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:

Brain Wave Patterns

The electrical activity in the brain, as detected by electroencephalography (EEG), which is associated with different states of consciousness.

Alpha Waves

Brainwave patterns associated with a state of wakeful relaxation and calm alertness.

Theta Waves

A type of brainwave pattern associated with sleep, deep relaxation, and certain stages of memory processing, typically in the frequency range of 4–8 Hz.

Beta Waves

Brainwave patterns associated with active, alert consciousness and cognitive engagement.