Internal-Medicine

Questions: 82–99 215
88. Resistance can be caused by drug inactivation
(SELECT ONE)
89. Work by inhibiting protein synthesis (SELECT
ONE)
90. Decreased intracellular accumulation can result
in resistance (SELECT ONE)
Questions 91 through 95
(A)
(B)
(C)
(D)
(E)
(F)
erythromycin
ciprofloxacin
tetracycline
sulfonamides
metronidazole
rifampin
For each antibiotic side effect, select the most likely
drug.
91. Can cause unwanted pregnancy (SELECT
ONE)
92. Can contribute to hypoglycemia in non-insulindependent
diabetes mellitus (NIDDM)
(SELECT ONE)
93. Can cause severe reaction to alcohol (SELECT
ONE)
94. Drug interaction can result in rejection for
transplant recipients (SELECT ONE)
95. Can result in phenytoin toxicity (SELECT ONE)
Questions 96 through 100
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
brucellosis
coccidioidomycosis
histoplasmosis
leprosy
leptospirosis
infectious mononucleosis
TB
tularemia
For each of the following patients, select the most
likely diagnosis.
96. A previously healthy 43-year-old man presents
with symptoms of cough, fever, weight loss,
and lymphadenopathy for the past 2 months.
His physical examination reveals multiple axillary
and cervical lymph nodes and oropharyngeal
ulcerations. His CXR reveals fibronodular
pulmonary infiltrates in the apex, his sputum is
negative for TB, and the HIV test is negative. A
bronchoalveolar lavage (BAL) confirms the
diagnosis. (SELECT ONE)
97. A 34-year-old man presents with fever, cough,
and sputum production. The CXR reveals a
thin-walled pulmonary cavity. His tests for TB
and HIV are negative. Four weeks ago, he was
traveling in southern California, including visiting
the San Joaquin valley. While there he did
experience a “flu-like” illness, which slowly
improved but then his symptoms of cough and
sputum started. A BAL confirmed the diagnosis.
(SELECT ONE)
98. A 42-year-old man presents with symptoms of
cough, sputum, fever, and weight loss. His
CXR reveals upper lobe pulmonary infiltrates
and his Mantoux test (purified protein derivative
[PPD]) is positive. He emigrated from
Southeast Asia 3 years ago. (SELECT ONE)
99. A 25-year-old woman presents with fever, night
sweats, and muscles aches for the past 1 month.
She was previously well. On examination, she
has axillary and cervical lymph nodes, but no
active joints or hepatosplenomegaly. She currently
works on a hog farm. Her investigations
are negative for EBV, CMV, and HIV. Serologic
tests for the infecting agent confirm the diagnosis
in her. (SELECT ONE)