1. A 45 year-old male, who is HIV positive, 4. A 3 week-old female born to a G1P1
comes in for periodic follow-up. He mother, who is a refugee, presents with
complains of a history of white patches in increased irritability, fever, and poor
the mouth that can be wiped off but may feeding. The mother did not have prenatal
result in slight bleeding. He also endorses care. The baby was born full term via
a loss of taste. Bloodwork showed a CD spontaneous vaginal birth. What is the
count of 134 cells/mm3. What most likely organism responsible for this
prophylactic management, if any, should presentation?
be started at this point? a) H. Influenzae
a) INH + pyridoxine b) S. pneumoniae
b) Azithromycin c) L. monocytogenes
c) TMP-SMX 1 SS d) GBS
d) None
5. A 31 year-old man with HIV was started
2. A 67 year-old female, who had a recent on antiretroviral medication. His CD4
hip replacement surgery, presents to the count is 22. The patient begins to develop
ER with 3 days of fever with Tmax of 38, blurred vision and poor visual acuity 1
HR 115, BP 98/60. She endorsed pain month later. While afebrile, fundoscopic
around the surgical site. On inspection, examination shows mixed hemorrhages
the skin appears dusky blue. She refused and yellow granular exudates centered on
the remainder of the examination due to a vessels. Which diagnosis is the most
significant amount of pain. What is the likely?
next best step? a) Bacterial conjunctivitis
a) Culture and sensitivity, then treat b) Neurosyphilis
accordingly c) Diabetic retinopathy
b) Empiric IV piperacillin/tazobactam + d) Immune reconstitution syndrome
clindamycin IV due to prior cytomegalovirus (CMV)
c) Emergency surgical debridement infection
d) IV fluids
6. The various species of Campylobacter
3. A 35 year-old male presents to the ER can cause diseases ranging from acute
with a one day history of acute onset of enteritis to bacteremia. Which of the
pain, swelling and decreased range of following modes of transmission does
motion in the right knee. He is afebrile. NOT apply to Campylobacter?
On history, he reveals to be sexually a) Contact with infected animals
active with both men and women in the b) Contaminated food and water
past 12 months. Joint aspiration c) Improperly cooked poultry
confirmed your suspicion. What is the d) Aerolized droplets
medical treatment? e) Person to person spread via fecal-
a) Vancomycin + ceftriaxone oral route
b) Cefazolin
c) Ceftriaxone + azithromycin
d) Cloxacillin
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