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A 25-Year-Old Man Comes to the Employee Health Center for a Physical

question 496

Multiple Choice

A 25-year-old man comes to the employee health center for a physical examination prior to starting work as a patient care technician in a community hospital. The patient's family immigrated to the United States from Eastern Europe when he was a toddler. He received a medical evaluation prior to immigrating, but the records are not available. The patient has had no fevers, chills, night sweats, weight loss, cough, or fatigue. He has no chronic medical problems and takes no medications. He consumes alcohol occasionally but does not use tobacco or illicit drugs. The patient went on a 2-month backpacking trip through Central and South America a year ago. His immunization records are up to date. He has a small scar in the right deltoid area and notes that he received a bacillus Calmette-Guérin vaccination as an infant. The patient has no other abnormalities on physical examination. The patient's interferon-gamma release assay (IGRA) is positive. He is asymptomatic and feels well. Chest x-ray reveals no abnormalities. Which of the following is the next most appropriate step in management of this patient?

Definitions:

Recorded Messages

Pre-made audio or video content that has been captured and stored for later replay or distribution.

Dream Content

The themes, narratives, images, and emotions that make up a dream, often subject to interpretation in terms of underlying psychology.

REM Rebound

The phenomenon where a person experiences increased REM sleep after being deprived of REM sleep for a period.

Narcolepsy

A chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep, often associated with cataplexy and other REM sleep disturbances.