Solved

A 52-Year-Old Man Comes to the Emergency Department with Fevers

question 121

Multiple Choice

A 52-year-old man comes to the emergency department with fevers, cough, and headache. The headache has worsened over the last week with localization to the right side and is associated with nausea. Yesterday he noted left-hand weakness and difficulty grasping objects. He has no history of travel outside of the northeastern United States or exposure to domestic animals or sick contacts. The patient underwent liver transplantation for primary biliary cirrhosis 8 months ago and had an uneventful postoperative course. His medications include prednisone and tacrolimus. His preoperative tuberculin skin testing was negative and he has had no postoperative infections. He is physically active and had walked 2-3 miles a day until 1 week ago.
His temperature is 38.2 C (100.8 F) , blood pressure is 124/84 mm Hg, pulse is 96/min, and respirations are 18/min. Crackles are present over the right upper lung field. There are no heart murmurs. The abdomen is soft without organomegaly. There are no skin rashes. Neurological examination is notable for left-hand weakness and decreased sensation of the left hand and forearm.
Chest x-ray reveals patchy alveolar opacities in the right upper lobe and a 3-cm abscess in the right middle lobe. Head CT scan shows an abscess in the right cerebral hemisphere. A transesophageal echocardiogram reveals no vegetations.
Which of the following conditions is most consistent with this patient's clinical presentation?

Recognize the significance of the diathesis-stress model in predicting illness.

Appreciate the role of behavioral factors in the development and management of diseases related to stress and immune function.

Understand the multifactorial nature of stress and its indirect effects on health conditions such as ulcers.

Grasp the relationship between stress, lifestyle factors (heavy drinking, smoking, caffeine consumption), and health.

Definitions:

Special Character

Special Character refers to any character that is not a letter or digit, often used in programming, mathematics, and password creation for added complexity.

Formatting

The process of arranging or modifying the appearance of a document.

MLA Style

A standard for formatting scholarly manuscripts and research papers, governed by the Modern Language Association, emphasizing clarity, precision, and consistency.

Header

The section at the top of a document or webpage that often contains important information like titles, author names, or section numbers.