A 26-Year-Old Man Comes to the Office Due to 2

question 148

Multiple Choice

A 26-year-old man comes to the office due to 2 days of headache, malaise, and myalgia.  The patient also has an enlarging, nonpruritic rash on his lower abdomen.  He is a graduate student with no significant medical history.  The patient is sexually active and uses condoms consistently.  He recently returned from a 2-week camping and hiking trip in eastern Pennsylvania.  The patient does not use tobacco or illicit drugs but drinks alcohol occasionally.  Temperature is 38 C (100.4 F) , blood pressure is 126/84 mm Hg, and pulse is 72/min.  Mucous membranes are moist with no lesions.  No lymphadenopathy is present.  The lungs are clear to auscultation, and heart sounds are normal with no murmur.  The abdomen is soft, nondistended, and nontender with no hepatosplenomegaly.  There is no nuchal rigidity.  Skin examination shows a 4-cm, oval, uniformly red, macular rash at the belt line.  Which of the following is the best next step in management of this patient?

• A)Administer intravenous ceftriaxone
• B)Obtain enzyme-linked immunosorbent assay for Borrelia burgdorferi
• C)Perform lumbar puncture and cerebrospinal fluid analysis
• D)Perform Western blot testing for Lyme disease
• E)Prescribe oral doxycycline

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Definitions:

Aggregate Demand

The total demand for all goods and services in an economy at a given overall price level and in a given time period.

Real GDP

Gross Domestic Product adjusted for inflation, providing a more accurate measure of an economy's size and how it's growing over time.

Aggregate Demand Curve

The aggregate demand curve represents the total quantity of all goods and services demanded by the economy at different price levels.

Aggregate Supply Curve

A graphical representation showing the relationship between the total production of goods and services in an economy and the overall price level.