A 29-year-old woman comes to the office because of a 5-day history of sore throat, fever, and mild lower abdominal pain. Her symptoms have persisted despite treatment with ibuprofen and acetaminophen. She does not have chills, fatigue, rhinorrhea, nasal congestion, cough, nausea, vomiting, diarrhea, constipation, or dysuria. She has no history of serious illness and has no known sick contacts. Vaccinations are up-to-date. The patient drinks alcohol socially and smokes marijuana occasionally. She recently broke up with her boyfriend and has had three new male sexual partners in the past 2 months. She has an intrauterine device; she and her partners do not use condoms consistently. Her temperature is 38.8°C (101.9°F), pulse is 84/min, and blood pressure is 110/78 mm Hg. Oral examination shows pharyngeal erythema without exudates; no ulcerative lesions or petechiae are noted. Nontender cervical lymphadenopathy is present bilaterally. There is no nuchal rigidity. Cardiopulmonary examination discloses no abnormalities. Abdominal examination shows tenderness to palpation of the lower abdomen without rebound or guarding. No hepatosplenomegaly or costovertebral tenderness is present. A urine pregnancy test is negative. Which of the following is the most likely cause of these symptoms?A. Adenovirus infectionB. Gonococcal infectionC. Infectious mononucleosisD. Secondary syphilisE. Streptococcal pharyngitisProceed to Next ItemShow Explanation

A 26-year-old man presents to his primary care physician with fatigue, headache, and a sore throat for the past week. There is also nausea and diarrhea, but no weight loss, productive cough, or difficulty breathing. He has no known past medical history, does not take any medications, and has no recent sick contacts. He is sexually active and uses condoms inconsistently; he drinks alcohol heavily on the weekends and has had previous IV drug use. On examination, his temperature is 39°C and the rest of his vital signs are normal. He has nontender cervical and axillary lymphadenopathy, tonsillar exudates, and mild splenomegaly. There are also several painful, well-demarcated ulcers within his mouth and a mild maculopapular rash over his chest and arms. A rapid Strep test and a monospot (heterophile antibody) test are negative; further screening for chlamydia, gonorrhea, syphilis, and HIV antibody is negative. What is the likely diagnosis?Ask StudybuddyGroup of answer choicesUpper respiratory infectionSecondary syphilisHodgkin lymphomaAcute retroviral syndromeInfectious mononucleosis

A 24-year-old woman presented to the hospital with lower abdominal pain and vomiting. She reported that the symptoms had developed suddenly, approximately 45-min earlier. She had felt well earlier in the day and denied any other symptoms. She had eaten some toast for breakfast and nothing since. She had not experienced any diarrhoea and had no contacts with similar symptoms. Her past medical history included gastro-oesophageal reflux disease and a recent diagnosis of pulmonary tuberculosis, for which she was being treated currently. Her regular medications included: isoniazid, rifampin, pyrazinamide, omeprazole and the combined oral contraceptive pill. She worked as a salesperson and did not smoke, drink alco- hol or take recreational drugs.Examination The patient appeared pale and distressed. Her heart rate was 140 bpm and her blood pressure was 106/74 mmHg. Her abdomen was generally tender, with particularly pain over the right iliac fossa, with guarding present. Results Bloods: WCC 14.2, Hb 10.5, Plt 460, Na 135, K 3.8, Creat 60, CRP 122 Urine dip: positive for leucocytes, and positive for the beta subunit of human chorionic gonadotropin (hCG)  1. What diagnoses should be considered for this young woman presenting with sudden-onset right iliac fossa pain? *1 pointa. Appendicitisb. Ectopic pregnancyc. Ovarian cyst ruptured. Gastrointestinal issues (diverticulitis, inflammatory bowel disease, irritable bowel syndrome)e. Kidney stonesf. Meckel's diverticulitisg. Pelvic inflammatory disease (PID)h. Renal colici. Herniaj. Gynecological issues (ovarian torsion, endometriosis, adnexal pathology)

27-year-old woman comes to an outpatient urgent care facility because of 3 days of joint pain. She reports significant pain in her wrists, ankles, and knees. She also has had a low-grade fever, fatigue, and a new skin rash. The patient does not have a headache, throat pain, abdominal pain, dysuria, vaginal discharge, or vision changes. She has otherwise been healthy and she takes no medications. She recently began a new sexual relationship with a male partner. The patient has an intrauterine device and does not use condoms. One month ago, she traveled to Connecticut for a camping trip with her parents. She drinks alcoholic beverages socially; she does not smoke or use illicit drugs. Temperature is 38.3°C (101°F), pulse is 96/min, and blood pressure is 127/80 mm Hg. Examination shows a clear oropharynx and no cervical or axillary lymphadenopathy. The abdomen is nontender and there is no hepatosplenomegaly. Upper extremity examination discloses pain along the tendon sheaths during passive and active movement of the hands. Lower extremity examination shows a total of six well-demarcated pustular lesions. Which of the following is the most likely diagnosis?A. BlastomycosisB. Gonococcal infectionC. Lyme diseaseD. Reactive arthritisE. Secondary syphilisProceed to Next ItemShow Explanation

A 51-year-old woman comes to the office because of fatigue and progressive exertional dyspnea during the past several months. She has not had fever, cough, chest pain, palpitations, or weight loss. She has a history of type 2 diabetes mellitus and hyperlipidemia and takes glyburide and simvastatin. Screening colonoscopy 1 year ago showed no abnormalities. The patient does not smoke cigarettes, drink alcohol, or use illicit drugs. BMI is 32 kg/m2. Her temperature is 37.0°C (98.6°F), pulse is 92/min, respirations are 12/min, and blood pressure is 115/70 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 99%. Physical examination shows mucosal and conjunctival pallor. The lungs are clear to auscultation. Cardiac examination discloses no murmurs. The abdomen is nontender to palpation. No peripheral edema is noted. Laboratory studies show:Hemoglobin 8.8 g/dLMean corpuscular volume 79 μm3Leukocyte count 6,300/mm3Platelet count 210,000/mm3Reticulocyte count 0.4%Hemoglobin A1c 7.8%Serum   Sodium 140 mEq/L   Potassium 4.3 mEq/L   Creatinine 0.9 mg/dL   Thyroid-stimulating hormone 1.2 μU/mLTest of the stool for occult blood is negative. Chest x-ray shows no abnormalities. Which of the following is the most likely underlying pathophysiology causing anemia in this patient?A. Acquired inhibition of aminolevulinic acid synthaseB. Immune-mediated hemolysisC. Increased erythrocyte recycling by macrophagesD. Intermittent nocturnal hypoxemiaE. Release of inflammatory cytokines

A 45-year-old Caucasian man is referred for further workup of chronic abdominal pain and diarrhea. These symptoms have been present for 2 months, and he has lost 10 kg of weight over this time. He also reports that he has developed pain in multiple joints that comes and goes and seems to spread from one joint to the next. He denies fevers, chills, chest pain, shortness of breath, vomiting, episodes of constipation, or hematochezia. He is married and works as a farmer, with no recent sick contacts or travel. His vitals are within normal limits, and his examination is unremarkable. A complete laboratory workup is unremarkable. He undergoes a colonoscopy, which is normal, and then undergoes an upper endoscopy. Biopsy of the small intestine shows many macrophages within the lamina propria that stain positive with periodic acid-Schiff (PAS). Which of the following is likely to cure this patient of his chronic diarrhea?Ask StudybuddyGroup of answer choicesCorticosteroidsAntibioticsRadioiodineDietary changesAntiretrovirals