American Board of Internal Medicine (ABIM) Certification Practice Exam

What condition should be considered for any patient with respiratory illness in the southwestern United States?

1. Coccidioidomycosis

2. Pneumococcal pneumonia

3. Tuberculosis

4. Histoplasmosis

The correct answer is: Coccidioidomycosis

Coccidioidomycosis, also known as Valley Fever, should be considered for any patient with respiratory illness in the southwestern United States due to its endemic nature in that region. This fungal infection is caused by inhaling spores of the fungus Coccidioides, which is commonly found in the soil of areas such as Arizona, California, New Mexico, and Texas. The symptoms of coccidioidomycosis can mimic those of other respiratory illnesses, including cough, chest pain, and fever, making it essential for healthcare providers to consider it when evaluating patients with respiratory complaints who have been in or near these endemic areas. Early diagnosis is crucial as the disease can progress to more severe forms, including disseminated disease that can affect the skin, bones, and central nervous system. The other conditions listed, while they may be relevant in various contexts, do not have the same level of geographical specificity associated with respiratory issues in the southwest. Pneumococcal pneumonia is common globally, tuberculosis has a wider distribution beyond just the southwestern U.S., and histoplasmosis, while also a fungal infection, is more commonly associated with bird and bat droppings and is primarily a concern in the central and eastern United States rather than specifically the southwest