A 46-Year-Old Man Comes to the Emergency Department Due to Fever

question 283

Multiple Choice

A 46-year-old man comes to the emergency department due to fever.  He returned from a vacation in Southeast Asia a week ago and began having symptoms toward the end of his trip.  The patient describes continuous fever that has risen slowly to reach a high plateau and is relieved only by antipyretics.  He has also had headaches and abdominal discomfort; he initially had constipation but has had loose stools for the past several days.  Temperature is 40 C (104 F) , blood pressure is 114/68 mm Hg, and pulse is 62/min.  No oropharyngeal lesions, cervical lymphadenopathy, or neck rigidity is present.  Lungs are clear on auscultation, and heart sounds are normal.  Abdominal examination shows mild distension and generalized tenderness with hepatosplenomegaly.  There is a faint, erythematous, macular skin rash over the trunk and abdomen.  Laboratory studies reveal mild, normocytic, normochromic anemia and leukopenia with left shift.  Peripheral blood smear is normal.  Which of the following is the most likely route of transmission of this patient's infection?

• A)Bite from a vector insect
• B)Exposure to a carrier animal
• C)Ingestion of contaminated food
• D)Inhalation of infectious droplets
• E)Sexual contact with infected person

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Definitions:

Well-structured Problems

Problems that have clear goals, fully specified constraints, and a known solution path, making them easier to resolve.

Existing State

The current condition or situation of a system, organization, or any defined set of circumstances.

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Phoenix Payroll System

A specific payroll processing software used by the Canadian government, noted for its significant implementation problems.