CASE STUDIES QUESTIONS AND ANSWERS

CASE STUDIES QUESTIONS AND
ANSWERS

G.P.,fiafi3fiyearfioldfigirl,ficomesfitofithefifreeficlinic.fiAccordingfitofiherfimother,fishefihasfisomefibright
firedfimarksfionfiherfistomachfiandfitrunkfithatfiarefipeelingfiandfialmostfilookfilikefiburns.fiG.P.fijustfire

turnedfifromfiafitwofiweekfivisitfiwithfiherfifatherfiandfiG.P.'sfimotherfiisficoncernedfiaboutfiabusefi(th
eyfiarefidivorced).fiYoufialsofilearnfithatfiG.P.'sfifatherfijustfiboughtfiherfiafipetfiguineafipigfiforfiherfibir
thday.fi-fianswer---Probablyfiringfiworm-fromfipet
-usefiClotrimazole-topicalfilamosil

Afi66fiyearfioldfimanfipresentsfitoficlinicfiforfiafipainfulfirash.fiStatesfihefistartedfitofihavefileftfisidedfirib
/
chestfipainfithatfiwasfiafiburningfisensationfiforfitwofidays,fithenfiafipainfulfirashfiappearedfionfithefiri
ghtfilateralfisidefioffithisfichest.fiThefiareafiisfiveryfitenderfiwhenfihefitouchesfiitfiandfihefiisfireluctantfit
ofiwearficlothing.



PhysicalfiExam:fileftfisidefioffichestfitherefiarefierythematousfipopularfiandfivesicularfirashfiinfiafider
matomalfidistributionfithatfidoesfinotficrossfimidline.fi-fianswer--
Whatfiisfithefivirusfimostfilikelyficausingfithisfiinfection?fiVaricellafiZoster

Whatfiisfithefimostfilikelyfidiagnosis?fiShingles

Whatfiisfithefirecommendedfitreatmentfiplan?
fisupportiveficarefiandfipainfimanagement,fimaybefiantivirals,fi



Howficanfithisfibefiprevented?fiVaccine

Afi27fiyearfioldfimanficomesfiinfitoficlinicfiwithficomplaintsfioffisorefithroat,fifever,fiandfifatigue.fiHefist
atesfisorefithroatfihasfipresentfiforfi4fidays,fiandfithefipainfimakesfiitfidifficultfitofieat.fiHisfifatiguefiisfiex
tremelyfiprofound.fiHefialsofihasfinoticedfiswollenfilymphfinodesfiinfihisfineck.fiHefihasfiassociatedfi
generalizedfiachiness.fiNofirespiratoryfisymptoms.fi

Exam:fiPosteriorfipharyngealfierythemafiwithfibilateralfitonsillarfienlargementfiwithfiexudate.fiPost
eriorficervicalfilymphadenopathyfipresent.fi-fianswer--
Whatfiisfithefivirusfimostfilikelyficausingfithisfiinfection?fiEBV-fimaybefiCMV

Whatfiisfithefimostfilikelyfidiagnosis?fiMononucleosus

Whatfiisfithefirecommendedfitreatmentfiplan?fiSupportivefiCare,finoficontactfisports

Howficanfithisfibefiprevented?fiGoodfiHygiene

, Afi4fiyearfioldfiboyfipresentsfitoficlinicfiwithfimotherfiafi1fidayfihistoryfioffiafirash.fiMotherfistatesfi4fiday
sfithefichildfistartedfitofihavefiafilowfigradefifeverfiandfiwasfiactingfi"notfilikefihisfinormalfiself,fimorefitir
ed"fiandfiafirunnyfinose.fiThenfiyesterdayfiafidiffusefirashfioffihisfiback,fichestfiandfifacefithatfiisfiitchy.
fiMotherfireportsfichildfiisfinotfiupfidatefionfihisfichildhoodfivaccinesfiandfihasfiskippedfivaccinesfisinc

efihisfi6fimonthfivaccines.fi

Exam:fi*Diffusefierythematousfivesicularfirash*fioffithefichestfiandfibackfi-fianswer--
VaricellafiZoster

ChickenfiPox

Supportiveficare,fiwatchfiforficomplicationsfisuchfiasfiPNA,fiOM

Vaccine

Afi22fiyearfioldfimanfipresentsfitoficlinicfiwithfihistoryfioffipainfulfilesionsfionfihisfi"groin."fiHefireportsfi
hefihasfiskinfiburningfiforfionefidayfiandfigeneralizedfibodyfiachinessfiandfifeelingsfioffifever.fiThenfit
hefiburningfiskinfieruptedfiintofiafipainfulfirashfionfihisfipenilefishaftfiandfilowerfipubicfiarea.fiHefihasfi
neverfihadfithesefisymptomsfibefore.fiHefiisfisexuallyfiactivefiwithfimultiplefipartners,fiandfiwearsfic
ondomsfiforficontraception.fi

Exam:fitherefiarefiscatteredfierythematousfivesicularfilesionsfiinficlustersfiatfithefibasefioffithefipubi
sfiandfipenilefishaftfithatfiarefitenderfi-fianswer--HerpesfiSimplexfiVirusfi2

GenitalfiHerpes

Supportiveficare,fiantivirals-acyclovir,fiValacyclovir.fipotentiallyfisuppressivefitherapy

Ptfieducation,fispreadfiriskfimanagement

Afi31fiyearfioldfiwomanficomesfiinfitoficlinicfiduefitofilipfisores.fiShefistatesfishefiremembersfihavingfit
hesefisoresfiasfiafichild,fibutfiresolvedfiinfiadolescence.fiShefistatesfiforfithefipastfi2fimonthsfishefiha
sfihadfiaboutfi7fioutbreaks.fiShefifeelsfiafitinglingfisensationfiinfiherfilipfiforfionefidayfiandfithenfianfi"ug
lyfisore"fiappears.fiShefireportsfinofiotherfiskinfirashesfiorfilesions.fi

Exam:fiTherefiisfiaficlusterfierythematousfibasefivesicularfilesionsfioffithefiupperfilip.fi-
fianswer--...ColdfisoreficausedfibyfiHSV-

1,fiherpesfilabialis,fisupportiveficare,fiantiviral,fisuprressivefitherapy,figoodfihygene

Afi29-year-
oldfiwomanfiwithfinofisignificantfipastfimedicalfihistoryficomesfiintoficlinicfiforfi3fidaysfiofficoughfiandfi
nasalficongestion.fiShefireportsfisymptomsfistartedfiwithfiafimildfisorefithroat,fiandfiprogressedfitofis
ignificantfinasalficongestion,fiandfiafinon-
productiveficough.fiShefihasfihadfiassociatedfiheadachefiandfifatigue.fiShefireportsfisymptomfireli
effiwithfiibuprofenfiandfi"AlkafiSeltzer"ficoldfimedicine.fiShefideniesfifevers,fichills.fiShefihasfinofiwh
eezing,fiproductivefisputum,fiorfichestfipain.