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40844 Pathology

A 58-year-old male presents with the sudden onset of excruciating pain. He describes the pain as beginning in the anterior chest, radiating to the back, and then moving downward into the abdomen. His blood pressure is found to be 160/110. Your differential diagnosis includes myocardial infarction; however, no changes are seen on ECG, and you consider this to be less of a possibility. You obtain an x-ray of this patient’s abdomen and discover a “double-barrel” aoa. This abnormality most likely results from

AAtherosclerosis of the abdominal aoa
BA microbial infection
CA congenital defect in the wall of the aoa
DLoss of elastic tissue in the media
Pathology
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40846 Microbiology

A 37-year-old woman, Maimuz, presents with 3 days of progressive joint pain in her ankles, knees, and wrists. She recalls three similar episodes over the past several years. On examination, she has a temperature of 38.7 C, her blood pressure is 110/70 mm Hg, and her hea rate is 90/min. She has a diffuse petechial rash over her trunk and extensor surfaces. Her ankles and knees are swollen, red, and tender with decreased range of motion, and there is tenderness over the tendon sheaths of her hands and forearms. Blood cultures are negative. Aspiration of joint fluid reveals a white cell count of 22,000/mm3 with no visible organisms, but culture on chocolate agar is positive. Which of the following is an attribute of the causative organism that allows it to produce recurrent infections?

AIt is an intracellular pathogen
BIt is resistant to ceftriaxone
CIt is resistant to complement-mediated lysis
DIts pili undergo antigenic and phase variation
Microbiology
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