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A patient presents with a pruritic, annular rash with fine scaling and central clearing, affecting the trunk and proximal extremities. The patient reports recent exposure to a new soap and laundry detergent. Which of the following conditions is most likely responsible for this presentation?
- A. Tinea corporis (ringworm)
- B. Nummular eczema
- C. Pityriasis rosea
- D. Lichen planus
Correct Answer: B
Rationale: The presentation described is consistent with nummular eczema, also known as discoid eczema. Nummular eczema typically presents as circular or oval-shaped patches of eczematous rash with fine scaling and central clearing. It is often pruritic and can be triggered by exposure to irritants such as new soaps or laundry detergents. The distribution on the trunk and proximal extremities is also typical for nummular eczema. Tinea corporis (ringworm) would present with a more raised, scaly, and well-defined border with central clearing. Pityriasis rosea presents with a herald patch followed by smaller oval or round lesions in a "Christmas tree" distribution. Lichen planus would present with polygonal, purplish, flat-topped papules typically located on flexural surfaces and extremities.
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A patient presents with fever, chills, headache, and myalgia after returning from a trip to sub-Saharan Africa. Laboratory tests reveal intraerythrocytic ring forms and trophozoites on blood smear examination. Which of the following is the most likely causative agent?
- A. Plasmodium falciparum
- B. Trypanosoma cruzi
- C. Borrelia burgdorferi
- D. Leishmania donovani
Correct Answer: A
Rationale: The most likely causative agent in this scenario is Plasmodium falciparum, a protozoan parasite that causes malaria. The patient's symptoms of fever, chills, headache, and myalgia align with the typical presentation of malaria. Additionally, the presence of intraerythrocytic ring forms and trophozoites on blood smear examination is characteristic of Plasmodium species, particularly P. falciparum, which causes the most severe form of malaria.
A patient presents with sudden-onset unilateral headache, along with ipsilateral ptosis, miosis, and anhidrosis. Which of the following neurological conditions is most likely responsible for these symptoms?
- A. Cluster headache
- B. Migraine headache
- C. Tension-type headache
- D. Trigeminal neuralgia
Correct Answer: D
Rationale: The presentation described in the question – sudden-onset unilateral headache along with ipsilateral ptosis, miosis, and anhidrosis – is characteristic of Horner syndrome. Horner syndrome is caused by disruption of the sympathetic nerve pathway and can occur in trigeminal neuralgia. Trigeminal neuralgia is a painful condition affecting the trigeminal nerve commonly characterized by sudden and severe facial pain that can be triggered by various stimuli. The involvement of the sympathetic pathway in trigeminal neuralgia can lead to Horner syndrome symptoms such as ptosis (drooping eyelid), miosis (constricted pupil), and anhidrosis (lack of sweating) on the affected side of the face. Cluster headaches usually involve severe unilateral pain around the eye, but they do not typically present with Horner syndrome symptoms. Migraine and tension-type headaches also do not typically present with Horner syndrome symptoms.
A patient undergoing mechanical ventilation in the ICU develops ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA). What intervention should the healthcare team prioritize to manage the patient's infection?
- A. Administer vancomycin or linezolid for MRSA coverage.
- B. Perform bronchoalveolar lavage for diagnostic purposes.
- C. Implement contact precautions to prevent transmission.
- D. Recommend prophylactic antifungal therapy to prevent candidiasis.
Correct Answer: A
Rationale: The most important intervention for managing ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) in a patient undergoing mechanical ventilation in the ICU is to start appropriate antimicrobial therapy targeting MRSA. Vancomycin or linezolid are commonly used antibiotics for MRSA infections. These medications are effective against MRSA and can help in treating the infection and preventing further complications. It is crucial to initiate antimicrobial therapy promptly once the diagnosis of VAP caused by MRSA is suspected or confirmed to improve patient outcomes. Other interventions such as bronchoalveolar lavage for diagnostic purposes, contact precautions, or antifungal therapy may be relevant but the priority is to start effective antibiotic therapy to target the specific pathogen causing the infection.
Which of the following statements accurately describes the process of opsonization during the immune response?
- A. Opsonins facilitate the lysis of target cells by forming membrane attack complexes.
- B. Opsonins promote the phagocytosis of pathogens by coating them with proteins.
- C. Opsonins neutralize toxins produced by pathogens.
- D. Opsonins stimulate the release of histamine from mast cells.
Correct Answer: B
Rationale: Opsonization is a process in the immune response where opsonins, which are proteins such as antibodies and complement proteins, bind to pathogens such as bacteria, making them more easily recognized and engulfed by phagocytic cells like macrophages and neutrophils. This coating of pathogens by opsonins enhances the efficiency of phagocytosis, helping in the elimination of pathogens from the body. Opsonins do not facilitate cell lysis, neutralize toxins, or stimulate histamine release; their main function is to tag pathogens for phagocytosis.
Which of the following medications is commonly used for the management of overactive bladder (OAB) symptoms such as urinary urgency and frequency?
- A. Furosemide
- B. Oxybutynin
- C. Spironolactone
- D. Finasteride
Correct Answer: B
Rationale: Oxybutynin is a medication commonly used for the management of overactive bladder (OAB) symptoms such as urinary urgency and frequency. It belongs to a class of medications known as anticholinergics, which work by relaxing the bladder muscles and reducing bladder spasms. By doing so, it helps to decrease the symptoms of OAB, including frequent urination, sudden urges to urinate, and leakage. Oxybutynin can be taken orally in tablet form, as a transdermal patch, or as a gel, providing various options for patients based on their preferences and needs. Overall, oxybutynin is an effective treatment option for individuals experiencing overactive bladder symptoms.