CASE HISTORY Case 1: Diane,a 20-Year-Old Accountant from Cedar City,Utah,came to the to the Valley

question 51

Essay

CASE HISTORY
Case 1: Diane,a 20-year-old accountant from Cedar City,Utah,came to the Valley View Medical Center urgent-care clinic with a low-grade fever,malaise,and headache.She was sent home with a diagnosis of influenza but again sought treatment seven days later with a macular rash (small,flat,red spots)on her trunk,arms,hands,and feet.Further questioning revealed that one month earlier,Diane had a painless ulcer on her vagina that healed spontaneously.Serology results indicated that Diane had contracted syphilis,caused by Treponema pallidum subspecies pallidum.Because this disease is sexually transmitted,Diane provided a list of her sexual partners over the previous months so the health department could contact them for testing and,if necessary,treatment.
Case 2: Fabrice,an 11-year-old boy from the village of Ngbongbo tokonzi in the Democratic Republic of Congo (Africa),was seen at a nearby clinic.He had a cluster of raised,papular lesions on his arm.When the doctor asked Fabrice whether he had ever seen lesions like these before,Fabrice remembered having a single lesion about two months earlier,which spontaneously healed.Serology revealed that the boy had secondary yaws disease caused by the spirochete Treponema pallidum subspecies pertenue,which is a spirochete closely related to the strain that causes syphilis.However,T.pallidum pertenue is transmitted by direct contact with a cut or wound.
The organism that caused Fabrice's illness is closely related to the organism that causes the sexually transmitted disease syphilis.However,transmission routes for the two are completely different.What phenotypic differences are known to exist between the Treponema subspecies,which causes syphilis,and that which causes yaws? Are major changes in genotype (i.e. ,greater than 1%)required to alter the infection pattern of an organism?

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Definitions:

Physics

The branch of science concerned with the nature and properties of matter and energy, including mechanics, heat, light, and other radiation, sound, electricity, magnetism, and the structure of atoms.

Engineering Principles

Fundamental guidelines that inform and support the problem-solving, design, and development processes within various fields of engineering.

Zone of Proximal Development

A concept developed by Lev Vygotsky referring to the difference between what a learner can do without help and what they can achieve with guidance and encouragement from a skilled partner.

Horizontal Décalage

The concept in developmental psychology indicating variations in a child's understanding and application of knowledge across different domains or tasks.