A 30-year-old woman presents with a 4-day history of extreme vulvar pruritus and vaginal discharge. The discharge is thick and white, moderate in amount, without associated foul odor. Her PMH is significant for poorly controlled diabetes for 2 years. On external exam, the vulva is erythematous with excoriations and presence of white plaques on the vaginal walls. The diagnosis was confirmed by examination of the wet-mount preparation of the discharge. Which of the following interventions is the most appropriate treatment for this patient?

A 3-year-old girl presents with a 1-day history of irritability and weakness in her legs. Neurologic exam reveals an ascending symmetrical paralysis with cranial neuropathy. A lumbar puncture is performed and cerebrospinal fluid is found to have a normal glucose level,

A 54-year-old male with HIV presents to the Emergency Department with worsening dry cough, now with increasing shortness of breath. He is currently on antiretroviral therapy. On exam, his temperature is 98.4°F (36.9°C), blood pressure is 124/83 mmHg, pulse is 110/min, respirations are 24/min, and oxygen saturation is 91% on room air. Diffuse crackles are present upon auscultation of bilateral lungs. His most recent CD4 cell count is 140/mm3 and an arterial blood gas reveals a PaO2 of 60 mmHg. CXR is noted to have extensive interstitial infiltrates. Which of the following is the most appropriate treatment for the patient at this time?

A 12-month-old boy presents with a rash that followed a 2-day fever of 102°F. His mother states that she saw a pink, raised rash on the child’s trunk as the fever went away. “The rash looks like pink or red spots that turn white when I touch them.” On physical exam, the child is currently afebrile, and there is a diffuse, maculopapular rash on the chest, abdomen, and thighs. The rash spares the face, palms, and soles. The child has no symptoms of upper respiratory infection, and the physical examination is otherwise normal. Which of the following conditions is the most likely diagnosis for this patient?

A 4-year-old boy develops fever and an upper respiratory infection in late December. On physical examination, the pediatrician notes whitish spots in his mouth near his second molars (see image below). A day later the boy develops a rash on his face. The rash consists of reddened macules and papules. Within the next several days, the rash becomes confluent and moves downward over his whole body. Which of the following interventions would be most helpful in confirming the diagnosis of this condition? 

Select the human papillomavirus subtypes most often associated with cervical cancer.

A 75-year-old female is brought to the Emergency Department by ambulance from a skilled nursing facility for altered mental status. She was found to be disoriented to person, place, and time this morning. She has had reduced oral intake over the past 2 days and was complaining of suprapubic discomfort yesterday. She has a history of diabetes mellitus for which she is on insulin. His temperature is 101.6°F (38.7°C). Physical examination shows marked costovertebral angle tenderness on the right. Serum laboratory results are shown below: Leukocyte count: 15,000 with 15% bandsLactate: 4.4 mmol/L (reference: 0.5-1.0 mmol/L) Which of the following additional findings would also be consistent with sepsis?

Which of the following statements best describes mumps?

A 3-month-old baby girl is brought to the Pediatric clinic by her parents because they are concerned about the infant’s health. They reported that the baby had grown lethargic and weak. They had tried to feed the baby, but she was unresponsive to the presence of the baby bottle or breast-feeding. Physical examination was remarkable for hypotonia of the extremities and flaccid neck. There was a poor gag and suck reflex. Vital signs include normal temperature with a slightly decreased respiration rate. Further questioning of the parents revealed that the infant had been previously induced to bottle feed by coating the nipple with honey. Blood was drawn for toxin studies and came back positive. The honey was also examined for the presence of toxin and found to be positive. Which of the following statements about this condition is TRUE?

Osteons of compact bones develop parallel to the force experienced by the bone.