A 36-Year-Old Man Is Admitted to the Hospital with Severe

question 125

Multiple Choice

A 36-year-old man is admitted to the hospital with severe left leg pain after suffering a minor laceration to the leg 2 days earlier.  Temperature is 39.5 C (103.1 F) and blood pressure is 85/45 mm Hg.  On physical examination, the left leg is swollen and firm with erythema of the overlying skin.  There is a small wound draining blood-tinged exudate on the left calf.  The patient is taken to the operating room immediately, and a large area of necrotic tissue is excised.  Gram stain of the necrotic tissue shows gram-positive cocci, and culture of the bacteria performed on a blood agar plate grows small colonies with a wide zone of surrounding hemolysis.  Coagulase and catalase tests are negative, and pyrrolidonyl arylamidase (PYR) test is positive.  Which of the following pathogens is most likely responsible for this patient's condition?

• A)Aeromonas hydrophila
• B)Clostridium perfringens
• C)Staphylococcus aureus
• D)Streptococcus agalactiae
• E)Streptococcus pyogenes

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Definitions:

Ten-Percent Plan

A Reconstruction plan proposed by President Abraham Lincoln in 1863, suggesting that a Southern state could be readmitted into the Union once 10% of its voters swore an oath of allegiance to the Union.

Reconstruction

The period after the American Civil War (1865–1877) during which the United States attempted to reintegrate the Confederate states back into the Union and rebuild the South.

Amnesty

A governmental act of forgiveness for individuals or groups who have committed a political offense, often after a conflict or under a new regime.

Attrition Strategy

is a military strategy aiming to gradually wear down the enemy by continuous losses in personnel and material until they are no longer capable of fighting.