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NBME 17 Answers

nbme17/Block 0/Question#0 (reveal difficulty score)
A 53-year-old man, who recently returned from ...
Malaria ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1780)
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Below are links to pictures of what each organism would look like on a stain:

  • Babesiosis is fever and hemolytic disease predominantly in the northeast US, usually presents with classic "maltese cross" in RBCs [FA2020 p157]
  • Leishmaniasis can be cutaneous with ulcer presentation or visceral with spiking fevers, hepatosplenomegaly, and pancytopenia. The amastigotes are present in macrophages not RBCs [FA2020 p158]
  • Malaria is caused by the plasmodium species and presents with trophozoite ring forms in RBCs. It is transmitted by the anopheles mosquito and is endemic in parts of Africa. It causes fever, headache, anemia, and splenomegaly [FA2020 p157]
  • Toxoplasmosis is is an intracellular parasite but a small numbr exist extracellularly as tachyzoites in blood; it can also cause tissue cysts filled with bradyzoites. In immunocompetent hosts it produces mono-like symptoms but in immunocompromised it will dissiminate and cause ring-enhancing brain/tissue abscesses. [FA2020 p156]
  • Trypanosomiasis can be caused by Trypanosoma bruceii (African sleeping sickness, p156) or Trypanosoma cruzii (Chaga's disease, South America, p158). These organisms are extracellular on blood smear.
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