Chapter 181-200. Chapter 201-250. Chapter 251-300

Chapter 181-200

27, 19

Chapter 201-250

24. A 3 yr old child whose mother has tuberculosis has a positive PPD skin test result. A chest film shows a localized, nonspecific infiltrate in the peripheral segments of the right lower lobe. The most appropriate course of action to confirm the diagnosis of tuberculosis disease in this child is:

A. Culture of sputum (induced with a jet nebulizer and chest percussion followed by nasopharyngeal suctioning)

B. Culture of pulmonary secretions obtained by bronchoscopy

C. Culture of gastric contents obtained by gastric aspiration

D. Percutaneous lung and pleural biopsies for culture and histopathology

E. Segmental lobectomy for culture and histopathology

63- A 5 yr old boy with AIDS and who is receiving zidovudine, lamivudine, and ritonavir presents with rapid respiratory rate and progressive dyspnea of 2 days' duration. There is no fever. The chest radiograph reveals bilateral diffuse alveolar disease. The most important diagnostic test would be:

A. CT of the chest

B. Pharyngeal swab for viral and bacterial cultures

C. Blood gas profile

D. Serum lactate dehydrogenase level

E. Bronchoalveolar lavage (BAL) for cytology

Most infants with localized neonatal herpes encephalitis become symptomatic at the age of:

A. 0-2 days

B. 3-5 days

C. 8-17 days

D. 21-30 days

E. Older than 30 days

Chapter 251-300

A 4 yr old child has an acute illness with coryza, barky cough, hoarseness, and anorexia. There is no fever, and lower respiratory tract findings are normal. The most likely etiologic agent is:

A. Influenza virus

B. Parainfluenza virus

C. Respiratory syncytial virus

D. Calicivirus

E. Adenovirus

5. Which of the following is false regarding human metapneumovirus (HMPV)?

A. HMPV outbreaks occur in annual epidemics during late winter and early spring in temperate climates

B. Humans are the only source of the virus

C. Prophylaxis with a recombinant vaccine has been shown to be effective in at-risk populations

D. PCR is the most sensitive test for HMPV infection

E. The diseases caused by RSV and HMPV cannot be distinguished clinically

9. Which statement about rhinovirus is false?

A. Rhinovirus is the most common cause of the common cold

B. Antibiotic treatment is not routinely indicated for upper respiratory tract infections

C. Over-the-counter remedies are safe and effective for treatment of rhinovirus in infants

D. Human rhinovirus infection may be life threatening in an immunocompromised person

E. Rhinovirus are the major infectious trigger for asthma in school-aged children

10. The severe acute respiratory syndrome (SARS) outbreak in the early 2000s was caused by what virus?

A. Coronavirus

B. Rhinovirus

C. Influenza virus

D. Parainfluenza

E. Human metapneumovirus

11. Diarrhea is a leading cause of mortality in the world. Which of the following viruses is not a cause of gastroenteritis?

A. Astrovirus

B. Adenovirus

C. Calicivirus

D. Rotavirus

E. Coronavirus

20. Which clinical scenario could be attributed to lymphocytic choriomeningitic virus (LCMV)?

A. Cause of leukopenia and multiorgan system failure after kidney transplant

B. Asymptomatic infection

C. A 2-phase illness: nonspecific febrile illness, then aseptic meningitis

D. Congenital infection resulting in chorioretinitis, microcephaly and periventricular calcifications

E. All of the above

31. Which of the following infants born to HIV-infected mothers should receive prophylaxis for Pneumocystis jiroveci?

A. Infants with a positive result on HIV culture, DNA or RNA PCR assay, or p24 antigen assay

B. Infants with an AIDS-defining diagnosis

C. Infants who have had a 1st episode of P. jiroveci pneumonia

D. Infants with a CD4 cell count of < 750/mm³ or a CD4 percentage of < 15%

E. All infants 6 wk-1 yr of age born to HIV-infected mothers, unless noninfection is proven

67. A child presents with several days of increasing myalgias, especially while chewing and with breathing, and fever. There is a history of eating undercooked meat. Laboratory testing shows 8% eosinophilia. The most likely etiologic agent is:

A. Trichuris trichiura

B. Trichinella spiralis

C. Strongyloides stercoralis

D. Toxocara canis

E. Ascaris lumbricoides

72. You are caring for a 5 yr old child with new onset seizures. MRI findings are consistent with neurocysticercosis, with multiple viable cysts. The most appropriate treatment strategy is:

A. Start albendazole therapy

B. Start valproic acid and prednisolone on day 1, followed by albendazole on day 3

C. Start albendazole and valproic acid together

D. Start praziquantel and prednisolone together

E. Start albendazole and valproic acid on day 1, followed by prednisone on day 3

75. A breast-fed infant has bloody stool. Which of the following causes is least likely?

A. Peptic ulcer

B. Swallowed maternal blood

C. Milk protein sensitivity

D. Bacterial enteritis

E. Anal fissure

80. On newborn exam, an infant is noted to have a single tooth, which is not loose. This finding is known to be associated with which other congenital condition?

A. Cleft palate

B. Pierre Robin syndrome

C. Hypothyroidism

D. Polydactyly

E. A and B

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