Name: Nina Vora

Theme: Zoonoses

OPTION LIST

A	Bacillus anthracis	I	Rabies
B	Borrelia burgodofori	J	Rickettsia typhi
C	Brucella abortus	K	Yersina pestis
D	Brucella melitensis	L
E	Coxiella burnetii	M
F	Leishmania major.	N
G	Leptospira interrogans	O
H	Pasteurella multocida	P

For each scenario below, choose the most appropriate causative agent from the list above. Each option may be used once, more than once or not at all.

1. A 30 year man presented with jaundice and conjunctival haemorrhages. He had recently been canoeing in the US and had felt ‘run-down’ upon his return to the UK.

2. A 25 year old Maltese man presented to his GP with lethargy for a month and headaches and fever. On examination, he had a temperature of 39°C and one fingerbreadth splenomegaly. Small Gram-positive coccobacilli were seen on culture in Casteneda’s medium.

3. A 22 year old student presented to her GP upon return from a biology field trip, with a lesion on her leg which was 3” in diameter and flat, with a red edge and dim centre. She also mentioned feeling tired and suffering from headaches. On examination, the GP noted a fever of 38.0°C and an irregular heartbeat.

4. A tanner on holiday from India presented to hospital with an ulcerating papule on his hand. On inspection of the ulcer, the centre was black and necrotic. Gram-positive rods grew on blood agar culture and responded to treatment with large doses of penicillin.

5. A 49 year old man was admitted in A&E with a 3 day history of worsening right arm pain and a 1 day history of dysphagia, hypersalivation, agitation and generalised muscle twitching. Vital signs and blood tests were normal but he became confused. He developed renal failure and died 4 days later.

ANSWERS

1. G

2. D

3. B

4. A

5. I