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A 50-year-old Caucasian woman presents to the hospital complaining of tingling sensations in her hands and legs for the past one month. She is not on any medications. She has had one previous admission for a jejunoileal bypass. She is a married clerk, and does not drink alcohol, smoke cigarettes, or use illicit drugs. What is the most likely diagnosis?
A. Celiac disease
B. Whipple disease
C. Short bowel syndrome
D. Tropical sprue
E. Lactose intolerance
Question 2
A 34-year-old Caucasian woodsman presents to the hospital complaining of lesions on his hands and legs for the past 2 days. He reports that he had been working in the woods when they developed. On examination you note vesicles in a streaky linear distribution on his upper and lower limbs. What is the most appropriate next step in the management of this patient?
A. Topical Steroid
B. Topical Antifungal
C. Topical Antibiotic
D. Topical Retinoid
E. Topical Chemotherapy
Question 3
A 40-year-old African American man presents to the emergency room complaining of difficulty breathing and cough that begins around noon every workday. He reports to work at 7.00 am at a local maple tree farm and reports that he never coughs or has difficulty breathing when he is off duty. On examination he is not in respiratory distress but he has inspiratory rales. What is the most likely cause of his symptoms?
A. Aspergillus fumigatus
B. Micropolyspora faeni
C. Cryptostroma corticale
D. Pullularia pullulans
E. Sitophilus granarius
Question 4
A 53-year-old fair-skinned Caucasian woman who is an avid gardener, presents to your office complaining of a red lesion which bleeds easily and has been present on left forearm for the past 6 months. On examination you note a scaly, irregular, ulcerated plaque. What is the most appropriate next step in the management of this patient?
A. Topical Retinoid
B. Topical Chemotherapy
C. Topical Antifungals
D. Topical Emollient
E. Topical Immunomodulator
Question 5
A 25-year-old Hispanic man who works as a chef presents to the hospital complaining of passing bloody diarrhea for the past one day. On examination, his temperature is 39 degrees centigrade. A stool examination reveals polymorphonuclear leukocytes but no trophozoites. Which one of the following is the most appropriate treatment for him?
A. Ceftriaxone
B. Metronidazole
C. Mebendazole
D. Paromomycin
E. Diloxanide furoate
Question 6
A 50-year-old fair-skinned Asian fisherman presents to your office complaining of painless swellings over his face for the past several years. On examination you note multiple plaques with an adherent scale on the sun damaged skin over his cheeks and forehead. What is the most appropriate next step in the management of this patient?
A. Topical Antifungal
B. Topical Steroid
C. Topical Chemotherapy
D. Topical Retinoid
E. Topical Emollient
Question 7
Which of the following is not true?
A. Pityriasis versicolor is caused by Malassezia furfur.
B. Form 2 is the most common type of Tinea versicolor.
C. Many patients with Tinea versicolor are unaware that they have the skin condition.
D. Malassezia furfur blocks the conversion of tyrosine to melanin.
E. Patients with dark skins present with whitish patches while those with light colored skin present with pinkish patches.
Question 8
Which of the following is not true?
A. Cryptosporidium parvum divides inside the brush border cells of the small intestines.
B. Humans get infected by ingesting the trophozoites
C. Cryptosporidium parvum can be spread to humans through animal to human transmission.
D. Cryptosporidiosis is considered to be one of the opportunistic infections of AIDS.
E. The incubation period of cryptosporidiosis is seven days.
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