A 45-Year-Old Woman Comes to the Emergency Department Due to 2

question 288

Multiple Choice

A 45-year-old woman comes to the emergency department due to 2 days of fever, chills, malaise, and fatigue.  The patient returned from an African jungle safari 3 weeks ago.  She received mefloquine chemoprophylaxis during the travel, which she stopped taking upon arrival in the United States.  Temperature is 38.9 C (102 F) , blood pressure is 122/68 mm Hg, pulse is 110/min, and respirations are 20/min.  Physical examination shows mucosal pallor.  Laboratory results reveal mild anemia and thrombocytopenia.  Peripheral blood smear shows intraerythrocytic Plasmodium falciparum.  Which of the following is the most likely underlying cause of this patient's infection?

• A)Inactivity of mefloquine against gametocytes
• B)Infection with parasites resistant to chloroquine
• C)Mosquito bite after discontinuation of prophylaxis
• D)Impaired clearance of liver schizonts
• E)Release of dormant hypnozoites from hepatocytes

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Definitions:

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A model used to determine the theoretical expected return of an investment, considering its risk and the time value of money, compared to a risk-free return.

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