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

Question 31# Print Question

A 62-year-old man presents to his new primary care physician for a first visit. The patient has not seen a doctor for more than 10 years. He has mild intermittent bronchial asthma. The patient is sexually active with a single long-term partner. He does not recall receiving any vaccines since childhood. Which of the following vaccines should be offered?

A. Pneumococcal, influenza, zoster, and tetanus-diphtheria-acellular pertussis (Tdap)
B. Pneumococcal, influenza, zoster, and tetanus-diphtheria (Td)
C. Pneumococcal, influenza, and human papilloma virus
D. Pneumococcal, influenza, and tetanus-diphtheria-acellular pertussis (Tdap)
E. Pneumococcal, influenza, and meningococcal


Question 32# Print Question

A 60-year-old female patient is admitted to the hospital in septic shock secondary to a urinary tract infection. The patient is started on antibiotics awaiting culture results. She improves with complete resolution of her symptoms. The patient continues to have a urinary catheter in place. On the 10th hospital day, the patient is discharged to a rehabilitation facility. As a part of the routine admission orders, urinalysis and culture are ordered. The patient denies fever, abdominal pain, nausea, or vomiting. The urinalysis shows 5 to 10 white blood cells and a negative dipstick for nitrite and leukocyte esterase, but the culture grows more than 10 5 colonies of Candida albicans. Which of the following is the best course of action?

A. Start antifungal therapy with fluconazole
B. Continue broad-spectrum antibiotics
C. Remove the urinary catheter
D. Encourage water intake and continue to observe
E. Remove the urinary catheter and start liposomal amphotericin B


Question 33# Print Question

An 18-year-old high school student presents to the emergency room with 1-day history of right knee pain, swelling, and redness. He is a quarterback in the school’s football team. He remembers falling on the knee while practicing 2 days ago. The knee is tapped and 15 mL of cloudy fluid is sent for cell count, Gram stain, and culture. The Gram stain shows gram-positive cocci in clusters. Which of the following is the best course of action?

A. Start vancomycin and consult orthopedic surgery
B. Consult orthopedic surgery
C. Start linezolid awaiting culture results
D. Start ceftriaxone
E. Start telavancin and order magnetic resonant imaging of the knee


Question 34# Print Question

A 40-year-old male patient presents to the emergency room with a 1-week history of fever, rigors, and generalized weakness. The patient denies recent travel or sick contacts but admits to intravenous drug use. On examination, he has splinter and subconjunctival hemorrhages. Cardiac examination shows a holosystolic murmur over the left lower sternal boarder. There are no other localizing signs. Chest x-ray and urinalysis are negative. After obtaining blood cultures, the patient is started on intravenous antibiotics and admitted to the medical floor. Twenty-four hours later, all sets of blood culture grow gram-positive cocci in clusters. A transthoracic echocardiogram is negative for vegetations. Which of the following is the best course of action? 

A. Place a peripherally inserted central catheter (PICC) and start vancomycin
B. Repeat blood cultures to confirm the positive cultures were not contaminants
C. Order a transesophageal echocardiogram
D. Continue vancomycin till the patient becomes afebrile, then discharge him on PO linezolid to finish a total of 2 weeks
E. Order a three-phase bone scan


Question 35# Print Question

A 20-year-old female patient presents with a 2-day history of dysuria, lower abdominal pain and low-grade fever. Her urine is cloudy with pyuria and abundant gram-positive bacteria. She is a college student who is sexually active with no previous history of sexually transmitted diseases. Which organism is most likely responsible for this woman’s symptoms?

A. Enterococcus faecalis
B. Escherichia coli
C. Neisseria gonorrhoeae
D. Staphylococcus saprophyticus
E. Candida albicans




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