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orion 77-93

Total questions: 114

Worksheet time: 57mins

Name
Class
Date
1.

Gene mutation of UGT1A1?

a)

atazanavir

b)

lamivudine

c)

zidovudine

2.

Which of the following is the exact date for a drug to be safely taken if its expiration date is December 2018?

a)

December 1, 2018

b)

December 15, 2018

c)

December 31, 2018

d)

January 1, 2019

3.

Which of the following concepts are most of public health strategies based on?

a)

Primary prevention

b)

Secondary prevention

c)

Clean water and food

d)

Ideal healthy community

4.

Public health is the science of protecting the health of a community. Which population from the following list is their target?

a)

People at risk of being sick

b)

Injured and sick people

c)

Mothers and children

d)

Entire community

5.

What resource should be used when searching for the most current clinical trials on the use of novel anticoagulants for pulmonary embolism?

a)

Pharmacotherapy, the pathophysiologic approach

b)

PubMed

c)

UpToDate

d)

Micromedex

6.

A 55-year-old man brings a prescription for Oxycontin in April. The script from a doctor is dated December 17 of the previous year and allows five refills. What quantity of fill(s) are likely to be received by the patient today?

a)

1 today + 1 refill

b)

0 today + 0 refill

c)

1 today + 2 refill

d)

1 today + 0 refill

7.

How many phases of clinical trials are required to approve a new drug?

a)

1 phase

b)

2 phase

c)

3 phase

d)

4 phase

8.

A patient is started on codeine 15 mg orally as needed for postoperative pain. One day after starting codeine, the patient presents to the Emergency Department with confusion, headache, and shortness of breath. Which of the following most likely describes the patient's genotype?

a)

slow metabolizer of CYP2D6

b)

slow metabolizer of CYP2C9

c)

rapid metabolizer of CYP2C9

d)

rapid metabolizer of CYP2D6

9.

Which of the following genetic testing results might derive a potential benefit from trastuzumab therapy in a breast cancer patient?

a)

TPMT positive activity

b)

VKORC1 genotype positive

c)

HER2/gene genotype positive

d)

HLA-B*5801 genotype positive

10.

Breast cancer. The gene HER2 is negative; which agent can we use?

a)

Letrozole

b)

Trastuzumab

11.

Which of the following is most likely to be associated with heartburn?

a)

paracetamol

b)

chlorpheniramine

c)

potassium chloride

d)

magnesium/aluminum hydroxide

12.

Which of the following medications is the most appropriate for nausea induced by the anti‑parkinson’s drug bromocriptine?

a)

itopride

b)

domperidone

13.

Which of the following is the main feature of celiac disease?

a)

Malabsorption of proteins

b)

Increased protein degradation

c)

Decreased excretion of proteins

d)

Decreased breakdown of protein

14.

A 39‑year‑old woman presents with epigastric burning and pain for the last 6 months and reports an allergy to beta‑lactam antibiotics. An office‑based urea breath test is performed to diagnose Helicobacter pylori infection and is positive. Which of the following is the most appropriate treatment regimen?

a)

Levofloxacin and lansoprazole for 14 days

b)

Omeprazole, clarithromycin, and amoxicillin for 10 days

c)

Omeprazole, clarithromycin, and metronidazole for 14 days

d)

Omeprazole, bismuth subsalicylate, tetracycline, and azithromycin for 14 days

15.

Which of the following regimens is most appropriate to prevent constipation in a patient starting on morphine for pain?

a)

docusate and senna

b)

bisacodyl and lactulose

c)

polyethylene glycol and Metamucil

d)

methylnaltrexone and magnesium sulfate

16.

Which of the following medications can cause pneumonia as a side effect?

a)

Lisinopril

b)

Metformin

c)

Simvastatin

d)

Omeprazole

17.

A 7‑year‑old girl presents with moderate dehydration due to vomiting. Based on the following lab results, what is the most suitable replacement fluid?

a)

0.9% sodium chloride

b)

5% dextrose with sodium bicarbonate

c)

0.9% sodium chloride with potassium chloride

d)

5% dextrose/0.225% sodium chloride with potassium

18.

Which of the following drugs can be safely recommended to a patient suffering from chronic constipation?

a)

Glycerol suppository

b)

Ispaghula husk

c)

Bisacodyl

d)

Senna

19.

Which of the following regimens is the treatment of choice for a patient who develops a gastric ulcer caused by Helicobacter pylori infection?

a)

famotidine and amoxicillin

b)

lansoprazole and clarithromycin

c)

misoprostol, clarithromycin, amoxicillin

d)

clarithromycin, amoxicillin, and lansoprazole

20.

Which of the following areas in the brain is the main target for metoclopramide to produce antiemetic activity?

a)

pituitary gland

b)

meso‑limbic brain area

c)

nigro‑striatal brain area

d)

chemoreceptor trigger zone

21.

Which of the following most likely is the action of histamine?

a)

constriction of capillaries

b)

paralysis of skeletal muscle

c)

elevation of blood pressure

d)

stimulation of gastric secretion

22.

Which of the following is the mechanism by which bisacodyl laxative relieves constipation?

a)

Causing colon relaxation

b)

Acting as a surfactant to soften the stool

c)

Absorbing water and forming a gelatinous mass

d)

Stimulating enteric nerves to increase colonic contractions

23.

Which of the following is the mechanism of action of loperamide’s antidiarrheal effect?

a)

Binding bile acids

b)

Blocking cholinergic receptors

c)

Activation of the opioid receptors

d)

Activation of alpha‑2 adrenergic receptors

24.

Which drug should be used for both bone and gastrointestinal tract problems?

a)

calcium gluconate

b)

calcium carbonate

c)

metoclopramide

d)

omeprazole

25.

A patient has severe gastric pain radiating to the right upper quadrant with vomiting; the pain radiates to the back and gets worse with fatty meals. What is the most likely cause?

a)

pancreatic disease

b)

gallstones

c)

hepatic disease

26.

When should omeprazole be taken?

a)

Morning with meal

b)

Night before sleep

c)

As needed

d)

Stimulate adrenergic

27.

Which of the following tests can be used to confirm Helicobacter pylori?

a)

Urea breath test

b)

Stool antigen assay

c)

EGD with biopsies

d)

Serologic testing

28.

Which one of the following medications can a gynecologist prescribe to a patient?

a)

tamoxifen

b)

fingolimod

c)

anastrozole

d)

misoprostol

29.

Which of the following hormones maintains the concentration of water in the body?

a)

vasopressin (antidiuretic hormone)

b)

thyrotropin

c)

adrenocorticotropin

d)

luteinizing hormone

30.

Which of the following hormones stimulates mammary gland development and milk production?

a)

prolactin

b)

oxytocin

c)

corticotropin

d)

growth hormone

31.

Type of hypersensitivity for drug‑induced hemolytic anemia?

a)

cytotoxic reaction

b)

immediate sensitivity reaction

32.

Which of the following immunoglobulin activates complement system?

a)

IgM

b)

IgE

c)

IgA

d)

IgG

33.

An 8-year-old child had difficulty in breathing, swelling of lips and tongue, and fainted after eating a piece of cake containing nuts. Which type of hypersensitivity reaction is the child exhibiting?

a)

Immune-complex

b)

Delayed hypersensitivity

c)

Cytotoxic hypersensitivity

d)

Immediate hypersensitivity

34.

Which white blood cell type is the target of human immunodeficiency virus during acquired immune deficiency syndrome (AIDS)?

a)

CD1 lymphocytes

b)

CD2 lymphocytes

c)

CD3 lymphocytes

d)

CD4 lymphocytes (T lymphocytes)

35.

Which of the following represents the immunity acquired by giving a living organism with attenuated virus?

a)

Local immunity

b)

Passive immunity

c)

Natural active immunity

d)

Artificial active immunity

36.

Which of the following is the first antibody to be produced in a new infection?

a)

IgM

b)

IgG

c)

IgA

d)

IgE

37.

A 28-year-old woman with Crohn’s disease was treated with high-dose intravenous corticosteroids, converted to oral drugs, and started on infliximab, a tumor necrosis factor-α inhibitor. Which test should be performed prior to infliximab?

a)

HIV screening

b)

Influenza screening

c)

Hepatitis C screening

d)

Tuberculosis screening

38.

To which of the following is the major histocompatibility complex unique?

a)

Each cell

b)

Each organ

c)

Each species

d)

Each individual

39.

A 27-year-old man with hepatitis C virus infection has elevated alanine aminotransferase and aspartate aminotransferase and mild fibrosis on liver biopsy (see lab results). Which drug should be avoided in his case?

a)

Amoxicillin

b)

Pregabalin

c)

Cephalexin

d)

Methotrexate

40.

Which of the following is used for the treatment of neovascular (wet) age-related macular degeneration?

a)

Aflibercept

b)

Latanoprost

c)

Muromonab

d)

Gemtuzumab

41.

Which of the following drugs is associated with progressive multifocal leukoencephalopathy?

a)

Bisoprolol

b)

Pregabalin

c)

Doxycycline

d)

Natalizumab

42.

Which of the following is the site of action for aflibercept?

a)

Fibroblast growth factor

b)

Human chorionic gonadotropin

c)

Brain-derived neurotrophic factor

d)

Vascular endothelial growth factor-A

43.

Which of the following is involved in type 2 hypersensitivity (cytotoxic hypersensitivity reaction)? Note: type 1 involves IgE.

a)

IgE

b)

IgG

c)

T lymphocytes

d)

Macrophages

44.

Which drug is used in organ transplantation?

a)

Cyclosporine

b)

Azithromycin

c)

Ibuprofen

d)

Metformin

45.

Immune cells have a Y shape. Antibodies attach to which part?

a)

Hinge side

b)

Consistent H side

c)

Variable H side

d)

Consistent L side

e)

Variable L and H side

46.

An 8-year-old child had difficulty in breathing, swelling of lips and tongue, and fainted after eating cake containing nuts. Which type of hypersensitivity reaction is the child exhibiting?

a)

Immune-complex

b)

Delayed hypersensitivity

c)

Cytotoxic hypersensitivity

d)

Immediate hypersensitivity

47.

Case with food allergy: what type of response is this?

a)

Immediate hypersensitivity

b)

No immediate hypersensitivity

48.

What is secondary prevention?

a)

Vaccination

b)

Immunization

c)

Do exercise

d)

Blood test

49.

Which immunoglobulin is frequently found elevated in asthmatic patients?

a)

IgA

b)

IgE

c)

IgM

d)

IgD

50.

Which cells have antibody on their surface?

a)

B cell

b)

T cell

c)

T helper

d)

T killer

51.

Which part of immunoglobulin attaches to the B cell?

a)

Light chain

b)

Heavy chain

52.

Which part of immunoglobulin attaches to antigen?

a)

Light chain

b)

Heavy chain

53.

Which of the following drugs is considered an enzyme inhibitor that may affect the metabolism of other drugs?

a)

Phenytoin

b)

Furosemide

c)

Cimetidine

d)

Theophylline

54.

Major toxic effect of chloramphenicol in infants is due to lack of which enzyme?

a)

Glucuronyltransferase enzyme (gray baby syndrome)

b)

B-methyltransferase enzyme

55.

During prescription verification, a pharmacist identified a drug interaction in a 23-year-old woman diagnosed with urinary tract infection and prescribed an antibiotic. Which antibiotic is the best option to avoid harm?

a)

Cephalexin

b)

Ciprofloxacin

c)

Nitrofurantoin

d)

Trimethoprim–sulfamethoxazole

56.

Which antibiotic is used for surgical prophylaxis of colorectal surgeries?

a)

Ampicillin

b)

Cefoxitin

c)

Linezolid

d)

Augmentin

57.

Which of the following is the first-line treatment for malaria caused by Plasmodium falciparum in Saudi Arabia?

a)

Quinine

b)

Primaquine

c)

Artesunate

d)

Doxycycline

58.

A 57-year-old man presents with 2 days of high fever, muscle and bone aches, headache, and loss of appetite, with recent close contacts with a friend who had influenza. Which management is best?

a)

Amoxicillin 500 mg PO every 8 hours for 10 days

b)

Azithromycin 500 mg PO once daily for 3 days

c)

Amoxicillin–clavulanic acid 1 g PO every 12 hours for 1 week

d)

Support treatment (fluids, rest, antihistamine, paracetamol)

59.

Which condition is a serious adverse reaction of fluoroquinolone therapy?

a)

Eczema

b)

Bleeding

c)

Depression

d)

Q–T interval prolongation

60.

Which is the reason doxycycline should be avoided in children less than 12 years?

a)

High toxicity

b)

Low tolerability

c)

Risk of bleeding

d)

Teeth discoloration

61.

Which disease can cause latent infection?

a)

Polio

b)

Measles

c)

Rubella

d)

Varicella–zoster

62.

Which topical antibiotic ointment can be used in MRSA infection?

a)

Vancomycin ointment

b)

Mupirocin ointment

63.

Case: Escherichia coli with chronic kidney disease. Which dosing regimen is most appropriate?

a)

Ciprofloxacin 400 mg IV every 12 hours

b)

Ciprofloxacin 400 mg IV every 24 hours

c)

Meropenem 500 mg IV every 8 hours

d)

Meropenem 500 mg IV every 12 hours

64.

A patient has severe endocarditis with Staphylococcus aureus on vancomycin, but sensitivity testing shows susceptibility only to linezolid, which is not FDA-approved for endocarditis. What is the best management?

a)

Increase vancomycin dose

b)

Add gentamicin to vancomycin

c)

Switch to linezolid off-label

d)

Stop antibiotics and observe

65.

Antibiotics that inhibit protein synthesis at the 30S ribosomal subunit affect which process?

a)

Elongation

b)

Initiation

c)

Termination

66.

Antibiotics that inhibit protein synthesis at the 50S ribosomal subunit have which effect?

a)

Elongation

b)

Initiation

c)

Termination

67.

Which of the following are encapsulated bacteria?

a)

Streptococcus pneumoniae

b)

Lactobacillus acidophilus

c)

Mycobacterium tuberculosis

d)

Salmonella Typhi

68.

Which of the following can be used for UTI infections?

a)

Garlic

b)

Cranberry

c)

Echinacea

d)

Ginko

69.

What is the adverse effect of fluoroquinolones?

a)

QT prolongation

b)

Rash

c)

Increase blood pressure

d)

Constipation

70.

A case about a child has pin worm infection. Which of the following is the best drug of choice?

a)

Mefloquine

b)

Albendazole

c)

Doxycycline

d)

Metronidazole

71.

A case about a girl has sore throat (mild) without any infection or other symptoms. What should you advise her?

a)

Gargle with salt and water

b)

Clindamycin

c)

Antihistamine

d)

Ceftriaxone IV every 12 hours

72.

Use in the prevention of RSV in neonate?

a)

Palivizumab

b)

Ostumab

73.

Months infant have RSV?

a)

Supportive

b)

Palivizumab

74.

Which of the following is a characteristic for facultative anaerobic?

a)

Only grow anaerobically

b)

Only grow in the presence of oxygen

c)

An anaerobe but can grow in the absence of oxygen

d)

Require simultaneous presence of aerobic and anaerobic environments for growth

75.

A 36-year-old man not known to have any medical illness diagnosed recently with an active pulmonary tuberculosis. Which of the following is the best regimen to start?

a)

Rifampin alone

b)

Isoniazid alone

c)

Isoniazid plus rifampin

d)

Isoniazid, rifampin, ethambutol and pyrazinamide

76.

A 23-month-year-old, 14-kg infant is brought to the hospital with signs and symptoms of bacterial meningitis. The baby attends day care and has a history of acute otitis media. A blood and CSF culture were ordered and pending. Which of the following is the empirical therapy for acute bacterial meningitis?

a)

Doxycycline plus linezolid

b)

Ampicillin plus gentamicin

c)

Cefuroxime plus ciprofloxacin

d)

Ceftriaxone or cefotaxime plus vancomycin

77.

Which of the following micro-organisms causes typhoid fever?

a)

Shigella

b)

Flavivirus

c)

Salmonella

d)

Treponema pallidum

78.

Which of the following describes the transmission mode of coronavirus?

a)

Respiratory route

b)

Blood-borne route

c)

Contaminated food and drinks

d)

Direct contact with patient saliva

79.

A 24-year-old male presented to the hospital with a skin infection. The microbiology technician received a sample from this patient; the sample in a special media was incubated over 24 hours and showed Staphylococcus aureus. The microbiologist used disk diffusion method to determine the susceptibility of different antibiotics (see image). What is the most sensitive antibiotic?

a)

Ampicillin (Amp)

b)

Vancomycin (Van)

c)

Methicillin (Meth)

d)

Penicillin (Control)

80.

Which of the following bacteria is involved in the development of dental caries?

a)

Streptococcus mutans

b)

Listeria monocytogenes

c)

Streptococcus

d)

Corynebacterium diphtheria

81.

What is the main method transmission of Brucella species?

a)

Airborne

b)

Blood transfusion

c)

Contact with infected person

d)

Ingestion of unpasteurized milk/milk products

82.

A pregnant woman is travelling to a high risk malarial country. Which antimalarial prophylactic agent carries the most fetal risk in pregnant women?

a)

Mefloquine

b)

Doxycycline

c)

Chloroquine

d)

Atovaquone–proguanil

83.

Which of the following viral infections best describes chronic infection?

a)

Infection in which host cell dies due to interference with normal cellular function

b)

Infections in which there is uncontrolled growth or immortalization of the host cell

c)

Infection in which virus persists within the host cell but new virions are not synthesized

d)

Infection in which virus persists within the host cell and continues to replicate the virions

84.

A 28-year-old pregnant female in labor is admitted to the hospital. She tested positive for Group B streptococcus colonization at her 36-week appointment. She has a penicillin allergy and her culture are resistant to both clindamycin and erythromycin. What is the recommended treatment for this patient?

a)

Cefazolin

b)

Penicillin G

c)

Ceftriaxone

d)

Vancomycin

85.

A 7-year-old boy presents with complain of itchiness around the anus at night. Lab tests revealed Enterobius vermicularis infection (pin worm infection). Which of the following is the most appropriate management?

a)

Fluconazole

b)

Praziquantel

c)

Pantoprazole

d)

Mebendazole

86.

Drugs may accumulate in tissues as result of their physicochemical characteristics or special affinity of the tissue for the drug. Which of the following parts of the body does tetracycline accumulate?

a)

Liver

b)

Bone

c)

Muscle

d)

Adipose tissue

87.

A 55-year-old woman presents with symptoms of Helicobacter pylori infections. She was previously treated with the classical amoxicillin, clarithromycin, omeprazole regimen. The physician is unable to obtain susceptibility testing for the Helicobacter pylori but the pattern of local antimicrobial resistance to penicillin's is well known. What would be the optimal treatment for her?

a)

Amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg plus omeprazole 20 mg BID for 14 days

b)

Amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg plus omeprazole 40 mg BID for 14 days

c)

Bismuth subsalicylate 525 mg QID and tetracycline 500 mg QID plus metronidazole 500 mg and omeprazole 40 mg BID for 14 days

d)

Bismuth subsalicylate (2) and doxycycline 100 mg QID plus metronidazole 500 mg TID and omeprazole 40 mg BID for 14 days

88.

A 16-month-old baby with bronchopulmonary dysplasia is admitted to the Pediatric Intensive Care Unit with respiratory distress requiring in (see lab results). What is the best management?

a)

Cefuroxime

b)

Palivizumab

c)

Corticosteroid

d)

Intravenous fluids and supportive care

89.

What is the description of viruses that live as parasites on bacteria?

a)

Fungi

b)

Lichens

c)

Commensals

d)

Bacteriophage

90.

Which of the following is a β-lactamase enzyme?

a)

Plasmid

b)

Pyrogens

c)

DNA gyrase

d)

Carbapenemase

91.

Which of the following Clostridium spp. is linked to the development of pseudomembranous colitis?

a)

Clostridium tetani

b)

Clostridium difficile

c)

Clostridium botulinum

d)

Clostridium perfringens

92.

Which is the best treatment for Staphylococcus aureus positive mastitis?

a)

Cephalexin

b)

Clindamycin

c)

Ciprofloxacin

d)

Nitrofurantoin

93.

A nurse has an inquiry about the appropriate time to withdraw a trough gentamicin level for a patient. What is the best answer for her inquiry?

a)

1 hour after gentamicin administration

b)

30 minutes after gentamicin administration

c)

1 hour before the scheduled gentamicin dose

d)

30 minutes before the scheduled gentamicin dose

94.

A 6-year-old boy is diagnosed with a pin-worm infection. Which of the following drugs should be used for treatment?

a)

Mefloquine

b)

Doxycycline

c)

Albendazole

d)

Pyrimethamine

95.

What is the recommended prophylactic therapy for pregnant women colonized with group B streptococcus in labor with penicillin allergies at high risk for anaphylaxis?

a)

Cefazoline

b)

Linezolid

c)

Penicillin G

d)

Clindamycin or vancomycin

96.

Which of the following might develop in association with high serum amikacin?

a)

Bleeding

b)

Ototoxicity

c)

Liver failure

d)

Visual changes

97.

Which of the following infections is prevented with the administration of 0.5% erythromycin eye ointment in newly born infants?

a)

Mycoplasmal conjunctivitis

b)

Adenoviral conjunctivitis

c)

Gonococcal ophthalmia

d)

Chlamydial infection

98.

Which of the following is the most appropriate empiric treatment for a patient with community-acquired pneumonia requiring admission to the hospital?

a)

Doxycycline and azithromycin

b)

Ceftriaxone and azithromycin

c)

Moxifloxacin and ceftriaxone

d)

Vancomycin and ceftriaxone

99.

An 18-year-old healthy girl admitted to the hospital with a diagnosis of necrotizing pneumonia. She received vancomycin 1 g IV q12h and meropenem 1 g IV q8h. The trough level of vancomycin was 16 mcg/ml (normal range: 10–20 mcg/ml). Which of the following is the next appropriate step in management of this patient?

a)

Continue the same treatment

b)

Request a drug level for meropenem

100.

Which of the following medications can cause hemolytic anemia in the newborn when used by a pregnant woman at full term?

a)

amoxicillin

b)

ciprofloxacin

c)

azithromycin

d)

nitrofurantoin

101.

Which of the following classes of medications have been associated with the development of newborn kernicterus when used by pregnant women at full term?

a)

Penicillin’s

b)

Vancomycin

c)

Cephalosporins

d)

Sulfa containing medications

102.

Which of the following mechanisms, cephalexin exerts antibacterial effects?

a)

inhibition of protein synthesis

b)

destruction of the bacterial cell nucleus

c)

inhibition of bacterial cell wall synthesis

d)

detergent effect on the bacterial cell membrane

103.

Which of the following clinical conditions is treated with zanamivir?

a)

cytomegalovirus disease

b)

myocardial infarction

c)

bacterial infection

d)

acute influenza

104.

Which of the following medications would inhibit uncoating of the viral RNA?

a)

acyclovir

b)

vidarabine

c)

didanosine

d)

rimantadine

105.

Which of the following has similar antibacterial mechanism of penicillin?

a)

neomycin

b)

cephalexin

c)

tetracycline

d)

clindamycin

106.

Which of the following best describes ceftazidime?

a)

A third-generation cephalosporin which covers gram negative and gram-positive organisms

b)

A second-generation cephalosporin which covers gram negative and gram-positive organisms

c)

A first-generation cephalosporin which covers gram positive organisms

d)

An amino penicillin

107.

A 60-year-old woman is admitted to the hospital for surgery. Colonization of gram-negative bacteria occurred after surgery. Which of the following is the best management?

a)

Cefprozil

b)

Cephalexin

c)

Ceftriaxone

d)

Phenoxymethyl penicillin

108.

Which of the following is an indication for ciprofloxacin?

a)

Fever

b)

Arthropathy

c)

Tuberculosis

d)

Inhalational anthrax

109.

Which of the following drugs has poor oral bioavailability?

a)

Cefixime

b)

Amoxicillin

c)

Vancomycin

d)

Ciprofloxacin

110.

Which of the following is the drug of choice for chlamydia infection?

a)

Amikacin

b)

Amoxicillin

c)

Tetracycline

d)

Azithromycin

111.

Which of the following is the best treatment for staphylococcus aureus positive mastitis?

a)

Cephalexin

b)

Nitrofurantoin

c)

Clindamycin

d)

Ciprofloxacin

112.

A case patient takes pyrazinamide, ethambutol, and rifampicin and develops problems in vision. Which drug is responsible for this side effect?

a)

Pyrazinamide

b)

Isoniazid

c)

Ethambutol

d)

Rifampicin

113.

Pregnant with vaginal discharge due to Candida: which medication is appropriate?

a)

fluconazole

b)

clotrimazole

c)

acyclovir

114.

Lab results show hemoglobin and glucose in range except high white blood cell count. What is the most likely condition?

a)

Anemia

b)

Infection

c)

hyperglycemia