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QUESTIONS

DIRECTIONS: Choose the one best response to each question.

All of the following statements regarding global infectious diseases are true EXCEPT:

A. Drug-resistant tuberculosis is common in the former Soviet bloc countries

B. Infectious diseases are the leading cause of death worldwide.

C. As of 2013 over 50% of deaths in sub-Saharan Africa were related to infectious diseases.

D. The absolute number of infectious disease–related deaths has remained relatively constant in the past 25 years.

E. The rate of infectious disease–related death has dropped notably in the past 25 years.

The answer is B. (Chap. 115) Infectious diseases remain the second leading cause of death worldwide. Although the rate of infectious disease–related deaths has decreased dramatically over the past 25 years, there were still 10.9 million such deaths in 2013. These deaths disproportionately affect children <1 year of age, adults older than 70 years, and persons living in low- and middle-income countries. In 2013, 20% of all deaths worldwide were related to infectious diseases, with rates >50% in most sub-Saharan African countries (Figure III-1). Given that infectious diseases are still a major cause of global mortality, understanding the local epidemiology of disease is critically important in evaluating patients. Diseases such as HIV/AIDS have decimated sub-Saharan Africa, with HIV-infected adults representing 19–29% of the total population in countries like South Africa, Botswana, and Swaziland. Moreover, drug-resistant tuberculosis is rampant throughout the former Soviet-bloc countries, India, China, and South Africa. The ready availability of this type of information allows physicians to develop appropriate differential diagnoses and treatment plans for individual patients. Programs such as the Global Burden of Disease seek to quantify human losses (e.g., deaths, disability-adjusted life years) due to diseases by age, sex, and country over time. These data not only help inform local, national, and international health policy, but they can also help guide local medical decision-making.

FIGURE III-1

(A) Magnitude of infectious disease–related deaths globally. The absolute number (blue line; left axis) and rate (red line; right axis) of infectious disease–related deaths throughout the world since 1990. (B) Projections of disease burden to 2030 for high-, middle-, and low-income countries (left, center, and right, respectively). TB, tuberculosis. (A, Institute for Health Metrics and Evaluation. Used with permission. All rights reserved. B, Reproduced with permission from World Health Organization: The Global Burden of Disease 2004 Update, 2008.)

Which of the following infectious organisms is most likely to cause relative bradycardia during a febrile event?

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