A 43-Year-Old Man Comes to the Emergency Department with a 3-Day

question 197

Multiple Choice

A 43-year-old man comes to the emergency department with a 3-day history of fever, malaise, and chills.  He was hospitalized a year ago for alcohol withdrawal symptoms but otherwise no medical history is available.  He admits to using intravenous drugs.
The patient's temperature is 38.4 C (101.1 F) , blood pressure is 144/90 mm Hg, and pulse is 102/min.  He has poor oral dentition.  A small white plaque is seen on the buccal mucosa.  Cervical lymph nodes are palpable bilaterally but are small and nontender.  Lungs are clear on auscultation.  There is a short 2/6 early diastolic murmur heard at the right upper sternal border.  The abdomen is soft and nontender.  Extremity pulses are full and symmetric, and there is no edema.
Laboratory results are as follows:

Blood cultures are sent.
Which of the following tests is most important for making treatment decisions at this point?

• A)Blood smear
• B)Bone marrow biopsy
• C)CT scan of the chest
• D)Echocardiography
• E)Rapid HIV testing

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Definitions:

Recent Costs

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Current Revenues

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Lower-of-cost-or-market

An accounting principle that valuables inventory at the lower of its historical cost or the current market price, ensuring assets are not overstated.

Item-by-Item Basis

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