LS4 clinical microbiology🥰

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A 22-year-old man who recently immigrated to the United States comes to the physician with jaundice, fever, abdominal pain. He takes no medication and has no known allergies. Laboratory testing Yields the following results: Anti-hepatitis A IgM Positive Anti- HBs Positive Anti-HBc Positive HBsAg negative Which of the following do these laboratory findings most likely suggests?
A. Acute Hep B infection
B. Acute Hep A infection
C. Chronic Hep B infection
D. None of the above
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Terms in this set (104)
A 22-year-old man who recently immigrated to the United States comes to the physician with jaundice, fever, abdominal pain. He takes no medication and has no known allergies. Laboratory testing Yields the following results: Anti-hepatitis A IgM Positive Anti- HBs Positive Anti-HBc Positive HBsAg negative Which of the following do these laboratory findings most likely suggests?
A. Acute Hep B infection
B. Acute Hep A infection
C. Chronic Hep B infection
D. None of the above
B
22-year old woman develops symptoms with hepatitis. Serologic tests for HBsAg, antibodies to HBsAg, and hepatitis A virus (HAV) are all negative; however, she is positive for IgM core antibody. The woman (Clinical)
A. She does not have hepatitis B
B. She has hepatitis A
C. She is in the late stages of hepatitis B infection
D. She is in the "window" (after the disappearance of HBsAg and before the appearance of anti-HBsAg)
E. She has hepatitis C
D
A 39 year-old patient has chronic inactive Hepatitis B with low infectivity. Choose the most appropriate combination of serologic markers: (Clinical)
A. HBsAg - HBeAg - Anti HBsAb+ Anti- HBcAg+ Anti-HBeAg
B. HBsAg + HBeAg - Anti HBsAb + Anti- HBcAg -Anti-HBeAg
C. HBsAg - HBeAg - Anti HBsAb- Anti- HBcAg+ Anti- HBeAg +
D. HBsAg + HBeAg - Anti HBsAb - Anti- HBcAg+ Anti-HBeAg +
E. HBsAg + HBeAg + Anti HBsAb- Anti- HBcAg+ Anti-HBeAg-
E
Which of the following clinical scenario most likely explains the following serologic markers found in the 17 year-old boy: Anti-HAV IgM + Anti-HAV IgG- HBsAg + HBeAg - Anti HBsAb- Anti- HBcAg+ Anti-HBeAg + Anti-HCV- (Clinical)
A. Acute Hepatitis A plus chronic HCV
B. Acute Hepatitis C
C. Acute Hepatitis A plus Hepatitis B
D. Acute Hepatitis B plus acute HDV E. Acute Hepatitis E
C
5. Which of the following clinical scenario most likely explains the following serologic markers found in the 17 year-old boy: Anti-HAV IgM + Anti-HAV IgG- HBsAg + HBeAg - Anti HBsAb- HBcAg+ Anti-HBeAg + Anti- HCV-
A. Acute Hepatitis E
B. Acute Hepatitis A plus chronic HCV C. Acute Hepatitis B plus acute HDV D. Acute Hepatitis C
E. Acute Hepatitis A plus Hepatitis B
E
6. Vaccination with Hep B recombinant vaccine leads to production of which type/types of antibodies?
A. Anti-HBc
B. Anti-HBe
C. Anti-HBs
D. All of the above
C
Which of the following is the correct interpretation of HBV serologic markers' dynamics shown in the graph below? (C. Micro)
A. The patient had Acute Hepatitis B that progressed to chronic Hepatitis with high infectivity
B. The patient has an exacerbation of chronic Hepatitis B
C. The patient successfully recovered
D. The patient was vaccinated against HBV previously
E. The patient had Acute Hepatitis B that progressed to chronic Hepatitis with low infectivity
A
A 34 year old nurse with recent onset of malaise is found to have the following set of laboratory findings: Anti HAV IgM - positive, Anti HAV IgG - negative, HBsAg — negative, HBeAg — negative, Anti-HBsAg — positive, Anti-HBcAg - negative, Anti- HBeAg - negative, Anti- HCV — negative. The patient most likely: (C. Micro)
A. Had an accidental needlestick
B. Had a recent tattoo
C. Had raw oysters at local restaurant D. Had unprotected sexual intercourse
C
All of the following is associated with chronic Hepatitis C infection. Except: (C. Micro)
A. Severe fatal illness during pregnancy B. Essential mixed cryoglobulinemia
C. Hepatocellular carcinoma
D. Fulminant Hepatitis
E. Palpebral Purpura
A
Which of the following set of test result corresponds to the patient with chronic HBV infection and is superinfected with HDV? (C. Micro)
A. HBsAg - , HBeAg - , ANTI-HBcAg IgM -, ANTI-HBcAg IgG -, ANTI-HBs Ag +, ANTI-HDV IgM+
B. HBsAg + HBeAg +, ANTI-HBc IgM+, ANTI-HBc IgG-, ANTI-HBs Ag-, ANTI-HDV IgM+
C. HBsAg - HBeAg -, ANTI-HBc IgM-, ANTI-HBc IgG+, ANTI-HBs Ag+, ANTI-HDV IgM+
D. HBsAg + HBeAg +, ANTI-HBc IgM-, ANTI-HBc IgG+, ANTI-HBs Ag-, ANTI-HDV IgM+
D
A previously healthy patient develops condition that has all the characteristics resembling hepatitis A virus (HAV), yet all diagnostic tests for HAV are nonreactive. A most likely cause of this infection is: (C. Micro) A. Hepatitis B B. Hepatitis C C. Hepatitis D D. Hepatitis E E. RotavirusDA 32-year-old tattoo artist has the following readings of serologic markers for viral hepatitis: Anti-HAV IgM - negative, Anti-HAV IgG positive, HBsAg - negative, HBeAg - negative, Anti-HBsAg - positive, Anti-HBcAg IgM - negative, Anti-HBcAg IgG - positive, Anti-HCV negative. The patient most likely: A. Is actively shedding HAV B. Is infected with HDV C. Is an asymptomatic carrier of HBV D. Has recovered from HBV E. Has been vaccinated against HBVDA 33-year-old nurse suffered a needle stick injury. Her patient used illicit intravenous drugs. One month later, the nurse develops jaundice. Which of the following findings would implicate hepatitis B as the etiology? A. Positive antihepatitis B surface antibody B. Positive antihepatitis -core antibody C. Positive hepatitis B surface antigen D. Positive antihepatitis B envelope antibody E. Positive antihepatitis A antibodyC42-year-old HIV patient with CD4 T cell count of 32 complains of increasing dyspnea. This patient is diagnosed with MAC infection. Prophylactic administration of which of the following could have prevented this infection? (Clinical) A. High dose penicillin B. Isoniazid C. Streptomycin D. TMP-SMX E. AzithromycinEA 43-year-old man HIV infected male is non-compliant with his treatment and is found to have a CD4 count of 80/microL. In addition to his antiretroviral regimen, what medication should be initiated? (Clinical) A. Fluconazole B. Azithromycin C. Acyclovir D. Isoniazid E. Trimethoprim-SulfamethoxazoleEA 46-year-old man comes to the emergency department with fever, lymphadenopathy, sore throat, fatigue, rash, night sweats . He has a history of intravenous drug use. If untreated increased risk of development of opportunistic infections and cancers, such as Pneumocystis carinii infection and Kaposi sarcoma. Which of the following is the most likely cause of condition? A. Cytomegalovirus B. Cryptococcus neoformans C. HIV D. Toxoplasma gondii E. Varicella zoster virusCA 23-year-old man develops fever and weight loss for the past 3 weeks. He is a soldier in the U.S. Army who recently returned from a tour of duty in the Middle East. Physical exam was noncontributory. Laboratory tests revealed anemia and leukopenia. Multiple blood cultures for bacteria and fungi were negative, as was a test for the p24 antigen of HIV. CT scan of the abdomen revealed splenomegaly. A bone marrow biopsy was performed, and a stained sample revealed amastigotes within mononuclear cells. The patient most likely has? A. African sleeping sickness B. Toxoplasmosis C. Malaria D. Visceral leishmaniasis E. Chage's diseaseDYour patient is a 25-year-old man with fever and weight loss for the past 3 weeks. He is a soldier in the U.S. Army who recently returned from a tour of duty in the Middle East. Physical exam was noncontributory. Laboratory tests revealed anemia and leukopenia. Multiple blood cultures for bacteria and fungi were negative, as was a test for the p24 antigen of HIV. CT scan of the abdomen revealed splenomegaly. A bone marrow biopsy was performed, and a stained sample revealed amastigotes within mononuclear cells. Of the following, which one is the most likely cause? A. L. donovani B. P. falciparum C. T. gondii D. T. brucei E. T. cruziAWhich of the following modes of transmission of human immunodeficiency virus (HIV) occurs significantly MORE often than the others? A. Direct skin contact B. During childbirth C. Fecal-oral route D. Respiratory aerosols E. Blood transfusionE37-year-old otherwise healthy man with no complaints wants to donate blood and he tests positive for HIV ELISA. What is the next best step ? (C. Micro) A. Measure HIV viral RNA B. Continue with Western blot C. Measure CD4T cells D. Repeat ELISADThe 41-year-old male is determined to have increased HIV ELISA titer followed by positive Western blot analysis. Which of the following is the correct interpretation of these findings? A. The patient has been exposed to HIV B. The patient is infected with HIV C. The patient is not infected with HIV D. It is not possible to diagnose infection according to these results E. PCR of the HIV RNA is also required to confirm the HIV status in this patientB42-year-old male with uncontrolled AIDS complains of progressive blurring of vision in his right eye. Eye examination reveals evidence of retinitis with cytomegalic viral inclusion disease. Risk of this disease is highest, when CD4 T cell count drops below: A. CD4 <100/ microliter B. CD4 <300/ microliter C. CD4 <400/ microliter D. CD4 <50/ microliter E. CD4 <200/ microliterD45-year-old man with AIDS comes to emergency department with fever and decreased vision. He is eventually diagnosed with viral retinitis. The same virus causes which of the following conditions in a healthy host? A. Hepatisis B. Mononucleosis C. Esophagitis D. Brain abscess E. Shingles F. LymphomaBA 39-year-old man was diagnosed with Pneumocystis pneumonia (PCP. His wife gives a 6-month history of her husband gradually losing weight and becoming generally unwell. The patient of IV drugs use about 5 years ago. Low lymphocyte count was found on his routine blood tests. What is the best next step to find the etiology of his symptoms? A. Wesern blotting B. Serology C. ELISA D. Bronchoalveolar lavage (BAL) E. PCRCViruses which carry an RNA-dependent RNA polymerase within the virion include all the following EXCEPT: A. Influenza virus. B. Rabies virus. C. HIV. D. Reovirus. E. Measles virus.CA 43-year-old woman with HIV is admitted with new- onset seizures. The CT scan of the head reveals multiple ring-enhancing lesions of the brain. which of the following is the most appropriate combination of the causing organism and CD4 T cell counts? A. Trypanosoma Cruzii: CD4 T cells <200 B. MAC: CD4 T cells <50 C. Cryptococcus Neoformans: CD4 T cells <100 D. Toxoplasma Gondii: CD4 T cells <100 E. Pneumocystis Jirovecii: CD4 T cells <200 F. Hispoplasma Capsulatum - CD4 T cells <100DA 50-year-old man originally from the Carribean islands complains of weakness and chronic constipation. He has an erythematous rash covering > 90% of his body surface area, with well-demarcated papules as well as purpuric lesions. He is also found with hepatosplenomegaly and lymphadenopathy. A peripheral blood smear reveals "flower" cells. Which virus most likely have caused the desease? A. Poxvirus B. Papillomavirus C. Retrovirus D. HerpesvirusBLaryngeal papillomas in children can be caused by which of the following viruses: A. Caliciviridae B. Moiluscum contagiosum virus C. Polyomavirus JC D. PapillomavirusesDA sexually active woman was seen for a routine gynecologic exam that included a Pap smear. The report indicated cervical intraepithelial neoplasia. Human papilloma virus (HPV) type 16 genome is found within the neoplastic cells. Which of the following process is required for HPV to lead to the development of cancer? (Immune) A. Mutation of the virus B. Loss of HPV E6 and E7 genes C. Viral replication D. Inactivation of p53 and RB proteinsDA 42-year-old woman with a previous history of abnormal Pap smears and positive HPV DNA testing is lost to follow-up, but presents with vaginal bleeding 10 years later. Physical examination finds a 3-cm lesion of the cervix. Histologic examination of this lesion is most likely to reveal which of the following abnormalities? (C. Micro) A. Clear cell carcinoma B. Verrucous carcinoma C. Small cell carcinoma D. Squamous cell carcinoma (Cervical cancer) E. AdenocarcinomaDWhich of the following viruses and the potential complications are mismatched? A. EBV - Development of nasopharyngeal carcinoma B. HPV - Development of ovarian cancer C. Measles virus - Transient immunosuppression D. Mumps - Aseptic meningitis E. Rubella - purpuric rash in a newbornBYour patient is a 30-year-old woman with nonbloody diarrhea for the past 14 hours. Which one of the following organisms is LEAST likely to cause this illness? (Clinical) A. Clostridium difficile B. Streptococcus pyogenes C. Shigella dysenteriae D. Salmonella enteritidisB (scarlet fever -> strawberry tongue )Your new patient is young female from Ireland, who came to visit Georgia 4 days ago. She complains of diarrhea, crampy abdominal pain and is nauseated. Stool analysis doesn't show RBCs or increased WBCs. Which of the following pathogenic bacteria is MOST COMMONLY associated with this condition? A. Shigella sonnei B. Salmonella typhimurium C. Yersinia enterocolitica D. Escherichia coli ETEC (enterotoxingenic). E. Campylobacter jejuniDWhich of the following pathogenic bacteria is MOST. COMMONLY associated with traveler's diarrhea? A. Shigella sonnei B. Salmonella typhimurium C. Yersinia enterocolitica D. Escherichia coli ETEC (enterotoxingenic). E. Campylobacter jejuniDYou isolate a virus from the stool of a 1-year-old infant with signs of fever, vomiting, and diarrhea. Laboratory results show that the viral genome is composed of multiple segments of double-stranded RNA. Which of the following is the most likelycausing agent of this patient's condition? A. Rhinovirus B. Rotavirus C. RSV D. Rubella virus E. Norovirus F. AdenovirusBGiardia lamblia usually causes: (Clinical) A. Encephalitis B. Hepatitis C. Gastroneteritis D. PneumoniaCA 15-year-old boy returns from a backpack trip with foul-smelling watery diarrhea. On further questioning, he admits to drinking water from a mountain brook without first boiling it. Stool is sent for microscopic examination, confirming the diagnosis of infection. Which of the following is the most likely cause? A. Giardia lamblia B. Rotavirus C. Norovirus D. Candida albicans E. Ascaris lumbricoides F. CMVA (found in surface of food,water,soil)Cryptosporidium parvum causes: A. Urinary tract infections in children; B. Eye infections in elderly; C. Meningoencephalitis in pregnant women; D. Severe diarrhea in immunocompromised.DSeveral Papua New Guinea villagers known to eat pork during celebrations were reported to be suffering from an outbreak of epileptiform seizures. One of the first things you should investigate is (Clinical) A. The prevalence of Ascaris infections in the population B. The presence of Toxoplasma gondii in cats C. The presence of Trypanosoma brucei gambiense in the villagers D. The presence of Taenia eggs in the drinking water E. The presence of adult Taenia solium in the pigsEA patient whose major source of protein is smoked fish, develops vitamin B12 deficiency anemia. Which of the following is the most likely associated with the above-mentioned condition? (C. Micro) A. Hepatitis A virus B. Hymenolepis nana C. Echinococcus granulosus D. Schistosoma japonicum E. Diphyllobothrium latum F. Taenia soliumEA 4-year-old girl is brought to the office by her mother because of anal itching. The mother has noticed her daughter scratching and rubbing her anal area frequently for the past few days. She attends daycare 4 days a week. On examination, she is a well-appearing child. Her vital signs and general examination are normal. You perform a microscopic examination of a sample collected by touching the perianal region with a piece of clear cellophane tape. What is the most likely cause of her symptoms? A. Enterobius vermicularis B. Ascaris lumbricoides C. Schistosomiasis D. Diphyllobothrium latum E. Taenia soliumAIn Tania tapeworm infections the mature adult worms are usually found in A. Lungs B. GI tract C. Liver D. CNSBGram-positive cocci isolated from the patient is able to metabolize sucrose to lactic acid. The bacteria most likely contribute to which of the following pathological states? A. Abscess formation B. Paroxysms of cough C. Skin rash D. Pharyngitis E. Dental CarriesEAn 8-year-old boy is brought in to the office with a 3- day history of fever and mild sore throat. The rash started on his face and spread to his arms and legs. On examination, his temperature is 37.7°C, and his other vital signs are normal. His cheeks are notably red, pharynx is normal-appearing. On his extremities there is a fine, erythematous, maculopapular rash but no vesicles or petechia. What is the most likely diagnosis? (Clinical) A. Erythema Infectiosum B. Erythema marginatum C. Erythema multiforme D. Erythema infantum E. Erythema nodosumAA person with asthma has an acute exacerbation with increased lower respiratory illness. A virus is recovered. The isolate is most likely to be which of the following virus types? A. Parainfluenza virus (upper) B. Parechovirus C. Rhinovirus D. Respiratory syncytial virus (upper and lower) E. EchovirusCA 15-year-old girl presents with fever, sore throat, odynophagia and a number of grayish-white papulo- vesicular lesions on the soft palate, uvula, and tonsils. Which of the following is the most likely diagnosis of this patient? A. EBV B. Herpangina (coxascakie A ) C. Strep throat D. CMV esophagitis E. Primary herpes F. Hand foot and moth diseaseBPlasmodium parasites cause malaria. In the first stage of infection the parasites infect A. Nerve cells B. Hepatocytes C. Intestinal epithelium D. ErythrocytesDA 6-year-old unvaccinated child develops lymphadenopathy behind his ears followed by appearance of reddish rash that started on his forehead and spread to his trunk. Minimal fever is present but the child generally feels well. What is the most likely cause of his symptoms? A. Epstein-Barr B. Varicella zoster C. Mumps D. Rubella (German measles) E. Measles (Rubeola)DWhich drug has been approved by the Food and Drug Administration (FDA) to treat Covid A. Remdesivir B. Ribavirin C. Alpha interferon D. EntecavirAA 32-year old sexually experienced female complains of increased vaginal discharge and vaginal pruritus. Increased PMN cells are found in her vaginal swab. Which of the following is the most likely cause of her symptoms? (Clinical) A. M. pneumoniae B. Acute HIV syndrome C. Syphilis D. Herpes simplex virus E. Papillomavirus F. C. TrachomatisFToxin of which of the following bacteria causes ADP- ribosylation of elongation factor 2 and inhibits protein synthesis? (Clinical) A. Clostridium tetani B. Corynebacterium Diphtheriae C. E.Coli D. Streptococcus pyogenesBA 54-year old female is hospitalized for severe headache and confusion. CSF is obtained by lumbar puncture and it shows Increased protein concentration, increased lymphocytes and low glucose concentration. IGRA test is positive. What is the most likely cause of this patient's condition? (Clinical) A. L. Monocytogens B. S. pneumoniae C. N. Meningitis D. M. Tuberculosis E. H. Influenzae Type BDAn 18 month old boy is brought to the physician by his parents for fever, runny rose, and sore throat. The physician reassures the parents and recommends supportive care with plenty of fluids. He sends them with instructions to follow up if the boy's symptoms worsen. Two days later, the infant is brought to the emergency department with persistent fever, brassy cough, and difficulty breathing. Physical examination reveals stridor. Which of the following pathogens is most likely responsible for the patient's condition? (Clinical) A. Paramyxovirus B. Parvovirus C. Calicivirus D. HSV1 E. Respiratory syncytial virusAA 59-year-old woman underwent hip joint replacement surgery. Metal prosthesis had to be placed. 1 month later she developed fever of 38.60C and the surgical wound started to drain pus. According to her risk- factors, which of the following is the most likely cause of her symptoms? (Clinical) A. Streptococcus bovis B. Viridans group Streptococci C. Staphylococcus Epidermidis D. Streptococcus pyogenes E. Staphylococcus saprophyticusCA 25-year-old female medical student reports that she had lunch at Fish restaurant in the afternoon. She reports eating sushi and seafood. She is presented in the emergency department of hospital with the complaints of abdominal cramps, nausea and vomiting. Culture and gram stain reveal no pathologic bacteria. Which of the following is the most likely cause of this infection? (Clinical) A. Clostridium botulinum food poisoning B. Listeria monocytogens C. Norovirus D. E. coli EIEC E. Rotavirus F. Clostridium difficileCSeveral pathogens are transmitted either during gestation or at birth. Which one of the following is LEAST likely to be transmitted at these times? (!!!) (Clinical) A. CMV B. T. Pallidum C. Parvovirus B19 D. Hepatitis B E. Hepatitis C F. Rubella virusCA 52-year-old woman develops ring-like rash. Over the next 5 months, she has migratory arthralgias and myalgias. Which of the following cardiologic complication is characteristic in this condition? (Lyme disease) A. Dilated cardiomyopathy B. Heart block C. Tricuspid regurgitation D. Ascending aortic aneurysm E. Mitral valve stenosisBAn 11-year-old boy develops sore throat, headache, tearing and bilateral conjunctivitis. After medical exam, he is found to have fever of 37.80C and mild preauricular lymphadenopathy. Within the next 2 days, several of his classmates develop similar symptoms. which of the following is most likely cause? (Clinical) A. HSV-1 B. Parvovirus B19 C. Adenovirus D. Chlamydia E. S. aureus F. Mumps virusCA 9-year old boy is admitted to ER with complaints of severe pain of left leg: He is unable and refuses to walk. He has fever of 38.7oC. WBCs are elevated. which of the following is the most likely cause of his symptoms? A. N. meningitis B. B. burgdorferi C. S. aureus D. Coxsackievirus B E. M. tuberculosisCA 7 year old girl presents with a 3-day history of sore throat. She has pain with swallowing and even with talking. She also has felt feverish for the past 2 days. She has no cough, runny nose, or shortness of breath. On oropharyngeal exam, her pharynx is erythematous and swollen. Tonsils are also edematous, red, and covered with whitish exudate. The cervical lymph nodes are swollen and tender. What is the most likely cause of her symptoms? A. Haemophilus influenza type B B. Bordetella pertussis C. Coxsackievirus D. Adenovirus E. Streptococcus pyogenes F. Mycoplasma pneumoniaE (enlarged lymph node, no cough,white exudates)A 32-year old sexually experienced female complains of increased vaginal discharge and vaginal pruritus. Increased PMN cells are found in her vaginal swab. Which of the following is the most likely cause of her symptoms? A. M. pneumoniae B. Herps simplex virus C. Syphilis D. Acute HIV syndrome E. Papillomavirus F. C. TrachomatisF39 year old otherwise healthy patient devlops chills and high fever of 39.2oC. Next day he complains of cough productive of yellow sputum. He is diagnosed with Community acquired pneumonia. Which of the following is the most likely causing agent? A. H. Influenza B. M. Pneumoniae C. L. Pneumoniae D. S. Pneumoniae E. C. PneumophiliaDA 43-year-old man, a recent immigrant from Botswana, is brought to the emergency room with a cough productive of bloody sputum. He first noticed a cough approximately 2 months ago. He reports having lost approximately 5kg in this time frame as well. He also notes that he's had drenching night sweats 2 or 3 nights a week for the past month. Which of the following is the most likely cause of his condition? A. S. Pneumoniae B. M. Tuberculosis C. HIV D. Chronic HVCBA 10-year-old child develops fever and headache. Acute viral meningitis is diagnosed. What is the most likely cause of this child's infection? A. HSV-1 B. Rubella C. EBV D. Mumps virus E. Enterovirus F. N. MeningitidesEA 70-year-old woman has fever, chills, and myalgias. It is January and an outbreak of influenza is occurring in the retirement community in which she lives. A rapid test for influenza antigen is positive. Which one of the following is the best choice of drug to treat the infection? A. Acyclovir B. Amantadine C. Interferon D. OseltamivirDA 35-year-old spelunker presents to the emergency room complaining of one week of worsening malaise. His last solo spelunking trip was two months ago. While in the examination room, he asks to turn down the lights because they are too bright. His temperature is 101°F (38.3°C), blood pressure is 130/80 mmHg, pulse is 100/min, and respirations are 18/min. On examination he appears tremulous and agitated. He is oriented to person and place but not time. Which of the following pathogens is most likely responsible for this patient's condition? A. Echovirus B. HSV 1 C. Rabies virus D. Polio virusC (rabies is a - single stranded RNA virus )Exposure to rubella early in pregnancy can result an infant to develop: A. Disseminated vesicular rash B. Intracerebral calcifications C. Ventricular septal defect (VSD) D. Cataracts E. Hearing loss F. ThrombocytosisDA 25-year-old female medical student reports that she had lunch at Fish restaurant in the afternoon. She reports eating sushi and seafood. She is presented in the emergency department of hospital with the complaints of abdominal cramps, nausea and vomiting. Culture and gram stain reveal no pathologic bacteria. Which of the following is the most likely cause of this infection? A. Clostridium difficile B. E. coli EIEC C. Rotavirus D. Clostridium botulinum food poising E. Listeria monocytogens F. NorovirusFWhich of the following viruses causes infectious mononucleosis and becomes latent in B-cells? A. Varicella-zoster virus B. Epstein-Barr virus C. Cytomegalovirus D. Human herpesvirus 6 E. Herpes simplex, virus type 2BA 30-year-old asymptomatic woman is found to have a positive VDRL test. She denies having had sexual contact with a partner who had symptoms of a venereal disease. The next best step would be to: A. Reassure her that the test is a false-positive if she doesn't have any symptoms B. Perform FTA-ABS test on a specimen of her serum C. Treat her with penicillin D. Trace her sexual contacts for serologic testingB (tests for syphilis )Toxin of which of the following bacteria binds to the motor end plate at neuromuscular junctions and causes irreversible muscle contractions A. Clostridium tetani B. Corynebacterium Diphtheriae C. E Coli D. Streptococcus pyogenesAA 10-month-old infant developed a croup. The most likely cause of the disease is A. Parainfluenza vinic B. Rhinovirus C. Influenza virus D. Measles virusAA 15-year-old girl presents with fever, sore throat, odynophagia and a number of grayish-white papulo- vesicular lesions on the soft palate, uvula, and tonsils. Which of the following is the most likely diagnsis of this patient? A. Strep throat B. Herpangina C. Primary herpes D. CMV esophagitis E. EBVBA 33-year-old man is admitted to the hospital due to new onset seizures. He has no significant medical history. Vital signs are normal. Neurologic examination shows no abnormalities. CT scan of the head reveals a 3cm cystic lesion in the temporal lobe. The mass is excised and histopathology is shown in the image below. Which of the following is the most likely diagnosis? (!!!) A. Meningioma B. Tuberculosis C. Infection with the tapeworm D. Metastatic diseaseBA 4-year-old girl is brought to the physician's office by her mother because of anal itching. The mother has noticed her daughter scratching and rubbing her anal area frequently for the past few days. The child attends day care. Examination of her perianal area reveals some erythema and excoriation from scratching. You perform a microscopic examination of a sample collected by touching the perianal region with a piece of clear cellophane tape. What is the most likely diagnosis of this girl? (C. Micro) A. Ascaris lumbricoides B. Enterobius vermicularis C. Dracunculus medinensis D. Onchocerca volvulus E. Wuchereria bancroftiBWhich of the following would be present in neonate with congenital rubella Syndrome but not in a neonate with cytomegalovirus inclusion disease? (C. Micro) A. Hearing loss B. Pulmonary artery stenosis C. Mental retardation D. Hepatosplenomegaly E. Intrauterine growth retardationAAn infant with microcephaly, jaundice and hepatosplenomegaly was small for gestational age and had thrombocytopenia. Cataracts are noted. Ultrasound of patient's heart revealed patent ductus arteriosus. Which one of the following viruses most likely caused these congenital malformations? (C. Micro) A. CMV B. Mumps virus C. RSV D. Rubella virus E. HIVD39-year-old male presents to your office in January with the sudden onset of high fever (39.3oC), headache, myalgias and severe sore throat. What is the first-line medication's mechanism of action? (C. Micro) A. Inhibition of neuraminidase B. Inhibition of reverse transcriptase C. Inhibition of protease D. Inhibits Hemagglutinin E. Inhibition of monoamine oxidase (MAO)AA 14-year-old boy presents with fever, sore throat, and cervical lymphadenopathy. Then he develops splenomegaly lasting for 2 months. His peripheral blood smear shows leukocytosis with "atypical" lymphocytes. Heterophil antibody test is positive. Which of the following can be caused by the same infectious agent? A. Burkitt Lymphoma B. Zoster C. Retinitis D. Kaposi sarcoma E. DeafnessA (EBV)67-year-old man comes to your office due to a rash that appeared on his chest yesterday. On exam a unilateral vesicular rash involving a single dermatome is present on his left chest. Which of the following is this patient most likely to suffer from within the next 3 months? (C. Micro) A. Normochromic anemia B. Recurrent skin rashes of similar pattern C. Visual impairment D. Persistent local pain E. Facial paralysisD (shingles )10 days after having unprotected sexual contact with the new partner a 23-year-old woman develops low- grade fever and multiple, very painful, vesicular lesions on the vulva. Which of the following is the possible complication of this condition(C. Micro) A. Meningitis B. Pancreatitis C. Myocarditis D. Cervical cancer E. Splenic rupture F. Chicken poxAPic (C. Micro) A. Coxsackievirus B. Parvovirus C. Adenovirus D. Herpesvirus 6 E. Paramyxovirus F. TogavirusAA 4-year-old girl presents to her pediatrician's office with fever and a pruritic rash on her torso and upper arms. Macules, vesicles, crusts are visualized on the physical exam. What is the most likely diagnosis? (C. Micro) (NEW) A. Rubella B. Roseola infantum C. Erythema infectiosum D. Chickenpox E. Measles F. Hand-foot-and-mouth DiseaseDPreviously healthy and physically active 23-year-old male comes to your office with the complaints of severe dyspnea. He is a former basketball player and used to exercise regularly until 10 days ago, when he developed flu-like febrile illness. Starting from that, patient gradually developed increasing fatigue and shortness of breath. He also reports occasional paroxysms of "heart racing". Serum levels of Troponin-| and CPK are elevated. Echocardiography shows decreased ejection fraction. Which of the following is the most likely viral cause of his symptoms? (C. Micro) A. Enterovirus 71 B. Calicivirus C. Echovirus 31 D. Parainfluenza virus E. Coxackievirus A F. Coxsackievirus BDA 6-year-old girl has a fever and nonspecific viral symptoms for 3 days. Rash appeared on her face today. The rash is bright red and located over the both cheeks. The rash is macular; there are no papules, vesicles, or pustules. She recovers from this illness without any complications. What is the most likely diagnosis? (C. Micro) A. Erythema infectiosum B. Roseola infantum C. Measles D. Hand-foot-and-mouth Disease E. Chickenpox F. RubellaAAn otherwise healthy 11-year-old child presents with low-grade fever, sore throat and red, irritated eyes. On examination, the patient is noted to have pharyngitis and bilateral conjunctivitis. Which of the following is the most likely etiologic agent? A. Rhinovirus B. Adenovirus C. Metapneumovirus D. Coronavirus E. Influenza virusA6-year-old unvaccinated boy is brought to your office with the complaints of a low-grade fever, arthralgia and a skin rash. The rash started on his face and spread rapidly down his body. Physical exam shows a generalized maculopapular rash and bilateral cervical lymphadenopathy. Which of the following is the likely cause of this patient's illness? (C. Micro) A. Parainfluenza virus B. Parvovirus C. Paramyxovirus D. Coxsackievirus E. Togavirus F. Herpesvirus 6E (face and body rash (rubella))4 year-old unvaccinated child presents with a 3-day history of malaise, fever of 38.9°C, cough, coryza, and conjunctivitis. He then develops the erythematous, maculopapular rash. He is noted to have white pinpoint lesions on a buccal mucosa. The most likely diagnosis is: (C. Micro) A. Measles B. Rubella C. Chickenpox D. Erythema infectiosum E. Hand-foot-and-mouth Disease F. Roseola infantumA (measles = coryza)An otherwise healthy 16 year-old boy develops increasing blurring of vision over the last 2 days. Necrotizing retinal infiltrates are seen by funduscopic exam. Which of the following is the most likely cause? A. Toxoplasma gondii B. Balamuthia mandrilaris C. Measles virus D. CMV E. Acanthamoeba species F. Giardia lambliaDParvovirus infection, the cause of a mild exanthem in childrcharacterized by (C. Micro) A. Acute hemolytic anemia B. Epidemic acute respiratory disease C. Gastroenteritis D. Whooping cough-like disease E. KeratoconjunctivitisAA 6-month-old child develops a persistent cough and a fever. Physical examination and chest X-ray suggest pneumonia. Which one of the following organisms is LEAST likely to cause this infection? A. Respiratory syncytial virus B. Adenovirus C. Parainfluenza virus D. RotavirusDA 10-month-old child has a temperature of 40°C for 4 days without other signs. On the fourth day a rose pink, maculopapular rash appears and the temperature returns to normal. What is the most likely diagnosis? A. Echovirus B. human herpes virus 6 C. measles virus D. Parvovirus E. RubellaB (hhv6 and hhv7 dont really do much)Which of the following is the antiparasitic drug: A. Fuzeon; B. Albendazole; C. Ribavirin; D. Ciprofloxacin.BPerianal pruritus is the most prominent symptom of: A. Taeniasis; B. Echinococcosis C. Trichinelosis D. Enterobiasis.DA 6-year-old unvaccinated child develops lymphadenopathy behind his ears followed by appearance of reddish rash that started on his forehead and spread to his trunk. Minimal fever is present but the child generally feels well. What is the most likely cause of his symptoms? A. Epstein-Barr B. Mumps C. Rubella D. Measles (Rubeola) E. Varicella zosterC (forehead to trunk)A 23-year-old female stores her contact lenses in the container filled with tap water. She noticed deterioration of vision and visited an ophthalmologist who diagnosed her with severe keratitis. Culture of the tap water as well as vitreous fluid would most likely reveal: A. Naegleria B. Pneumocystis C. Acanthamoeba D. CMV E. ToxoplasmaCA 31-year-old man is brought to the ER because of rapid onset of high fever, dyspnea and malaise. He is tachypneic and tachycardie. Diagnosis of severe pneumonia is made. His CD4 T cell count is found to be 133/microliter. Which of the following is the most accurate combination of causing organism and the appropriate treatment? A. Candida albicans - Amphotericin B B. Pneumocystis jirovecii - TMP/SMX (>200) C. Toxoplasma gondii - Azythromycin (> 100) D. Cytomegalovirus - Foscarnet (> 50) E. Mycobacterium Avium Complex (MAC) - Dapsone (> 50)CA sexually active 17-year-old man presents to the local free clinic to check some small papules that appeared on his penis. The papules are small and white and contain a central depression in their center. There is no penile discharge, nor is there pain on urination. To what group is the organism most likely associated with? A. Poxviridae B. Papovaviridae C. Adenoviridae D. Parvoviridae E. ArenaviridaeAA 5-year-old girl is brought to the office because of "pink eye." She was sent home from kindergarten yesterday by the school nurse because her left eye was red. When she awakened this morning, the right eye was red as well. She has had watery drainage but no purulent discharge. She's had a mild head cold with a runny nose and a mild sore throat but no fever. what is the most likely cause of her condition? A. Astrovirus B. Entamoeba histolytica C. Parainfluenza virus D. CMV E. Adenovirus F. ToxoplasmaEAn 8-year-old sickle cell patient arrives at the emergency room in respiratory distress. Over the previous several days, the child has become progressively tired and pale. The child's hemoglobin concentration in the emergency room is 3.1 mg/dL (normal: 11-13 mg/dL) Which of the following viruses commonly causes such a clinical picture? A. Roseola B. Parvovirus B-19 C. Coxsackie A-16 D. Echovirus 11 E. Respiratory syncytial virus F. EvtomegalovirusBSARSCoV-2 is: (Clinical) A. An enveloped RNA virus B. An enveloped DNA virus C. Naked RNA Virus D. Naked DNA VirusAA 72 year-old patient comes to your office and complains of fever 38.20C every evening, arthralgia and myalgia for 3 days. She also has dry cough, sore throat and rhinorrhea. Sense of smell and taste is somewhat decreased. Which of the following tests is reasonable to perform this time? A. CT scan of the lungs B. PRP, VDRL C. SARS-CoV-2 PCR D. Blood culture E. Lumbar punctureCACE 2 is a receptor for which of the following viruses: A. SARS-CoV2 B. HTLV 1 C. Herpes simplex D. HIV E. Ebstein-Bar virusAThe coronavirus SARS-CoV 2 pandemic in 2020-2021 resulted in many cases and deaths. What is the primary route of transmission of human coronaviruses? A. Fecal-oral B. Respiratory C. Blood D. Perinatal mother-to-infant E. Sexual activityB