1. A 40 year old bird handler was admitted to the hospital with soreness over his upper jaw, progressive vision loss, and bladder dysfunction. He had been well 2 months earlier. Within weeks he lost reflexes in his lower extremities and subsequently died. Examination of CSF showed lymphocytes. What etiology do you suspect? What further information do you need? (20 points)
2. Please watch the film on Polio and comment. Also OPV is no longer used for routine vaccination. Provide the rationale for this policy. (10 points)
3. Nearly 70% of the patients seen in STI clinics are men.
a. Offer a reason men are more likely to seek treatment than women
b. Why is it important that women seek treatment for STIs? (15 points)
4. Pneumonia is diagnosed by the presence of fluid (dark shadows in an X-ray image) in the alveoli. Given that pneumonia usually is caused by a microorganism, what causes the fluid accumulation? Name a bacterium, a virus, a fungus, a protozoan and a helminth that can cause pneumonia (15 points)
5. A 31 year old man became feverish 4 days after arriving at a vacation resort in Idaho. During his stay he ate at two restaurants that were not associated with the resort. AT the resort he drank soft drinks with ice, used the hot tub and went fishing. The resort is supplied by a well that was dug 3 years ago. He went to the hospital when he developed vomiting and bloody diarrhea. Gram-negative, lactose-negative bacteria were cultured from his stool. The patient recovered after receiving intravenous fluids. What microorganism most likely caused his symptoms? How is this disease transmitted? What is the most likely source of his infection and how would you verify the source? (15 points)
6. The tropical skin disease called yaws is transmitted by direct contact. Its causative agent, Treponemapallidumpertenue is indistinguishable from T. pallidum. One theory is that syphilis epidemics in Europe coincided with the return of Columbus from the New World. How might T. Pallidumpertenue have evolved into T. Pallidum in the temperate climate of Europe? (15 points)