E. coli bacteria normally live in the human gut and produce vitamin K that the body uses. This is best termed a/an _________ relationship.

An 18-month-old girl presents to your office with her mother with a chief complaint of fever and a cough. The symptoms started about 4 days ago with nasal congestion but then progressed into a cough that can be productive of clear sputum. She is tolerating normal oral intake and making the usual amount of wet and stool diapers. Temperature is 100.8°F, respiratory rate is 30/minute, and pulse oximetry in the office reveals an oxygen saturation of 94% on room air. You auscultate faint wheezing on exam. Chest radiography is unremarkable. Which of the following is the most likely diagnosis based on this patient’s presentation?

A 6-month old fell out of her high chair onto the kitchen floor three hours ago and is brought to the ED by her parents. Parents report no loss of consciousness, vomiting, or seizure activity. She seems increasingly drowsy and has been fussy and refusing feeds. Her physical exam is normal, with the exception of a left frontal hematoma. Which of the following should be considered next in the plan of treatment?

You are seeing a 12-year-old girl for her annual exam. She has no significant medical history and no complaints. Vital signs are normal and she is 57 inches in height (25th percentile) and 151 pounds (98th percentile). BMI is above the 97thpercentile for her age. Her BMI at her last exam 2 years ago was at the 83rd percentile and her lipid screen was normal.  What are the current recommendations for lipid screening for this patient?

A patient in the hospital had a bacterial infection treated with Erythromycin. After some time, she is discharged and goes home where she takes some of her left-over Penicillin in hopes that more antibiotics will help kill her bacterial infection faster. A few days later she returns to the ER and notices some GI upset along with Diarrhea. Due to the severity of the GI symptoms and broad-spectrum oral antibiotics not working against the infection, the provider decides to conduce a colonoscopy. This test yield results for a Pseudomembranous Colitis. What is the most likely the causative agent and appropriate treatment?

Which of the following drugs is responsible for interfering with protein synthesis? 

A primer comprised of _________ is needed at the origin of nucleotide addition.

You are the provider on a Pediatric floor in the hospital. A new admission is brought in for observation due to consistent bloody diarrhea with GI upset. The patient’s mother is trying to give you the child’s history, but she is distress as she has two other children with her, and no one has had nap time. The mother explained that the child has some kind of French named disease but can’t recall the exact name. You as a brilliant microbiologist student remembered that the associated disease name was called Guillain-Barre Syndrome. The next step is to run routine labs and get a gram stain. The labs showed a gram-negative bacterium that was partially comma shaped. What is the causative agent and the first line treatment? 

A 10-month-old boy present for complaints of “screaming episodes” for the past 24 hours. He appears well except for episodes of screaming with flexion of the hips and knees about every 25-30 minutes. The episodes last < 1 minute and he appears well again right after. He has had 2 episodes of non-bilious vomiting. Parents deny fever, blood in stool or vomit. Vital signs and hydration are normal. On exam, he has hyperactive bowel sounds in the right upper quadrant. His abdomen is not notable tender. Rectal and stool exams are negative for blood. What is the BEST next step in management?

A 3-year-old boy is evaluated by a pediatrician for symptoms of malabsorption. Since age 5-months, he has had bulky, strong-smelling stools with painful abdominal bloating and flatulence after eating breakfast each morning. He is currently eating a normal diet but appears malnourished. On physical exam, his abdomen is distended. If you ordered an intestinal biopsy, which of the following findings would most likely be present?