A 53-Year-Old Man Comes to the Emergency Department Due to 2

question 29

Multiple Choice

A 53-year-old man comes to the emergency department due to 2 weeks of intermittent low-grade fevers and fatigue.  Temperature is 38.5 C (101.3 F) , blood pressure is 120/80 mm Hg, pulse is 92/min, and respirations are 16/min.  On cardiovascular examination, an early diastolic murmur is present and best heard at the left sternal edge.  Subungual splinter hemorrhages are seen.  Laboratory study results show leukocytosis and an elevated erythrocyte sedimentation rate.  Blood cultures are drawn and grow gram-positive cocci that synthesize dextrans from sucrose.  The organism contributing to this patient's current condition is also associated with which of the following?

• A)Anterior uveitis
• B)Colon cancer
• C)Dental caries
• D)Erythema nodosum
• E)Glomerulonephritis
• F)Migratory polyarthritis

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