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Page 6

_____65. A 39-year-old man had an acute febrile illness with fever, pharyngitis,
lymphadenopathy, and malaise following a trip to a city known for is commercial sex
workers. In how many years would you predict that his peripheral blood CD4
lymphocyte count will drop below 200/microliter:
A. 1 year C. 10 years
B. 5 years D. 30 years

_____66. A 30-year-old patient has a CD4 lymphocyte count of 152/microliter. Physical
examination reveals oral thrush. There has been a 10% loss of body weight over
the past month. These findings are LEAST likely to have resulted from:
A. Sexual intercourse with an HIV-infected person
B. Sharing a needle for drug injection from an HIV-infected person
C. Transplacental spread from an HIV-infected mother
D. Cleaning up a spill of HIV-infected blood without gloves

_____67. A 41-year-old man has a 0.4 cm diameter firm reddish area on the glans of his penis
that has surface ulceration. This has developed over the past week. It is not
particularly painful. This lesion subsides, but then a month later he develops a
bilateral palmar maculopapular rash. The rash subsides in a few weeks. Which of
the following infectious agents is most likely to produce these findings:
A. Treponema pallidum C. Human papillomavirus
B. Hemophilus ducreyi D. Nesseria gonorrhea

_____68. A 20-year-old commercial sex worker has lower abdominal pain of 24 hours
duration. There is no previous history of pain. She is febrile, her total WBC is
29,000/mm3 with 85% neutrophils. She has a markedly tender lower abdomen on
palpation. Laparotomy reveals a distended, fluid-filled reddened left fallopian tube
that is about to rupture. The tube is removed. A culture of the fluid from the tube is
most likely to grow:
A. Treponema pallidum C. Human papillomavirus
B. Hemophilus ducreyi D. Neisseria gonorrheae

_____69. A 19-year-old student has noted fever for one week with foul smelling urethral
discharge. A history of unprotected sexual intercourse with female partners was
obtained. A grams stain of the discharge will revealed:
A. Intracellular gram positive diploccoci C. Gram positive spirochete
B. Intracellular gram negative diplococci D. Gram positive cocci in clusters

_____70. A 30-year-old HIV-infected man has a CD4 count of 125/microliter. He now has a
profuse watery diarrhea. Which of the following infections is he most likely to have:
A. Cytomegalovirus C. Cryptosporidium
B. Pneumocystis carinii D. Mycobacterium tuberculosis

_____71. A 20-year-old healthy woman is sexually active. She has noted multiple painful
genital epithelial vesicles ranging in size from 0.1 to 0.3 cm that have occurred
sporadically over months.
A. Staphylococcus aureus C. Treponema pallidum
B. Calymmatobacterium sp D. Herpes simplex virus

_____72. Ulceration of the male external genitalia is LEAST likely with infection by:
A. Human papillomavirus C. Calymmatobacterium granulomatis
B. Treponema pallidum D. Hemophilus ducreyi

_____73. Urethritis with pain and a burning sensation on urination is present in a 30-year-old
sexually active man. The most likely organism associated with this finding is:
A. Herpes simplex virus C. Treponema pallidum
B. Chlamydia trachomatis D. Hemophilus ducreyi

_____74. A 21-year-old man was notified by the health department that his last sexual contact
3 weeks prior was VDRL positive. The best indicator of the same infection in him is:
A. Positive VDRL in the CSF C. Testicular gumma on biopsy
B. Mucocutaneous rash D. Genital condyloma lata

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