A 17-year-old female is referred to the ED by her primary physician; she presents with a 3-day history of fevers, dysuria, and vomiting. She has not had vaginal discharge, abdominal pain, or diarrhea. She is sexually active with her partner. Vital signs are as follows: Temperature 103°F, RR 20, BP 98/65, pulse 100. She appears ill and is unable to tolerate liquids, but she is alert and oriented. Her examination is positive for suprapubic as well as costovertebral angle tenderness bilaterally. Urinalysis reveals numerous WBCs and bacteria, and it is positive for WBC casts and leukocyte esterase. Other laboratory study results are within normal limits, including a negative urine pregnancy test. What is the likely diagnosis?Ask StudybuddyGroup of answer choicesNephrolithiasisPyelonephritisAppendicitisAcute interstitial nephritisEctopic pregnancy

A 22-year-old female presents to the ED with abrupt onset of a rash, high fever, and vomiting. Vital signs are as follows: Temperature 104°F, HR 118, RR 22, BP 76/40, and pulse oximetry 98% on room air. On examination, she appears confused and disoriented. Her skin is warm, and there is a diffuse macular rash over her body. She is admitted to the ICU and subsequently develops multisystem organ dysfunction. Which of the following organisms is most likely implicated in this patient's diagnosis?Ask StudybuddyGroup of answer choicesEscherichia coliRickettsia rickettsiiStaphylococcus aureusNeisseria meningitidisStreptococcus pneumoniae

A 45-year-old female is brought to the ED complaining of fatigue. The patient has been feeling extremely weak over the past few days. Today she stood up and almost fainted, prompting her visit. She has had cough, rhinorrhea, and nasal congestion for the past week. Today she also began having nausea, vomiting, and severe abdominal pain. Past medical history is significant for hypertension, CKD, and SLE. Home medications are lisinopril, hydroxychloroquine, and prednisone 20 mg daily. Vitals: Temperature 38.5°C, BP 85/55 mm Hg, HR 126. In general, she appears weak and lethargic. Her heart sounds are tachycardic, regular, without murmurs. Her lungs have occasional rhonchi but no wheezing. Her abdomen is diffusely tender throughout without rebound tenderness. Labs: Na 124 mEq/L, K 5.3 mEq/L, Cr 3.0 mg/dL (baseline 1.8). Hgb is 11.1 g/dL. The patient is diagnosed with Influenza A and started on IV fluids. After 2 L of crystalloid fluids her blood pressure is 90/60 mm Hg. What is the most appropriate next step?Ask StudybuddyGroup of answer choicesMRI pituitaryCT adrenal glandsCortisol levelCosyntropin stimulation testIV hydrocortisone

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

The patient, who had recently been treated for a UTI, presented with fever, chills, nausea, vomiting, and lumbar pain. She was diagnosed with an inflammation of the renal pelvis and kidneys orSelect one:a.pyelonephritis.b.polycystic kidney disease.c.hydronephrosis.d.ureteritis.

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