Infectious Disease 6

A 24-year-old male presents to the emergency room for management of a wound he was working on a construction site and sustained a puncture wound with a nail. He has had a complete tetanus series as a child and his last tetanus shot was 3 years ago. On examination there is a small, deep puncture wound through skin that is very dirty. Which of the following is the most appropriate management for this patient?

A 56-year-old female presents to the clinic with a history of a flu-like illness consisting of fever, fatigue, arthralgia, myalgia and headache. She reports depressed mood and emotional lability. She is concerned that she may have Lyme disease because she had a tick bite while hiking on Martha’s Vineyard last week. She does not recall any skin lesion around the area of the bite. On examination she appears to be mildly jaundiced and has mild splenomegaly. Laboratory test reveal a hemolytic anemia and thrombocytopenia. Which of the following is the most likely diagnosis?

A 34-year-old female is newly diagnosed with HIV infection. She is going to start on highly active antiretroviral treatment (HAART). Which of the following would represent an appropriate treatment regimen to start her on initially?

A 2-year-old female is brought to the clinic for refusal to eat or drink for one day. She is crying a lot, but appears to be otherwise well. On examination her mucous membranes are dry, and there are numerous ulcerative lesions on the buccal and gingival mucosa. There are no lesions on her hands or feet. Which of the following is the most appropriate treatment for this child?

A 57-year-old male presents for a follow up examination of shingles. The skin lesions have cleared up completely; however, he is still in considerable pain in the distribution of the rash. Which of the following medications has been shown to be helpful in reduction of symptoms of post-herpetic neuralgia?

A 34-year-old female presents for evaluation of a skin lesion. She reports that she had a tick bite on her left leg approximately three days earlier and now there is a 6 cm annular lesion which she says is expanding in size. She reports that she has mild flu like symptoms and her joints are aching. Her last menstrual period was two weeks ago. Which of the following is the correct name of this skin lesion?

A high-school football player develops infectious mononucleosis. He has no splenomegaly on physical examination and is anxious to return to play in this, his senior, year. What is the most appropriate management for this young man?

A 2-month-old boy is hospitalized with respiratory syncytial virus bronchiolitis. This puts him at increased risk for which of the following later in his life?

Which of the following persons should receive Lyme disease prophylaxis?

A 9-month-old who is in daycare develops a fever and seems to have lost her appetite. Her mother noticed scattered flat and slightly raised pinkish spots on her back and abdomen. The next morning these areas have developed blisters and more of the pink lesions are present. The following day the blistered areas develop crusts and still more pink lesions and blisters are present. What is the most likely diagnosis?

Deaths associated with cholera are usually due to which of the following?

Most Coxsackievirus infections occur at what time of year?

An infant has received immunization with PRP-OMPfor Haemophilus influenza type b at two and four months. Which of the following would be an appropriate age for the third dose?

A 17-year-old high school student comes to the office with what he says is a spider bite on top of his foot, which he has had for five days. There is a red, swollen, painful abscess on the top of his right foot. It is about 2 cm in diameter. The patient said he thinks he got the spider bite from walking barefoot in the school locker room after a wrestling match. He said the pustule will not go away, and it seems to be getting bigger and redder every day. You lance the abscess and biopsy it. What do you suspect is the cause of the boy’s condition?

On a June afternoon, a 65-year-old man comes to the office for an annual physical exam. He states he does not remember the last time he had a vaccination, but it was probably when he was a child. The only surgery he has ever had was an appendectomy as a child. What type of vaccination should he receive?

A 2-year-old boy is brought into the emergency nursing clinic with a complaint of fever for 6 days and development of a limp. On examination, he is found to have an erythematous macular exanthem over his body, ocular conjunctivitis, dry and cracked lips, a red throat, and cervical lymphadenopathy. There is a grade II/VI systolic ejection murmur at the lower left sternal border. A white blood cell count and differential show predominant neutrophils with increased platelets on smear. What is the most likely diagnosis?

A 2-year-old boy is brought into the emergency nursing clinic with a complaint of fever for 6 days and development of a limp. On examination, he is found to have an erythematous macular exanthem over his body, ocular conjunctivitis, dry and cracked lips, a red throat, and cervical lymphadenopathy. There is a grade II/VI systolic ejection murmur at the lower left sternal border. A white blood cell count and differential show predominant neutrophils with increased platelets on smear. What would be the next steps in the management of the child?

Which of the following infectious diseases causes gastrointestinal symptoms, such as upset stomach, diarrhea, and nausea, which may progress to myalgia, fever, weakness, splinter hemorrhaging of the nails, and circumorbital edema, and is most commonly transmitted by eating undercooked pork?

Genital herpes is caused by the herpes simplex virus type 1 or type 2, and causes outbreaks of painful, red blisters on the genitals. Transmission of genital herpes:

Intravenous Amphotericin B combined with oral flucytosin has been proven to be an effective treatment for which of the following infectious diseases?

Which of the following is an appropriate treatment for oral candidiasis?

Helminth infections are most effectively treated by which of the following medications?

A 42-year-old female presents with increasing frequency and urgency of urination. She complains of intermittent hematuria. Urinalysis reveals bacteriemia and hematuria. Physical exam reveals suprapubic tenderness. Your diagnosis for this female is cystitis. Which of the following medications would you suggest to treat this condition?

A 37-year-old HIV-positive female presents with fever, tachypnea, and nonproductive cough. Chest X-ray reveals perihilar infiltrates, but no pleural effusions. Bloodwork reveals lymphopenia and a CD4 count of 122 cells/mL. Based on the patient’s presentation and test results, which of the following is the most appropriate diagnosis?

A 17-year-old male presents with restlessness, muscles spasms, excitability, and bizarre behavior. Physical examination reveals excessively thick saliva. Patient also states he experiences pain when drinking water. Based on patient’s history, presentation, and physical examination, which of the following is the most appropriate diagnosis?

Which of the following vaccines contains antigens against 23 common strains of Pneumococcus?

Which of the following vaccines should be administered to a tuberculin-negative person at risk for intense, long-term exposure to tuberculosis?

A 24-year-old female presents with dysuria, increased urinary frequency and urgency, and a purulent urethral discharge. Physical exam reveals vaginitis and cervicitis. Gram stain of urethral discharge reveals Gram-negative intracellular diplococci. Based on the patient’s presentation, physical examination, and test results, which of the following is the most appropriate diagnosis?

Which of the following vaccines is given as a series of four doses and is recommended for children aged 6 weeks to 15 months?

Which of the following pneumonia vaccines is indicated for children between 2 to 5 years of age who have not previously been immunized?