and amphotericin B.

Educational Objective:
References: ]]

Approved Approved::No
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