Woman with Fever

A 37-year-old female presents to the emergency room with a fever. Chest x-ray shows multiple patchy infiltrates in both lungs. Echocardiography and blood cultures suggest a diagnosis of acute bacterial endocarditis limited to the tricuspid valve. Which of the following is the most probable etiology?

A. Congenital heart disease
B. Illicit drug use
C. Rheumatic fever
D. Rheumatoid arthritis
E. Systemic lupus erythematosus

40 year old man with productive cough

A 40-year-old, moderately obese man presents with a persistent productive cough. The cough has been present for several weeks, but recently the man noted that his sputum has assumed a greenish color. Further questioning elicits a history of productive cough , usually in the winter months, over the past several years. He has smoked two packs of cigarettes per day since he was 16 years old. On examination, the man is febrile (100° F), and coarse rhonchi and wheezes can be appreciated bilaterally. Which of the following is the most likely diagnosis?

A. Bronchogenic carcinoma
B. Chronic bronchitis with superimposed infection
C. Cystic fibrosis
D. Emphysema
E. Pulmonary tuberculosis

The mother of a one and a half year old child gives history of a white reflex from one eye for the past 1 month.

The mother of a one and a half year old child gives history of a white reflex from one eye for the past 1 month. On computed tomography scan of the orbit there is calcification seen within the globe. The most likely diagnosis is:
1 Congenital cataract.
2 Retinoblastoma.
3 Endophthalmitis.
4 Coats of disease.

A 27-year old sexually active male develops a vesiculobullous lesion on the glans soon after taking tablet paracetamol for fever.

 A 27-year old sexually active male develops a vesiculobullous lesion on the glans soon after taking tablet paracetamol for fever. The lesion healed with hyperpigmentation. The most likely diagnosis is:
1 Behcet’s syndrome.
2 Herpes genitalis.
3 Fixed drug eruption.
4 Pemphigus vulgaris.

A 30 years old male patient presents with complaints of weakness in right upper and both lower limbs for last 4 months. He developed digital infarcts involving 2nd and 3rd fingers on right side and 5th finger on left side.

 A 30 years old male patient presents with complaints of weakness in right upper and both lower limbs for last 4 months. He developed digital infarcts involving 2nd and 3rd fingers on right side and 5th finger on left side. On examination, BP was 160/140 mm Hg, all peripheral pulses were palpable and there was asymmetrical neuropathy. Investigations showed a Hb-12 gm, TLC - 12000 Cu mm, Platelets 4,30,000, ESR - 49mm. Urine examination showed proteinuria and RBC - 10-15/hpf with no casts. Which of the following is the most likely diagnosis.
1 Polyarteritis nodosa.
2 Systemic lupus erythematosus.
3 Wegener’s granulomatosis.
4 Mixed cryoglobulinemia.

A 40-year-old woman presents with a 2-year history of erythematous papulopustular lesions on the convexities of the face.

A 40-year-old woman presents with a 2-year history of erythematous papulopustular lesions on the convexities of the face. There is a background of erythema and telangiectasia. The most likely diagnosis in the patient is:
1 Acne vulgaris.
2 Rossacea.
3 Systemic lupus erythematosus.
4 Polymorphic light eruption.

A 25year old female presents with 2year history of repetitive, irresistible thoughts of contamination with dirt associated with repetitive hand washing.

A 25year old female presents with 2year history of repetitive, irresistible thoughts of contamination with dirt associated with repetitive hand washing. She reports these thoughts to be her own and distressing; but is not able to overcome them along with medications. She is most likely to benefit from which of the following therapies:
1. Exposure and response prevention.
2. Systematic desensitization.
3. Assertiveness training.
4. Sensate focusing.