A nurse develops clinical symptoms consistent with hepatitis. She recalls sticking herself with a needle approximately 5 months before, after drawing blood from a patient. Serologic tests for HBsAg, and antibodies to HBsAg and HAV are all negative; however, she is positive for HBcAg IgM antibody. Which of the following characterizes the current health state of the nurse?
Correct!
Wrong!
A 65-year-old Florida fisherman forgot his insect repellent on a recent sporting trip. A week later, he developed fever, chills, headache, and flulike symptoms. He was brought to the Emergency Department by his wife with photophobia, extreme lethargy, and severe headache. CNS examination revealed cranial nerve deficits and hemiparesis. The patient was admitted to intensive care with a grave prognosis. Which of the following is the vector that transmitted the infection from which this man is suffering?
Correct!
Wrong!
A local school district finds a large number of student absences, with the children presenting with rhinorrhea, nasal obstruction, headache, and malaise, but no fever. A strain of rhinovirus is the most likely etiologic agent of these infections. By which method is this virus most frequently spread?
Correct!
Wrong!
A 10-month-old infant who was born 4 weeks premature was brought to the Emergency Department with high fever, rhinorrhea, cough, and difficulty breathing. On examination, the baby had dyspnea and tachypnea; rales and wheezing were heard over both lungs. The baby was admitted to Pediatric Intensive Care where she suffered respiratory failure and was placed on mechanical ventilation. Two different types of tests for respiratory syncytial virus (RSV or Pneumovirus) were negative, as were tests for parainfluenza virus, influenza A and B viruses, and adenovirus. Which of the following viruses is the most likely etiologic agent?
Correct!
Wrong!
Kuru was a fatal disease of certain New Guinea natives and was characterized by tremors and ataxia; Creutzfeldt–Jakob disease (CJD) is characterized by both ataxia and dementia. CJD has been accidentally transferred to others by contaminated growth hormone from human pituitary glands, corneal transplants, and contaminated surgical instruments. These diseases are thought to be caused by which of the following?
Correct!
Wrong!
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Kuru was a fatal disease of certain New Guinea natives and was characterized by tremors and ataxia; Creutzfeldt–Jakob disease (CJD) is characterized by both ataxia and dementia. CJD has been accidentally transferred to others by contaminated growth hormone from human pituitary glands, corneal transplants, and contaminated surgical instruments. These diseases are thought to be caused by which of the following?
Correct!
Wrong!
A patient who works in an industrial setting presents to his ophthalmologist with prominent subconjunctival hemorrhage, periorbital swelling, and corneal changes consistent with keratitis. The patient reported severe photophobia and the sensation that something was in his eye. Nine other workers developed similar symptoms 7 days later. The differential diagnosis should include infection with which of the following viruses?
Correct!
Wrong!
A hospital worker is found to be positive for hepatitis B surface antigen. Subsequent tests reveal the presence of HBeAg as well. Which of the following best describes the worker?
Correct!
Wrong!
An extended family met for a family reunion in a rural area of Texas. All reported numerous mosquito bites. One week later several family members had headache, nausea, fever, and malaise. Two developed stiff neck and severe headache that resolved over the next 5 days, and an 8- month-old was hospitalized with diffuse encephalitis. All family members recovered completely except the infant who was left with a seizure disorder. An arbovirus was confirmed as the etiologic agent by serologic testing of the effected persons. Which of the following is the most likely etiologic agent?
Correct!
Wrong!
A 2-month-old infant was admitted to the medical center in February for treatment of bronchiolitis. An immunofluorescent assay was positive for a respiratory virus. As the infant was struggling to breathe, ribavirin treatment was started immediately. With which virus was this infant infected?
Correct!
Wrong!
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In January, a 74-year-old woman from Iowa is brought to the emergency department by her husband. He states that she had recent onset of high fever and headache. During the last 2 days, she has been confused and cannot perform daily chores. Shortly after arrival she suffers a seizure. Her physical examination indicates some weaknesses in her left side and neck stiffness. Magnetic resonance imaging images show encephalitis localized to the right temporal lobe. What is the most likely causative agent?
Correct!
Wrong!
An 8-month-old girl suddenly developed a high fever (103°F). Her pediatrician examined her and found no signs of upper respiratory tract infection, meningitis, or encephalitis. Two days later, the girl’s fever reached 105°F and she suffered a febrile seizure. By the time the child was brought to the pediatrician’s office, her temperature had dropped. The doctor noted a generalized papular rash. What was the doctor’s most likely diagnosis for this child?
Correct!
Wrong!
A 5-month-old infant, seen in the emergency room in winter, presents with fever and persistent cough with wheezing. Her mother states that the baby’s older brother, age 3, had recently had a runny nose, sore throat, and fever. Physical examination of the infant revealed tachypnea and tachycardia; expiratory wheezes were heard over both lungs. The baby was cyanotic and retractions were observed and a chest x-ray showed hyperinflated lung fields. Which of the following is most likely the cause of this infection?
Correct!
Wrong!
Which one of the following groups of people is most likely to be at increased risk for HIV infection?
Correct!
Wrong!
An obstetrician sees a pregnant patient who was exposed to rubella virus in the 18th week of pregnancy. She does not remember getting a rubella vaccination. Which of the following is the best immediate course of action?
Correct!
Wrong!
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Two viral vaccines are expected to reduce the incidence of cancers. Which vaccines are these?
Correct!
Wrong!
A group of healthcare workers from the United States staffing a clinic in India were working with children admitted with acute flaccid paralysis. The illness began with fever, nausea, vomiting, and severe headache followed by neck stiffness, muscle pain and weakness, and constipation. None of the workers became ill because they had been vaccinated against this disease. Which viral vaccine protected these workers?
Correct!
Wrong!
A group of healthcare workers from the United States staffing a clinic in India were working with children admitted with acute flaccid paralysis. The illness began with fever, nausea, vomiting, and severe headache followed by neck stiffness, muscle pain and weakness, and constipation. None of the workers became ill because they had been vaccinated against this disease. Which viral vaccine protected these workers?
Correct!
Wrong!
Along with several children at his elementary school who had similar symptoms, a 6-year-old boy was sent home from school because his eyes were red with a watery, nonpurulent discharge. He had a fever of 102°F and complained of sore throat. A rapid test for Group A Streptococcus was negative and his doctor told the boy’s mother that her child would recover within a week. Which of the following organisms was the most likely cause of his infection?
Correct!
Wrong!
A husband and wife performed the yearly spring cleaning of their mountain cabin, located in the southwestern part of the United States. The woman presented to her physician 2 weeks later with fever, myalgia, headache, and nausea, followed by progressive pulmonary edema and respiratory failure. How did she acquire this viral infection?
Correct!
Wrong!
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