A 25-Year-Old Man Is Brought to the Emergency Department Due

question 258

Multiple Choice

A 25-year-old man is brought to the emergency department due to high-grade fever, chills, myalgias, and skin rash, which started on the day of admission.  He also had nausea and 3 episodes of profuse watery diarrhea and is now feeling lightheaded.  Two days ago, he underwent corrective surgery for a deviated nasal septum but otherwise has no other past medical history.  The patient has not traveled recently and has not been around sick contacts.  He does not use illicit drugs.  His temperature is 39.4 C (103 F) , blood pressure is 85/50 mm Hg, and pulse is 116/min.  Oxygen saturation is 98% on room air.  He is lethargic but has no focal weakness or nuchal rigidity.  Examination shows clear lung fields and tachycardia with normal first and second heart sounds.  The abdomen is soft and nontender.  There is nasal packing in both nostrils.  Skin examination shows a diffuse, red, macular rash that also involves the palms and soles. Blood cultures are sent. Item 1 of 2 Which of the following is the most likely cause of this patient's symptoms?

• A)Bacterial exotoxin production
• B)Bacterial overgrowth and dissemination
• C)Cell-mediated allergic reaction
• D)Immediate hypersensitivity reaction
• E)Massive bacterial lysis and circulating endotoxin

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Definitions:

Unrealized Gain

Profit that has been made on paper from investments but has not yet been converted to cash by selling the asset.

Commercial Substance

A characteristic of a business transaction that leads to a change in the cash flows of the entity, indicating that the change has a significant economic effect.

Joint Venture

A business arrangement in which two or more parties agree to pool their resources for the purpose of accomplishing a specific task.

Fair Value

The fund received from an asset sale or the cost for a liability shift in a smoothly facilitated transaction among participants of the market on the price determination date.