A 26-Year-Old Man Comes to the Office Due to a Week

question 800

Multiple Choice

A 26-year-old man comes to the office due to a week of fever, malaise, fatigue, and sore throat.  The patient has no chronic medical conditions and takes no medications.  He drinks 1 or 2 beers on the weekends but does not use tobacco or illicit drugs.  The patient has had 3 male sexual partners over the past year and uses condoms inconsistently.  Temperature is 38.3 C (101 F) , blood pressure is 120/76 mm Hg, pulse is 75/min, and respirations are 14/min.  Physical examination shows pharyngeal erythema, mild splenomegaly, and a morbilliform rash.  No enlarged lymph nodes are present.  Laboratory results are as follows: Peripheral blood smear is shown in the exhibit below.  Heterophile antibody testing is negative.  Which of the following is the most likely diagnosis?

• A)Acute lymphoblastic leukemia
• B)Acute toxoplasmosis
• C)Cytomegalovirus infection
• D)Disseminated gonorrhea
• E)Herpangina
• F)Streptococcal pharyngitis

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Definitions:

Gasoline

An explosive, quick-to-evaporate substance made from petroleum, mainly serving as a fuel source in internal combustion engines.

Auto Repairs

Services aimed at fixing and maintaining vehicles for optimal performance.

Hours Per Day

A measure of time used to quantify the number of hours spent on an activity or activities within a 24-hour period.

Gasoline

A refined petroleum product used primarily as fuel in internal combustion engines.