Correct Answer: C

Rationale: The correct answer is C: "This is a fungal infection caused by all the antibiotics you've received." The black, hairy tongue is a known side effect of prolonged antibiotic use, which disrupts the balance of normal oral flora and predisposes to fungal overgrowth, specifically of the yeast Candida. Antibiotics can eliminate the competing bacteria that normally keep Candida in check. Therefore, the patient's symptoms are most likely due to a fungal infection related to antibiotic therapy, rather than a bacterial issue or temporary overgrowth of hair. Biopsy is not necessary as the condition is commonly seen in this context and can be managed with appropriate treatment for fungal overgrowth.

Correct Answer: C

Rationale: Step-by-step rationale for why choice C (CN VII) is correct: 1. Palpebral fissures are controlled by muscles innervated by CN VII (facial nerve). 2. Damage to CN VII can result in facial asymmetry, affecting palpebral fissures. 3. CN III (choice A) controls eye movement, not palpebral fissures. 4. CN V (choice B) controls facial sensation, not palpebral fissures. 5. CN VIII (choice D) controls hearing and balance, not palpebral fissures. Summary: Choice C is correct as damage to CN VII affects palpebral fissures due to facial muscle innervation. Choices A, B, and D are incorrect as they do not control the muscles responsible for palpebral fissures.

Correct Answer: C

Rationale: The correct answer is C because shining a light across the pupil from the side allows for both direct (ipsilateral) and consensual (contralateral) pupillary constriction to be observed. This technique helps to assess the integrity of the cranial nerves involved in the pupillary light reflex (CN II and III). Direct constriction occurs in the eye exposed to the light, while consensual constriction occurs in the opposite eye. This comprehensive assessment ensures that both pupils are responding appropriately to light stimulation, providing a more accurate evaluation of the reflex. Choice A is incorrect because inspecting for pupillary constriction from directly in front may not adequately assess for consensual constriction in the opposite eye. Choice B is incorrect as asking the patient to follow the penlight in eight directions does not specifically target the pupillary light reflex. Choice D is incorrect as it focuses on accommodation rather than the pupillary light reflex.

Correct Answer: C

Rationale: The correct answer is C: Erythematous scaly patch with sharp margins in the sacral area. In patients with AIDS, this presentation is most likely indicative of a common opportunistic infection called tinea corporis. This fungal infection often presents as erythematous scaly patches with well-defined borders. The location in the sacral area is also common due to the warm and moist environment. Choice A, tinea capitis, is a fungal infection of the scalp and is not typically associated with AIDS. Choice B describes a presentation more indicative of a condition like seborrheic dermatitis rather than an AIDS-related skin manifestation. Choice D describes a presentation more typical of tinea corporis, which is not commonly seen in the axilla region in patients with AIDS.

Correct Answer: A

Rationale: The correct answer is A: parotid gland. This gland is located in the cheek in front of the ear. It is the largest salivary gland in the human body. The parotid gland secretes saliva into the mouth through Stenson's duct. The other choices are incorrect because Stenson's gland does not exist, the sublingual gland is located under the tongue, and the submandibular gland is located under the mandible. Therefore, the parotid gland is the only gland that fits the description given in the question.