COMPREHENSIVE CASE STUDY WEEK
SEVEN SCRIPT 2026 COMPLETE ANSWERS
GRADED A+
⩥ 2. A 24-year-old woman in her third trimester of pregnancy presents
with urinary frequency and burning for the past few days. She denies
fever, nausea, vomiting, or chills. She takes no medications besides
prenatal vitamins and is generally in good health. Physical examination
is remarkable for mild suprapubic tenderness, and a urine dipstick is
positive for white blood cells, protein, and a small amount of blood.
Culture produces greater than 100,000 colonies of gram-negative bacilli.
Which of the following attributes of this uropathogenic organism is most
strongly associated with its virulence?
1) Bundle-forming pili
2) Type 1 pili
3) Heat labile toxins
4) Heat stable toxins
5) P-pili. Answer: 5) P-pili
⩥ 3. A 35-year-old man presents to the emergency department with
intense back pain. He is hydrated and given pain medication. After
several hours he passes a kidney stone. Laboratory analysis of the stone
reveals that it composed of struvite (magnesium ammonium phosphate).
Infection with which of the following organisms promotes the
production of such stones?
,1) Escherichia coli
2) Proteus mirabilis
3) Pseudomonas aeruginosa
4) Staphylococcus saprophyticus
5) Ureaplasma urealyticum. Answer: 2) Proteus mirabilis
⩥ 4. A 47-year-old man with a history of sickle cell disease has had
numerous hospitalizations requiring the placement of IV lines. The
patient has poor peripheral venous access, and a catheter is placed in
right subclavian vein. The patient subsequently develops right arm
discomfort and swelling and a temperature of 40.1 C with chills.
Multiple blood cultures are taken, and gram-positive cocci are isolated.
The organism is catalase-positive and produces whitish colonies on
mannitol salt agar. The colonies are gamma-hemolytic on sheep blood
agar. Which of the following organisms is the most likely cause of this
patient's symptoms?
1) Enterococcus faecalis
2) Staphylococcus aureus
3) Staphylococcus epidermidis
4) Streptococcus agalactiae
5) Streptococcus pyogenes. Answer: 3) Staphylococcus epidermidis
⩥ 5. A 7-year-old boy presents to the pediatrician because his mother
noticed a "smoky" color to his urine. On questioning the mother, it is
revealed that the child had a sore throat several weeks ago that was left
,untreated. Physical examination reveals hypertension and mild
generalized edema. Urinalysis is significant for red blood cell casts.
Which of the following accurately describes the microorganism
responsible for this child's illness?
1) It causes alpha-hemolysis on blood agar
2) It is catalase-positive
3) It is coagulase-positive
4) It is sensitive to bacitracin
5) It is sensitive to optochin. Answer: 4) It is sensitive to bacitracin
⩥ 6. A baby born at 32 weeks' gestation with Apgar scores of 2 and 7
was placed in the neonatal intensive care unit. She developed a fever and
leukocytosis; lumbar puncture revealed pleocytosis with increased
protein, decreased glucose, and gram-positive rods. Which of the
following organisms was most likely isolated from the CSF?
1) Escherichia coli
2) Listeria monocytogenes
3) Neisseria meningitidis
4) Streptococcus agalactiae
5) Streptococcus pneumoniae. Answer: 2) Listeria monocytogenes
⩥ 7. After eating a dinner of leftovers that included rewarmed vegetable
fried rice, a 17-year-old boy develops diarrhea and stomach pain. Which
of the following is the most likely pathogen?
, 1) Bacillus cereus
2) Campylobacter jejuni
3) Clostridium difficile
4) Listeria mocytogenes
5) Shigella dysenteriae. Answer: 1) Bacillus cereus
⩥ 8. A 16-year-old boy with sickle cell disease is hospitalized for a
severe infection. His spleen has autosplenectomized, and he has had
other minor infections in the past. His symptoms include fever, chills,
cough, and chest pain. Bacteria from the patient's sputum are optochin-
sensitive organisms with a positive Quellung reaction. Which of the
following is the most likely pathogen?
1) Escherichia coli
2) Haemophilus influenzae
3) Klebsiella pneumoniae
4) Neisseria gonorrhoeae
5) Streptococcus pneumoniae. Answer: 5) Streptococcus pneumoniae
⩥ 9. A 3-year-old boy presents with a 1 -day history of loose stools,
fever, abdominal cramping, headache, and myalgia. He has no blood in
the stool. A careful history reveals that he has several pet turtles. Which
of the following is the most likely pathogen?
1) Corynebacterium diphtheriae
2) Serratia marcescens
SEVEN SCRIPT 2026 COMPLETE ANSWERS
GRADED A+
⩥ 2. A 24-year-old woman in her third trimester of pregnancy presents
with urinary frequency and burning for the past few days. She denies
fever, nausea, vomiting, or chills. She takes no medications besides
prenatal vitamins and is generally in good health. Physical examination
is remarkable for mild suprapubic tenderness, and a urine dipstick is
positive for white blood cells, protein, and a small amount of blood.
Culture produces greater than 100,000 colonies of gram-negative bacilli.
Which of the following attributes of this uropathogenic organism is most
strongly associated with its virulence?
1) Bundle-forming pili
2) Type 1 pili
3) Heat labile toxins
4) Heat stable toxins
5) P-pili. Answer: 5) P-pili
⩥ 3. A 35-year-old man presents to the emergency department with
intense back pain. He is hydrated and given pain medication. After
several hours he passes a kidney stone. Laboratory analysis of the stone
reveals that it composed of struvite (magnesium ammonium phosphate).
Infection with which of the following organisms promotes the
production of such stones?
,1) Escherichia coli
2) Proteus mirabilis
3) Pseudomonas aeruginosa
4) Staphylococcus saprophyticus
5) Ureaplasma urealyticum. Answer: 2) Proteus mirabilis
⩥ 4. A 47-year-old man with a history of sickle cell disease has had
numerous hospitalizations requiring the placement of IV lines. The
patient has poor peripheral venous access, and a catheter is placed in
right subclavian vein. The patient subsequently develops right arm
discomfort and swelling and a temperature of 40.1 C with chills.
Multiple blood cultures are taken, and gram-positive cocci are isolated.
The organism is catalase-positive and produces whitish colonies on
mannitol salt agar. The colonies are gamma-hemolytic on sheep blood
agar. Which of the following organisms is the most likely cause of this
patient's symptoms?
1) Enterococcus faecalis
2) Staphylococcus aureus
3) Staphylococcus epidermidis
4) Streptococcus agalactiae
5) Streptococcus pyogenes. Answer: 3) Staphylococcus epidermidis
⩥ 5. A 7-year-old boy presents to the pediatrician because his mother
noticed a "smoky" color to his urine. On questioning the mother, it is
revealed that the child had a sore throat several weeks ago that was left
,untreated. Physical examination reveals hypertension and mild
generalized edema. Urinalysis is significant for red blood cell casts.
Which of the following accurately describes the microorganism
responsible for this child's illness?
1) It causes alpha-hemolysis on blood agar
2) It is catalase-positive
3) It is coagulase-positive
4) It is sensitive to bacitracin
5) It is sensitive to optochin. Answer: 4) It is sensitive to bacitracin
⩥ 6. A baby born at 32 weeks' gestation with Apgar scores of 2 and 7
was placed in the neonatal intensive care unit. She developed a fever and
leukocytosis; lumbar puncture revealed pleocytosis with increased
protein, decreased glucose, and gram-positive rods. Which of the
following organisms was most likely isolated from the CSF?
1) Escherichia coli
2) Listeria monocytogenes
3) Neisseria meningitidis
4) Streptococcus agalactiae
5) Streptococcus pneumoniae. Answer: 2) Listeria monocytogenes
⩥ 7. After eating a dinner of leftovers that included rewarmed vegetable
fried rice, a 17-year-old boy develops diarrhea and stomach pain. Which
of the following is the most likely pathogen?
, 1) Bacillus cereus
2) Campylobacter jejuni
3) Clostridium difficile
4) Listeria mocytogenes
5) Shigella dysenteriae. Answer: 1) Bacillus cereus
⩥ 8. A 16-year-old boy with sickle cell disease is hospitalized for a
severe infection. His spleen has autosplenectomized, and he has had
other minor infections in the past. His symptoms include fever, chills,
cough, and chest pain. Bacteria from the patient's sputum are optochin-
sensitive organisms with a positive Quellung reaction. Which of the
following is the most likely pathogen?
1) Escherichia coli
2) Haemophilus influenzae
3) Klebsiella pneumoniae
4) Neisseria gonorrhoeae
5) Streptococcus pneumoniae. Answer: 5) Streptococcus pneumoniae
⩥ 9. A 3-year-old boy presents with a 1 -day history of loose stools,
fever, abdominal cramping, headache, and myalgia. He has no blood in
the stool. A careful history reveals that he has several pet turtles. Which
of the following is the most likely pathogen?
1) Corynebacterium diphtheriae
2) Serratia marcescens
