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A 4-Year-Old Girl Is Brought to the Emergency Department Due

question 337

Multiple Choice

A 4-year-old girl is brought to the emergency department due to fever and lethargy. Her parents say she has been withdrawn and less playful over the last 2 weeks. She has also had several days of low-grade fever and headaches. Since yesterday morning, the patient has mostly slept and seems to be increasingly confused. She has no significant prior medical problems and is up to date with recommended vaccinations. Her grandfather, who is visiting the family from South Asia, is being evaluated for cough; otherwise, the patient has no sick contacts. The family has a pet cat. Temperature is 38 C (100.4 F) . The patient is somnolent and responds to painful stimuli. There is resistance to passive neck flexion. Her right eye is deviated medially, and funduscopic examination reveals several ill-defined, raised, yellow-white nodules near the bilateral optic discs. CT scan of the head reveals basilar meningeal enhancement. Lumbar puncture is performed, and cerebrospinal fluid analysis results are as follows: Item 1 of 2 Which of the following is most likely to yield the diagnosis in this patient?

Definitions:

Larceny

The wrongful or fraudulent taking and carrying away of another person’s personal property with the intent to deprive the person permanently of the property.

Forgery

The fraudulent making or altering of any writing in a way that changes the legal rights and liabilities of another.

Privilege of Self-Defense

The legal right of a person to defend themselves against harm, using reasonable force as necessary, without facing criminal liability.

Broad Categories

General classifications used to group items, ideas, or concepts based on shared characteristics or attributes.