Situation: A 33-year-old male presents to your clinic with 7 days fever, abdominal pain, nausea and

vomiting. On examination, there is a faint, salmon-colored, blanching, maculopapular rash on the chest.

1. Which test will have the highest yield in the first 2 weeks of illness to confirm the diagnosis?
A. Stool culture
B. Blood culture
C. Widal test
D. Tyhidot test

2. What is the diagnosis of the case above?

a. Colorectal Carcinoma
b. lymphoma
c. German Measles
d. Typhoid Fever

3. which of the following is true regarding the above diagnosis?

a. the most common cause is a virus
b. Salmonella typhi is a DNA single stranded enveloped virus
c. amoxicillin is a drug that can be given to the patient
d. chloramphenicol can be given in pediatric patient

Rationale:
A. Bacteria
B. DNA single stranded enveloped virus- Hepadnavirus
C. Treatment, table 1, CPG of typhoid fever
D. Chloram cant be given in pedia. May cause gray baby syndrome. See nelsons, katzung and
brenner

4. which of the following statements are true regarding influenza infection? Select all that applies.

I. Most common mode of transmission is by fomite

II. Typical incubation is 24 to 48 hours
III. 2 year old boy recently diagnosed with asthma is safe to receive Live Attenuated Influenza
Vaccine (LAIV)
IV. Pregnant women on the other hand cannot receive LAIV
V. Annual influenza vaccination in age 6 months and older is a grade A recommendation

a. II, IV and V only

b. I and IV only
c. I only
d. All are correct
Rationale
 Most common mode of trans is droplet
  Contraindications of LAIV: pregnant, immunocompromised, less than 2 yo, 2 to 4 dx with
asthma for the past 12 months, 50 yo above
5. Which is a Grade A colon cancer screening strategy?
A. Colonoscopy at age 40 if with history of familial polyposis
B. Colonoscopy every 5 years for patient’s 50-75, regardless of family history of colon cancer
C. FOBT every 3 years for patients 50-75
D. Sigmoidoscopy every 5 years with FOBT every 3 years for patients 50-75

6. For a woman with no family history of breast carcinoma and has no risk factors for developing
cancer of the breast. When should screening mammography on a yearly basis be commenced?
A. at the age of 35
B. at the age of 40
C. at the age of 50
D. at the age of 55

7. With regard to the natural history of breast cancer, which of the following statements is true:
A. On average, a 1 cm breast cancer has been subclinically present for approximately 1 year.
B. Dimpling of the skinoccurs as a result of glandular fibrosis and shortening of Cooper’s ligaments
C. Skin edema in breast cancer results only from direct skin invasion by tumor
D. Vertebral metastases result from arterial dissemination of cancer cells
E. Ipsilateral lung involvement occurs most often as a result of direct
lung invasion.

8. A 64-year-old man presents to the clinic with a 1-month history of 10-lb weight loss and rectal
bleeding. His hematocrit is found to be 27. On colonoscopy he is found to have a large cecal mass.
What risk factors should he have modified to prevent development of colon cancer?
A. Eating a high-fat, high-protein, and low-carbohydrate diet and drinking a bottle of wine a day.
B. Eating a high-fiber, low-fat, and low-protein diet, drinking a six packs of beer a day.
C. Eating a high-fiber, low-fat, and high-protein diet and drinking only on holidays.
D. Eating a high-fat, low-fiber diet and drinking only on holidays