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128146 Microbiology

A 9-year-old child is brought to the emergency room with the chief complaint of enlarged, painful axillary lymph nodes. The resident physician also notes a small, inflamed, dime-sized lesion surrounding what appears to be a small scratch on the forearm. The lymph node is aspirated and some pus is sent to the laboratory for examination. A Warthin-Starry silver impregnation stain reveals many highly pleomorphic, rod-shaped bacteria. Which of the following is the most likely cause of this infection?

ABartonella henselae
BBrucella canis
CMycobacterium scrofulaceum
DYersinia enterocolitica
Microbiology
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128147 Surgery

Kamli Rani, 75 year old-woman present with post myocardial infarction after 6 weeks mild CHF. There was past H/O neck surgery for parathyroid adenoma 5 years ago, ECG shows slow atrial fibrillation. Serum Ca+2 13.0 mg/L and urinary Ca+2 is 300 mg/24 h. On examination there is small mass in the paratracheal position behind the right clavicle. Appropriate management at this time is:

ARepeat neck surgery
BTreatment with Technitium-99
CObservation and repeat serum Ca+2 in two months
DUltrasound-guided alcohol injection of mass
Surgery
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