Question 186#

It would be most appropriate to withhold rabies prophylaxis for which one of the following? 

A. A mouse bite occurring in the patient’s basement

Correct Answer A:

Rabies postexposure prophylaxis (RPEP) should be given for all bat bites and most raccoon bites unless brain test results will be available within 48 hours.  

Bites from small rodents (e.g., rats, mice, squirrels) never require RPEP.

RPEP should be given after a domestic animal bite if it was unprovoked and/or the animal demonstrated abnormal behavior and is not available for observation.

Question 187#

Which one of the following would be most likely to have secondary hypertension?

A. A 39-year-old white male who weighs 119 kg (262 lb) and whose blood pressure is 142/94 mm Hg

Correct Answer D:

Physical findings which suggest secondary hypertension include the presence of abdominal bruits, particularly those that lateralize or have a diastolic component. Excess body weight is correlated closely with increased blood pressure, but is not a cause of secondary hypertension. Hypertension is the most important risk factor for stroke, but a history of stroke is not an indication of secondary hypertension. Left ventricular hypertrophy is a result of hypertension, but is not an indication of secondary hypertension. The prevalence of hypertension is greater in blacks than in whites, but black race is not a risk factor for secondary hypertension. 

Question 188#

Which one of the following antihypertensive agents may help preserve bone mineral density?

A. Atenolol (Tenormin)

Correct Answer D:

In healthy older adults, low-dose hydrochlorothiazide preserves bone mineral density of the hip and spine. The modest effects observed over 3 years, if accumulated over 10-20 years, may explain the one-third reduction in risk for hip fracture associated with thiazide use in many epidemiologic studies. There are no such benefits reported for the other medications listed.

Question 189#

Your community recently experienced an outbreak of infectious diarrheal illness due to the protozoan Cryptosporidium, a chlorine-resistant organism. A reporter from the local newspaper asks you if there are other chlorine-resistant fecal organisms that could contaminate public drinking water.

You would tell the reporter that such organisms include: 

A. Escherichia coli

Correct Answer D:

Organisms that can persist in water environments and survive disinfection, especially chlorination, are most likely to cause disease outbreaks related to drinking water. Cryptosporidium oocysts and Giardia cysts are resistant to chlorine and are important causes of gastroenteritis from drinking water. Entamoeba histolytica and hepatitis A virus are also relatively chlorine resistant. The other organisms listed are chlorine sensitive. 

Question 190#

Outbreaks of dermatitis and folliculitis associated with swimming pools and hot tubs are often caused by which one of the following? 

A. Listeria

Correct Answer B:

Pseudomonas organisms have been associate with outbreaks of otitis externa, dermatitis, and folliculitis in persons using swimming pools and hot tubs.