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Case No. 35

Case No. 35 Clinical History: This was a 26 year old female with congenital heart disease. She presented to the emergency room complaining of chest and flank pain. She developed ventricular tachycardia soon after admission and expired. [Case 35 ImageScope ] [Case 35 WebScope].

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Case No. 35

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  1. Case No. 35 • Clinical History: This was a 26 year old female with congenital heart disease. She presented to the emergency room complaining of chest and flank pain. She developed ventricular tachycardia soon after admission and expired.

  2. [Case 35 ImageScope] [Case 35 WebScope]

  3. [Case 35 ImageScope][Case 35 WebScope]

  4. [Case 35 ImageScope][Case 35 WebScope]

  5. Case No. 370 (UMich slide NP002_20x) • Clinical History: The patient was a 67 year old white female who became disoriented and confused seventeen days prior to death and developed paresis on the left side of the body.

  6. [Case 370 ImageScope][Case 370 WebScope]

  7. [Case 370 ImageScope][Case 370 WebScope]

  8. Case No. 54 • Clinical History: An 18 year old female had nausea, vomiting, periumbilical and lower abdominal pain, shaking chills and fever beginning two days prior to admission. The WBC count was 21,900. Physical examination revealed local tenderness and rigidity with rebound pain in the lower abdomen. A surgical procedure was performed.

  9. [Case 54 ImageScope][Case 54 WebScope]

  10. [Case 54 ImageScope][Case 54 WebScope]

  11. [Case 54 ImageScope] [Case 54 WebScope]

  12. [Case 54 ImageScope][Case 54 WebScope]

  13. Case No. 240 • Clinical History: This patient was a 54 year old male who had a long history of peptic ulcer disease. A portion of the stomach was removed. Medical management is more common today.

  14. [Case 240 ImageScope][Case 240 WebScope]

  15. [Case 240 ImageScope][Case 240 WebScope]

  16. [Case 240 ImageScope][Case 240 WebScope]

  17. [Case 240 ImageScope][Case 240 WebScope]

  18. [Case 240 ImageScope][Case 240 WebScope]

  19. Micro case 5 • A 33 year old female dairy farmer develops a severe headache and neck stiffness. On physical examination, her temperature is 38.20 C. She has no papilledema. A lumbar puncture is performed, and a Gram stain of the CSF obtained shows many short, gram-positive rods.

  20. Micro case 9 • A 52 year old homeless, alcoholic man had a fever and a cough productive of thick sputum that worsened over several days. His temperature is 38.2. Diffuse crackles are heard at the right lung base. Laboratory studies show hemoglobin of 13.3 g/dL, hematocrit 40%, platelet count 291, 8000/mm3, and WBC count 13, 240/mm3 with 71 segmented neutrophils, 7% bands, 16% lymphocytes, and 6% monocytes.

  21. Micro case 10 • A 66 year old man incurs extensive thermal burns to his skin and undergoes skin grafting procedures in the surgical intensive care unit. Two weeks later, he has increasing respiratory distress. Laboratory studies show hemoglobin of 13.1 g/dL, hematocrit 39.2%, platelet count 222,200/mm3, and WBC count 4520/mm3 with 15% monocytes. A chest radiograph shows extensive bilateral infiltrates with patchy areas of consolidation.

  22. MacConkey's

  23. Sheep Blood Agar

  24. Micro case 12 (UMich slide 017) • A 45-year-old woman is being treated in the hospital for pneumonia complicated by septicemia. She has required multiple antibiotics and was intubated and mechanically ven­tilated earlier in the course. On day 20 of hospitalization, she has abdominal distention. Bowel sounds are absent, and abdominal radiograph shows dilated loops of small bowel suggestive of ileus. She has a low volume of bloody stool.

  25. [UMich 017 ImageScope][UMich 017 WebScope]

  26. [UMich 017 ImageScope][UMich 017 WebScope]

  27. Micro case 13 • A 25 year old man is involved in an accident in which he is ejected from the vehicle. He sustains a compound fracture of the left humerus and undergoes open reduction with internal fixation of the humeral fracture. Several days later, he has marked swelling of the right arm and crepitus.

  28. Egg yolk agar

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