American Board of Internal Medicine (ABIM) Certification Practice Exam

Which illness should be suspected in individuals with respiratory issues after travel in the Arabian Peninsula?

1. Influenza

2. MERS (Middle East Respiratory Syndrome)

3. COVID-19

4. Pneumonia

The correct answer is: MERS (Middle East Respiratory Syndrome)

MERS, or Middle East Respiratory Syndrome, should be suspected in individuals who develop respiratory issues after traveling in the Arabian Peninsula due to the specific epidemiological link the illness has with that region. MERS is caused by the MERS-CoV virus, which is known to circulate in the Arabian Peninsula and is typically transmitted from camels to humans, with human-to-human transmission also occurring, particularly in healthcare settings. Considering the context of recent travel, especially to areas where MERS outbreaks have been reported in the past, the likelihood of encountering this virus increases significantly. Travelers returning from the Arabian Peninsula with respiratory symptoms should be evaluated for MERS, making it a priority in differential diagnoses. While conditions like influenza, COVID-19, and pneumonia must also be considered in a broad differential diagnosis for respiratory symptoms, they do not have the same geographic and epidemiological association with travel to the Arabian Peninsula as MERS does. Influenza and COVID-19 are more global concerns and could occur regardless of travel history, while pneumonia can be caused by a variety of organisms and is not specifically tied to travel in that region. Thus, the unique criteria linking MERS to the Arabian Peninsula makes it the most appropriate concern for individuals presenting with respiratory issues following travel there