Question bank

Select the organism associated with the Furunculosis aureus beta-hemolytic Streptococcus respiratory syncytial virus (RSV) Mycoplasma pneumoniae Haemophilus pertussis

A term infant male is born after an uncomplicated vaginal delivery. The mother's prenatal labs were negative with the exception of being GBS positive at 36 weeks' gestation. The mother received two doses of ampicillin prior to delivery and did not have a fever. The infant had APGAR scores of 9 at 1 minute and 9 at 5 minutes. The infant was brought to the newborn nursery and appears well The father tells you that he has hemophilia. His wife neither has hemophilia nor is a carrier. What does this mean for the baby?

Select the organism associated with the following clinical findings: A male student returns from traveling to a developing country, with a complaint of eructation, abdominal cramps, and diarrhea for the past 2 weeks, and has lost 10 lbs. aureus beta-hemolytic Streptococcus respiratory syncytial virus (RSV) Mycoplasma pneumoniae Haemophilus pertussis Helicobacter pylori

A45-year-old woman, seen by her medical internist, has been experiencing fears that she may have a serious illness. She complains that after eating she experiences "a lot of gas" and abdominal pain, followed by diarrhea on occasion. Her heart at times seems to be beating rapidly, and she feels faint at times, has chest "discomfort," and wonders if she is having a heart attack. Multiple tests have identified only a mild irritable bowel syndrome. The woman's fears are not allayed by this. She makes repeated calls to be seen by her doctors as well as seeking consultation from other specialists. She insists that "there's something there" and believes the doctors are not taking her seriously. Which of the following is the most likely diagnosis?

A mildly mentally retarded 9-year-old girl is brought to your office for acne. On examination, she does not actually have acne but has small flesh colored papules along her nasolabial fold. Her past history is significant for having had a first (afebrile) seizure last year. The mother reminds you that she has a faint birthmark on her hip that is pale and becomes more prominent in the summer, when the child's skin tans. Examination of this area reveals a 5-cm oval patch that is hypopigmented. Which condition would she most likely have? In evaluating her first seizure, a head CT was performed. Which finding would be most consistent with her diagnosis?

A22-year-old nulliparous woman who desires future fertility is found to have a pap smear consistent with high-grade squamous intraepithelial lesion (HGSIL). The test you performed above was inadequate. What would be your next step in management?

For the screening tests listed below, select the screening schedule that is appropriate for women (as per the U.S. Preventive Services Task Force [USPSTF], The Guide to Clinical Preventive Services, 2006) Cervical cytology (Pap smear) do not routinely screen yearly over age 50

On a Monday morning you see a 12-year-old otherwise healthy boy in the emergency department. The parents brought the boy in because they noticed that he started to have an abnormal gait in the past few days. He seems to be shuffling his feet. The boy complains that his legs feel heavy and are tingling. He relates that his arms feel fine. His past history is significant for attention deficit/hyperactivity disorder (ADHD) for which he is taking methylphenidate. He denies trauma or taking any other medicines or drugs. On examination, he is afebrile with normal vital signs. His entire physical examination is normal with the exception of the examination of is lower extremities. He has 3/5 strength throughout both of his lower extremities with a normal muscle mass. His all joints have a full range of motion, without any pain or swelling. His reflexes are absent and he describes some paresthesias of his feet and ankles Which of the following is the most appropriate initial management plan?

You are consulted by a 55-year-old asymptomatic postmenopausal woman who has been on tamoxifen for 2 years following a diagnosis of breast cancer. She has no other risk factors for endometrial cancer but she was searching the Internet and found information about the risks of tamoxifen therapy. She inquires about endometrial cancer screening. You tell her that for asymptomatic woman on tamoxifen, the screening recommendations for endometrial cancer are which of the following?

An 8-year-old male presents to your office complaining of a 1-week history of painful knee and elbow joints. On examination, you find a painful, hot, and swollen knee. He also has multiple erythematous macules with pale centers on his trunk and extremities. The laboratory work you order reveals elevated antistreptococcal antibodies. Which of the following information is required to make this diagnosis?

Parents bring you a 9-month-old boy they recently have adopted from western Russia. They have sparse medical records of the child's past. They do know that the boy was the result of a sexual assault on the mother and was given up at birth. The child has been in a "baby home" for 5 months. The records which accompanied the boy indicate that there had been some testing done. These tests include HIV, hepatitis B and C serologies, and a rapid plasma reagin (RPR), all of which are negative at 8 months of age. There is what appears to be a Russian immunization record as well. It seems to indicate that the child has had three diphtheria, tetanus, pertussis (DTP), three oral polio, and three hepatitis B vaccinations. There is also an indication that BCG (Bacille Calmette-Guérin) was given. The parents are concerned about fetal alcohol syndrome (FAS). Which physical feature is most consistent with FAS?

A 24-year-old male is involved in a house fire. His sputum is carbonaceous and he has suffered second-and third-degree burns to 65% of his total body surface area (TBSA). He is intubated in the ED without difficulty. A capnometer is placed at the end of the endotracheal tube and there is positive change in color. Examination of his chest reveals bilateral equal breath sounds. Suddenly he experiences ECG changes and goes into cardiac arrest. Which of the following drugs is most likely to be responsible for this event?

What is the most sensitive indicator of pneumonia in a child?

A 62-year-old man undergoes transplantation of a kidney from a cadaveric donor. The surgery is uncomplicated and his recovery proceeds well for the first week postoperatively. In the second postoperative week, he develops hypertension, peripheral edema, and decreased urinary output. He states that he has been taking his medications as ordered. What is the most likely cause of this condition?

Which of the following can induce menstrual bleeding in a 21-year-old anovulatory, amenorrheic woman with PCOS?

Identify the following personality disorders with the symptoms listed below. Preoccupied with feelings of superstitiousness; has a sixth sense; seems odd antisocial avoidant borderline dependent histrionic

A 54-year-old male presents to the ED with acute onset of severe abdominal pain. His history is significant for gnawing epigastric pain that radiates to the back for several months. Physical examination demonstrates mild hypertension and tachycardia as well as a rigid "board like" abdomen with generalized rebound tenderness and hypoactive bowel sounds. Rectal examination reveals dark hemoccult positive stools without gross blood. Which of the following would be the next appropriate step in management?

A 30-year-old asymptomatic male presents to your office because his father just had a heart attack. He is concerned that he may have inherited his father's condition because a cholesterol level test done at his work site last year was 220 mg/dL. You review his history and find that he smokes 25 cigarettes a day, eats mostly at fast food restaurants, sits at a desk job, and has no regular moderate intensity physical activities. His blood pressure is 130/85 mmHg and his body mass index (BMI) is 26. Which of the following is the most effective step to successfully help the patient quit smoking?

A 16-year old male becomes ill with fever, chills, headache, myalgia, and arthralgia 6 days after hunting prairie dogs with his cousin at his uncle's farm. Examination reveals extremely large, painful, and tender inguinal lymph nodes and a couple of small papules around his ankles. Which of the following is the most likely diagnosis?

Apatient undergoes a gastrectomy following a gunshot injury. How would you counsel him about postgastrectomy syndromes?