A 10-year-old boy presents to the emergency department with his parents. The boy complains of fever, neck stiffness, and drowsiness for the last several days. His past medical history is noncontributory. The boy was born at 39 weeks gestation via spontaneous vaginal delivery. He is up to date on all vaccines and is meeting all developmental milestones. There were no sick contacts at home or at school. The family did not travel out of the area recently. His heart rate is 100/min, respiratory rate is 22/min, blood pressure is 105/65 mm Hg, and temperature is 40.5ºC (104.9°F). On physical examination, he appears unwell and confused. His heart rate is elevated with a regular rhythm and his lungs are clear to auscultation bilaterally. During the examination, he experiences a right-sided focal seizure, which is controlled with lorazepam. A head CT reveals bilateral asymmetrical hypodensities of the temporal region. A lumbar puncture is performed and reveals the following: WBC count 25/mm3 Cell predominance lymphocytes Protein elevated The patient is started on a medication to treat the underlying cause of his symptoms. What is the mechanism of action of this medication?
AFusion inhibition
BNucleoside reverse transcriptase inhibition
CInhibition of DNA polymerase
DBinding with ergosterol in the cell membrane
ECell wall synthesis inhibition
A 2300-g (5-lb 1-oz) male newborn is delivered to a 29-year-old primigravid woman. The mother has HIV and received triple antiretroviral therapy during pregnancy. Her HIV viral load was 678 copies/mL 1 week prior to delivery. Labor was uncomplicated. Apgar scores are 7 and 8 at 1 and 5 minutes respectively. Physical examination of the newborn shows no abnormalities. Which of the following is the most appropriate next step in management of this infant?
AAdminister lamivudine and nevirapine
BAdminister zidovudine, lamivudine and nevirapine
CAdminister nevirapine
DAdminister zidovudine
EHIV antibody testing
A 3-year-old girl is brought to the emergency department because of chest pain for 2 hours. Eight days ago, she was admitted to the hospital for treatment of low-grade fever, malaise, and sore throat. The hospitalization was complicated by pharyngitis with pseudomembrane formation and severe cervical lymphadenopathy briefly requiring intubation. She has not received any routine childhood vaccinations. Serum studies show elevated cardiac troponins. An ECG shows diffuse T wave inversions and prolonged PR interval. Which of the following preventative measures would most likely have prevented this patient's cardiac symptoms?
AAntibiotic that binds to penicillin-binding protein 3
BSalicylate that inhibits prostaglandin synthesis
CElectrolyte that reduces cardiomyocyte excitability
DImmunoglobulin that targets circulating proteins
EDenatured bacterial toxin that contains an intact receptor binding site
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