I HUMAN CASE WEEK 2 60 2026 SOLVED
QUESTIONS ANSWERS GRADED A PLUS
EVIDENCE BASED PATIENT CARE HANDBOOK
◉ A lethargic 22-month old black female was presented by her
mother to the emergency room at 2:15am on a Sunday. The child
had a history of a runny nose, hoarse cough and low-grade fever
(~99F) for the past 48 hours. The mother was concerned about the
forced and noisy breathing of the child. The pediatrician examined
the child and found cloudy eyes and mild inflammation of the ears,
but no overt signs of bacterial infection (no significant changes in
the eardrums). The throat of the child was red and coated with
mucus. The larynx was swollen and raw. The physician performed a
rapid Strep test and found it was negative. Throat swabs were taken
for culture. The physician placed the child in a room with a warm
vaporizer for about 30 minutes. This dramatically improved the
breathing of the child.
Answer: Diagnosis: Croup = An upper airway infection that blocks
breathing and has a distinctive barking cough; may begin like a cold,
progress into barking cough due to swelling of vocal cords
Cause: parainfluenza virus
Transmission: Respiratory droplets
Treatment: supportive care, steroids
Prevention: good hygiene, avoiding contact with infected
Susceptibility: generally occurs in children
,◉ A 22-year old male college student was presented at the ESU
health clinic. He looked tired and pale. He presented because of high
fever and chest pain. He was afraid he was having a heart attack (bad
week of exams). He was examined immediately by the PA and an
EKG strip was run. He had no evidence of acute heart problems. The
attending physician visited the patient. He obtained the following
history from the past 36 hours. The patient had a tight cough. He had
significant muscle aches and pains. He had a bad headache and had
had fevers of 101-103F.
The physician ordered a chest x-ray. It did not show any significant
consolidated inflammation suggestive of pneumonia. The patient
showed significant nasal drainage and a moderately tight, but
productive cough on physical exam. He had a fever of 101F and
generally inflamed mucous membranes. A rapid Strep test showed
no evidence of Streptococcal infection and his tonsils a
Answer: Diagnosis: Influenza
Cause: Influenza virus types A and B
- Enveloped RNA virus
- Hemagglutinin and neuraminidase mutations produce the ever
changing array of strains
- Mutations occur via antigenic shift and drift
Transmission: via inhalation of airborne viruses or self-inoculations
Prevention: good hygiene, vaccine
Treatment: antiviral drugs in first 48 hours and shorten duration;
supportive care for symptoms
,Complications: Bacterial pneumonia - occur most often in elderly,
children, and those with chronic disease
◉ A 68-year old patient with Alzheimer disease was brought to the
emergency room by the staff of a local nursing home. He presented
as lethargic with a sallow complexion. He had an admission
temperature of 102.4F and a respiratory rate of 33/minute. During
respiration, the right side of his chest moved better than the left. He
showed dense consolidation of the lower lobe of the left lung on
physical exam. A sputum sample revealed blood and a greenish
color.
A chest x-ray showed tight consolidation of the left lung with
evidence of formation of cavities in the lung tissue from cytotoxic
damage. The patient complained of chills in the exam room,
combined with his fever. A smear of his sputum demonstrated no
acid-fast bacteria.
Answer: Diagnosis: Klebsiella Pneumonia (leading cause of
nosocomial death)
- Gram stain would reveal gram negative, rod shaped, with capsule
- TB ruled out because it is not acid-fast bacteria
- green sputum indicates bacterial infection
Cause: Klebsiella pneumoniae
Transmission/Portal of entry: inhalation
Treatment: antibiotic therapy and supportive care
, Prevention: hygiene and ascriptive techniques by health care
workers
Susceptibility: AIDS patients, very young, very old, people living in
nursing homes, jails, hospitals
◉ A 35-year old accountant presented to his physician with a steady
burning pain just right of the mid-line of the abdominal region in an
area from 1 to 4 inches above the "belly button." The pain usually
followed meals by about 1-3 hours. He had several episodes of
vomiting, which included frank blood.
On physical examination, the patient had no fever. He appeared
generally well. He had no evidence of weight loss. He showed slight
rebound tenderness in the upper abdomen. An occult blood test
revealed the presence of blood.
Answer: Diagnosis: Peptic Ulcers
Cause: Helicobacter pylori
- blood in vomit indicates bleeding ulcer (upper respiratory)
Transmission: Fecal-oral
Susceptibility: those colonized by H. pylori
Treatment: antimicrobial and acid blocking drugs
Prevention: lifestyle changes
◉ A 4-year old girl presents at the emergency room with bloody
diarrhea, fever and vomiting. The child's mother reports that the
QUESTIONS ANSWERS GRADED A PLUS
EVIDENCE BASED PATIENT CARE HANDBOOK
◉ A lethargic 22-month old black female was presented by her
mother to the emergency room at 2:15am on a Sunday. The child
had a history of a runny nose, hoarse cough and low-grade fever
(~99F) for the past 48 hours. The mother was concerned about the
forced and noisy breathing of the child. The pediatrician examined
the child and found cloudy eyes and mild inflammation of the ears,
but no overt signs of bacterial infection (no significant changes in
the eardrums). The throat of the child was red and coated with
mucus. The larynx was swollen and raw. The physician performed a
rapid Strep test and found it was negative. Throat swabs were taken
for culture. The physician placed the child in a room with a warm
vaporizer for about 30 minutes. This dramatically improved the
breathing of the child.
Answer: Diagnosis: Croup = An upper airway infection that blocks
breathing and has a distinctive barking cough; may begin like a cold,
progress into barking cough due to swelling of vocal cords
Cause: parainfluenza virus
Transmission: Respiratory droplets
Treatment: supportive care, steroids
Prevention: good hygiene, avoiding contact with infected
Susceptibility: generally occurs in children
,◉ A 22-year old male college student was presented at the ESU
health clinic. He looked tired and pale. He presented because of high
fever and chest pain. He was afraid he was having a heart attack (bad
week of exams). He was examined immediately by the PA and an
EKG strip was run. He had no evidence of acute heart problems. The
attending physician visited the patient. He obtained the following
history from the past 36 hours. The patient had a tight cough. He had
significant muscle aches and pains. He had a bad headache and had
had fevers of 101-103F.
The physician ordered a chest x-ray. It did not show any significant
consolidated inflammation suggestive of pneumonia. The patient
showed significant nasal drainage and a moderately tight, but
productive cough on physical exam. He had a fever of 101F and
generally inflamed mucous membranes. A rapid Strep test showed
no evidence of Streptococcal infection and his tonsils a
Answer: Diagnosis: Influenza
Cause: Influenza virus types A and B
- Enveloped RNA virus
- Hemagglutinin and neuraminidase mutations produce the ever
changing array of strains
- Mutations occur via antigenic shift and drift
Transmission: via inhalation of airborne viruses or self-inoculations
Prevention: good hygiene, vaccine
Treatment: antiviral drugs in first 48 hours and shorten duration;
supportive care for symptoms
,Complications: Bacterial pneumonia - occur most often in elderly,
children, and those with chronic disease
◉ A 68-year old patient with Alzheimer disease was brought to the
emergency room by the staff of a local nursing home. He presented
as lethargic with a sallow complexion. He had an admission
temperature of 102.4F and a respiratory rate of 33/minute. During
respiration, the right side of his chest moved better than the left. He
showed dense consolidation of the lower lobe of the left lung on
physical exam. A sputum sample revealed blood and a greenish
color.
A chest x-ray showed tight consolidation of the left lung with
evidence of formation of cavities in the lung tissue from cytotoxic
damage. The patient complained of chills in the exam room,
combined with his fever. A smear of his sputum demonstrated no
acid-fast bacteria.
Answer: Diagnosis: Klebsiella Pneumonia (leading cause of
nosocomial death)
- Gram stain would reveal gram negative, rod shaped, with capsule
- TB ruled out because it is not acid-fast bacteria
- green sputum indicates bacterial infection
Cause: Klebsiella pneumoniae
Transmission/Portal of entry: inhalation
Treatment: antibiotic therapy and supportive care
, Prevention: hygiene and ascriptive techniques by health care
workers
Susceptibility: AIDS patients, very young, very old, people living in
nursing homes, jails, hospitals
◉ A 35-year old accountant presented to his physician with a steady
burning pain just right of the mid-line of the abdominal region in an
area from 1 to 4 inches above the "belly button." The pain usually
followed meals by about 1-3 hours. He had several episodes of
vomiting, which included frank blood.
On physical examination, the patient had no fever. He appeared
generally well. He had no evidence of weight loss. He showed slight
rebound tenderness in the upper abdomen. An occult blood test
revealed the presence of blood.
Answer: Diagnosis: Peptic Ulcers
Cause: Helicobacter pylori
- blood in vomit indicates bleeding ulcer (upper respiratory)
Transmission: Fecal-oral
Susceptibility: those colonized by H. pylori
Treatment: antimicrobial and acid blocking drugs
Prevention: lifestyle changes
◉ A 4-year old girl presents at the emergency room with bloody
diarrhea, fever and vomiting. The child's mother reports that the
