A 27-year-old man comes to the physician for a follow-up appointment. He has traveled extensively the past few years through Europe and Africa backpacking. A scraping from a skin lesion is shown. In the absence of appropriate treatment, which of the following is most likely to develop in this patient?

A) Asterixis
B) Intention tremor
C) Romberg sign
D) Pill-rolling tremor
E) Uhthoff sign

A researcher performs an autopsy on a 49-year-old man who passed away following a rupture of the aorta. He was from Papua New Guinea and had not received any prior care. The researcher notes a characteristic “tree bark” appearance of the aorta on gross inspection.

Which of the following best describes the causal organism?

A) Associated with patent ductus arteriosus in neonates
B) Cord factor is a virulence factor
C) Morphologically resembles a question mark
D) Treated first-line with high-dose amoxicillin
E) Visualized with dark field microscopy

A 59-year-old man comes to the physician for a follow-up appointment. He is on the methadone program. Vitals are normal.

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

A) Bloody diarrhea
B) Blurry vision
C) Pulmonary infiltrates
D) Steatorrhea
E) Watery diarrhea

A 34-year-old woman is evaluated at the outpatient clinic. Vitals are normal.

Which of the following is the mechanism of action of the most appropriate pharmacotherapy?

A) 30S inhibitor
B) 50S inhibitor
C) Dihydrofolate reductase inhibitor
D) DNA gyrase inhibitor
E) Forms toxic metabolites

A 52-year-old man comes to the physician for a 2-day history of mildly productive cough and low-grade fever. A chest x-ray is shown.

Which of the following best describes the most likely causal organism?

A) Gram-positive cocci in chains
B) Gram-positive cocci in clusters
C) Gram-positive diplococci
D) Gram-negative diplococci
E) Gram-negative rods

A 31-year-old man from Massachusetts comes to the physician for a 3-day history of slightly yellow eyes, fatigue, and low-grade fever. He has no past medical history or history of travel. Physical examination shows mild scleral icterus. A blood smear is shown.

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

A) Acanthamoeba
B) Anaplasmosis
C) Babesiosis
D) Ehrlichiosis
E) Malaria

A 51-year-old man comes to the physician for a follow-up appointment.

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

A) Cerebrospinal fluid RBCs of 500/hpf
B) Sensitivity to bacitracin
C) Sensitivity to novobiocin
D) Sensitivity to folate pathway agents
E) Sensitivity to optochin

A 23-year-old woman comes to the physician for a follow-up appointment. Results from a biopsy confirm neoplastic cells with intercellular bridges and keratin pearls. Which of the following is most likely to be a part of this patient’s history?

A) Consumption of bear meat
B) Consumption of fish
C) Consumption of pork
D) Swimming in fresh water lake
E) Walking barefoot

A 3-year-old boy is brought to the physician for a follow-up appointment. The organism most likely responsible for this patient’s condition is most taxonomically similar to which of the following?

A) Adenovirus
B) Borrelia burgdorferi
C) Epstein-Barr virus
D) Giardia lamblia
E) Measles virus

A 59-year-old man is recovering in ICU following an aortic valve transplant two days ago. A median sternotomy was performed. His vitals are: temperature 102.9 F, HR 100, RR 16, BP 90/60. There is erythema around the surgical site. Palpation elicits a clicking sound, with a crunching sensation. Which of the following is the most likely explanation for these findings?

A) Gram-positive cocci in clusters
B) Gram-positive rod, non-spore-forming, motile
C) Gram-positive rod, spore-forming, aerobic, motile
D) Gram-positive rod, spore-forming, anaerobic, motile
E) Gram-positive rod, spore-forming, anaerobic, non-motile