Clinical Case Based Questions in Microbiology

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  1. 20-year-old man admitted with fever for five days duration associated with chills and rigour. on examination splenomegaly.
    1.  what is your most probable diagnosis
    2. describe the life cycle of the causative agent
    3.  how will you confirm the diagnosis in the lab ?
  2. A 35 year old female commercial sexual worker with history of sexual contact with many clients is diagnosed to be suffering from cervical cancer the cancer is linked to a viral aetiology which is found worldwide
    1. Name the CAUSATIVE viral agent of the cervical cancer
    2. How will you diagnose the condition in the laboratory
    3. Enumerate sexually transmitted viral diseases
  3. 5-year-old child with high fever and severe pain in throat. O/E patient was toxic and white, grey membrane seen over the tonsils. probable diagnosis?
    1. Diagnosis?  ⭐
    2. write pathogenesis
    3. lab diagnosis 
  4. A nurse has needle stick injury while performing phlebotomy. The patient’s HIV and HBV status is unknown the patient is refusing to get tested for HIV. How do you convince the patient to get tested ?⭐⭐
  5. Discuss about issuing of wrong report to a patient in a ward.
  6. A 23-year-old male patient from an endemic area came to the OPD with complaints of intermittent fever with chills and rigours. For the past three days there was intense sweating following each fever episode. On examination, he was febrile with temperature of 101 degree Fahrenheit and had mild splenomegaly. Peripheral smear study shows presence of parasites inside RBC.
    1. Causative agent?
    2. Vector?
    3. Life cycle of causative agent.
    4. Pathogenicity of causative agent
    5. Lab diagnosis of causative agent
    6. Complications of this parasite.
  7. An eight-year-old boy with complaints of fever, headache, pain in the right ear, along with purulent air discharge for 3 days. Sample is inoculated on blood Agar and Mac-Conkey’s agar and incubated for 18 to 24 hours. Observation: –
    1. Blood agar: spreading type of colonies forming a thin, filmy layer of swarming growth with fishy odour is seen.
    2. Mac-A agar: moist non lactose fermenting colonies are seen.
    3. Hanging drop preparation: Motile bacilli.
    4. Oxidase Test: -ve
    5. Catalase Test: +ve
    6. Indole Test: +ve
    7. Citrate Test: Citrate not utilised.
    8. Urease Test: Urea is hydrolysed
    9. TSI: Shows Alkaline slant/acid but with abundant H2S gas.
    10. PPA: +ve. Based on these, answer:-
      1. Probable clinical diagnosis?
      2. Lab Diagnosis?
      3. Name the organism isolated.
  8. An 8-year-old boy brought to casualty with complaints of high-grade fever, severe joint pain, back pain, and myalgia. Gradually He developed petechial rashes over the body. On examination, he was found to have jaundice, hepatomegaly, and low platelet count with 25,000 per mm cube. A torniquet test done over cubital fossa shows petechial spots.
    1. Clinical diagnosis?
    2. How is the disease transmitted?
    3. Lab diagnosis?
    4. Complications?
    5. Name 4 differential diagnosis for rashes on human body
  9. A 28-year-old male came to OP with history of RTA 3 days before and he was diagnosed as fracture of tibia. Now he has pain and swelling at the test site. On examination there was tenderness and crepitation.
    1. Diagnosis?
    2. Causative Agents?
    3. Lab Diagnosis?
  10. A 28-year-old male was admitted to the hospital with complaints of low-grade fever loss of weight and appetite and chronic cough with expectoration for the past 6 months. Sputum examination revealed tiny slender and beaded acid-fast bacilli.
    1. Provisional diagnosis?
    2. Describe the pathogenesis
    3. Lab diagnosis
    4. Mention briefly about drug resistance that can occur in this etiological agent.
  11. A 40-year-old male presented with history of loss of appetite, malaria, and jaundice of 2 months duration. O/E, there was icterus, hepatomegaly, and tenderness in the right hypochondriac region. He gave a history of blood transfusion in the past. On lab examination he was found to be positive for HBsAg.
    1. Probable etiological diagnosis?
    2. Lab diagnosis?
  12. A young lady was brought to the emergency department with complaints of fever, headache, and projectile vomiting on examination. Neck rigidity was noted.
    1.  What are the possible agents responsible for this condition?
    2. Describe the lab diagnosis of this case.
    3. Is there any prophylactic measure to prevent such clinical condition ?explain if any.
  13. A young man was admitted in medicine ward with a history of fever, cough with expectoration and loss of weight for 15 days. Chest X-ray revealed diffused haziness, sputum culture on LJ medium was negative after 10 days and ESR was raised.
    • Diagnose the condition.
    • Discuss the methods of laboratory diagnosis.
    • Add a note on recent methods of diagnosis of this condition.
    • Describe the vaccines available against the disease
  14. A 29-year-old female came to casualty with complaints of high-grade fever, severe joint pain, back pain and myalgia. Gradually, she developed petechial rashes over the body. On examination, she was found to have jaundice, hepatomegaly, and a low platelet count (30,000/cm), Raised haematocrit (packed cell volume) by 20%. A tourniquet test done over the cubital fossa demonstrated 25 petechial spots/square inch area. On inquiry, she said that the mosquitoes have bit her. (4+4+4+8 marks)
    • a. What is the clinical diagnosis?
    • b. how is this disease transmitted?
    • c. Discuss the pathogenesis?
    • d. How will you confirm the diagnosis in the laboratory
  15. A 50 yom who had a successful renal transplant 2 weeks ago presented with fever, tenderness in right iliac fossa and decreased urine output.
    1. Probable diagnosis?
    2. Explain immunological process leading to this conditions?
  16. A 23 years old male presents with complaints of unexplained fever,progressive loss of weight, persistent diarrhoea and generalized lymphadenopathy for the past 6 months. He gives a history of multiple unprotected sextual exposure 1 year back. (2+4+6+3 marks)
    • Most probable diagnosis?
    • Discuss the pathogenesis
    • Lab Diagnosis
    • Post exposure prophylaxis?
  17. A 18 year old college student presented with fever with headache, loss of appetite and abdominal pain for 7 days. On examination, pyrexia with relative bradycardia, rose spots and splenomegaly was observed. Blood culture sent to the laboratory yielded Gram negative bacilli. What is your probable diagnosis and discuss the laboratory diagnosis?
  18. A 20-year-old male was admitted with a history of profound diarrhoea resembling rice water in the past 24 hours along with severe vomiting and dehydration.
    • A. What is the probable diagnosis?
    • B. Explain the pathogenesis of this condition.
    • C. Discuss the sample collection and laboratory diagnosis in this patient.
    • D. How will you prevent the transmission of this infection?
  19. A 60 year old woman admitted to ICU, develops fever with chills and rigor after 48 hours of ICU admission. She was catheterised on the day of admission.
    1. Probable diagnosis?
    2. Enumerate agents causing this infection
  20. A 25 year of age male, was admitted to the pulmonary medicine department with a history of evening rise of temperature and productive cough for the past three weeks. He also gives a history of blood-stained sputum. On examination, patient looked emaciated with pallor, RR -30/mt, bilateral rhonchi in lower lobes. CXR showed large cavitation in the upper lobe of the right lung.
    • a. What is the probable diagnosis and add a note on the etiological agent (3 marks)
    • b. Explain the pathogenesis of this condition (4 marks)
    • c. Give a detailed description of the sample collection and its laboratory diagnosis (2+4 marks)
    • d. Add a note on the resistance pattern of this causative agent (2 marks)
  21. A 15-year-old boy presents with a history of fever with headache, malaise and coated tongue of 8 days duration. On examinations, boy was found to have step ladder pyrexia, bradycardia and soft palpable liver & spleen.
    1. What is the probable diagnosis?
    2. Write the mode of infection.
    3. Pathogenesis
    4. Sample Collection
    5. Lab diagnosis
    6. Treatment
    7. Add a note on its prophylaxis
    8. How will you prevent the transmission of this infection
  22. A 28 yof admitted with high-grade fever, vomiting, flank pain with increased frequency of micturition for the past 2 days.
    • Diagnosis?
    • Etiological Agents?
    • Lab Diagnosis?
  23. 45 y/o, foreigner male, visiting India. C/O hypotension, respiratory depression, high grade fever. Fever spiked eved 48 hours. O/E hepatomegaly, icterus and dark colored urine. Peripheral smear- normochromic normocytic anemia and infected RBC cells with crescent shaped gametocytes.
    • Causative agents?
    • Pathogenesis, life cycle, complications.
    • lab Diagnosis
    • Preventive measures.
  24. 22 month old male baby. C/O persistent cough, evening rise of temperature, weight loss for past 2 months. O/E tachycardia, decreased breath sound in right apical region of lung.
    • What tests should be performed?
    • Sample collection methods and Lab diagnosis as per government programme?
  25. A 74 year old male hospitalised with 101°F fever, severe back pain and weakness in lower limb. O/E non tender, small, erythematous nodular lesions on sole were seen. ECG showed changes indicating vegetation on mitral valve. Previous H/O valvular vegetations 3 years ago. Lab investigations showed- CRP 2.6 mg/dl, ESR 6.6 mm/h, Creatinine 5.4 mg/dl. Positive blood culture with Viridians streprococci. He was given Benzyl Penicillin.
    • Probable diagnosis
    • Etiological agents
    • Diagnostic criteria
    • Specimen collection