Multiple Choice Questions (MCQ)

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Category: Medicine--->Infectious Disease
Page: 2

Question 6# Print Question

A 22-year-old male patient, recently incarcerated and now homeless, has received 1 week of clarithromycin for low-grade fever and left upper-lobe pneumonia. He has not improved on antibiotics, with persistent cough productive of purulent sputum and flecks of blood. Repeat chest x-ray suggests a small cavity in the left upper lobe. Which of the following statements is correct?

A. The patient has anaerobic infection and needs outpatient clindamycin therapy
B. Sputum for acid fast bacilli stain and culture is required
C. The patient requires glove and gown contact precautions
D. Isoniazid to treat latent tuberculosis should be started if PPD is positive
E. Interferon-gamma release assay should be ordered

Question 7# Print Question

 A 19-year-old male patient presents with a 1-week history of malaise and anorexia followed by fever and sore throat. On physical examination, the throat is inflamed without exudate. There are a few palatal petechiae. Cervical adenopathy is present. The liver span is 12 cm and the spleen is palpable.

  • Throat culture: negative for group A streptococci
  • Hgb: 12.5, Hct: 38%
  • Reticulocytes: 4%
  • WBC: 14,000/µL
  • Segmented: 30%
  • Lymphocytes: 60%
  • Monocytes: 10%
  • Bilirubin total: 2.0 mg/dL (normal 0.2-1.2)
  • Lactic dehydrogenase (LDH) serum: 260 IU/L (normal 20-220)
  • Aspartate aminotransferase (AST): 60 U/L (normal 8-40 U/L)
  • Alanine aminotransferase (ALT): 55 U/L (normal 8-40 U/L)
  • Alkaline phosphatase: 40 IU/L (normal 35-125)

Which of the following is the most important initial test combination to order?

A. Liver biopsy and hepatitis antibody
B. Streptococcal screen and antistreptolysin O (ASO) titer
C. Peripheral blood smear and heterophile antibody
D. Toxoplasma IgG and stool sample
E. Lymph node biopsy and cytomegalovirus serology

Question 8# Print Question

 A 30-year-old man presents with right upper quadrant pain. He has been well except for an episode of diarrhea that occurred 4 months ago, just after he returned from a missionary trip to Mexico. He has lost 7 lb. He is not having diarrhea. His blood pressure is 140/70, pulse 80, and temperature 37.5°C (99.5°F). On physical examination there is right upper-quadrant tenderness without rebound. There is some radiation of the pain to the shoulder. The liver is percussed at 14 cm. There is no lower quadrant tenderness. Bowel sounds are normal and active. Which of the following is the most appropriate next step in evaluation of the patient? 

A. Serology and ultrasound
B. Stool for ova and parasite
C. Blood cultures
D. Diagnostic aspirate
E. Empiric broad-spectrum antibiotic therapy

Question 9# Print Question

An 80-year-old female patient complains of a 3-day history of a painful rash extending over the right half of her forehead and down to her right eyelid. There are weeping vesicular lesions on physical examination. Which of the following is the most likely diagnosis?

A. Impetigo
B. Adult chickenpox
C. Herpes zoster
D. Coxsackie A virus
E. Herpes simplex

Question 10# Print Question

A 28-year-old woman presents to her internist with a 2-day history of low-grade fever and lower abdominal pain. She denies nausea, vomiting, or diarrhea. On physical examination, there is temperature of 38.3°C (100.9°F) and bilateral lower quadrant tenderness, without point or rebound tenderness. Bowel sounds are normal. On pelvic examination, an exudate is present and there is tenderness on motion of the cervix. Her white blood cell count is 15,000/µL and urinalysis shows no red or white blood cells. Serum β-hCG is undetectable. Which of the following is the best next step in management?

A. Treatment with ceftriaxone and doxycycline
B. Treatment with ciprofloxacin and metronidazole
C. Diagnostic laparoscopy
D. CT scan of abdomen and pelvis
E. Aztreonam

Category: Medicine--->Infectious Disease
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