Review Questions

1. A previously healthy 19-year-old college student comes to the clinic because of a headache, sore throat, muscle aches, and a constant, irritating, dry cough for the past 4 days. She says that she is "never sick" and has only been to this clinic for her "immunizations." She exercises regularly, does not smoke cigarettes, and has an "occasional glass of wine on the weekends with sorority sisters." Her temperature is 38.8°C (101.8°F), blood pressure is 120/80 mm Hg, pulse is 68/min, and respirations are 16/min. Scattered rhonchi are heard in the left lower lobe. A chest x-ray shows diffuse interstitial infiltrates in the left lower lobe. Laboratory studies show elevated cold agglutinin titers. Which of the following is the most likely diagnosis?

A.

Haemophilus influenzae

B.

Influenza virus

C.

Mycoplasma pneumoniae

D.

Pneumocystis carinii pneumonia

E.

Respiratory syncytial virus

F.

Streptococcus pneumoniae

2. A 28-year-old woman comes to the physician because of a 2-month history of an "annoying cough," difficulty breathing when she climbs the steps to her fifth-floor apartment, and eye irritation. She says that she has been unusually tired lately frequently going to sleep at 8:30 in the evening. She is generally healthy, except for an episode of nephrolithiasis 6 months ago. Her temperature is 37.8°C ( I00°F). A chest x-ray shows hilar lymphadenopathy and parenchymal infiltrates. Laboratory studies show an elevated level of angiotensin-convert-ing enzyme. Which of the following is the most likely diagnosis?

A.

Asthma

B.

Primary pulmonary hypertension

C.

Sarcoidosis

D.

Systemic lupus erythematosus

E.

Tuberculosis

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