Infectious Disease & Hematology MCQs

Medicine · 5 free questions with answers & explanations.

1. A 30-year-old HIV-positive man not on antiretroviral therapy presents with 3 weeks of fever, headache, and neck stiffness. His CD4 count is 68 cells/µL. CSF analysis shows: opening pressure 320 mmHg, glucose 32 mg/dL (serum 96 mg/dL), protein 75 mg/dL, WBC 8 cells/µL (lymphocytes), and India ink stain positive for encapsulated yeast. What is the treatment of choice?
2. A 22-year-old medical student develops fever to 39.5°C, severe sore throat, and cervical lymphadenopathy 3 days after starting ampicillin for presumed bacterial tonsillitis. On examination he has a maculopapular rash covering the trunk and limbs, mild splenomegaly, and exudative tonsillitis. Monospot test is positive. What is the mechanism of the rash in this patient?
3. A 45-year-old man presents with a 2-week history of fever, night sweats, and fatigue. He underwent splenectomy 10 years ago for trauma. Blood film shows ring-form intraerythrocytic parasites, some tetrads ('Maltese cross' or Babesia cross), and occasional extracellular merozoites without banana-shaped gametocytes or hemozoin pigment. What is the MOST likely causative organism?
4. A 35-year-old woman presents with fatigue, pallor, and episodic dark urine in the morning. CBC shows hemoglobin 7.2 g/dL, MCV 104 fL, reticulocyte count 8%. Peripheral smear shows polychromasia. LDH is elevated, haptoglobin is undetectable, and indirect bilirubin is elevated. Flow cytometry of peripheral blood shows absence of CD55 and CD59 on red blood cells. What is the MOST appropriate treatment for her underlying condition?
5. A 28-year-old man from sub-Saharan Africa presents with painless cervical lymphadenopathy for 4 months, fever, drenching night sweats, and a 10% weight loss. CT scan shows mediastinal and retroperitoneal lymph node enlargement. Lymph node biopsy shows a background of lymphocytes, plasma cells, and eosinophils with scattered large binucleated cells having prominent 'owl eye' nucleoli that are CD30+ and CD15+. Which subtype of Hodgkin's lymphoma is MOST likely?