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Репост из: NBME | CMS
Видео недоступно для предпросмотра
Смотреть в Telegram
🎉 FREE NBME Self-Assessment! 🎉

Get NBME Form 25 at no cost—limited-time offer!

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Stay updated on Telegram:

💬 @NBMECMS


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"A 35-year-old woman comes to the office due to a vulvar lesion. She has also experienced occasional headaches and memory loss recently. The patient has had unprotected sexual intercourse with multiple partners. "
Опрос
  •   A. Chancre
  •   B. Condylomata acuminata
  •   C. Condylomata lata
  •   D. Granuloma inguinale
  •   E. Gumma
1699 голосов


Neisseria meningitidis can cause sepsis and circulatory collapse in previously healthy young individuals. Lipooligosaccharide, a virulence factor in the pathogens outer membrane, is the major underlying cause of disease severity.


Which of the following microbial components is directly responsible for the severity of disease in this patient?
Опрос
  •   A. Capsular polysaccharide
  •   B. Immunoglobulin protease
  •   C. Lipo-oligosaccharide
  •   D. Lipoteichoic acid
  •   E. Superantigen exotoxin
1364 голосов


A 16-year-old girl is brought to the emergency department after she became unresponsive. Temperature is 39.7 C (103.5 F), blood pressure is 70/40 mm Hg, and pulse is 130/min and thready. There is a diffuse petechial and ecchymotic skin rash. Laboratory testing reveals leukocytosis with left shift and evidence of disseminated intravascular coagulation and multiorgan failure. Despite aggressive interventions, the patient dies several hours after admission. Autopsy reveals hemorrhagic necrosis of many internal organs, including the bilateral adrenal glands. Which of the following microbial components is directly responsible for the severity of disease in this patient?


Bacterial meningitis causes an increase in cerebrospinal fluid (CSF) neutrophil count and protein concentration as well as a decrease in CSF glucose. Streptococcus pneumoniae is a leading cause of community-acquired pneumonia, otitis media, and meningitis in adults. S pneumoniae appears on Gram stain as lancet-shaped, Gram-positive cocci in pairs.


which of the following?
Опрос
  •   A. Bean-shaped, Gram-negative cocci in pairs
  •   B. Lancet-shaped, Gram-positive cocci in pairs
  •   C. Gram-positive cocci in clusters
  •   D. Non-motile Gram-negative coccobacilli
  •   E. Motile Gram-positive rods
768 голосов


A 44-year-old man is brought to the emergency department by his wife because of confusion that began a few hours ago. Earlier in the day, he complained of a severe headache and nausea. On physical examination, his temperature is 38.3 C (101 F) and nuchal rigidity is present. Lumbar puncture and cerebrospinal fluid (CSF) examination show:Opening pressure300 mm H2OGlucose20 mg/dLProtein200 mg/dLRBCs4 cells/µLLeukocytes760 cells/µL Neutrophils90% Lymphocytes10%Gram stain of the CSF would most likely reveal which of the following?


Acute rheumatic fever is a complication of untreated group A streptococcal pharyngitis. Rheumatic heart disease is the most common cause of acquired valvular heart disease and cardiovascular death in developing countries. The incidence of acute rheumatic fever and rheumatic heart disease has been reduced in industrialized nations with prompt treatment of streptococcal pharyngitis with penicillin.


Which of the following would be expected to decrease after long-term implementation of this guideline?
Опрос
  •   A. Deaths associated with diarrheal illness
  •   B. Diagnoses of serum sickness-like reactions
  •   C. Incidence of nephritic syndrome
  •   D. Need for cardiac surgery
  •   E. Use of broad-spectrum antibiotics
382 голосов


The public health department of a developing country performs an epidemiologic study to assess the nationwide incidence of upper respiratory infections among children. The data show a high rate of childhood bacterial pharyngitis. Current practice guidelines indicate that a rapid test should be performed in children to identify the presence of bacterial antigens. If this test is negative, a throat culture, the gold standard for definitive diagnosis, is then performed. To offset cost and avoid losing patients to follow-up, the department is considering recommending the empiric use of penicillin for the treatment of suspected bacterial pharyngitis. Which of the following would be expected to decrease after long-term implementation of this guideline?


The major virulence factor of Streptococcus pyogenes is M protein, an alpha-helical coiled-coil protein that shares structural homology with tropomyosin and myosin. It extends from the cell wall and prevents phagocytosis, inhibits complement binding, and mediates bacterial adherence. Antibodies against M protein form shortly after acute infection and may cross-react with epitopes on myosin, leading to rheumatic carditis.


Which of the following is the most likely function of this bacterial cell wall–associated protein?
Опрос
  •   A. Excrete antibiotics
  •   B. Protect from osmotic lysis
  •   C. Provide mechanical cell support
  •   D. Resist phagocytosis
  •   E. Transport nutrients into the cell
498 голосов


A microbiologist is studying the structure and function of bacterial cell walls. In an experiment, group A streptococci are treated with chemicals to solubilize the cell wall. Various cell wall–associated proteins are subsequently extracted. Electron microscopic evaluation of a specific protein shows structural homology with mammalian tropomyosin and myosin. This protein acts as a virulence factor for certain species of the organism. Which of the following is the most likely function of this bacterial cell wall–associated protein?


Staphylococcal scalded skin syndrome occurs in infants and children due to the production of exfoliative exotoxins by Staphylococcus aureus. The toxins cleave desmoglein in desmosomes, leading to widespread epidermal blistering and shedding, especially with gentle pressure (ie, Nikolsky sign). Mucous membranes are spared.


Which of the following is the most likely cause of this patient's symptoms?
Опрос
  •   A. Autoantibody binding to epithelial cell surface
  •   B. Cell-mediated hypersensitivity
  •   C. Endotoxin-mediated inflammatory response
  •   D. Exotoxin-mediated skin damage
  •   E. Mast cell degranulation
385 голосов

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