A 40-Year-Old Woman Comes to the Office for Evaluation of a Sore

question 481

Multiple Choice

A 40-year-old woman comes to the office for evaluation of a sore throat.  It began 2 months ago, worsens with swallowing, and is making it difficult for her to swallow solid foods.  She has also noticed worsening bad breath.  Medical history is unremarkable.  She has never smoked and uses alcohol rarely.  The patient is currently in a long-term monogamous relationship and has had multiple sexual partners over her lifetime.  Temperature is 37 C (98.6 F) , blood pressure is 118/76 mm Hg, and pulse is 82/min.  Ear examination reveals a clear external ear canal with an intact tympanic membrane with no middle ear fluid.  The nasal mucosa is pink with no nasal drainage.  Oral cavity examination shows mild dental disease but no mucosal lesions.  Oropharyngeal examination reveals an enlarged, firm right tonsil with a 2-cm ulceration.  There are also 2 enlarged, firm, fixed, nontender lymph nodes in the right side of her neck.  Which of the following is most likely responsible for this patient's condition?

• A)Actinomyces israelii
• B)Epstein-Barr virus
• C)Fusobacterium necrophorum
• D)Human papillomavirus
• E)Streptococcus pyogenes
• F)Treponema pallidum

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Definitions:

Norms

The informal rules that govern behavior within a society or group, guiding what is considered acceptable or unacceptable conduct.

Technological Change

The process of innovation and the introduction of new technologies or improvements on existing ones that impact society and the economy.

Sexual Values

The personal or societal beliefs regarding the morality, ethics, and acceptability of sexual behaviors and relationships.

Queer Theory

An intellectual movement that explores sexual orientation and gender identity as fluid, challenging traditional binaries.