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Case Study 1 A 25-year old female walks into a medical clinic in Boise complaining of an erythematous maculopapular rash, malaise, and fever of two days duration. She also reports a headache, sore throat, and mild cough, but denies any gastrointestinal symptoms. Upon examination, she has a temperature of 38.5 C, blood pressure of 100/62 mm Hg, pulse rate of 110 beats per minute, and a respiratory rate of 38/minute. She also reports malaise, swollen lymph nodes, and recent patchy hair loss. The doctor checks her buccal mucosa for Koplik's spots and asks about any recent history of tick bites. He also inquires about her MMR vaccination status and whether she might be pregnant. A throat culture is ordered and blood is drawn for serological testing. 1. What bacterial/viral diseases might cause this type of rash and fever? (Give your differential diagnosis of about 5 diseases that this case study might be based upon.) 2. What is the doctor ruling out by looking for buccal mucosa lesions? Serology ordered includes RPR and Weil-Felix. What diseases will these tests diagnose? 3. The throat culture is reported negative for B hemolytic Group A Strep. The disease is diagnosed serologically by a positive RPR and confirmed with an MHA-TP. 4. What disease and stage of the disease is this? What risks can this pose to a fetus? Describe the usual symptoms seen at other stages of this disease and what the outcome might be without treatment.

          Case Study 1
A 25-year old female walks into a medical clinic in Boise complaining of an
erythematous maculopapular rash, malaise, and fever of two days duration. She also
reports a headache, sore throat, and mild cough, but denies any gastrointestinal
symptoms.
Upon examination, she has a temperature of 38.5 C, blood pressure of 100/62 mm Hg,
pulse rate of 110 beats per minute, and a respiratory rate of 38/minute. She also reports
malaise, swollen lymph nodes, and recent patchy hair loss. The doctor checks her buccal
mucosa for Koplik's spots and asks about any recent history of tick bites. He also inquires
about her MMR vaccination status and whether she might be pregnant. A throat culture is
ordered and blood is drawn for serological testing.
1. What bacterial/viral diseases might cause this type of rash and fever? (Give your
differential diagnosis of about 5 diseases that this case study might be based upon.)
2. What is the doctor ruling out by looking for buccal mucosa lesions?
Serology ordered includes RPR and Weil-Felix. What diseases will these tests
diagnose?
3. The throat culture is reported negative for B hemolytic Group A Strep. The disease is
diagnosed serologically by a positive RPR and confirmed with an MHA-TP.
4. What disease and stage of the disease is this?
What risks can this pose to a fetus?
Describe the usual symptoms seen at other stages of this disease and what the
outcome might be without treatment.

Case Study 1
A 25-year old female walks into a medical clinic in Boise complaining of an
erythematous maculopapular rash, malaise, and fever of two days duration. She also
reports a headache, sore throat, and mild cough, but denies any gastrointestinal
symptoms.
Upon examination, she has a temperature of 38.5 C, blood pressure of 100/62 mm Hg,
pulse rate of 110 beats per minute, and a respiratory rate of 38/minute. She also reports
malaise, swollen lymph nodes, and recent patchy hair loss. The doctor checks her buccal
mucosa for Koplik's spots and asks about any recent history of tick bites. He also inquires
about her MMR vaccination status and whether she might be pregnant. A throat culture is
ordered and blood is drawn for serological testing.
1. What bacterial/viral diseases might cause this type of rash and fever? (Give your
differential diagnosis of about 5 diseases that this case study might be based upon.)
2. What is the doctor ruling out by looking for buccal mucosa lesions?
Serology ordered includes RPR and Weil-Felix. What diseases will these tests
diagnose?
3. The throat culture is reported negative for B hemolytic Group A Strep. The disease is
diagnosed serologically by a positive RPR and confirmed with an MHA-TP.
4. What disease and stage of the disease is this?
What risks can this pose to a fetus?
Describe the usual symptoms seen at other stages of this disease and what the
outcome might be without treatment.

Added by Thomas C.

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