CASES FOR TBL

1. A 23-year-old diabetic woman presents with high grade fever with chills and dysuria. Physical
examination reveals costo-vertebral tenderness, and urinary analysis shows the presence of
bacteria in the urine. Her physician suspects a complicated urinary tract infection and begins a
5-day course of ciprofloxacin.
What is the mechanism of action of Ciprofloxacin? How it prevents the proliferation of infection

2. A 34-year-old man of Italian descent is seen for a yearly physical examination. He has no
complaints and is in good health. However, he has a family history of anemia, and a complete
blood count demonstrates a mild anemia; the physician suspects thalassemia minor in the
patient. Thalassemia is often due to an alteration in RNA splicing, which is an essential part of
mRNA processing in eukaryotes.
What is the mechanism of RNA splicing?
In Which process it takes place?
What alteration can take place in RNA splicing that can lead to Thalessemia?

3. A 54-year-old man presents to his family physician with a 3 to 4 week history of a non-
productive cough and a low-grade fever. The physician suspects an atypical pneumonia from
Mycoplasma pneumoniae, and decides to treat the patient empirically with erythromycin.
What is mechanism of action of erythromycin and how it prevents the growth of bacteria?

4. A new patient visits to a medical OPD due to his concern of developing colon cancer. A large
number of relatives have had premature (less than the age of 45) colon cancer, and all cases
were right-sided, with the only visible polyps being found on that side.
Explain the reason for this type of cancer in families

5. A patient suffering from chills, vomiting, and cramping was rushed to the emergency
department. He had eaten wild mushrooms for dinner that he had picked earlier in the day.
Why the patient has symptoms on eating mushrooms?
What is its mechanism for developing these symptoms?
6. A 2-year-old girl exhibits a very high fever of sudden onset and complains of a stiff neck. Physical
exam reveals a positive Brudzinski and Kernig sign and petechiae on the extremities. The
pediatrician, in addition to rushing the child to the hospital, prescribes a drug that blocks
prokaryotic peptide bond formation, even though it can have serious side effects.
Which is the drug and how it acts?

7. A 2-year-old boy with an ear infection was given amoxicillin, but it did not clear up the problem.
Switching to azithromycin successfully eradicated the infection, and subsequent laboratory work
indicated that the offending bacterium was resistant to amoxicillin.
What is the mechanism that leads to Bacterial resistance in patients?