A 7-year-old boy is brought to the ED with a 4-day history of fever, sore throat, and difficulty swallowing. They immigrated to the United States from China 6 years ago. Physical exam shows cervical lymphadenopathy and a thick, grayish-white membrane in the posterior oropharynx. Which of the following best describes the most likely causal organism?

A. Gram-negative diplococcus
B. Gram-negative rod, lactose-fermenting
C. Gram-positive coccus, catalase-positive, coagulase-positive
D. Gram-positive rod, non-spore-forming, immotile
E. Gram-positive rod, spore-forming, motile

A 32-year-old man is evaluated in hospital for a 2-week history of progressively worsening pain with swallowing. He has history of IV drug use. Vitals are normal. Which of the following represents the most appropriate oral pharmacotherapy for this patient?

A 3-year-old boy is brought to the pediatrician by his mom for recurrent bacterial skin infections since infancy. His parents report that the affected areas frequently become erythematous and swollen but rarely produce pus. Physical exam shows various ulcerated skin lesions without surrounding inflammation. Which of the following is the most likely molecular defect in this patient?

A. Adenosine deaminase
B. CD40L
C. Integrin
D. Myeloperoxidase
E. Tyrosine kinase

A 38-year-old woman is managed in hospital. Hydralazine is administered as part of the management. Which of the following is most likely to occur as a result of this pharmacotherapy?

A) Arterioloconstriction; bradycardia; decreased CNIX firing
B) Arterioloconstriction; tachycardia; increased CNIX firing
C) Arteriolodilation; bradycardia; increased CNIX firing
D) Arteriolodilation; tachycardia; decreased CNIX firing
E) Venoconstriction; bradycardia; decreased CNIX firing
F) Venoconstriction; tachycardia; increased CNIX firing
G) Venodilation; bradycardia; increased CNIX firing
H) Venodilation; tachycardia; increased CNIX firing

A 40-year-old man presents to the physician. His right hand is shown.

Which of the following is most likely to be associated with this patient?

A) Hypothyroidism
B) Marjolin ulcer
C) Morton neuroma
D) Norwegian ancestory
E) THC use

A 30-year-old man is evaluated in hospital. A urinalysis and his hand are shown.

Which of the following is most likely to be seen in this patient?

A) Conjunctivitis
B) Deficiency of complement protein C1q
C) Infection with obligate intracellular organism
D) Tenosynovitis
E) Treatment with azithromycin or doxycycline

A 40-year-old man presents to the clinic with a 1-week history of progressively worsening visual acuity in his left eye. He has not had blood work performed in many years. He is enrolled in a methadone program.

Which of the following is most likely to be seen in this patient?

A) Blood glucose of 440 mg/dL
B) Blood pressure of 200/100
C) Bone-spicule pigmentation
D) Cowdry bodies
E) Owl eyes

A 15-year-old boy is brought to the physician for a 2-day history of loose, foul-smelling stools. He has a long history of pneumonia, sinusitis, and otitis media since childhood. Current medications include albuterol and fluticasone inhalers. His mother had an episode of deQuervain thyroiditis last year. Results of a stool sample are shown.

Which of the following is the most likely explanation for this patient’s findings?

A) Deficiency of CD40-Ligand
B) Deficiency of cell-mediated immunity
C) Deficiency of mucosal immunoglobulin
D) IL-2 receptor mutation
E) Tyrosine kinase mutation

A 63-year-old man comes to the physician for a follow-up appointment. The physician recommends commencement of an agent that is both an anti-platelet agent and vasodilator. Which of the following is the most likely pharmacologic agent recommended by the physician?

A) Aspirin
B) Clopidogrel
C) Dipyridamole
D) Eptifibatide
E) Tirofiban

A 2-day-old newborn is evaluated for poor feeding and abnormal eye findings. Physical exam shows bilateral cloudy lenses, a pan-systolic pan-diastolic murmur, and numerous purplish-red skin lesions on the trunk and extremities. The infant fails the newborn hearing screening. Which of the following is most likely to have been seen in the mother during pregnancy?

A) Arthritis
B) Chancre
C) Cowdry bodies
D) Owl-eye inclusions
E) Working in a pet store