intern_doc
Forum Guru
Topics: 98
Posts: 433
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3 yo boy has 7 day history of fever and a painful swollen lymph node in groin.
6th episode of lymph node swelling.; previous episode resolved after drainage and
prolonged antibiotic therapy.
Had pheumonia at age of 12 months that required chest tube placement for drainage.
Maternal uncle died in childhood from recurrent infections.
Patient is 5% for height and weight.
Temp 38.5.
Exam shows a warm tender erythamateous lymph node in the right inguinal area.
THer are several healed incisions over the inguinal area and neck from old drainage sites.
Lab studies show:
hematocrit 35%
leukocyte count 17000 / mm3
segmented neutrophils 65%
bands 10%
lymphocytes 25%
platelet count 350000 / mm3
Gram's stain of the lymph node aspirate whos numerous segmented nuetrophils filled with bacteria;
cultures grow staph aureus.
What is the most likely mechanism for these findings?
1. adenosine deaminase deficiency
2. consumption of complement
3. defective opsonization
4. destrucition of CD4+ lymphocytes
5. developemental arrest of maturation of B lymphocytes
6. dysmorphogenesis of the 3rd and 4th pharyngeal pouches
7. impaired chemotaxis
8. impaired phagocytic oxidative metabolism
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| Merih
Forum Junior
Topics: 9
Posts: 59
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8.Chr Granulomatous Dis.
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| anne06
Forum Elite
Topics: 11
Posts: 103
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can some1 explain this?
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| jvo_md
Forum Senior
Topics: 22
Posts: 189
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8 is the answer
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| MHP
Forum Senior
Topics: 15
Posts: 110
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Anne06,
The answer is 8, this is a chronic granulomatous disease, an X linked disease which is caracterized by lymphadenopathy, infe4cting organisms are catalasa positive. nITROBLUE TETRAZOLIUM TEST IS DIAGNOSTIC.
We have in the Q some features that coincide with the presentation
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| Data297
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so whats the answer?
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| prod
Forum Junior
Topics: 9
Posts: 53
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C 
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| Ivonne
Forum Guru
Topics: 53
Posts: 1,419
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8 for sure
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