A 15-year-old girl comes to the physician because of a sore throat and subjective fevers for the past 2 weeks. She has been feeling lethargic and is unable to attend school. She has a history of multiple episodes of streptococcal pharyngitis treated with amoxicillin. She immigrated with her family to the United States from China 10 years ago. She appears thin. Her temperature is 37.8°C (100°F), pulse is 97/min, and blood pressure is 90/60 mm Hg. Examination shows pharyngeal erythema and enlarged tonsils with exudates and palatal petechiae. There is cervical lymphadenopathy. The spleen is palpated 2 cm below the left costal margin. Her hemoglobin concentration is 12 g/dL, leukocyte count is 14,100/mm3 with 54% lymphocytes (12% atypical lymphocytes), and platelet count is 280,000/mm3. A heterophile agglutination test is positive. The underlying cause of this patient's symptoms is most likely to increase the risk of which of the following conditions?
AKaposi sarcoma
BGlomerulonephritis
CPneumonia
DNasopharyngeal carcinoma
ENecrotizing retinitis
A 23-year-old woman presents with progressively worsening headache, photophobia, and intermittent fever that have lasted for 6 days. She says her headache is mostly frontal and radiates down her neck. She denies any recent history of blood transfusions, recent travel, or contact with animals. Her past medical history is unremarkable. She is sexually active with a single partner for the past 3 years. Her temperature is 38.5°C (101.3°F). On physical examination, she appears pale and diaphoretic. A fine erythematous rash is noted on the neck and forearms. A lumbar puncture is performed and CSF analysis reveals: Opening pressure: 300 mm H2O Erythrocytes: None Leukocytes: 72/mm3 Neutrophils: 10% Lymphocytes: 75% Mononuclear: 15% Protein: 100 mg/dL Glucose: 70 mg/dL Which of the following is the most likely diagnosis in this patient?
ALymphocytic choriomeningitis virus
BEhrlichiosis
CEnterovirus meningitis
DBrucellosis
EMumps meningitis
A 25-year-old man presents to the emergency department after a motor vehicle accident. He was the unrestrained front seat driver in a head on collision. The patient is unresponsive and his medical history is unknown. His temperature is 99.5°F (37.5°C), blood pressure is 67/38 mmHg, pulse is 190/min, respirations are 33/min, and oxygen saturation is 98% on room air. The patient is started on IV fluids, blood products, and norepinephrine. A FAST exam is performed and a pelvic binder is placed. One hour later, his temperature is 98.3°F (36.8°C), blood pressure is 119/66 mmHg, pulse is 110/min, respirations are 15/min, and oxygen saturation is 97% on room air. The patient is currently responsive. Management of the patient's pelvic fracture is scheduled by the orthopedic service. While the patient is waiting in the emergency department he suddenly complains of feeling hot, aches, and a headache. The patient's temperature is currently 101°F (38.3°C). He has not been given any pain medications and his past medical history is still unknown. Which of the following is the most likely diagnosis?
AAcute hemolytic transfusion reaction
BFebrile non-hemolytic transfusion reaction
CSympathetic response to pain
DMinor blood group incompatibility
ELeukoagglutination reaction
+ 7 more in the PDF
Browse all chapters