A 12-year-old African American male presents for follow-up for otitis me

dia, for which he was prescribed trimethoprim-sulfamethoxazole. He appears pale

and weak. History reveals that certain Mediterranean foods have elicited a simil
ar problem in the past. Family history reveals a maternal uncle with similar hea
lth concerns. Which of the following statements is most correct?
A Current assessment of an erythrocyte would reveal normal
glucose-6-phosphate dehydrogenase activity.
B Genetic analysis would reveal one of two possible geneti
c defects.
C Most glutathione cannot be oxidized at present.
D NADPH is globally reduced throughout the entire body.
E NADPH levels remain normal during the acute episode.
Your patient has pernicious anemia. She has been receiving injections of
vitamin B12 for years. Recently she began complaining that she is losing a lot
of weight. What do you suspect?
A Degeneration of the spinal cord
B Gastric cancer
C Hypothyroidism
D Leukemia
E She missed two shots

Your 72-year-old patient presented to your office with severe back pain,
upper leg pain, hearing loss, and high some signs of cardiac failure. You took
an X ray of the pelvis and noticed that bone architecture in the femur and spine
was abnormal. You described the architecture as mosaic. Which lab abnormalities w
ould you expect to see in this patient?
A Increased alkaline phosphatase levels
B Decreased calcium levels
C Decreased phosphorus levels
D Decreased alkaline phosphatase levels
E Normal alkaline phosphatase levels
Your team has just admitted a 36-year-old female who complains of feelin
g really down for the last two weeks and has no interest in her usual activities
. She has been waking at 3 a.m. every day. Her appetite is poor and she feels li
ke she is moving in slow motion. She admits that she has thought about killing h
erself because life isn't worth living anymore. Which of the following medicatio
ns would you prescribe?
A Alprazolam (Xanax)
B Amitriptyline (Elavil)
C Chlorpromazine (Thorazine)
D Fluoxetine (Prozac)
E Temazepam (Restoril)
You have just told your 55-year-old patient that she has inoperable panc
reatic cancer that has metastasized to the liver and that she has at most six mo
nths to live. She laughs at you and says, Don t be silly. I feel fine. I'm going to
live to be 100.' Which stage of grieving is she currently in?
A Acceptance
B Anger
C Bargaining
D Denial
E Grieving
An eight-week-old infant is brought to clinic by his Old World Mennonite
parents. They have noticed sweet-smelling urine in this child, and they also ha
ve a three-year-old daughter who has failed to meet developmental milestones. Up
on evaluation of the infant's urine, which metabolite would you expect to be ele
vated?
 A Histidine
B Homocystine
C Homogentisate
D Phenylalanine
E Valine
A 16-year-old female comes into your office for a routine physical exam.
She tells you that she is shorter than the rest of her classmates. On physical
exam, you notice that she has an increase in skin folds around the neck (webbed
neck). When taking her blood pressure, you find it to be 145/92 when taken from
her left arm and 90/55 in her left leg. Upon further questioning, you find that
she has never had a menstrual period. What is the chromosomal abnormality you wo
uld expect to find in this patient?
A 45, XO
B 45, XY with trisomy 18
C 45, XY with trisomy 21
D 47, XXY
E 47, XYY
An infant is diagnosed and admitted to the hospital with bacterial meningitis
based on CSF studies, an elevated WBC, and her clinical presentation. On rounds
, you are asked to describe why chloramphenicol should not be used in this patie
nt's therapy. Which of the following is the deficient phase II process resulting
in the gray baby syndrome ?
A Epoxidation
B Glucuronidation
C Glutathione reaction
D Hydroxylation
E Methylation
Your 64-year-old patient with congestive heart failure (CHF), hypertensi
on (HTN), and diabetes mellitus type II (DM2) complains of seeing yellow-green h
aloes around lights. She is currently taking digoxin, hydrochlorothiazide, metfo
rmin, hydralazine, and glyburide. Which of these drugs causes the previously men
tioned side effect?
A Digoxin
B Glyburide
C Hydralazine
D Hydrochlorothiazide
E Metformin
An 84-year-old white male presents to the outpatient clinic with a chief
complaint of back and leg pain. History reveals that his hat size has increased
. Physical exam shows decreased auditory acuity, 2 + lower-extremity pitting ede
ma, and skin warmth over the bilateral thigh. Plain films of his femurs demonstr
ate large bones, increased bone density, and thick cortical bone with mottled ap
pearance. Which is the following is most consistent with this disease process?
A Normal serum alkaline phosphatase
B Normal risk of cardiac failure
C Normal risk of fracture
D Normal risk of neoplasia
E Normal serum calcium
On internal medicine rounds, the attending physician is discussing amino
acids. You remember that some amino acids are essential that is, found only in th
e diet. Which of the following is an essential amino acid?
A Arginine
B Asparagine
C Glutamate
 D Glycine
E Proline
F Serine
G Tyrosine
A 29-year-old male returns from a two-day trip to Mexico with frequent loose
stools that do not contain blood. You diagnose the patient with traveler's diarr
hea. Of the following organisms, which is most likely to cause nonbloody, watery
diarrhea?
A Campylobacter jejuni
B Entamoeba histolytica
C Enterotoxigenic E. coli
D Salmonella
E Shigella
A patient comes into your office for her prenatal visit. She is currentl
y four weeks pregnant and has no complaints. She casually mentions that she is t
hinking about adopting a kitten for her five-year-old son so that he won't be je
alous when the baby comes. This will be the first time that she has owned a kitt
en. You are most concerned about which infection?
A Cat scratch fever
B CMV
C Francisella tularensis
D Rubella
E Toxoplasmosis
A 58-year-old white male presents to the emergency room with complaints
of frequent morning headaches and vomiting. The patient has a cigarette habit of
two packs per day for 40 years. Physical exam reveals papilledema, positive Ker
nig and Brudzinski signs, but no photophobia. CT reveals three well-demarcated,
spherical, dense foci with significant edema and displacement. Two masses are fr
ontal, while one appears to be dural. Which is the most likely primary site?
A Acoustic canal
B Frontal lobe
C Lung
D Meninges
E Posterior fossa
You are in the pediatric clinic doing a well child check on an eight-year-old b
oy. He has a past medical history of asthma that is currently being treated as n
eeded (PRN) with albuterol, given via a multidose inhaler. When asked, his mothe
r tells you that he has been using the inhaler daily for the last month due to i
ncreased shortness of breath. What is the most appropriate thing to do?
A Add inhaled corticosteroids such as fluticasone on a dai
ly basis, reserving the albuterol for exacerbations only
B Add systemic steroids
C Congratulate them on using the albuterol as prescribed
D Stop the albuterol; the child has outgrown his asthma
E Stop the albuterol; prescribe only inhaled corticosteroi
ds
A 28-year-old patient with no significant medical history is undergoing
general anesthesia for the first time for a surgical procedure. The patient is p
ut under anesthesia but soon into the operation experiences a sudden rapid rise
in temperature, muscle rigidity, sweating, and tachycardia. Which of the followi
ng statements best explains what is happening to the patient?
A The patient is experiencing malignant hypertension secon
dary to defects in a potassium-channel receptor
 B The patient is experiencing malignant hypertension secon
dary to defects in a sodium-channel receptor
C The patient is experiencing malignant hyperthermia secon
dary to defects in a calcium-channel ryanodine receptor
D The patient is experiencing malignant hyperthermia secon
dary to defects in a chlorine-channel receptor
E The patient is experiencing malignant hyperthermia secon
dary to defects in a selenium-channel receptor
A cruise ship returns to port early, due to an outbreak of diarrhea. Eig
ht hundred of 2000 passengers have been affected. Physicians aboard the ship bel
ieve that Norwalk virus is probably responsible. Which of the following statemen
ts is correct?
A Antiviral therapy will attenuate the symptoms.
B Norwalk virus infection has equal incidence in children
and adults.
C Immunity after infection is life-long.
D The primary mode of transmission is via inhaled particle
s.
E Symptoms usually subside within 24 h.
After attempting to replicate Columbus's original voyage, a 40-year-old
sailor comes to your office describing a several-month trip across the Atlantic
Ocean with few provisions. In your office, he presents with swollen gums, anemia
, and diffuse bruises over his body. Which of the following vitamin deficiencies
best explains your patient's current presentation?
A Vitamin A
B Vitamin B1
C Vitamin C
D Vitamin D
E Vitamin E
A 15-week pregnant female comes to the clinic complaining of nausea and
vomiting. The patient has had one cesarean section in the past for breech presen
tation. Her gynecologic history includes menarche at age 14 and regular menses.
All prenatal lab samples are drawn, including a full hormone panel. Which of the
following statements is true of hormones during pregnancy?
A Human placental lactogen has anti-insulin properties.
B The high level of human placental lactogen in pregnancy
prevents milk letdown.
C Progesterone and estrogen are made by corpus luteum unti
l the fetoplacental until can take over production.
D Prolactin starts to increases after birth.
E There is a steady increase in hCG during pregnancy.
A test for disease X is known to have a sensitivity of 0.95, specificity
of 0.65, positive predictive value of 0.73, and negative predictive value of 0.
93. What is the false-negative rate?
A 0.05
B 0.08
C 0.27
D 0.35
E Undeterminable from the information given
As a third-year medical student on your surgery clerkship, you are obser
ving a direct inguinal hernia repair on a 24-year-old man. The attending physici
an is now ascertaining your knowledge regarding direct inguinal hernias. He asks
you what makes up the medial border of Hesselbach's triangle, also known as the
inguinal triangle. What is your response?
A Conjoint tendon
 B Inferior epigastric vessels
C Inguinal ligament
D Lacunar ligament
E Lateral edge of the rectus abdominis muscle
An 18-year-old female presents to the gynecology clinic, concerned because sh
e has never had a menstrual period. A physical exam reveals an absence of axilla
ry and pubic hair. The patient has breast tissue present bilaterally. A pelvic e
xam reveals the vagina ending in a blind pouch. A bimanual exam reveals an absen
ce of cervix, uterus, and ovaries. What is the most likely karyotype of this pat
ient?
A 45, XO
B 46, XX
C 46, XY
E 47, XYY
On the Internal Medicine service, you are working as an intern. A patien
t of yours has a history of TB in the distant past, along with gastroesophageal
reflux, myocardial infarction, stroke, and osteoporosis. The patient is currentl
y admitted for pneumonia. He also complains of back pain, for which you have rel
uctantly given him narcotics to assuage his continued complaining. On a past CT
of his spine, you observe some spherical hypodensity in the psoas muscle. You or
der an MRI for a better look and bring up the likely diagnosis of which of the f
ollowing?
A Fracture of vertebral bodies secondary to osteoporosis
B Prosthetic placement
C Recurrent TB infection
D Torn muscle
E Tumor metastatic to the psoas muscle
A college rugby player comes to the student health clinic for a hot, inflamed
knee. It has been this way for almost five days, since a big game during the pr
evious weekend. The patient does not remember injuring it, nor can you find any
evidence of a scrape. The left knee has the following qualities: calor, dolor, r
ubor. The patient is limited in his range of motion and cannot walk due to the p
ain. You aspirate the knee and Gram-stain it yourself. Your findings are as foll
ows: bean-shaped, gram-negative diplococci. You infer that your history should h
ave included which of the following?
A Eye exam
B History of IV drug use
C History of passing out
D History of trauma within the past year
E Sexual history

A patient who is allergic to peanuts develops anaphylactic shock after a

ccidentally eating a candy bar with peanuts in it. What is the mechanism of anap
hylaxis in this patient?
A Type I hypersensitivity
B Type II hypersensitivity
C Type III hypersensitivity
D Type IV hypersensitivity
E Anaphylaxis is not a hypersensitivity reaction
A nurse calls you to the pediatric floor to evaluate a 14-month-old chil
d for vomiting. The child was admitted four days ago with complaints of persiste
nt vomiting at home. The nurse states the child slept peacefully through the nig
ht and began vomiting around 11 a.m. You review the medical record and note a su
spicious pattern to the vomiting since the child's admission. The vomiting usual
ly starts within one hour of the start of visiting hours and seems to occur only
when the child's mother is visiting. It does not occur when the father visits o
r other family members are visiting. What do you suspect?
A Munchausen's syndrome and the mother is the culprit
B Munchausen's syndrome by proxy and the mother is the cul
prit
C This child has been physically abused by the mother and
the vomiting is a stress reaction by the child to the mother's presence
D The child's mother is carrying an infectious agent that
keeps reinfecting the child every time she visits
E The child is vomiting in front of the mother because he
knows he will get extra attention for this behavior
Estrogen is important for many different actions in the body, including
the LH surge, growth of the follicle, and myometrial excitability. Which of the
following is another function of estrogen?
A Endometrial proliferation
B Increased body temperature around ovulation
C Production of thick cervical mucus
D Spiral artery development in the endometrium
E Uterine smooth muscle relaxation
A 65-year-old man presents to the clinic with a cold. He is accompanied
by his son. During your conversation with him, you realize that he does not seem
to comprehend what you are saying to him. He also seems to have difficulty find
ing the correct words to express himself and is talking faster than normal. The
patient does not seem to notice these communication deficits. Which of the follo
wing conditions does this patient most likely have?
A Broca's aphasia
B Conduction aphasia
C Damage to the corpus callosum
D Frontal lobe syndrome
E Wernicke's aphasia
A known HIV/AIDS patient comes into the ER while you're on duty. She com
plains of dysphagia to the point that she has not taken any food or water in two
days. She is a very thin and frail female. The most likely infectious cause of
her dysphagia is which of the following?
A Candidal esophagitis
B CMV esophagitis
C Cryptococcal esophagitis
D Herpes simplex esophagitis
E HIV encephalopathy
Your patient presents with symptoms of fatigue and shortness of breath. She c
laims that her symptoms have been getting progressively worse over the last coup
le of months. You notice that she looks a little pale. You take a blood test. Th
e laboratory results say that this patient's red blood cells are microcytic and
hypochromic, there is decreased serum iron, and the blood has decreased total ir
on-binding capacity. What is your diagnosis?
A Anemia of chronic disease
B b-Thalassemia minor
C Folate deficiency anemia
D Iron deficiency anemia
E Pernicious anemia
A 22-year-old white male presents to the family practice clinic with a compla
int of back pain. The man is hunched over and cannot stand vertically. Plain fil
ms of his back reveal fusion of his entire spine, appearing bony across the inte
rvertebral disks. No peripheral joints are affected. Which is the following stat
ements is correct?
A The association with HLA-DR4 is well documented.
 B This condition has no gender predominance.
C This case is an example of a noninflammatory arthropathy
.
D You will most likely observe subcutaneous nodules on the
elbows, back of the forearms, and back of the skull.
E This condition is most often polyarticular.
F Sacroiliac joints are almost always involved.
While on your psychiatric rotation, you are assigned to follow a bipolar
patient. You review all of your patient's medications and medical records. You
are concerned because you do not believe adequate monitoring lab work has been o
btained on this patient. In addition to obtaining levels for the drug of choice
for long-term prophylaxis for bipolar disorder, which laboratory values would yo
u most like to obtain with regard to this medication?
A Cardiac enzymes due to the drug's effect on the myocardi
um
B Complete blood count because this drug causes agranulocy
tosis
C Thyroid-stimulating hormone and blood urea nitrogen (BUN
)
D Thyroid-stimulating hormone and creatinine
E Thyroid-stimulating hormone and complete blood count
A 55-year-old alcoholic patient presents to cardiology after having an e
chocardiogram that revealed dilated congestive heart failure. No other abnormali
ties are noted. Which of the following abnormal physical exam findings might you
expect?
A S1
B S2
C S3
D S4
E Jugular venous distention
You examine a patient in the ICU who has an irregularly irregular breathing p
attern that abruptly starts and stops. Which part of the brain causes this dysfu
nction?
A Bilateral cerebral hemisphere
B Bilateral diencephalons
C Dorsomedial medulla
D Lower pons
E Midbrain pons junction
Your patient presents with a 25-year, pack-a-day history of smoking. Recently
, he has been experiencing shortness of breath and some sputum production. You o
rder pulmonary function tests. What does functional vital capacity represent?
A Everything except residual volume
B Inspiratory capacity and functional reserve capacity
C Tidal volume, expiratory reserve volume, and residual vo
lume
D Tidal volume and inspiratory reserve volume
E Total lung capacity minus inspiratory reserve volume
You are a chief internal medicine resident working in an urgent care cen
ter. You are called by your colleague to see a 13-year-old boy in diabetic ketoa
cidosis. What does diabetic ketoacidosis suggest?
A Type I diabetes with metabolic acidosis, elevated blood
glucose levels, and electrolyte imbalance
B Type I diabetes with metabolic alkalosis, elevated blood
glucose levels, and electrolyte imbalance
 C Type II diabetes with metabolic acidosis, elevated insul
in levels, and electrolyte imbalance
D Type II diabetes with metabolic alkalosis, elevated bloo
d glucose levels, and electrolyte imbalance
E Type II diabetes with normal glucose levels, normal insu
lin levels, and abnormal glucagon levels
A 17-year-old girl comes to see you at your office. She has been learnin
g about breast cancer at school and wants to know the possible symptoms of breas
t cancer. What is the best answer?
A No symptoms
B Presence of a breast mass
C Nipple discharge (bloody or creamy)
D Traction or dimpling of the skin
E All of the above
A 48-year-old male presents to the internal medicine clinic with his wif
e. She reports that he has recently lost weight and that he is confused and diso
riented. She has mentions that he has been having problems with loose stools, up
to 10 times per day. Further questioning reveals that the patient has drunk 8 10
beers per day for the past 20-plus years. A physical exam reveals an erythematou
s, scaling rash of the dorsal aspect of his hands as well as his face and neck.
The patient also has glossitis and angular stomatitis. A neurological exam revea
ls decreased pain and touch sensation in all four extremities bilaterally and sy
mmetrically. The heart and lung exams are within normal limits. In which vitamin
is this patient most likely deficient?
A Vitamin A
B Vitamin B2
C Vitamin B3
D Vitamin C
E Vitamin K
A 38-year-old female has just been diagnosed with breast cancer. She has
since read a variety of books, journals, and newspaper articles on the topic. S
he comes to see you in your office today. She asks you which of the following si
gns of breast cancer affect prognosis. Choose the best answer.
A Size of the tumor
B Number of involved lymph nodes
C Presence or absence of estrogen and progesterone recepto
rs
D Degree of new vessel growth that is feeding the tumor
E All of the above
A 19-year-old white male presents to the infirmary complaining of pharyn
gitis, rhinorrhea, and intermittent wheezing. Pertinent social history includes
enlistment in the U.S. Army two months ago, and the patient is currently station
ed at Fort Bragg, North Carolina. A physical exam reveals injected conjunctivae
bilaterally and diffuse wheezing bilaterally on pulmonary auscultation. Positive
cold agglutinin reaction is noted. A virus is isolated in cell culture, and fur
ther evaluation reveals a non-enveloped virus with double-stranded linear DNA. W
hich of the following statements is correct, concerning this viral infection and
neoplasia?
A This viral infection is linked to Burkitt's lymphoma
B This viral infection can cause progressive multifocal le
ukoencephalopathy.
C This viral infection is linked to hepatocellular carcino
ma.
D This viral infection is linked to histiocytoma.
E Infection by certain serotypes may cause sarcoma.
F This viral infection is linked to nasopharyngeal carcino
ma.
A 32-year-old man returned home from a hunting trip with a high fever an
d severe headaches. He relates that about six days earlier he developed a boil o
n his right upper lip that resulted from a cut while shaving. He went to his fam
ily physician, who gave him penicillin injections and kept him under close obser
vation. Because the patient did not improve, but rather became delirious, he was
transferred to the hospital. Blood cultures and a complete blood count, along w
ith findings on MRI, indicated that he had an acute infection in the cavernous s
inus. Which of the following sensory deficits might best be expected in this pat
ient?
A Altered sensations of taste from the posterior one-third
of the tongue
B Loss of the sensory limb of the blink reflex
C Loss of the sensory limb of the gag reflex
D Reduced sensations of touch, pain, and temperature on th
e anterior two-thirds of the tongue
E Reduced sensations of touch, pain, and temperature in sk
in over the mandible
A 70-year-old male presents to your clinic for follow-up exam. He has a
history of congestive heart failure after more than 40 years of hypertension. On
exam, you note that he has 2 + pitting edema in both of his lower extremities.
Which of the following mechanisms best explains fluid movement in this patient?
A Increased capillary pressure
B Decreased plasma proteins
C Increased capillary permeability
D Increased interstitial fluid osmotic pressure
E Decreased capillary permeability
A 45-year-old homeless man is brought to the ER after being found uncons
cious near an interstate highway. In the ER he regains consciousness and says, I
don t know what happened to me. All I can remember is that I had very severe diarr
hea and vomiting for the last couple of days, and I've been feeling really tired
.' The patient has a potassium level of 2.8 mmol/L. Which of the following would
best describe the patient's EKG pattern?
A Absent Q waves
B Peaked T waves, flattened P waves, wide QRS complexes
C Prolonged QT interval
D Prominent U waves with T-wave depression
E Shortened QT interval
Your patient presents to the office stating that he has been experiencing cou
ghing and sneezing when he walks outside. After several examinations and laborat
ory analyses, you determine that he has allergies. Your patient is an airline pi
lot. To relieve his allergic symptoms, what would you prescribe?
A Cimetidine
B Diphenhydramine
C Fexofenadine
D Metoclopromide
E Theophylline
You see a patient in a locked inpatient psychiatric ward at 7 a.m. He we
ars a long formal overcoat and a top hat, walks with a straight black cane, and
wears bright pink bunny slippers and a matching bright pink shirt. Before even s
peaking to this gentleman, you think it most likely he has which of the followin
g disorders?
A Antisocial
B Borderline
C Paranoid
 D Schizoid
E Schizotypal
A 50-year-old man presents to the ER with a chief complaint of a painful
, swollen big toe that began hurting two days ago. He admits that he was using a
lcohol heavily over the weekend because he was celebrating a big promotion at wo
rk. Usually he has only one beer per week. He denies injury to his foot and stat
es that he does not have pain in any other joints. On physical exam, you find an
erythematous, swollen metatarsophalangeal joint on the left big toe (podagra),
which is very tender to palpation. Blood work was normal except for an elevated
level of uric acid. Aspiration of the joint revealed negatively birefringent nee
dle-shaped crystals. What is the most likely diagnosis?
A Gonococcal arthritis
B Gout
C Osteoarthritis
D Pseudogout
E Rheumatoid arthritis
In the ER, you see a 17-year-old male patient who was brought in by his
family for acute, severe agitation and aggressiveness. His blood pressure is 175
/100, and he appears very restless with noticeably rapid, loud speech. He is una
ble to answer questions appropriately. A urinary drug screen (UDS) is found to b
e positive for cocaine. Which of the following medications would be the most app
ropriate for calming this young man?
A Alprazolam
B Atenolol
C Haldol
D Terazosin
E Zolpidem
A 28-year-old female is brought to the emergency room by her mother, who
states that she witnessed the patient experience a seizure 30 min ago. On physi
cal examination, you notice that the patient has severe muscle rigidity, shows s
ome myoclonic movements, and is hyperthermic. Upon questioning, the mother state
s that the only prescribed medication that her daughter is taking is fluoxetine.
She also states that her daughter has recently been asking around for alternati
ve treatments for her depression. What is the cause of the patient's present sta
te?
A A drug interaction between fluoxetine and gingko biloba
B A drug interaction between fluoxetine and hawthorn
C A drug interaction between fluoxetine and saw palmetto
D A drug interaction between fluoxetine and St. John's wor
t
E A drug interaction between fluoxetine and tranylcypromin
e
A 17-year-old Honduran male presents to your office with a complaint of increas
ing spells of losing attention and falling during exercise. He has also noted fe
eling some shortness of breath lately. The patient states that he has always suf
fered such spells, but previously they happened rarely. On further questioning,
you find out that a brother, father, paternal aunt, and grandmother all had simi
lar spells. The patient has another brother who is unaffected. The brother who h
ad these spells died when he was 14. One of his father's siblings who did not ha
ve these spells died suddenly at age 18 during a soccer game. On physical examin
ation, you would expect to hear which of the following cardiac murmurs?
A A continuous murmur
B A crescendo decrescendo systolic ejection murmur beginning
immediately after S1
C A crescendo decrescendo systolic ejection murmur beginning
 well after S1
D A high-pitched diastolic murmur beginning immediately af
ter S2
E A high-pitched systolic murmur beginning well after S2,
often accompanied with an initial snap
A 20-year-old college woman comes into the ER with complaints of severe
throbbing headache, fever, neck stiffness, nausea, vomiting, and photophobia tha
t started several hours ago. She also noticed a rash that had developed on her e
xtremities. She took Tylenol and Benadryl to help her sleep, but the pain is unb
earable. You decide to do a lumbar puncture after confirming that she does not h
ave increased intracranial pressure. Her CSF reveals an increase in WBC with pre
dominant neutrophils, decreased glucose, and gram-negative diplococci. What orga
nism is the cause of her meningitis?
A Group B Streptococcus
B Haemophilus influenzae
C Listeria monocytogenes
D Neisseria meningitidis
E Streptococcus pneumoniae