The Quizzes about Infection diseases – Part 3 (20 test)

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The Quizzes about Infection diseases – Part 3 (20 test)
5 (100%) 1 vote

Select the ONE answer that is BEST in each case.

A patient undergoing emergency surgery for trauma receives 20 blood transfusions during the operation. Four weeks later, she develops a syndrome resembling infectious mononucleosis. Which of the following is the most likely causative organism?

CMV is probably transmitted in the leukocyte component of transfusions. The syndromes include fever and lymphocytosis. Screening donors for this virus reduces the incidence of transmission.

 

See all quizzes of  the Infection diseases at here:

Part 1Part 2 | Part 3 | Part 4| Part 5|

 

41. A patient undergoing emergency surgery for trauma receives 20 blood transfusions during
the operation. Four weeks later, she develops a syndrome resembling infectious mononucleosis. Which of the following is the most likely causative organism?
(A) EBV
(B) hepatitis C virus
(C) delayed hemolysis
(D) CMV
(E) serum sickness
42. A 32-year-old woman acutely develops high fever, hypotension, and rash. This is followed by vomiting, diarrhea, confusion, and abdominal pain. In the hospital, evidence of multiorgan failure develops. Desquamation of the skin occurs 1 week after the acute illness. On further history, the illness started 3 days after the onset of menstruation. Which of the following is the most likely diagnosis?

(A) S. aureus toxic shock syndrome (TSS)
(B) streptococcal infection (scarlet fever)
(C) clostridial infection
(D) RMSF
(E) staphylococcal scaled skin syndrome

43. An 18-year-old man develops fever, neck stiffness, and headache. On examination, his blood pressure is 105/80 mm Hg, pulse 100/min, temperature 38.7°C, and neck flexion is very painful. The ears, throat, and sinuses are normal; there are no focal neurologic signs, and the remaining examination is normal. His is the second case of meningitis in his university dormitory building. Which of the following is the most likely causative organism?
(A) Neisseria meningitidis
(B) Streptococcus pneumoniae
(C) Haemophilus influenzae
(D) Staphylococcus
(E) Listeria species
44. A 45-year-old woman is undergoing chemotherapy for breast cancer. She presents 10 days after her last chemotherapy with fever (temperature >38.5°C), but no other symptoms except a sore throat and mouth. On examination, she looks well, there is oral mucositis, ears are normal, lungs are clear, and the central line site is clean. The CXR, urinalysis, and biochemistry are normal. Her WBC is 800/mL and the absolute neutrophil count is low (<500). Which of the following is the most appropriate next step in management?
(A) start empiric bacterial antibiotics
(B) start empiric antifungal and bacterial antibiotics
(C) acetaminophen alone until culture results are available
(D) start antiviral medications for HSV-1
(E) start antiviral and bacterial antibiotics
45. An elderly bedridden patient in the hospital develops cough, fever, and shortness of breath. On examination, the JVP is 4 cm, heart sounds are normal, and there are crackles on inspiration in the right lower lobe. A CXR reveals a new right lower lobe infiltrate and his WBC is 15,000/mL. He was admitted to the hospital 7 days ago for the treatment of congestive heart
failure. Which of the following is the most likely diagnosis?
(A) hospital-acquired pneumonia
(B) atelectasis
(C) pulmonary embolism
(D) community-acquired pneumonia
(E) asymmetric congestive heart failure
46. A 74-year-old man residing in a nursing home develops symptoms of high fever, diarrhea, chest pain, and nonproductive cough. His temperature is 40°C, blood pressure 120/80 mm Hg, respiration 24/min, and oxygen saturation 90%. He has bibasilar crackles, normal heart sounds, and a soft nontender abdomen. His CXR reveals bilateral lower lobe infiltrates. He is not able to provide any sputum, and the urine is positive for legionella antigen. Which of the following is the most appropriate antibiotic choice?
(A) trimethoprim-sulfamethoxazole
(B) azithromycin
(C) ceftriaxone
(D) cefuroxime
(E) gentamicin
47. A businesswoman needs to make frequent trips to South America, but every time she is there, she develops traveler’s diarrhea, which requires her to change her business schedule. To prevent future episodes during business trips, she is inquiring about prophylaxis methods. Which of the following is the most helpful advice for her?
(A) take loperamide for symptoms
(B) take trimethoprim-sulfamethoxazole every day
(C) take azithromycin every day
(D) take doxycycline every day
(E) take ciprofloxacin only if moderate or severe symptoms develop
48. The dental condition illustrated in Fig. is usually associated with a congenital infectious disease. The teeth are characterized by centrally notched, widely spaced, peg-shaped upper central incisors and molars that have poorly developed cusps. Which of the following is the most likely diagnosis?
(A) congenital rubella
(B) congenital syphilis
(C) congenital toxoplasmosis
(D) congenital HIV
(E) congenital measles
49. A 53-year-old man with alcoholic cirrhosis presents with increasing jaundice and abdominal discomfort. He reports no fevers or chills. On examination, his blood pressure is 100/60 mm Hg, pulse 100/min, temperature 38.1°C. He has a distended abdomen, peripheral edema, and shifting dullness. The abdomen is tender and bowel sounds are present. A diagnostic paracentesis is performed; the total cell count is 940/mL with polymorphonuclear neutrophils (PMNs) equal to 550/mL, Gram stain is negative, and cultures are pending. Which of the following is the most likely diagnosis?
(A) pancreatic ascites
(B) malignant ascites
(C) spontaneous bacterial peritonitis (SBP)
(D) secondary peritonitis
(E) tuberculous ascites
50. A 20-year-old woman presents with headache, anorexia, chilly sensations, pain, and drawing sensations in both sides of her jaw. She has also noticed discomfort in both lower abdominal quadrants. Physical examination reveals bilateral enlarged parotid glands that are doughy, elastic, and slightly tender; with a reddened orifice of Stensen’s duct. Her abdomen is soft with bilateral lower quadrant abdominal tenderness, a temperature of 38.5°C, and a pulse rate of 92/min. Laboratory data show hemoglobin 13 g/dL; hematocrit 40%; WBC 9000/mL, with 35% segmented neutrophils, 7% monocytes, and 58% lymphocytes. Which of the following is the most likely diagnosis?
(A) cervical lymphadenitis
(B) Mikulicz’s syndrome
(C) parotid gland tumor
(D) uveoparotid fever
(E) mumps
51. Which of the following statements concerning Lyme disease is correct?
(A) the incubation period is 3 months
(B) after an initial brisk immune response, immunity wanes with continuous infection
(C) the disease is caused by a spirochete
(D) the disease is caused by a tick
(E) the characteristic skin lesion of erythema migrans is found in over 95% of cases
52. An 18-year-old woman visits her physician because of 3 weeks of malaise, 2 weeks of fever,
and a sore throat. Physical examination shows pharyngeal infection with enlarged tonsils and a patchy, white exudate; enlarged, palpable anterior and posterior cervical, axillary, and inguinal lymph nodes; tenderness in the right upper quadrant; and minimal splenomegaly. Laboratory data show hemoglobin 14 g/dL; hematocrit 42%; platelets 380,000/mL; WBC 8500/mL, with 35% segmented neutrophils, 1% eosinophils, and 64% lymphocytes, of which 36% were atypical. Which of the following is the most likely diagnosis?
(A) infectious hepatitis
(B) lymphocytic leukemia
(C) infectious mononucleosis
(D) Hodgkin’s disease
(E) cat-scratch fever
53. A 19-year-old woman was traveling in a rural area of South America. She returned 3 weeks ago and, over the past few days, has gradually developed lower abdominal pain and diarrhea. Now the symptoms are much worse with 10 stools a day consisting mostly of mucus and blood. She is afebrile, the abdomen is tender in left lower quadrant, and the remaining examination is normal. Her stool is mostly comprised of blood and mucus. Which of the following is the most likely causative organism?
(A) Escherichia coli infection
(B) Salmonella infection
(C) Shigella infection
(D) Vibrio parahaemolyticus infection
(E) E. histolytica infection
54. An 18-year-old man develops fever, neck stiffness, and headache. On examination, his blood pressure is 110/80 mm Hg, pulse 100/min, temperature 38.7°C, and neck flexion is very
painful. The ears, throat, and sinuses are normal; there are no focal neurologic signs; and the remaining examination is normal. There are no reported similar cases in the community. Which of the following is the most likely causative organism?
(A) Neisseria meningitides
(B) Streptococcus pneumoniae
(C) Haemophilus influenzae
(D) Staphylococcus
(E) Listeria species
55. A 21-year-old man presents with symptoms of headache, fever, chills, and discomfort in both sides of his jaw. He has also noticed discomfort in his testes, but no dysuria or urethral discharge. Physical examination reveals bilateral enlargement of the parotid glands, as well as
bilateral testicular enlargement and tenderness on palpation. His temperature is 38.5°C pulse
rate of 92/min, and the remaining examination is normal. Laboratory data show hemoglobin 15 g/dL; hematocrit 40%; WBC 12000/mL, with 30% segmented neutrophils, 8% monocytes, and 62% lymphocytes. Which of the following statements concerning this disease is true?
(A) the disease is caused by a herpesvirus
(B) the incubation period is 3–5 days
(C) the most common complication of this disease in postpubertal boys and men is orchitis
(D) recurrent infections may occur
(E) an increased serum amylase is proof of the existence of pancreatitis as a complication
56. A 43-year-old businesswoman is developing a new enterprise in Mexico. On her most recent trip, she developed diffuse watery diarrhea with severe cramps 1 week after arriving. The illness resolved after about 2 days with no further complications. Which of the following is
the most likely causative organism?
(A) Campylobacter
(B) E. coli
(C) Salmonella
(D) Shigella
(E) rotavirus
57. A 22-year-old man is an avid spelunker (cave explorer) and has recently been exploring several caves. A routine CXR taken for a new job reveals hilar adenopathy and two patches of pneumonitis. His physical examination is completely normal. Careful questioning reveals he has just gotten over a “cold” with mild fever, cough, and malaise. Which of the following is the most likely diagnosis?
(A) tuberculosis (TB)
(B) sarcoidosis
(C) candidiasis
(D) histoplasmosis
(E) coccidioidomycosis
58. A previously well 28-year-old female has developed gradual onset of fever and malaise over 2–3 weeks. She also complains of arthralgias and myalgias. Repeated measurement of her
temperature reveals a low grade fever between 38°C and 39°C. Physical examination reveals an oval retinal hemorrhage with a clear, pale center; a pansystolic cardiac murmur heard best at the apex; and small, tender nodules on her fingertips. Which of the following is the most likely causative organism?
(A) Staphylococcus aureus
(B) S. epidermidis
(C) Viridans streptococci
(D) enterococcus
(E) Candida
59. A 55-year-old man is receiving chemotherapy for colon cancer. His last dose was 2 weeks ago, and he now has symptoms of fevers and chills but no other localizing symptoms. His examination is normal except that he is pale. Investigations reveal that he is neutropenic (absolute neutrophil count <500/mL), and his CXR is normal. (SELECT ONE)

(A) Staphylococcus aureus
(B) Candida
(C) P. carinii
(D) Streptococcus pneumoniae
(E) Gram-negative enteric bacilli
(F) Haemophilus influenzae
(G) Neisseria species
(H) Nocardia species
(I) Salmonella
(J) rubella virus

60. An 18-year-old man of European decent with selective immunoglobulin A (IgA) deficiency
presents with another respiratory tract infection. He has had two episodes of pneumonia in the past year requiring antibiotic therapy. He now has symptoms of fever, cough, and sputum production. His CXR reveals a right lower lobe infiltrate. (SELECT ONE)(A) Staphylococcus aureus
(B) Candida
(C) P. carinii
(D) Streptococcus pneumoniae
(E) Gram-negative enteric bacilli
(F) Haemophilus influenzae
(G) Neisseria species
(H) Nocardia species
(I) Salmonella
(J) rubella virus

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