Answer to Question 1
Ans: C
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Syphilis is primarily indicated by ulcerative sores occurring mainly on the external genitals, vagina, anus, or in the rectum, although they can occur on the lips or in the mouth. The sore is usually firm, round, and painless. Rashes associated with secondary syphilis appear as rough, red, or reddish brown spots both on the palms of the hands and/or the bottoms of the feet. Infections with Neisseria gonorrhoeae, like those resulting from Chlamydia trachomatis, cause several clinical syndromes including urogenital, pharyngeal, and rectal infections in males and females, and conjunctivitis in adults and neonates. Chlamydia is known as a silent infection because most infected people are asymptomatic and lack abnormal physical examination findings. Men who are symptomatic typically have urethritis, with a mucoid or watery urethral discharge and dysuria. A minority of infected men develop epididymitis (with or without symptomatic urethritis), presenting with unilateral testicular pain, tenderness, and swelling. Human papillomavirus infections, if manifest, are primarily indicated by genital warts.
Answer to Question 2
Ans: C
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Two criteria must be met for an event to be defined as a water-associated disease outbreak. First, two or more people must have experienced a similar illness after exposure to water. Second, epidemiologic evidence must implicate recreational water (not drinking water) or volatilization of water-associated compounds into the air surrounding the water as the probable source of illness. Evidence of primary amebic meningoencephalitis and chemical poisoning are not required for confirmation of a water-associated disease outbreak.