A 35-year-old white man presents to the primary care physician with complaints of fever, weight loss, and a skin rash. The fevers are intermittent and began approximately two months ago. The rash appeared six-week ago. He also complains of abdominal pain and nausea for the past month with a weight loss of 3 kg (6.6 lbs). His medical history is significant for HIV, diagnosed two years ago, and he has not been compliant with his antiretroviral therapy. He denies any sick contacts, but he did recently buy a cat from a shelter three months ago. He lives in Florida and has no recent travel. He is febrile with a temperature is 38.3ºC (101.4ºF) but in no distress. On examination, there are numerous exophytic, raised purple patches on his skin that bleed when instrumented. There are similar lesions on the oral mucosa, tongue and genitals. There is hepatomegaly on abdominal examination. A complete blood count reveals normocytic anemia and mild thrombocytopenia. Alkaline phosphatase is markedly elevated, and transaminases are at the upper limit of normal. His CD4+ count is 140/mm3. CT scan of the abdomen reveals hypodense ring like lesions in the liver that enhance with contrast. Which of the following is the most likely diagnosis?A. AngiosarcomaB. Bacillary angiomatosisC. CryptococcosisD. HistoplasmosisE. MalariaProceed 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 22-year-old man comes to the emergency department because of a 1-day history of fever and nontender skin rash over his trunk. He was diagnosed with Hodgkin lymphoma 1 month ago and recently began combination chemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine. Medical history otherwise is unremarkable. His temperature is 39.0°C (102.2°F), pulse is 110/min and regular, respirations are 16/min, and blood pressure is 115/70 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 98%. Cardiopulmonary auscultation discloses clear breath sounds bilaterally and normal heart sounds. The abdomen is soft and nontender; bowel sounds are normal throughout. Multiple nontender, indurated macules and pustules and few gangrenous ulcers are noted over his trunk. Laboratory studies show:Hemoglobin 9.2 g/dLMean corpuscular volume 91 μm3Leukocyte count 2,100/mm3Platelet count 100,000/mm3Serum  Sodium 141 mEq/LPotassium 4.3 mEq/LCreatinine 1.0 mg/dLWhich of the following is the most likely diagnosis?A. Bacillary angiomatosisB. Ecthyma gangrenosumC. Herpes zosterD. Pyoderma gangrenosumE. Stevens-Johnson syndrome

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

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

Which hospitalized patient is most at risk for developing a healthcare-associated infection? Mr. Y, a 60-year-old patient who smokes two packs of cigarettes daily Mrs. J, a 40-year-old patient who has a white blood cell count of 6,000/mm3 Mr. L, a 65-year-old patient who has an indwelling urinary catheter in place Mrs. M, a 60-year-old patient who is a vegetarian and slightly underweight