A 42-Year-Old Man Comes to the Office Due to 2

question 106

Multiple Choice

A 42-year-old man comes to the office due to 2 weeks of progressive fever, chills, abdominal discomfort, and loose stools, which began during a trip to Southeast Asia.  He received no pre-travel vaccinations and did not strictly follow food and water safety precautions during the trip.  The patient has no chronic medical conditions but has experienced a prior episode of Salmonella enteritidis gastroenteritis, which resolved with symptomatic care.  Temperature is 39.4 C (103 F) , blood pressure is 110/64 mm Hg, pulse is 62/min, and respirations are 18/min.  Physical examination reveals a faint macular rash on the trunk.  There is mild tenderness on palpation of lower abdominal quadrants with no guarding or rebound tenderness.  Blood culture grows non-lactose fermenting gram-negative rods.  Which of the following best explains the prolonged and severe disease course from this pathogen compared to the patient's previous bacterial infection?

• A)Contact-dependent host cytotoxicity
• B)Cross-reacting antibody formation
• C)Extensive intra-phagocytic multiplication
• D)Potent exotoxin production
• E)Villus epithelial cell destruction

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Definitions:

All-cause Mortality

The total number of deaths from any cause in a given population and time period.

Moderately-fit

Describes an individual who engages in regular physical activity, leading to a level of fitness that is above sedentary but below highly fit statuses.

Very-fit

A description of an individual who possesses a high level of physical fitness, often characterized by endurance, strength, and flexibility.

Sources Of Energy

Various origins from which organisms can derive power, commonly including carbohydrates, fats, proteins, and, in broader terms, food and sunlight.