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You see a young child for evaluation of fever, abdominal pain, enlarged liver and eosinophilia. You suspect toxocariasis from Toxacara canis or cati. Which of the following statements is false about Toxocara?
A. It can result in retinal lesions that can impair vision
B. It is caused by the larvae of the "dog or cat ascaris" that wander through the body unable to find the lung to complete their life cycle
C. It is associated with persons who eat dirt
D. It can be spread by contact with human feces
E. It is often found in young puppies or kittens |
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Several years ago there was an outbreak of Trichinosis among a group of Vietnam immigrants in New York that had made their own pork sausage. About 30 people who ate the sausage all become ill. Which of the following statements is false about Trichinella spiralis?
A. It can be spread by eggs passed in the stool
B. It is a tissue nematode that induces a high eosinophil response
C. It is a disease of meat eating animals
D. It is usually self limiting
E. Heavy infection causes symptoms of diarrhea and abdominal pain that progresses to fever, facial and periorbital edema and myalgias
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You have just examined a patient from Brazil who has a chronic ulcer of his ear that has been present for 6 months. You are concerned that he has Leishmaniasis and want to differentiate L. mexicana from L. braziliensis. Which of the following statements about these 2 organisms is false?
A. They are both transmitted by the sand fly
B. Both appear as amastigotes in macrophages on biopsy
C. Both can start as a cutaneous ulcer that eventually heals on its own
D. Both heal with a residual scar
E. Both will eventually cause lesions of the mucous membranes
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This year a report from India indicates that a single dose of Amphotericin B can result in the cure of Leishmania donovani rather than prolonged treatment by fairly toxic medication. If confirmed this will be a major advance in the treatment of Kala-azar. Which of the following statements is false regarding systemic Leishmaniasis?
A. It is spread by the bite of the sand fly
B. Macrophages ingest the organism and move about the body facilitating its spread
C. Diagnosis can often be made by identifying amastigotes in cells aspirated from the spleen or bone marrow
D. Untreated patients frequently recover themselves
E. Kala-azar should be considered as one of the possibilities in someone who has lived in an endemic area and has an enlarged spleen
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Blood banks in Southern California and Texas have done studies to evaluate how often blood containing Trypansoma cruzi is found in their blood donor pool. They have found that the incidence varies between 1:8,000 and 1:40,000 donors. If you were making up a list of questions to ask blood donors, which of the following questions would be least helpful in screening to exclude this organism from persons that have grown up in an endemic area?
A. Have you ever been bitten by a reduvid bug?
B. Have you ever eaten pigs, dogs, or other animals that are reservoir hosts for Chaga's diseas
C. Have you lived in an adobe hut with a thatched roof?
D. Have you ever had swelling of your eye that lasted more than 3 days?
E. Have you ever had a blood test positive for Chaga's disease?
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This year there have been 7 travelers to eastern Africa that have contracted Trypanosoma brucei rhodesiense. They have all presented in the early stage of the disease with a chancre of the skin associated with cellulitis (red hot swelling) around the chancre. Which of the following is false regarding Trypanosoma brucei?
A. Progression of the disease is more rapid in rhodesiense than in gambiense
B. Early diagnosis allows for a more effective, safer medication that can be used before the parasite reaches the brain
C. Rhodesiense has multiple hosts while in gambiense, humans are the only host
D. Epidemics of African sleeping sickness have occurred by person to person spread
E. Both are transmitted by the Tsetse fly
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This year there have been 7 travelers to eastern Africa that have contracted Trypanosoma brucei rhodesiense. They have all presented in the early stage of the disease with a chancre of the skin associated with cellulitis (red hot swelling) around the chancre. Which of the following is false regarding Trypanosoma brucei?
A. Progression of the disease is more rapid in rhodesiense than in gambiense
B. Early diagnosis allows for a more effective, safer medication that can be used before the parasite reaches the brain
C. Rhodesiense has multiple hosts while in gambiense, humans are the only host
D. Epidemics of African sleeping sickness have occurred by person to person spread
E. Both are transmitted by the Tsetse fly |
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A 22-year old college student is seen because he has had severe chronic diarrhea and a stool for O&P is positive for Giardia lamblia. He has lost 50 pounds in weight and has been treated for Giardia on 6 occasions only to have it reoccur. You are concerned that he has an immunodeficiency and lab results demonstrate a very low IgA level. Which of the following statements would be false regarding Giardia?
A. It is one of the causes of H2S or rotten egg gas
B. It is often a self-limiting disease
C. A weight loss of 50 pounds due to Giardia is very unusual
D. You are not surprised when 5 of 11 dorm mates are found to have Giardia because it is spread from person to person easily
E. It often results in iron deficiency anemia due to gastrointestinal blood loss
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You see a 20-year old female for complaints of vaginal itching, discharge, pain with intercourse and discomfort with urination. She has had 3 different sexual partners over the past 2 years. As part of your workup, you do a wet mount of vaginal secretions and see a flagellated organism about the size of a white blood cell with twitching motility that makes you think of Trichomonas vaginalis. Which statement is false regarding Trichomonas?
A. Men are most likely asymptomatic but efficient transmitters of this organism
B. The cyst form of the life cycle is the most common method of transmission
C. Simultaneous treatment of the patient and her sexual contacts will decrease the chance of recurrences
D. In severe cases the regional mucosa may be red with petechial lesions and the cervix has been described as a "strawberry cervix"
E. Patients found to have Trichomonas should be evaluated for other venereal transmitted diseases
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A 30-year old patient is evaluated for chronic diarrhea that has gone on for 4 months with a 20-pound weight loss. By history you find that he has had sex with men for 12 years. You are concerned about the possibility of HIV and his test is positive with a low CD4 count that makes you think of immunodeficiency. You order a test for Cryptosporidium in his stool. Which of the following statements is false regarding Cryptosporidium?
A. Most people who have this organism are symptomatic
B. Person to person transmission is common and it is seen frequently in outbreaks in daycare centers
C. It is fairly resistant to chlorine treatment in municipal water treatment centers and is a recognized cause of waterborne outbreaks of diarrhea
D. It is frequently associated with systemic symptoms of fever, chills and bloody diarrhea
E. It has been difficult to treat in immunocompromised patients and usually persists for the duration of the patient's life
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A 42-year old patient from Ecuador is admitted with fever, right upper abdominal pain and is found to have a cystic mass of the liver. You suspect an amebic abscess and order stool exams that are reported as positive for E. histolytica and an ameba serology is positive at 1:256. Which statement is false regarding ameba?
A. He should be treated with two medications. One to kill the active trophozoites and a second to kill the cysts.
B. Transmission is by fecal-oral means
C. Amebic liver abscess can usually be treated with medication and do not need to be drained
D. Transmission to a new person is generally done by the more resistant cyst form of the life cycle
E. Aspirate from liver cysts can be used to make the diagnosis because they are loaded with white blood cells and E. histolytica cysts
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Each of the following statements (except one) is true regarding malaria. Which one is false?
A. Once someone has malaria infection, they will have it for the rest of their life in spite of treatment
B. All persons who contract P. vivax malaria have Duffy Antigen present on their red blood cells
C. Persons with sickle cell trait or disease are more resistant to serious malaria
D. Schuffner's dots in red cell cytoplasm are most consistent with P. vivax or ovale malaria
E. One way to help diagnose P. malariae is to carefully record the pattern of symptoms since it is the only species to have a 72 hour interval of symptoms
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This July a group of 30 volunteers went to Kenya to help build a school and all of them took prophylaxis to prevent malaria. They claim that they took the medication as prescribed 2 weeks before, during their stay, and for 4 weeks after returning home. In October, one person developed malaria and by April of this year, 9 of the 30 volunteers had been treated for malaria. Which of the following is the least likely explanation for this apparent failure of prevention?
A. This is most likely P. vivax or ovale which have a latent stage in their life cycle that persists in the liver and can result in disease weeks to months after exposure
B. Most of the medication used for prophylaxis of malaria acts only on the red blood cell stage of the infection
C. This could be P. malariae which is known to result in a more chronic malaria state
D. This could be P. falciparum that was not completely treated by the prophylaxis
E. The nine who got malaria must not have taken the medication as prescribed since this should have prevented malaria
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A 44-year-old native Nigerian who has lived in the USA for 10 years returned to visit his family in Africa and now presents with a history of shaking chills, followed by high fever and then profuse sweating. He states that this is the most severe case of malaria he has ever had. His blood smear shows malaria organisms consistent with Plasmodium falciparum. Which of the following statements is false regarding P. falciparum?
A. His symptoms are more severe this time because he has lost some of the immunity that comes with frequent recurrences of malaria
B. Taking appropriate prophylactic medication has an 80-90% chance of preventing P. falciparum malaria
C. P. falciparum causes organ damage in the brain, lungs, and kidneys because of adhesion of infected red cells to the endothelium of the capillaries which impairs the microcirculation to these organs
D. P. falciparum gametocytes are ameboid shaped
E. Plasmodium falciparum has the highest mortality rate of the four malaria species
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Each of the following is true regarding Pneumocystis carinii. Which statement is false?
A. It lives as a commensal in most humans
B. It is a common cause of community acquired pneumonia
C. It is an AIDS defining illness in patients with HIV
D. It caused pneumonia in malnourished children after World War II
E. The most sensitive way of making the diagnosis is with a direct immunoflourescence stain on sputum or Bronchoalveolar lavage
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Each of the following parasites pass through the human lung at some time during their life cycle but only one establishes a home where it divides and causes a chronic disease state. Which one lives in the lung as a definitive host?
A. Strongyloides stercoralis
B. Wuchereria bancrofti
C. Ancylostoma duodenale
D. Paragonimus westermani
E. Ascaris lumbricoides |
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The most likely infection to occur following exposure to Sporothrix is?
A. A urinary tract infection
B. Pneumonia
C. Meningitis
D. An ulcerating skin lesion |
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A 22 year old diabetic with poor control of blood glucoses comes into clinic with a 2 month history of nasal congestion and low grade fever. Over the past 3 days he has also had a painful right eye-it hurts to look from side to side. In addition he feels that his vision is impaired now in that eye. On exam his right eye appears red and swollen and seems to be pushed forward. His nasal mucosa on that side appears dark and almost necrotic. You should be worried about?
A. A zygomycete infection
B. Toxic shock syndrome
C. Meningococcemia
D. Trachoma |
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A 20 year old college student is part of an archeological team traveling to northeastern Arizona to help excavate Indian ruins. One month after returning she develops a flu-like illness with cough, myalgias, and low grade fever. A chest x-ray shows a small localized infiltrate in the right mid lung field. An organism to consider would be?
A. Histoplasma
B. Coccidioides
C. Legionella
D. Brucella |
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The usual initiating event when infection occurs with a fungus is for?
* A. The patient to ingest it from meat
B. The patient to ingest it from water
C. The patient to acquire it from another person
D. The patient to inhale it
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QUESTIONS LISTING
Payment of time- barred debt is:
(a) Valid
(b) Void
(c) Illegal
(d) Voidable