A 56-Year-Old Man with Advanced AIDS Comes to the Emergency

question 306

Multiple Choice

A 56-year-old man with advanced AIDS comes to the emergency department due to several weeks of progressive fever, night sweats, weight loss, diarrhea, and generalized weakness.  Physical examination shows mucosal pallor, generalized lymphadenopathy, and hepatosplenomegaly.  Laboratory studies reveal anemia and elevated alkaline phosphatase and lactate dehydrogenase levels.  CD4 count is 16/mm³.  Bone marrow biopsy shows aggregates of epithelioid histiocytes with foamy cytoplasm and numerous acid-fast intracellular organisms.  Nucleic acid amplification test of the sample for Mycobacterium tuberculosis is negative.  Which of the following pathogens is the most likely cause of this patient's illness?

• A)Cryptococcus neoformans
• B)Cryptosporidium parvum
• C)Legionella pneumophila
• D)Mycobacterium avium
• E)Mycobacterium marinum
• F)Nocardia asteroides

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Definitions:

Power Distance

A cultural dimension that reflects the extent to which less powerful members of organizations and institutions accept and expect power to be distributed unequally.

Equality

The state or quality of being equal, especially in status, rights, and opportunities.

Power Distance

A cultural dimension that describes the extent to which members of a society accept and expect power to be distributed unequally.

Expertise

Specialized skill or knowledge in a particular field, gained through education, experience, or training.