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Kaplan Qbank USMLE



Author3 Posts
  #1

A 3-year-old boy is brought to the physician because of a 7-day history of fever and a painful swollen lymph node in his groin. This is his sixth episode of lymph node swelling; the previous episodes resolved after drainage and prolonged antibiotic therapy. He also had pneumonia at the age of 12 months that required chest tube placement for drainage. A maternal uncle died during childhood of recurrent infections. The patient is at the 5th percentile for height and weight. His temperature is 38.5 C (101.3 F). Examination shows a warm, tender, erythematous lymph node in the right inguinal area. There are several healed incisions over the inguinal area and neck from old drainage sites. Laboratory studies show:

Hematocrit 35%
Leukocyte count 17,000/mm3
Segmented neutrophils 65%
Bands 10%
Lymphocytes 25%
Platelet count 350,000/mm3

A Gram's stain of the lymph node aspirate shows

numerous segmented neutrophils filled with bacteria; cultures grow Staphylococcus aureus.

Which of the following is the most likely mechanism for these findings?

A
) Adenosine deaminase deficiency

B
) Consumption of complement

C
) Defective opsonization

D
) Destruction of CD4+ T lymphocytes

E
) Developmental arrest of maturation of B lymphocytes

F
) Dysmorphogenesis of the third and fourth pharyngeal pouches

G
) Impaired chemotaxis

H
) Impaired phagocytic oxidative metabolism

is it CGD /or

chediak hegashi coz neutrophil filled with bacteria


  #2

CGD, choice H

___________________
The Key to Succeed is Patience.

  #3

CGD







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