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High Yield Notes
2 pages

USMLE® Step 1 style questions USMLE

1 questions

A 37-year-old woman presents to the clinic after developing a large circular wound on the right leg. She recently participated in a medical mission trip to Africa. The patient has several swollen lymph nodes in the right groin. The wound is shown below. Routine blood work is unremarkable. Which of the following is the vector that transmitted the pathogen responsible for her illness?

Image reproduced from Britannica


Leishmania is a protozoan that causes a disease called leishmaniasis. Leishmania species are classified into Old World species and New World species. Old World species include L. major, L. tropica, and L. aethiopica commonly found in Africa and Asia, and are known to cause cutaneous or visceral leishmaniasis.

The New World species include L. mexicana, L. venezuelensis, and L. amazonensis found in Central and South America, which are associated with cutaneous or visceral disease plus mucosal leishmaniasis. Leishmaniasis presents with varying symptoms depending on the affected organs and the culprit agent, but the common symptoms include skin sores, fever, weight loss, anemia, lymphadenopathy, and damage to the nasopharyngeal mucosae.