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3- In the above patient, the most appropriate approach for therapy is:
a. IV antibiotic only
b. Oral Antibiotic only
c. Surgical debridement with IV antibiotic
d. Observation
e. Surgical Drainage with IV antibiotic
9- A young male patient presents with non productive cough, chills, and
fever. He has type 1 diabetes. A chest Xray shows diffuse interstitial
infiltrate bilaterally, the most probable infecting organism in this
patient is:
a. Strep. Pneumonia
b. Klebsiella pneumonia
c. Mycoplasma Pneumonia
d. Legionella pneumophilla
e. Pneumocystis Carinii
11- 22 year old male who is currently receiving treatment for acute
sinusitis develops neck stiffness and sever headache with N and V.
Kernigs and prudzinski signs are positive. CSF exam shows low
glucose with elevated protein and elevated lymphocyte and neutrophil
count. Gram stain is negative. To confirm the diagnosis, the best next
step would be:
a. CSF VDRL
b. CSF culture
c. CSF latex agglutination test
d. CSF ZN stain
e. Blood Culture
14- the best emperic antibiotic regimen for this patient should be:
a. Ceftraixone alone
b. Ceftraixone + Ampicillin
c. Ampicillin + Gentamicin
d. Ciprofloxacin
e. Augmentin
19- A 25 year old with seizure disorder had his last seizure episode
7 days ago. Presents now with increasing cough and shortness of
breath for 3 days and fever of one day duration with a fowl smelling
sputum. Crackles were heard on auscultation. Chest Xray shows right
lower lobe infiltrate of the lung, the most likely pathogen is:
a. a gram positive aerobe
b. a gram negative aerobe
c. an anaerobe
d. mycoplasma
e. an Acid fast bacillus
21- a 31 year old HIV positive male presents with a 3 day history of
shortness of breath, chest pain and non productive cough. His CD4
count is 180. Chest Xray shows a ground glass appearance. His PO2 is
65 and A-a Gradient is 30. The most appropriate therapy for this
patient is:
a. IV ceftraixone
b. Oral Penicillin
c. Trimethoprim/Sulfamethoxazole
d. TMP/SMZ plus steroids
e. Dapsone
f. Ocacillin
23- Pleural Biopsy specimen taken from the above patient will most
likely show:
a. Non Caseating granulomas
b. Caseating granulomas
c. Non specific inflammatory changes
d. Normal Appearance
e. Hyaline degeneration
28- After a recent camping trip, a 30 year old female develops rash
on her right lower extremity. the rash was associated with flue like
symptoms and disappeared spontaneously. Three weeks later, the
patient suddenly develops paralysis of the left half of her face. The
most likely offending organism in the above patient is:
a. Ricketttsia Rickettsi
b. oxiella Burnetti
c. Borrellia Burgdorferi
d. Toga Virus
e. Herpes Zoster virus
31- A 33 year old physician had a needle stick injury while trying to
draw blood from an HIV positive patient. He presents to the ER
highly anxious and requests immediate help. The needle was
contaminated with the patients blood and had certainly penetrated the
doctor’s skin. The best course of action at this time is:
a. Perform An Elisa test
b. Perform a PCR test
c. Prescribe AZT for one month
d. Prescribe Triple anti-retroviral therapy for 1 month
e. Repeat HIV test on patient
34- The most common causative organism in the above patient is:
a. Staph Aureus
b. Pseudomonas Aeroginosa
c. Strep Pneumonia
d. Candida Albicans
e. Actinomyces Israeli
35- a 10 year male with sickle cell anemia is brought to your office
by his mother with fever and a severe redness of the face with a lacy
rash on the proximal extremities and upper chest. On examination, he
appears to have been slapped on both cheeks with some lesions on
forehead. There is spaing of the circumoral area. The child is restless
but stable. The most probable diagnosis is:
a. Roseola
b. Infectious mononeoclosis
c. Scarlet fever
d. Erythema Infectiosum
e. Coxscakie A virus
36- a very serious complication that could very possibly arise in the
above patient is:
a. Sepsis
b. Encephalitis
c. Worsening of Anemia
d. Septic arthritis
e. Hypoglycemic coma
37- 62 year old female is being treated in the hospital for severe
bacterial pneumonia. Her previous medical history and
symptomatology were unknown at the time of admission. Initial blood
laboratory tests confirmed gram positive bacteremia. Culture was
done before emperic therapy was started. The patient continued to
improve on her levofloxacin treatment. Culture results were obtained
3 days later and showed Streptococcus Bovis bacteremia. Which of
the following statements is correct:
a. The bacteremia is consistent with her diagnosis of pneumonia
b. There is a high possibility that this patient has a malignancy
c. A new drug has to be added to her regimen to cover for Strep.
Bovis
d. The patient has to be investigated for bacterial endocarditis
e. The blood cultures have to be repeated since Strep. Bovis is
highly suggestive of specimen contamination
Answers
1-C 2-A 3-C 4-A 5-C 6-B 7-E 8-C 9-C 10-A 11-C 12-C
13-B 14-B 15-C 16-A 17-C 18-A 19-C 20-B 21-D 22-A 23-B
24-E 25-C 26-B 27-C 28-C 29-E 30-B 31-D 32-A 33-B 34-B
35-D 36-C 37-B