A 10-Month-Old Boy Is Brought to the Emergency Department Due

question 96

Multiple Choice

A 10-month-old boy is brought to the emergency department due to 2 days of fever, irritability, and vomiting.  The patient has had no prior significant medical conditions and has received all recommended vaccinations, including protein-conjugated, 13-valent pneumococcal capsular polysaccharide vaccines (PCV13) at ages 2, 4, and 6 months.  On physical examination, the patient is febrile and lethargic, with a bulging anterior fontanelle.  Lumbar puncture yields turbid fluid with an abundance of neutrophils.  Gram stain of cerebrospinal fluid reveals lancet-shaped, gram-positive diplococci.  Which of the following best explains this patient's current condition?

• A)Antigenic variation of bacterial cell wall
• B)Infection from capsule-lacking bacteria
• C)Infection from nonvaccine serotype
• D)Primary T-cell immunodeficiency
• E)T-cell-independent vaccine response

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Definitions:

Effective Annual Rate

The interest rate on an investment or loan, annualized and taking into account the effects of compounding within the year.

Quarterly Return

The financial performance of an investment or asset over a three-month period, typically expressed as a percentage.

Investment

This refers to the allocation of resources, often financial, in assets or projects with an expectation of generating future returns.

Lower Partial Standard Deviation

A measure of the risk of negative asset returns, focusing only on the volatility of returns that fall below the average.