Multiple Choice Questions (MCQ)

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Category: Medicine--->Infectious Disease
Page: 4

Question 16# Print Question

A 30-year-old man with sickle cell anemia is admitted with cough, rusty sputum, and a single shaking chill. Physical examination reveals increased tactile fremitus and bronchial breath sounds in the left posterior chest. The patient is able to expectorate a purulent sample. Which of the following best describes the role of sputum Gram stain and culture? 

A. Sputum Gram stain and culture lack the sensitivity and specificity to be of value in this setting
B. If the sample is a good one, sputum culture is useful in determining the antibiotic sensitivity pattern of the organism, particularly S pneumoniae
C. Empirical use of antibiotics for pneumonia has made specific diagnosis unnecessary
D. There is no characteristic Gram stain in a patient with pneumococcal pneumonia
E. Gram-positive cocci in clusters suggest pneumococcal infection

Question 17# Print Question

A family of four presents to the emergency room with sudden-onset abdominal cramps, nausea, and vomiting. None of them has fever or diarrhea. Four hours earlier, they had lunch at a road side restaurant. They ate a variety of grilled meats, fried rice, and seasoned vegetables. Symptoms resolved in 24 hours. Which organism is most likely responsible for this outbreak?

A. Bacillus cereus
B. Campylobacter jejuni
C. Salmonella enterica
D. Giardia lamblia
E. Yersinia enterocolitica

Question 18# Print Question

A 40-year-old female nurse was admitted to the hospital because of fever to 39.4°C (103°F). Despite a thorough workup in the hospital for over 3 weeks, no etiology has been found, and she continues to have temperature spikes greater than 38.9°C (102°F). Which of the following statements about diagnosis is correct?

A. Chronic infection, malignancy, and collagen vascular disease are the most common explanations for this presentation
B. Influenza may also present in this manner
C. Lymphoma can be ruled out in the absence of palpable lymphadenopathy
D. SLE is an increasing cause for this syndrome
E. Factitious fever should be considered only in the patient with known psycho-pathology

Question 19# Print Question

A 40-year-old school teacher develops nausea and vomiting at the beginning of the fall semester. Over the summer she had taught preschool children in a small town in Mexico. She is sexually active, but has not used intravenous drugs and has not received blood products. Physical examination reveals scleral icterus, right upper quadrant tenderness, and a palpable liver. Liver function tests show aspartate aminotransferase of 750 U/L (normal < 40) and alanine aminotransferase of 1020 U/L (normal < 45). The bilirubin is 13 mg/dL (normal < 1.4) and the alkaline phosphatase is normal. What further diagnostic test is most likely to be helpful?

A. Liver biopsy
B. Abdominal ultrasound
C. IgM antibody to hepatitis A
D. Antibody to hepatitis B surface antigen
E. Determination of hepatitis C RNA

Question 20# Print Question

A previously healthy 25-year-old music teacher develops fever and a rash over her face and chest. The rash is itchy and, on examination, involves multiple papules and vesicles in varying stages of development. One week later, she complains of cough and is found to have an infiltrate on x-ray. Which of the following is the most likely etiology of the infection?

A. Streptococcus pneumoniae
B. Mycoplasma pneumoniae
C. Histoplasma capsulatum
D. Varicella-zoster virus
E. Chlamydia psittaci

Category: Medicine--->Infectious Disease
Page: 4 of 7