Multiple Choice Questions (MCQ)

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Category: Medicine--->Infectious Disease
Page: 6

Question 26# Print Question

A 70-year-old nursing home resident had been admitted to the hospital for pneumonia and treated for 10 days with levofloxacin. She improved but developed diarrhea 1 week after discharge, with low-grade fever, mild abdominal pain, and 2 to 3 watery, nonbloody stools per day. A cell culture cytotoxicity test for Clostridium dif icile–associated disease was positive. The patient was treated with oral metronidazole, but did not improve after 10 days. Diarrhea has increased and fever and abdominal pain continue. What is the best next step in the management of this patient? 

A. Obtain C difficile enzyme immunoassay
B. Continue metronidazole for at least 2 more weeks
C. Switch treatment to oral vancomycin
D. Hospitalize patient for fulminant C difficile–associated disease
E. Use synthetic fecal bacterial enema

Question 27# Print Question

A college wrestler develops cellulitis after abrading his skin during a match. He is afebrile and appears well, but the lateral aspect of his arm is red and swollen with a draining pustule. Gram stain of the pus shows gram-positive cocci in clusters. Which of the following statements is correct? 

A. The patient will require hospital admission and treatment with vancomycin
B. The organism will almost always be sensitive to oxacillin
C. The organism is likely to be sensitive to trimethoprim-sulfamethoxazole
D. Community-acquired methicillin-resistant staphylococci have the same sensitivity pattern as hospital-acquired methicillin-resistant staphylococci
E. The infection is likely caused by streptococci

Question 28# Print Question

A 27-year-old man has fever, macular rash, and lymphadenopathy. He had unprotected sex with a male partner 2 weeks before the onset of these symptoms and has just learned that the partner is infected with HIV. The patient’s rapid HIV test is negative. What is the best test to evaluate this patient for HIV infection?

A. HIV enzyme-linked immunoabsorbent assay (ELISA)
C. Western blot testing
D. Glycoprotein 120 using ELISA

Question 29# Print Question

A businessman traveling around the world asks about prevention of malaria. He will travel to India and the Middle East and plans to visit several small towns. What is the most appropriate advice for the traveler? 

A. Common sense measures to avoid malaria such as use of insect repellants, bed nets, and suitable clothing have not really worked in preventing malaria
B. The decision to use drugs effective against resistant P falciparum malaria will depend on the knowledge of local patterns of resistance and the patient’s very specific travel plans
C. Prophylaxis should be started the day of travel
D. Chemoprophylaxis has been proven to be entirely reliable
E. He should stay inside at the noon as this is the mosquito’s peak feeding time

Question 30# Print Question

A 36-year-old man with history of acute myelogenous leukemia is admitted to the ICU with neutropenic fever and low blood pressure that requires norepinephrine drip. The patient finished his first cycle of chemotherapy 10 days ago. He denies respiratory, gastrointestinal, or urinary symptoms. CBC reveals mild thrombocytopenia and an absolute neutrophil count of 100/µL. Urinalysis is within normal limits and chest x-ray does not show any infiltrate. Awaiting culture results, which of the following antibiotic regimens is most appropriate? 

A. Imipenem
B. Vancomycin
C. Vancomycin, cefepime, and tobramycin
D. Piperacillin/tazobactam, levofloxacin, and amphotericin B
E. Continue supportive measures awaiting culture results

Category: Medicine--->Infectious Disease
Page: 6 of 7