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Select the ONE answer that is BEST in each case.
Three individuals living on the same floor in a university dormitory residence develop symptoms and signs of pneumonia. The diagnosis is confirmed by CXR, and sputum samples are positive for S. pneumoniae. In an outbreak, which of the following conditions most likely predisposed these three individuals to developing pneumococcal pneumonia?
It is possible that such outbreaks can occur in people with no predisposing factors, unlike the vast majority of sporadic cases. However, the only common predisposing factor in a young healthy population such as this would be a previous viral respiratory infection.
See all quizzes of the Infection diseases at here:
|82. Three individuals living on the same floor in a university dormitory residence develop symptoms and signs of pneumonia. The diagnosis is confirmed by CXR, and sputum samples are positive for S. pneumoniae. In an outbreak, which of the following conditions most likely predisposed these three individuals to developing pneumococcal pneumonia?
(A) immotile cilia syndrome
(B) previous viral infection
(D) cigarette-induced chronic lung disease
|83. A 78-year-old woman with a prior stroke is not feeling well. Her appetite is poor, and today her family noticed that she is confused so they sent her to the emergency room. She reports no cough, fever, or sputum production but her CXR reveals a left lower lobe infiltrate. Blood cultures are drawn, and she is started on antibiotics. The next day the cultures are positive for S. pneumoniae sensitive to penicillin. Which of the following is the most likely complication of pneumococcal pneumonia?
|84. A 23-year-old woman presents with cough, malaise, and fever. She reports minimal whitish sputum production and now has chest soreness from coughing so much. She has no other past medical history and no risk factors for HIV. On examination, her 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 her pneumonia. Which other symptom besides cough is also prominent in patients with mycoplasma pneumonia?
(B) shortness of breath
(D) shaking chills
|85 A 24-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 likely causative organism?
(A) Gram-positive bacterium
(B) Gram-negative bacterium
(D) type of rickettsia
(E) type of chlamydia
|96. A previously healthy 43-year-old man presents with symptoms of cough, fever, weight loss, and lymphadenopathy for the past 2 months. His physical examination reveals multiple axillary and cervical lymph nodes and oropharyngeal ulcerations. His CXR reveals fibronodular pulmonary infiltrates in the apex, his sputum is negative for TB, and the HIV test is negative. A bronchoalveolar lavage (BAL) confirms the diagnosis.
|97. A 34-year-old man presents with fever, cough, and sputum production. The CXR reveals a
thin-walled pulmonary cavity. His tests for TB and HIV are negative. Four weeks ago, he was
traveling in southern California, including visiting the San Joaquin valley. While there he did
experience a “flu-like” illness, which slowly improved but then his symptoms of cough and sputum started. A BAL confirmed the diagnosis.
|98. A 42-year-old man presents with symptoms of cough, sputum, fever, and weight loss. His
CXR reveals upper lobe pulmonary infiltrates and his Mantoux test (purified protein derivative [PPD]) is positive. He emigrated from Southeast Asia 3 years ago. (SELECT ONE)
|99. A 25-year-old woman presents with fever, night sweats, and muscles aches for the past 1 month. She was previously well. On examination, she has axillary and cervical lymph nodes, but no active joints or hepatosplenomegaly. She currently works on a hog farm. Her investigations are negative for EBV, CMV, and HIV. Serologic tests for the infecting agent confirm the diagnosis in her. (SELECT ONE)
|100. A 42-year-old man presents with sudden-onset fever, chills, headaches, myalgias, and arthralgias. He has no prior medical history, but noticed a new ulcer on his hand 1 week ago. On examination, there is a small “punched out” ulcer, which is erythematous and indurated on
his hand, as well as epitrochlear and axillary lymph nodes that are tender. As a hobby, he keeps rabbits in a large pen outside his house and recalls being bitten by one 2 weeks ago. Serologic testing for the organism confirms the diagnosis. (SELECT ONE)
|101. A 28-year-old man presents with a new genital ulcer on his penis that is painless. He is sexually active and noticed the lesion 1 week ago. The ulcer is 1 cm in size, has an eroded base, and an indurated margin. Dark-field examination of the ulcer fluid confirmed the diagnosis. (SELECT ONE)
|103. A 35-year-old woman develops nausea, vomiting, abdominal pain, and diarrhea 1 day after attending an outdoor picnic. Other people who attended the picnic have similar gastrointestinal symptoms. Most symptomatic individuals recall having egg salad sandwiches. (SELECT ONE)
|105. A 34-year-old man who works as a carpenter presents with symptoms of jaw discomfort, dysphagia, and pain as well as stiffness in his neck, back, and shoulders. On examination, he is unable to open his jaw, his proximal limb muscles are stiff as is his abdomen and back, but the hands and feet are relatively spared. He occasionally has violent generalized muscles spasms that cause him to stop breathing, but there is no loss of consciousness. A clinical diagnosis is made and he is treated with antibiotics, antitoxin, and diazepam as well as muscle relaxants for the spasms. (SELECT ONE)
|102. Infection with this organism during pregnancy can cause congenital hydrocephalus. (SELECT ONE)
|104. For this infectious disease, preventive measures are no longer used since it has been effectively eradicated. (SELECT ONE)