Dizziness and Its Associated Causes

Dizziness and Its Associated Causes: A common symptom, dizziness is a sensation of imbalance or faintness, sometimes associated with giddiness, weakness, confusion, and blurred or ...

A 34-year-old woman having vague chest discomfort

Question NO 34

A 34-year-old woman, a recent immigrant from Eastern Europe, is
seen with complaints of vague chest discomfort after an upper respiratory
tract infection. She is not a smoker and gives a history of BCG vaccination
when she was an infant. Physical examination is normal. PPD is 10-mm
induration and induced sputum for acid-fast bacilli is negative. CXR is
shown

What is the most likely diagnosis?


a. Granuloma
b. Scar carcinoma
c. Coccidioidomycosis
d. Hamartoma



 What is the next step in the management of this patient?


a. MRI of the chest
b. Fiberoptic bronchoscopy
c. Comparison of previous chest radiograph, if available, and repeat chest radiograph
in 3 mo
d. Treatment with four-drug anti-TB chemotherapy

A 40-year-old male smoker presents with a history of chronic cough

Question NO 33

 A 40-year-old male smoker presents with a history of chronic cough. He
has had symptoms of an upper respiratory illness for a few months since
visiting family in Arizona. Physical exam is normal. CXR is shown below in

The next step in management should be



a. Complete pulmonary function tests
b. Fiberoptic bronchoscopy
c. Percutaneous needle biopsy
d. Observation and repeat CXR in 6 to 8 mo

Mycobacterium tuberculosis results in

Question NO 32

Mycobacterium tuberculosis results in an intracellular bacterial infection
that provokes which one of the following immune responses?


a. Natural killer cytotoxic response
b. CD8-positive cytotoxic T cell response
c. T helper 1 delayed type hypersensitivity response
d. Complement mediated lysis of infected cell
e. Eosinophilia

Direct killing of cells infected with virus is usually accomplished by

Question NO 31

Direct killing of cells infected with virus is usually accomplished by

a. CD8-positive T cells
b. CD4-positive T helper 1 cells
c. CD4-positive T helper 2 cells
d. plasma cells
e. CD19-positive B cells

Neutralizing antiviral antibody produced in response to infection

Question NO 30

Neutralizing antiviral antibody produced in response to infection by
an enveloped virus acts on which one of the following components of the
virus?

a. Matrix proteins
b. One or more surface glycoproteins
c. Internal protein components
d. Nucleic acid
e. Internal nonprotein components

Toxic shock syndrome toxin-1 is produced by

Question No 29

Toxic shock syndrome toxin-1 is produced by some strains of S. aureus
and is thought to be responsible for the clinical manifestations of disease by
this organism. This toxin is referred to as a superantigen because it can

a. Activate T cells in an antigen-nonspecific manner
b. Activate B cells without T cell help
c. Become immunogenic when attached to a carrier protein
d. Prolong the presence of antigen in a tissue
e. Evoke IgE