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A 3-year-old boy is admitted to the Emergency Department in acute respiratory distress. The patient has T: 40°C (104°F), RR: 70/min, and HR:130/min. Auscultation of the lungs is unremarkable. An examination of the throat reveals an exudate in the posterior pharynx that is yellowish and membranous. Bleeding occurs when it is scraped and removed. The parents of the child reveal that the child has received no prior immunizations. A throat culture was ordered and worked up specifically for an organism that selectively grows on cystine tellurite agar. What organism is causing this child’s disease?

The causative organism for syphilis is _____________________.

A 4-year-old girl presents with a 2-day history of muscle weakness. Her parents state she has stopped walking, and she tells them her legs feel “loose.” Two weeks ago, she had mild flu-like symptoms, including fever, sore throat, headache, and fatigue. Her family is seeking asylum from West Africa. Her vitals are blood pressure 110/78 mm Hg, heart rate 64 bpm, respiratory rate 15 breaths/min, and temperature 98 °F (36.7 °C). The physical examination demonstrates asymmetric proximal muscle weakness in the lower extremities and the absence of reflexes. Polymerase chain reaction confirms the suspected diagnosis. A vaccine would have prevented this child’s condition. Which of the following is a component of this vaccine?

Which of the following statements regarding diphtheria is TRUE?

A 30-year-old woman presents with a 4-day history of extreme vulvar pruritus and vaginal discharge. The discharge is thick and white, moderate in amount, without associated foul odor. Her PMH is significant for poorly controlled diabetes for 2 years. On external exam, the vulva is erythematous with excoriations and presence of white plaques on the vaginal walls. The diagnosis was confirmed by examination of the wet-mount preparation of the discharge. Which of the following interventions is the most appropriate treatment for this patient?

A 4-year-old boy develops fever and an upper respiratory infection in late December. On physical examination, the pediatrician notes whitish spots in his mouth near his second molars (see image below). A day later the boy develops a rash on his face. The rash consists of reddened macules and papules. Within the next several days, the rash becomes confluent and moves downward over his whole body. Which of the following interventions would be most helpful in confirming the diagnosis of this condition? 

A 12-month-old boy presents with a rash that followed a 2-day fever of 102°F. His mother states that she saw a pink, raised rash on the child’s trunk as the fever went away. “The rash looks like pink or red spots that turn white when I touch them.” On physical exam, the child is currently afebrile, and there is a diffuse, maculopapular rash on the chest, abdomen, and thighs. The rash spares the face, palms, and soles. The child has no symptoms of upper respiratory infection, and the physical examination is otherwise normal. Which of the following conditions is the most likely diagnosis for this patient?

A 22-year-old man presents to the emergency department with a burning cut on his left arm. The patient states that he noticed a few cuts along his arm which have become more swollen and are associated with bumps. He now feels fatigued and has a fever. The patient is otherwise healthy and is not currently taking any medications. The patient lives alone, is a student, and owns a new cat. His temperature is 101°F (38.3°C), blood pressure is 120/88 mmHg, pulse is 97/min, respirations are 14/min, and oxygen saturation is 99% on room air. Physical exam is notable for the finding in the image (see below). There is notable tender lymphadenopathy in the ipsilateral antecubital fossa and axilla. Which of the following is the most likely infectious etiology of this patient’s symptoms? 

Select the human papillomavirus subtypes most often associated with cervical cancer.

A 43-year-old female is admitted for evaluation of nausea, emesis, ataxia, and dizziness. Previous medical history reveals HIV (+) status for 4 years with the most recent CD4 count of 100/mm3. Vital signs and neurologic examination are normal. MRI shows 2 ring-enhancing lesions of the basal ganglia, each approximately 1 cm in diameter. The patient is treated with sulfadiazine plus pyrimethamine and she is discharged following rehydration. Within 1 week, the patient’s symptoms improve and a second MRI 4 weeks later shows a significant reduction in the size of the lesions. Which of the following conditions is the most likely diagnosis for this patient?