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3556 Pathology

A 35-year-old woman complains of vaginal discomfort for 2 weeks. Physical examination reveals a scanty vaginal discharge. The fluid develops a “fishy” odor after treatment with 10% potassium hydroxide. A Pap smear taken during the pelvic examination shows squamous cells covered by coccobacilli (“clue” cells). Which of the following is the most likely etiology of vaginal discomfort in this patient?

AChlamydia trachomatis
BGardnerella vaginalis
CHerpes simplex virus
DHuman papillomavirus
Pathology
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3563 Pathology

A 12-year-old boy has had multiple recurrent infections for the past 10 years, including Pneumocystis jiroveci pneumonia, Streptococcus pneumoniae otitis media, and Pseudomonas aeruginosa urinary tract infection. On physical examination, he has a temperature of 38.5deg C and pharyngeal erythema with exudate. Laboratory studies show hemoglobin, 9.1 g/ dL; hematocrit, 27.6%; platelet count, 130,900/mm3; and WBC count, 3440/mm3 with 47% segmented neutrophils, 3% bands, 40% lymphocytes, and 10% monocytes. Serum immunoglobulin levels show very low IgG, very high IgM, and undetectable IgA. A peripheral blood smear shows nucleated RBCs. Which of the following immunologic defects is most likely to produce this disease?

AAbsence of adenosine deaminase
BAbnormal CD40-CD40L interaction
CDeletion of chromosome 22q11
DHIV infection
Pathology
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