The Quizzes about Infection diseases – Part 4

Ad Blocker Detected

Our website is made possible by displaying online advertisements to our visitors. Please consider supporting us by disabling your ad blocker.

The Quizzes about Infection diseases – Part 4
5 (100%) 1 vote

Select the ONE answer that is BEST in each case.

A 24-year-old woman complains of pain in the upper chest every time she eats or drinks anything. She is HIV positive, but currently not on any antiretroviral therapy. Her last CD4 count was 400/mL.

All forms of T-lymphocyte deficiency/ dysfunction are characterized by candidal infections. Candida species can cause thrush, skin lesions, esophagitis, and cystitis. Hematogenous spread can occur and disseminate the organism widely in individuals with low CD4 counts.

 

See all quizzes of  the Infection diseases at here:

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

62. A 24-year-old woman complains of pain in the upper chest every time she eats or drinks anything. She is HIV positive, but currently not on any antiretroviral therapy. Her last CD4 count was 400/mL. (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

63. A 67-year-old man has back pain and newly discovered hypercalcemia. Further investigations determine that he has multiple lytic lesions, anemia, and a monoclonal protein in his serum. A bone marrow aspirate confirms the diagnosis of multiple myeloma. (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

64. A 34-year-old woman is at a family picnic where she has a ham sandwich and potato salad. Three hours after the meal, she feels nauseous and throws up. (SELECT ONE)

(A) Staphylococcus aureus
(B) C. perfringens
(C) Vibrio cholerae
(D) enterotoxigenic E. coli
(E) Salmonella
(F) Shigella
(G) Vibrio parahaemolyticus
(H) Bacillus cereus

65. A 22-year-old university student is backpacking in South America. Ten days after arriving, she develops symptoms of anorexia, malaise, and abdominal cramps followed by a sudden onset of watery diarrhea. There are no symptoms of fever or chills, and the stools are nonbloody. (SELECT ONE)

(A) Staphylococcus aureus
(B) C. perfringens
(C) Vibrio cholerae
(D) enterotoxigenic E. coli
(E) Salmonella
(F) Shigella
(G) Vibrio parahaemolyticus
(H) Bacillus cereus

66. A 24-year-old man is traveling in Southeast Asia. He is eating at local restaurants and from street vendors. He now develops high fevers, anorexia, and frequent passage of small-volume stools containing blood, pus, and mucus. This is associated with severe abdominal cramps and painful straining when having bowel movements. (SELECT ONE)

(A) Staphylococcus aureus
(B) C. perfringens
(C) Vibrio cholerae
(D) enterotoxigenic E. coli
(E) Salmonella
(F) Shigella
(G) Vibrio parahaemolyticus
(H) Bacillus cereus

67. A 27-year-old woman is on holiday on the East coast of the United States. She is at a seafood restaurant and has fresh shellfish for dinner. Twenty-four hours later, she develops symptoms of nausea, vomiting, abdominal cramps, and watery diarrhea. (SELECT ONE)

(A) Staphylococcus aureus
(B) C. perfringens
(C) Vibrio cholerae
(D) enterotoxigenic E. coli
(E) Salmonella
(F) Shigella
(G) Vibrio parahaemolyticus
(H) Bacillus cereus

68. A family of four has dinner at a local Asian restaurant, where multiple dishes are ordered and shared amongst the group. Three hours after the meal, all members develop stomach symptoms consisting of nausea and vomiting. (SELECT ONE)

(A) Staphylococcus aureus
(B) C. perfringens
(C) Vibrio cholerae
(D) enterotoxigenic E. coli
(E) Salmonella
(F) Shigella
(G) Vibrio parahaemolyticus
(H) Bacillus cereus

69. A 19-year-old man is seen in the office 9 days after a hiking trip in Colorado. Five days ago,
he developed a fever, headache, myalgia, and nausea. Two days later, he noticed the start of a nonitchy rash on his wrists and ankles. He presents today because of light-headedness while standing and progression of the rash on to his body. He reports that he had numerous insect bites during his hike. On examination, his blood pressure is 90/60 mm Hg, pulse 100/min, and respirations 20/min. There are multiple 1–5 mm macules on his body and some of them have a hemorrhagic center consistent with petechia. His heart sounds are normal, lungs clear, and legs are edematous. Which of the following is the most likely diagnosis?
(A) circulating immune complex disease
(B) a drug reaction
(C) infective endocarditis
(D) Rocky mountain spotted fever (RMSF)
(E) S. aureus sepsis
70. A 22-year-old sexually active man presents with painful urination. He reports no joint symptoms, rash, fever, or penile discharge. Examination of the prostate, testes, and penis are normal, and there is no visible discharge that can be expressed from the urethra. Which of the following is the most appropriate initial diagnostic test?
(A) history alone
(B) anterior urethral swab
(C) routine urinalysis
(D) Gram stain of a midstream urine specimen
(E) urine culture
71. A 25-year-old woman has new symptoms of fever, headache, myalgia, and macular rash. She recently went on a camping trip with friends to the South-Central United States. She endured many “bug bites” during the trip but does not specifically recall any tick bites. The rash consists of macules 3 mm in size on her hands and feet. A clinical diagnosis of RMSF is made and she is started on treatment. Serology is drawn to confirm the diagnosis. Which of the following is the most appropriate treatment choice for this condition?
(A) plasmapheresis plus glucocorticoids
(B) ampicillin
(C) vancomycin
(D) erythromycin

(E) doxycycline

72. A 21-year-old man presents with cough, headache, malaise, and fever. He reports minimal whitish sputum production and now has chest soreness from coughing so much. He has no other past medical history and no risk factors for HIV. On examination, his temperature is 38.3°C, pharynx is normal, and lungs are clear. CXR reveals diffuse bilateral infiltrates. Mycoplasma pneumonia is considered in the possible differential diagnosis of his pneumonia. Which of the following skin manifestations is most likely seen in mycoplasma pneumonia?
(A) erythema nodosum
(B) erythema multiforme
(C) maculopapular rash
(D) vesicular rash
(E) urticaria
73. A 23-year-old university student presents with painful urination and penile discharge. He is sexually active, and reports no joint symptoms, rash, or fever. Examination of the prostate, testes, and penis are normal, and there is a visible discharge that can be expressed from the urethra. Which of the following is the most likely causative organism?
(A) Neisseria gonorrhoeae
(B) Chlamydia trachomatis
(C) herpes simplex virus (HSV)
(D) Ureaplasma ureolyticum
(E) Mycoplasma genitalium
74. A 22-year-old woman complains of vulvar itching, burning, and pain when voiding urine. She has no other symptoms of fever, vaginal discharge, or urinary frequency. Physical examination reveals some vulvar ulceration but no vaginal discharge. The ulcers are small 2–3-mm lesions with an erythematous base. Which of the following is the most likely diagnosis?
(A) HSV infection
(B) Trichomonas vaginalis infection
(C) N. gonorrhoeae infection
(D) C. trachomatis infection
(E) M. genitalium infection
75. A 34-year-old woman presents with symptoms of fever, headache, and myalgia. She recently returned from a camping trip to the SouthCentral United States. She endured many insect bites during the trip but does not specifically recall any tick bites. On examination her neck is supple, heart sounds are normal, and lungs are clear. She does have a rash consisting of macules 3 mm in size on her hands, feet, and upper body. A clinical diagnosis of RMSF is made and treatment is started. Serology is drawn to confirm the diagnosis. Which of the following sites is the major target for intracellular injury by this infectious agent?
(A) microcirculation
(B) liver
(C) heart
(D) brain
(E) kidney
76. A 29-year-old sexually active man presents with painful urination and penile discharge. He reports no joint symptoms, rash, or fever. Examination of the prostate, testes, and penis are normal, and there is a visible discharge that can be expressed from the urethra. Microscopic examination of the appropriate specimens is not possible in this clinic. Which of the following is the most appropriate next step in management?
(A) send the patient to another clinic for cultures
(B) treat for C. trachomatis with azithromycin
(C) treat for N. gonorrhoeae infection with ceftriaxone
(D) treat for N. gonorrhoeae infection with penicillin
(E) treat for C. trachomatis and N. gonorrhoeae with azithromycin and ceftriaxone
77. A 56-year-old previously healthy man is admitted to the hospital for community-acquired pneumonia. He is started on empiric antibiotics. Two days later, his blood cultures are positive of S. pneumoniae. Which of the following statements concerning the epidemiology of S. pneumoniae is correct?
(A) most children are nasopharyngeal carriers
(B) most adults are nasopharyngeal carriers
(C) bacteremia is not common in people over 55
(D) in adults, bacteremia is most common in midwinter
(E) bacteremia always occurs with pneumonia
78. A 62-year-old woman presents with fever, cough, sputum production, and pleuritic chest pain. CXR reveals a right middle lobe infiltrate, and she is started on antibiotics for the treatment of pneumonia. Her sputum Gram stain is positive for S. pneumoniae. Which of the following immunologic mechanisms is the most specific host defense against pneumococcal
infection?
(A) intact splenic function
(B) intact complement function
(C) IgG antibody directed against capsular antigens
(D) alveolar macrophages
(E) liver macrophages
79. A 5-year-old boy presents with ear pain and fever. The left eardrum is inflamed with a small perforation in it and pus is seen in the external canal. A swab of the area grows S. pneumoniae. Which of the following is the most likely mechanism for S. pneumoniae to cause otitis media?
(A) hematogenous spread
(B) direct extension from the nasopharynx
(C) direct inoculation on the ear
(D) spread through lymphatic tissue
(E) associated dental disease
80. A 31-year-old woman presents with symptoms of vulvar itching and burning made worse by urinating. She has no fever or frequency, but has noticed a recent whitish vaginal discharge. Clinical examination reveals vulvar erythema, edema, and fissures. On speculum examination, there is a white discharge with small white plaques loosely adherent to the vaginal wall. Which of the following treatments is appropriate for her asymptomatic male sexual partner?
(A) azole cream to the penis
(B) oral fluconazole
(C) standard urethritis investigation
(D) no investigation or treatment
(E) azithromycin plus cefixime
81. A 29-year-old man is seen in the office after returning from a hiking trip in Colorado. He complains of feeling unwell and reports symptoms of fever, myalgia, headache, and nausea. Two days ago, he noticed a rash on his wrists and ankles that has now spread to his body. He recalls having had numerous insect bites during his trip. On examination, his blood pressure is 90/60 mm Hg, pulse 100/min, and respirations 20/min. There are multiple 1–5 mm macules on his body and some of them have a hemorrhagic center consistent with a petechia. His neck is supple and fundi are normal. The heart sounds are normal, lungs clear, and legs are edematous. Cranial nerve, motor and sensory examination is normal. A clinical diagnosis of RMSF is made and he is started on appropriate therapy. Which of the following is the most common type of central nervous system (CNS) presentation in this condition?
(A) hemiplegia
(B) cranial nerve abnormalities
(C) paraplegia
(D) encephalitis
(E) ataxia

Leave a Reply