Your-Doctor Multiple Choice Questions (MCQ)

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Category: Medicine--->Infectious Disease
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Question 11#Print Question

A 35-year-old man complains of inability to close his right eye. Examination shows facial nerve weakness of the upper and lower halves of the face. There are no other cranial nerve abnormalities, and the rest of the neurological examination is normal. The patient is afebrile. Examinations of the heart, chest, abdomen, and skin show no additional abnormalities. There is no lymphadenopathy. About 1 month ago the patient was seen by a dermatologist for a bull’s-eye skin rash 2 weeks after returning from a camping trip in upstate New York. Which of the following is the most likely diagnosis? 

a. Sarcoidosis
b. Idiopathic Bell palsy
c. Lyme disease
d. Syphilis
e. Lacunar infarct

Question 12#Print Question

A 25-year-old woman complains of dysuria, frequency, and suprapubic pain. She has not had previous symptoms of dysuria and is not on antibiotics. She is sexually active and on birth control pills. She has no fever, vaginal discharge, or history of herpes infection. She denies back pain, nausea, or vomiting. On physical examination she appears well and has no costovertebral angle tenderness. A urinalysis shows 20 white blood cells per high power field. Which of the following statements is correct?

a. A 3-day regimen of trimethoprim-sulfamethoxazole is adequate therapy
b. Quantitative urine culture with antimicrobial sensitivity testing is mandatory
c. Obstruction resulting from renal stone should be ruled out by ultrasound
d. Low-dose antibiotic therapy should be prescribed while the patient remains sexually active
e. One dose of a parenteral antibiotic such as gentamicin should be given to prevent progression to pyelonephritis

Question 13#Print Question

A 59-year-old man undergoes coronary bypass surgery. He receives cefazolin prophylactically for 24 hours. On the ninth postoperative day, he develops a fever of 39.8°C with a heart rate of 115 beats/minute and a blood pressure of 105/65 mm Hg. The surgical site is healing well with no redness or discharge. His white blood cell count is 14,000/mm3 and urinalysis reveals many white blood cells per high power field. Blood and urine cultures grow a non-lactose fermenting oxidase-positive gram-negative rod. Which of the following antibiotics is most appropriate to treat this infection? 

a. Moxifloxacin
b. Ceftriaxone
c. Doripenem
d. Trimethoprim-sulfamethoxazole
e. Tigecycline

Question 14#Print Question

You are a physician in charge of patients who reside in a nursing home. Several of the patients have developed influenza-like symptoms, and the community is in the midst of influenza A outbreak. None of the nursing home residents have received the influenza vaccine. Which course of action is most appropriate?

a. Give the influenza vaccine to all residents who do not have a contraindication to the vaccine (ie, allergy to eggs)
b. Give the influenza vaccine to all residents who do not have a contraindication to the vaccine; also give oseltamivir for 2 weeks to all residents
c. Give amantadine alone to all residents
d. Give azithromycin to all residents to prevent influenza-associated pneumonia
e. Do not give any prophylactic regimen, but treat with oseltamivir if a clinical outbreak should occur

Question 15#Print Question

A 60-year-old male patient complains of low back pain, which has intensified over the past 3 months. He had experienced some fever at the onset of the pain. He was treated for acute pyelonephritis about 4 months ago. Physical examination shows tenderness over the L2-3 vertebra and paraspinal muscle spasm. Laboratory data show an erythrocyte sedimentation rate of 80 mm/h and elevated C-reactive protein. Which of the following statements is correct? 

a. Hematogenous osteomyelitis rarely involves the vertebra in adults
b. The most likely initial focus of infection was soft tissue
c. Blood cultures will be positive in most patients with this process
d. An MRI scan is both sensitive and specific in defining the process
e. Surgery will be necessary if the patient has osteomyelitis

Category: Medicine--->Infectious Disease
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