Alterations in which of the following microbial cell binding sites is the most likely cause of this resistance? (A) Lanosterol demethylase (B) Peptidyl transferase (C) Thymidine kinase (D) Topoisomerase IV (E) uridine kinase
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(59) A 60-year old woman with type-2 diabetes mellitus comes to the physician because of a 6-week history of a progressive rash under both breasts. She says that the rash irritability responded to use of an over-the-counter topical preparation containing clotrimazole, but the treatment has recently has become ineffective in relieving her symptoms. Physical examination shows a 10-cm of erythema with a mucous discharge under each breast. Her finger stick blood glucose concentration is 115 mg/dL. Microscopic examination of the discharge shows branching hyphae. The physician suspects that the causal organism in this patient is resistant to clotrimazole. Alterations in which of the following microbial cell binding sites is the most likely cause of this resistance?
(A) Lanosterol demethylase
(B) Peptidyl transferase
(C) Thymidine kinase
(D) Topoisomerase IV
(E) uridine kinase
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- A 58-year-old homeless man with long-standing insulin-treated type 2 diabetes has been diagnosed with right lower extremity cellulitis. He has taken a prescribed oral antibiotic for the past week but has not noticed much improvement. For the past 2 days, he has complained of intermittent fevers and chills, nausea with poor oral intake, and proximally spreading erythema over his right leg. On the evening of admission, a friend notices that he is markedly confused and calls 911. In the emergency room, he is oriented only to his name. The patient is tachypneic, breathing deeply at a rate of 24/min. He is febrile at 38.8°C. He is normotensive, but his heart rate is elevated at 112 bpm. On examination, this patient is a delirious, unkempt man with a fruity breath odor. His right lower extremity is markedly erythematous and exquisitely tender to palpation. Serum chemistries reveal a glucose level of 488 mg/dL, potassium of 3.7 mEq/dL, and sodium of 132 mEq/L. Urine dipstick is grossly…A 58-year-old homeless man with long-standing insulin-treated type 2 diabetes has been diagnosed with right lower extremity cellulitis. He has taken a prescribed oral antibiotic for the past week but has not noticed much improvement. For the past 2 days, he has complained of intermittent fevers and chills, nausea with poor oral intake, and proximally spreading erythema over his right leg. On the evening of admission, a friend notices that he is markedly confused and calls 911. In the emergency room, he is oriented only to his name. The patient is tachypneic, breathing deeply at a rate of 24/min. He is febrile at 38.8°C. He is normotensive, but his heart rate is elevated at 112 bpm. On examination, this patient is a delirious, unkempt man with a fruity breath odor. His right lower extremity is markedly erythematous and exquisitely tender to palpation. Serum chemistries reveal a glucose level of 488 mg/dL, potassium of 3.7 mEq/dL, and sodium of 132 mEq/L. Urine dipstick is grossly…A 52-year-old woman comes to the physician because of diffuse itching that has worsened over the past 2 weeks. Physical examination shows jaundice and an enlarged, firm liver. Laboratory studies of serum show: Total cholesterol: 620 mg/dL Alkaline phosphatase: 502 U/L AST: 120 U/L ALT: 75 U/L Anti-smooth muscle antibody: negative Antinuclear antibody: negative Antimitochondrial antibody: 1:1280 (N=negative) Which of the following pathologic findings is most likely in a biopsy specimen of her liver? Eosinophilic globules in the periportal hepatocytes. Granulomatous inflammation of hepatic bile ducts Hepatocellular carcinoma Hepatocellular necrosis with Mallory bodies Macrovesicular hepatocellular steatosis
- 89. A 65-year-old woman comes to the physician because of a 1-day history of a burning, tingling rash on her right breast. Physical examination shows several grouped vesicles on an erythematous base over the lateral aspect of the right breast; some of the vesicles have crusted over. This patient's pain sensation is most likely being transmitted via which of the following nerves? A) Ansa cervicalis B) Axillary nerve C) Fifth intercostal nerve D) Long thoracic nerve E) Posterior cervical plexusA) The following signs and symptoms occurs with an anxious patient: Maculopapular rash, Artharlgia, Pyuria, wheezing and chest tightness. The lab. Results indicate the elevation in eosinophil and serum immunoglobulin E. Describe the different diseases he may suffer from? Explain your answer. B) How you can treat the patient who is suffering from dehydration resulting from severe diarrhea and metabolic acidosis.A 5-year-old boy is brought to the physician with itchy, bilateral erythematous skin lesions on the flexural surfaces of the elbow and knees for the past one week (image attached). He has had similar lesions on and off for the past four years. His mother mentions that his older sister also has similar lesions. His laboratory parameters show an increased number of eosinophils. Which of the following conditions is most likely associated with this disorder? Answers A-E A Bronchial asthma B Deforming joint disease C Gluten sensitivity D Hepatitis C virus infection E Underlying malignancy O O O Question # 35 attachment Q Q
- A 5-year-old boy is brought to the physician with itchy, bilateral erythematous skin lesions on the flexural surfaces of the elbow and knees for the past one week (image attached). He has had similar lesions on and off for the past four years. His mother mentions that his older sister also has similar lesions. His laboratory parameters show an increased number of eosinophils. Which of the following conditions is most likely associated with this disorder? Answers A - E A Bronchial asthma B Deforming joint disease C Gluten sensitivity D Hepatitis C virus infection E Underlying malignancy O O Question # 35 attachment148. A 42-year-old man has persistent swelling and tenderness of his right great toe joint Turbid fluid aspirated from the joint contains many leukocytes, as well as microscopic extracellular and intracellular birefringent crystals. A routine serum chemistry profile shows a uric acid concentration of 10.2 mg/dL. Which of the following is most likely to act as an inflammatory chemoattractant in his joint? A) Bradykinin B) Eosinophil chemotactic factor C) Histamine D) Leukotriene B4 E) Prostaglandin E2A patient being treated for metastatic carcinoma was found to have a white cell count of 5 x 10°/L with 5 metarubricytes (nucleated red cells) per 100 WBCs. What is the corrected white cell count for this patient?
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