Infectious Disease 4

A 33-year-old man has recurrent folliculitis on his trunk and thighs. Which of the following is the most likely underlying cause?

Metronidazole therapy is not indicated in the patient who has which of the following conditions?

A mother brings her 10-year-old son to see because of a one-day history of low-grade fever accompanied by red, flushed cheeks, circumoral pallor and a lacy erythematous pruritic rash on his body, most notable over the upper arms and legs. Some of his classmates have also developed the same illness in the past week. Which of the following is the most likely diagnosis?

Which of the following antibiotics is considered the drug of choice in treating anthrax?

Which of the following is preferred in the treatment of botulism?

Which of the following is an important reservoir for Campylobacter jejuni?

A 52-year-old male who is HIV positive presents for evaluation of a skin lesion that has been present for approximately one week.   He reports that he has had fevers since the day before the lesion appeared. His last CD4 count was 600 cells/cc and his viral load was undectable. He works as a veterinarian. On examination there is a single 2 cm raised erythematous lesion that blanches with pressure on his right forearm. There are enlarged, tender epitrochlear and axillary lymph nodes.   Which of the following is the most likely diagnosis?

A 10-year-old girl is first seen with a history of a persistent, swollen lymph node and intermittent fever. She was well until 3 weeks before her visit, when several scratches on her lower legs appeared to be infected. At the initial visit, she was afebrile and reported a history of cat scratches on her legs that resolved with a short course of cephalexin. One week later, she is again seen with swollen lymph nodes in her neck, left armpit, and groin, which persisted for 3 to 4 weeks. Which of the following is the most likely cause of this patient’s disorder?

Many residents of a hastily built refugee camp on the border of Pakistan develop severe diarrhea. Their stools are liquid, gray, copious, and frequent but have no pus, blood, or odor. What is the most likely diagnosis?

A 45-year-old woman with long-standing HIV disease develops fever, weight loss, cough, and wheezing. Examination reveals a cachectic woman with scattered rhonchi and bilateral wheezing. Her CD4 count is 45 μL, and blood cultures are positive for Mycobacterium avium complex (MAC). Of the following, what is the most appropriate treatment for her new problem?

A 43-year-old man who works as a fisherman arrives at the office complaining of redness and swelling of his left thumb. He noticed it after returning from a fishing trip off the Pacific Northwest coast, and it has been getting progressively worse over the last 2 weeks. He has no significant medical history and no other symptoms. Examination reveals a painful, erythematous lesion with irregular margins and central clearing at the base of the patient’s left thumb. Which of the following is the most likely diagnosis?

A 30-year-old Indian woman comes to the office with a 6-month history of pain and numbness in her right leg and foot. The symptoms began with mild paresthesias and blistering sores on her hands gradually increasing to bilateral numbness. Examination demonstrates two well-demarcated areas of hypopigmentation on the right foot and a hyperpigmented rash over the right ankle. She has profound sensory loss in the left hand and decreased sensation to pinprick in the ulnar distribution of the right hand. Peripheral nerves are easily palpable at the left elbow. Which of the following is the most likely diagnosis?

Salmonella typhimurium is most commonly transmitted to humans by what route?

A 4-year-old child cared for in a daycare center during the week is seen in the clinic after experiencing an episode of grossly bloody diarrhea. Her mother reports that the child has had a 2-day history of fever and abdominal cramping. Laboratory tests disclose fecal leukocytes in her stool. Stool culture results in a nonmotile Gram-negative facultative rod. What etiologic agent is most likely?

According to the Centers for Disease Control and Prevention, at what age should an infant FIRST receive tetanus immunization?

A 30-year-old woman from New York City has a 1-week history of fever, headache, chills, nausea, and malaise. She had been hiking in the woods while on vacation in Connecticut with her husband 2 weeks before the onset of her symptoms. Her medical history is unremarkable. On examination, the patient has scleral icterus and is diaphoretic. She has two ecchymotic lesions on her right upper arm and mild right upper quadrant tenderness but no hepatosplenomegaly. Complete blood cell count shows leukopenia, lymphopenia, and thrombocytopenia. Which of the following tick-borne diseases is most likely?

Where does the rash of Rocky Mountain spotted fever most typically FIRST appear?

A 28-year-old female with a history of HIV reports the clinic concerned because her son has chicken pox. She herself had chicken pox at age 8. She is on anti-retroviral agents and has an undetectable viral load. She has no current lesions.   What type of prophylaxis is indicated in this patient?

Which of the following persons with Lyme disease requires intravenous antibiotic therapy?

A recent immigrant from Ghana is found to have ascariasis. She is 30 weeks pregnant. What is the most appropriate treatment for her?

The classic lesion of anthrax is best described as a localized skin lesion with which of the following characteristics?

Farcy, crater-like skin ulcers that form along the lymph vessels in the extremities are associated with which of the following infections?

Of the following, which is classified as a category A potential bioterrorism agent?

What is the most common manifestation of chronic Q fever?

An immunocompromised patient has developed an aspergilloma after she developed hemoptysis. What is the treatment of choice?

Which of the following is preferred in the treatment of toxoplasmic encephalitis?

Which of the following is a contraindication to administering the varicella immunization?

A mother brings her 3-year-old boy to the clinic with a 1-week history of mild fever, pharyngitis, and malaise. She seeks treatment because today she noticed “sores inside his mouth.” Examination reveals lesions on his tongue and hard palate, including macules, vesicles, and shallow erosions surrounded by an erythematous halo. Tender macular skin lesions on an erythematous base also appear on the soles of his feet and palms of his hands. What is the most likely cause of this child’s illness?

A 13-year-old female with a history of asthma presents to the clinic with abrupt onset of fever, chills, myalgias, cough and rhinorrhea.   There is currently an influenza outbreak in her school, and rapid testing confirms that she does have influenza A. Which of the following medications would be the most appropriate for the management of this patient?

A 62-year-old male complains of recent hearing loss. Today, his physical exam is negative. Recently he had been hospitalized and treated for pneumonia due to Klebsiella. The class of drugs that most likely caused his ototoxicity is: