Question

Write up three clinical questions using the following format: Presumptively diagnose the etiologic agent of a specific disease scenario based on facts that include: 1) patient history, 2) clinical presentation, and 3) selected laboratory findings or treatment scenario. (Please be as simple as possible) Note: Pathogens can be from the following list: (You MUST provide at least one viral and one bacterial question) 1. Treponema ( pallidum, pertenue, carateum, and endemicum) 2. Borrelia ( recurrentis, hermsii, burgdorferi, garinii, and afzelii) 3. Leptospira ( interrogans) 4. DNA viruses ( pox, adenovirus, papilloma, herpes, hepatitis B) 5. RNA viruses ( picornaviruse: I) enteroviruses, II) rhinoviruses, III) hepatitis

Answer 1

	CASE 1	CASE 2	CASE 3
Patient History	Patient came with transient history of lesion on genital for last 4 weeks. Sexually active, H/o slight fever & malaise is also there.	Patient came with H/o fever with chills & severe headache from last 2-3 days. Around week back he went for windsurfing competition & afterwards he is not feeling well.	Patient came with pain in abdomen, malaise weight loss and have a history of consuming community food few days back.
Clinical Presentation	Painless eroded & indurated papule located on genitals in heterosexual and on rectum in Homosexual individuals. On palpation Cartilaginous consistency on edge & base of chancre.	Influenza like illness with fever, Chills, severe headache, nausea, Vomiting and myalgia. Muscle pain typically affecting calves, back and abdomen. Conjuctival suffusion present	Jaundice is present in patient, Complaint of low frade fever, anorexia,nausea , vomiting, fatigue and myalgia. Large and tender liver or upper abdominal pain.
Laboratory findings	On Dark field microscope examination motile organism is available. RPR & VDRL test are positive	Raised ESR & leukocyte count, Raised Bilirubin, Alkaline phosphatase & Aminotransferases. Positive Microscopic Agglutination Test (MAT)	Raised Aminotransferases AST & ALT. Raised Serum bilirubin, Anti-HAV of IgM is positive
Causative Organism	T.pallidium	Leptospira	Hepatitis A