Multiple Choice Questions (MCQ)

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Category: Q&A Medicine--->Infectious Diseases
Page: 10

Question 46# Print Question

A 40-year-old man with a history of HIV infection presents to his physician due to the development of several skin lesions. The lesions erupted over the past few days, and are associated with fevers, chills, and a headache. He had no other medical problems and admits to being inconsistent in taking his antiretroviral medications. He works at a pet adoption center, has not recently traveled, and has no known sick contacts. On examination, there are several violaceous papular and nodular lesions that vary in appearance on the patient’s abdomen.

Which of the following is most likely responsible for these lesions?

A. Mycobacterium avium complex
B. Human herpesvirus-8 (HHV-8)
C. Human T-lymphotropic virus-1 (HTLV-1)
D. Bartonella henselae
E. Human papillomavirus (HPV)

Question 47# Print Question

A 24-year-old medical student experiences an accidental needle stick from a patient known to have HIV.

Which of the following is the most appropriate management?

A. Tenofovir, emtricitabine, and raltegravir
B. Tenofovir and emtricitabine
C. Abacavir
D. Reassurance

Question 48# Print Question

A 38-year-old man presents to his physician complaining of fatigue, weight loss, cough, and shortness of breath. The symptoms have been present for 2 weeks now, and he has lost 4 kg over this time. He also complains of waking up in the middle of the night drenched with sweat. The cough is productive of yellow sputum and occasionally small amounts of blood. His medical history is significant for hypertension, for which he takes chlorthalidone, and he has a 12 pack-year smoking history. His temperature is 38.3°C, blood pressure is 138/88 mmHg, heart rate is 96 beats per minute, and respiratory rate is 24 breaths per minute. On examination, he has a normal S1 and S2 with no murmurs or gallops on auscultation. There is dullness to percussion over the right lower portion of his anterior chest, with decreased breath sounds over this area. A chest x-ray shows consolidation of the right middle lobe, and the right heart border is obscured. He is treated with antibiotics and is discharged. The patient follows up in clinic a couple of weeks later, and his laboratory values reveal elevated liver enzymes and uric acid.

Which of the following agents could cause both of these findings?

A. Ceftriaxone
B. Vancomycin
C. Ethambutol
D. Isoniazid
E. Pyrazinamide

Question 49# Print Question

A 42-year-old man who recently immigrated to the United States from Turkey presents with lower urinary tract symptoms. He reports that 4 months ago he had a localized rash on his trunk after swimming in a lake. Within the past few weeks, he has developed urinary urgency, frequency, and pain with urination. He has no history of kidney stones, UTIs, or congenital urinary tract abnormalities. He is afebrile with a normal physical examination. His laboratory values are significant for a hemoglobin of 11.1 g/dL, and a serum leukocyte differential shows eosinophilia. Microscopic analysis of the urine reveals numerous RBCs and parasite eggs.

If left untreated, which of the following is this patient at risk of developing?

A. Bladder cancer
B. Portal hypertension
C. Severe hemolytic anemia
D. Asthma

Question 50# Print Question

A 32-year-old man comes to the physician complaining of fever, shortness of breath, and a productive cough that has developed slowly over the past week. He has no other medical history and does not take any medications. His temperature is 38.5°C, blood pressure is 122/78 mmHg, heart rate is 68 beats per minute, respiratory rate is 18 breaths per minute, and oxygen saturation is 98% on room air. There are decreased breath sounds and dullness to percussion over the right lung base. The rest of the physical examination, including cardiac auscultation, is normal. A chest x-ray confirms consolidation of the right lower lobe.

What is the most appropriate course of action for this patient?

A. Outpatient treatment with azithromycin
B. Perform diagnostic blood and sputum tests, then treat as an outpatient with antibiotics based on the culture and sensitivities
C. Admit the patient and treat with levofloxacin
D. Admit the patient and treat with ceftriaxone and clindamycin

Category: Q&A Medicine--->Infectious Diseases
Page: 10 of 11