A 3yearold boy presents with a 7day history of fev

Question 1 of 5

A 3-year-old boy presents with a 7-day history of fever, cervical adenopathy, foul breath, and painful oral lesions on his tongue, gums, and lips. For the past 3 days, he has had a red, painful swollen area about the nail of his right thumb with an area of fluid by the nail bed, unresponsive to warm soaks and a first-generation cephalosporin. The most likely etiology is

A. Staphylococcus aureus B. mucocutaneous candidiasis C. coxsackievirus D. herpes simplex virus

Correct Answer: D

Rationale: Herpes simplex virus causes herpetic gingivostomatitis and whitlow, matching the oral lesions and thumb involvement.

Question 2 of 5

Toxoplasmosis causes all of the following patterns of disease EXCEPT

A. congenital infection in neonates manifested by chorioretinitis, cerebral calcifications, and hydrocephalus due to first-trimester infection B. congenital infection in neonates who appear normal at birth but become blind in adolescence because they have retinal (macular) lesions that recrudesce at that time C. brain abscess that results in confusion, seizures, and paralysis in a patient with acquired immunodeficiency syndrome (AIDS) D. congenital malformations, such as cleft palate, or patent ductus arteriosus

Correct Answer: D

Rationale: Toxoplasmosis does not cause congenital malformations like cleft palate; these are more typical of rubella.

Question 3 of 5

The Fitz-Hugh-Curtis syndrome is characterized by

A. right upper quadrant pain caused by gonococcal perihepatitis B. polyarticular arthritis and rash of disseminated gonococcal infection C. lower quadrant pain caused by gonococcal endometritis D. gonococcal meningitis

Correct Answer: A

Rationale: Fitz-Hugh-Curtis syndrome involves perihepatitis from gonococcal or chlamydial infection, causing RUQ pain.

Question 4 of 5

All of the following are true of cat-scratch disease EXCEPT that

A. lymph nodes are tender in $80 \%$ of patients B. lymph nodes vary in size from 1 to $12 \mathrm{~cm}$ C. fever $\left(\geq 38.1^{\circ} \mathrm{C}\right)$ occurs in $90 \%$ of patients D. malaise and fatigue occur in $30 \%$ of patients

Correct Answer: C

Rationale: Fever occurs in about 30-60% of cat-scratch disease cases, not 90%.

Question 5 of 5

An HIV-seropositive female comes to her physician for advice because she is pregnant. She has never been on any antiviral medication because she had remained healthy without symptoms of AIDS. However, she wonders whether antiviral treatment might diminish the likelihood of fetal HIV infection. Which one of the following statements is correct?

A. Treatment of the pregnant woman will produce maternal thrombocytopenia. B. Treatment will result in viral resistance in all infected infants. C. Treatment will decrease the likelihood of fetal infection but adversely affect the woman, so it should be avoided. D. Treatment will decrease the likelihood of fetal infection by greater than $50 \%$.

Correct Answer: D

Rationale: Antiretroviral therapy reduces vertical HIV transmission by over 50% with minimal maternal or fetal harm.

Nurselytic

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