IMMUNODEFICIENCY MCQS: MATCH THE CORRECT ANSWERS

Match each clinical condition with the most appropriate diagnostic laboratory test. Each lettered option may be used once, more than once, or not at all.

a. ESR

b. Serum immunoglobulin levels

c. Nitroblue tetrazolium (NBT) test

d. CH50 assay

e. CBC demonstrating Howell-Jolly bodies

f. Platelet count

g. Intradermal skin test using Candida albicans

Cases: 

01. A 1-year-old boy has been admitted three times in the past with abscess formation requiring incision and drainage. He is now admitted for surgical drainage of a hepatic abscess identified on ultrasound.

02.  A 5-month-old infant is admitted with severe varicella infection. The lesions cover the infant’s entire body, and the infant is beginning to show symptoms of respiratory distress. Past medical history is significant for a history of severe atopic dermatitis. The family also notes frequent epistaxis; the last episode required nasal packing in the ED.

03. A 3-year-old boy has had repeated episodes of sinusitis and otitis media. He was recently admitted for osteomyelitis of his femur with Staphylococcus aureus. The family notes that while his first 4 or 5 months of life were normal, he has been persistently ill with multiple infections in the ensuing months. The mother notes that her brother had similar problems with infections and died at the age of 3 years from a “lung infection.” Physical examination is significant for the absence of lymph nodes and tonsillar tissue.

04. A general practitioner refers to you for evaluation of a 3-year-old boy with frequent infections. You note the child to have a loud systolic murmur, posteriorly rotated ears that are small and low-set, down-slanting and widely spaced eyes, a small jaw, and an upturned nose. At birth the child spent 2 weeks in the nursery for “low calcium” and seizures, and he still receives calcium supplementation, but the mother does not know why. You would like to order a rapid diagnostic test for this child.

05. A 2-year-old girl has had two episodes of Neisseria meningitidis septicemia and is now admitted for Streptococcus pneumoniae septicemia.


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