A 67-Year-Old Man Comes to the Emergency Department Due to 2

question 47

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A 67-year-old man comes to the emergency department due to 2 days of fever, malaise, headache, and myalgia. He has also noticed a nonpruritic skin rash on his right leg. The patient has had no abdominal pain, vomiting, or diarrhea. Prior medical problems include hypertension, type 2 diabetes mellitus, and chronic obstructive pulmonary disease. He is an ex-smoker and does not use alcohol or illicit drugs. The patient lives in Texas and a week ago returned from visiting family in Connecticut, where he spent most of his time outdoors.
Temperature is 39.4 C (103 F), blood pressure is 124/84 mm Hg, pulse is 102/min, and respirations are 20/min. Examination shows no scleral icterus or lymphadenopathy. Breath sounds are mildly decreased throughout. The abdomen is soft with no hepatosplenomegaly. There is no neck stiffness. A 4-cm, erythematous skin rash with central clearing is present on the right popliteal area.
Laboratory results are as follows:
Chest x-ray reveals no parenchymal opacity or pleural effusion.
Which of the following diagnostic studies is most appropriate for this patient?
A)Anti-parvovirus antibodies
B)Antirickettsial antibodies
C)Bone marrow biopsy
D)Borrelia burgdorferi serology
E)Peripheral blood microscopy

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Definitions:

Personal Selling Process

describes the sequence of steps salespeople follow to persuade potential customers to purchase a product or service.

Cultural Setting

The environment and context influenced by societal norms, values, practices, and beliefs in which individuals or groups operate.

Stimulus-Response Selling

A sales technique that focuses on triggering a positive customer response through specific stimuli or cues.

Social Selling

The practice of using social media networks to identify, connect with, understand, and nurture sales prospects.