09-04-2015, 09:37 AM
NBME 4 Q
A 19 y/o woman brought to the ER by her roommate because of progressive lethargy and confusion for the last 12 hrs. Her roommate says that she had a 10kg (22 lb) weight loss during the past month despite substentially increasing her food and fluid intake. On arrival she is obtunded. Her temp is 36.2C (97.2F), pulse is 92/min and B.P. is 90/40 mmHg. Physical examination shows no other abnormalities. Serum studies show:
Na-------------- 151 mEq/L
K --------------- 5.8 mEq/L
Cl -------------- 118 mEq/L
HCO3--------- 8 mEq/L
Glucose------- 492 mg/dl
Creatinine---- 1.4 mg/dl
Without appropriate treatment she is at greatest risk for sinonasal infection with which of the following organisms?
A-Cryptococcus neoformans
B-Histoplasma capsulatum
C-Mucor circinelloides
D-Nocardia braziliensis
E-Trichophytonrubrum
A 19 y/o woman brought to the ER by her roommate because of progressive lethargy and confusion for the last 12 hrs. Her roommate says that she had a 10kg (22 lb) weight loss during the past month despite substentially increasing her food and fluid intake. On arrival she is obtunded. Her temp is 36.2C (97.2F), pulse is 92/min and B.P. is 90/40 mmHg. Physical examination shows no other abnormalities. Serum studies show:
Na-------------- 151 mEq/L
K --------------- 5.8 mEq/L
Cl -------------- 118 mEq/L
HCO3--------- 8 mEq/L
Glucose------- 492 mg/dl
Creatinine---- 1.4 mg/dl
Without appropriate treatment she is at greatest risk for sinonasal infection with which of the following organisms?
A-Cryptococcus neoformans
B-Histoplasma capsulatum
C-Mucor circinelloides
D-Nocardia braziliensis
E-Trichophytonrubrum
thanks