How Would You Deal With A Hostile Customer?

⟩ How would you deal with a hostile customer?

I would listen to his complaint, offer an apology, and ask how I can improve the situation for him. Probe, ask questions, uncover the real problem.

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A 44-year-old native Nigerian who has lived in the USA for 10 years returned to visit his family in Africa and now presents with a history of shaking chills, followed by high fever and then profuse sweating. He states that this is the most severe case of malaria he has ever had. His blood smear shows malaria organisms consistent with Plasmodium falciparum. Which of the following statements is false regarding P. falciparum?

This July a group of 30 volunteers went to Kenya to help build a school and all of them took prophylaxis to prevent malaria. They claim that they took the medication as prescribed 2 weeks before, during their stay, and for 4 weeks after returning home. In October, one person developed malaria and by April of this year, 9 of the 30 volunteers had been treated for malaria. Which of the following is the least likely explanation for this apparent failure of prevention?

A 42-year old patient from Ecuador is admitted with fever, right upper abdominal pain and is found to have a cystic mass of the liver. You suspect an amebic abscess and order stool exams that are reported as positive for E. histolytica and an ameba serology is positive at 1256. Which statement is false regarding ameba?

A 30-year old patient is evaluated for chronic diarrhea that has gone on for 4 months with a 20-pound weight loss. By history you find that he has had sex with men for 12 years. You are concerned about the possibility of HIV and his test is positive with a low CD4 count that makes you think of immunodeficiency. You order a test for Cryptosporidium in his stool. Which of the following statements is false regarding Cryptosporidium?

You see a 20-year old female for complaints of vaginal itching, discharge, pain with intercourse and discomfort with urination. She has had 3 different sexual partners over the past 2 years. As part of your workup, you do a wet mount of vaginal secretions and see a flagellated organism about the size of a white blood cell with twitching motility that makes you think of Trichomonas vaginalis. Which statement is false regarding Trichomonas?

A 22-year old college student is seen because he has had severe chronic diarrhea and a stool for O&P is positive for Giardia lamblia. He has lost 50 pounds in weight and has been treated for Giardia on 6 occasions only to have it reoccur. You are concerned that he has an immunodeficiency and lab results demonstrate a very low IgA level. Which of the following statements would be false regarding Giardia?

This year there have been 7 travelers to eastern Africa that have contracted Trypanosoma brucei rhodesiense. They have all presented in the early stage of the disease with a chancre of the skin associated with cellulitis (red hot swelling) around the chancre. Which of the following is false regarding Trypanosoma brucei?

Blood banks in Southern California and Texas have done studies to evaluate how often blood containing Trypansoma cruzi is found in their blood donor pool. They have found that the incidence varies between 18,000 and 140,000 donors. If you were making up a list of questions to ask blood donors, which of the following questions would be least helpful in screening to exclude this organism from persons that have grown up in an endemic area?

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