Infectious Disease 3

A 22-year-old intravenous drug abuser who is HIV-infected has completed antibiotic therapy for tricuspid valve endocarditis. Which of the following is the most appropriate counseling?

A 22-year-old man has a painless, indurated ulcer on his penis. Primary syphilis is diagnosed. Which of the following is the preferred initial therapy?

A 16-year-old woman has fever and productive cough. Mycoplasma pneumonia is diagnosed. Which of the following is the preferred antibiotic therapy?

A 24-year-old man is hospitalized for treatment of a lung abscess. Which of the following is the most likely preceding event causing the pulmonary illness?

A 56-year-old woman has acute pyelonephritis manifest by fever, chills, dysuria, and back pain. Which of the following is the most likely complication?

Which of the following is the preferred endocarditis prophylaxis for gingival (gum) surgery in a 71-year-old woman who has a mechanical aortic valve prosthesis and is allergic to penicillin?

An intravenous drug abuser has tricuspid valve endocarditis. Which of the following is the most likely infecting organism?

A 35-year-old woman has the acute onset of right hemiplegia. Blood pressure 116/76 mm Hg, pulse 116/min/irregularly irregular, respirations 20/min, axillary temperature 102 degrees F. Examination of the lungs is normal. A 2/6 apical holosystolic murmur is heard. Right hemiplegia is noted with positive right Babinski. Which of the following is the most likely diagnosis?

In a 77-year-old man who has an acute ischemic stroke, the presence of which of the following is most suggestive of endocarditis?

A 62-year-old woman has the sudden onset of painless drooping of the right side of her face. Examination shows weakness of facial muscles on the right side and excessive tearing of the right eye. No skin lesions are noted. Which of the following is the most likely underlying cause?

Infection by which of the following hepatitis viruses is most likely to cause chronic hepatitis?

A healthy 26-year-old man is bitten on the thumb by a stray dog. Which of the following organisms is most likely to cause infection of the bite wound?

Ten hours earlier a 75-year-old man was bitten by a stray dog on the left leg. Which of the following is the preferred antibiotic to be given in prevention of infection?

An 18-year-old man has a tape worm after travel on a medical mission to South America. What finding will be seen on his CBC differential that is associated with helminth infection?

The presence of which of the following differentiates peripheral cranial nerve VII palsy in Ramsay Hunt syndrome from the typical Bell’s palsy?

A 16-year-old teenager with neutropenia secondary to long-standing aplastic anemia was first seen with a 5-day history of pharyngitis and fever. Initial chest radiographs and laboratory studies disclosed no underlying cause of his symptoms, and he was thought to have a febrile neutropenic episode. Despite a course of intravenous antibiotics, he developed a progressive cough, hemoptysis, and pleuritic chest pain. Repeat chest radiographs show progressive pulmonary infiltrates. Microscopic examination of lung bulla tissue discloses large, septated, branching hyphae. Which of the following is the most likely diagnosis?

Which of the following is a risk factor for blastomycosis?

Which of the following fungal diseases may be associated with development of erythema nodosum and painful swelling in the ankles and knees?

An elderly woman is brought to the office by her husband who reports that she has a 4-year history of increasing episodes of confusion, irritability, and memory loss. Over the past 2 years, she also has had 5-minute episodes of vertigo that occur approximately twice a week. These episodes are not positional and are not associated with nausea, diplopia, dysarthria, dysphagia, tinnitus, or hearing loss. An exhaustive evaluation reveals cognitive decline and myopathy. Which of the following organisms, if cultured from the CSF sample, is the most likely cause of her dementia?

A 36-year-old man who is HIV positive develops fever, prostration, cough, and dyspnea. Urine antigen for Histoplasma capsulatum is positive. What is the most appropriate drug for treating this patient?

In amebiasis, what is the primary site of extraintestinal disease?

Following a wilderness camping trip, a number of Scouts develop an acute diarrheal illness. Their stools are copious, frothy, and particularly malodorous but contain neither blood nor pus. These Scouts report drinking from a mountain stream where they later saw a beaver dam. What is the most likely infective agent causing their illness?

An infant female is born at 38 weeks gestation, after a seemingly uncomplicated pregnancy. The infant is born with a “blueberry muffin rash,” jaundice, retinitis, microcephaly, and is small for gestational age. Serologic testing confirms congenital cytomegalovirus infection. Which of the following conditions is likely to be present in this infant?

A 23-year-old woman in her first trimester of pregnancy reports that a friend told her not to get a new kitten because it could “mess up the baby.” The potential cat-associated problems in the fetus are caused by which of the following organisms?

A 29-year-old man who has sex with men has developed nontender lesions on the lateral aspects of his tongue. The lesions are white, stringy, and do not come off when gently scraped with a tongue depressor. What is the most likely diagnosis?

Hand-foot-and-mouth disease is caused by which of the following organisms?

Which of the following is most likely to cause tender swelling of the parotid gland?

A young woman was bitten by a wild raccoon when she attempted to keep it away from her dog. After washing the wound with soap and water, how should she be treated?

An 8-month-old boy with serious congenital cardiac disease has two older siblings who are in preschool. What is appropriate for the boy as prophylaxis for respiratory syncytial virus (RSV) infection?

A 45-year-old man developed a stiff neck, tender lymph nodes, visual blurring, and low-grade fever shortly after a 2-week vacation. He is now nauseated and has developed vertigo, myalgias, and nuchal rigidity. On examination, the patient had more than 100 mosquito bites that he had sustained while camping in the Florida Keys. Which of the following is the most likely explanation of this patient’s symptoms?