A 54-Year-Old Woman Is Brought to the Emergency Department Due

question 178

Multiple Choice

A 54-year-old woman is brought to the emergency department due to fever and lethargy.  The patient has had several days of productive cough and yesterday developed severe headache, nausea, and vomiting.  This morning, she became weak and confused and could not get out of bed by herself.  She has a history of type 2 diabetes mellitus.  The patient drinks 1 or 2 glasses of wine daily.  Temperature is 39.1 C (102.4 F) , blood pressure is 110/70 mm Hg, and pulse is 108/min.  The patient is somnolent and requires constant physical stimuli to remain awake.  She is oriented to person only.  Marked neck rigidity is present.  Pulmonary auscultation reveals crackles and bronchial breath sounds in the right lower lung field.  There is no skin rash.  Laboratory testing shows leukocytosis.  CT scan of the head is normal.  Lumbar puncture is performed.  Which of the following organisms is most likely to be seen in the spinal fluid of this patient?

• A)Hemophilus influenzae
• B)Klebsiella pneumoniae
• C)Listeria monocytogenes
• D)Neisseria meningitidis
• E)Streptococcus pneumoniae

---

Definitions:

Unemployment Spells

Periods of time during which an individual is searching for employment but is unable to find work.

Frictional Unemployment

Temporary unemployment existing in a job market due to time taken by workers to move between jobs, including new or re-entering workers.

Structural Unemployment

Unemployment arising from a persistent mismatch between the skills of workers and the requirements of jobs, often exacerbated by technology or market changes.

Frictional Unemployment

Temporary unemployment experienced by individuals transitioning between jobs, seasons, or moving to new locations.