SHELF / USMLE step 2 Practice Questions - Infectious Disease

SHELF / USMLE step 2 Practice Questions > Internal Medicine > Infectious Disease

Q1) A 35 y/o woman has been vacationing in Mexico for the past wk. This morning she noted the sudden onset of crampy, watery diarrhea without any passage of blood or mucus. She has no fever and her only other sxs are mild nausea & anorexia x 1 day. She has a h.p occasional migraines, NKDA, and doesn't take any medications. Which of the following organisms is most likely the cause of this pt's diarrhea?

a) Enterotoxigenic Escherichia coli (ETEC)
b) Clostridium difficile
c) Entamoeba histolystica
d) Strogyloides stercoralis
e) Salmonella enteritidis

Q2) A 49 y/o woman has a h/o 4 UTIs over the past 7 mos. She was referred to a urologist who found no abnormalities on cytoscopy. The pt. refused further work-up. Which of the following is the most appropriate management strategy?

a) long-term low dose amoxicillin (250 mg P.O. qd)
b) long-term full dose TMP/SMX (160/800 mg P.O. bid)
c) pt. initiated 3 day course of ciprofloxacin (250 mg P.O. bid)
d) use of spermicides
e) prompt post-coital urination

Q3) In January a 56 y/o woman w. COPD & type II DM comes for routine office visit. She is currently clinically stable w. no complaints. An outbreak of influenza A is occurring in the community, but the pt. was not vaccinated last fall. Which of the following is appropriate for preventing influenza in this pt?

a) administer the influenza vaccine and prescribe no new drugs
b) obtain a nasopharyngeal culture and tx only if (+) for influenza
c) administer influenza vaccine & prescribe amantadine, rimantadine or oseltamivir for 2 wks.
d) administer influenza vaccine & prescribe amantadine, rimantadine or oseltamivir for 6 wks.
e) tell the pt. it is too late for an influenza vaccine & prescribe amantadine, rimantadine or oseltamivir for 2 wks.

A1) a) Enterotoxigenic Escherichia coli (ETEC)
A2) c) pt. initiated 3 day course of ciprofloxacin (250 mg P.O. bid)
A3) c) administer influenza vaccine & prescribe amantadine, rimantadine or oseltamivir for 2 wks.